bluuebunny/crossref_metadata_2025 huggingface dataset:
Adherence to Objective Therapeutic Monitoring and Outcomes in Patients with Inflammatory Bowel Disease with Adalimumab Treatment. A Real-world Prospective Study
Authors: Wetwittayakhlang Panu , Golovics Petra A , Khoury Alex Al , Ganni Elie , Hahn Gustavo Drügg , Cohen Albert , Wyse Jonathan , Bradette Marc , Bessissow Talat , Afif Waqqas , Wild Gary , Bitton Alain , Lakatos Peter Laszlo
Published: December 2022

Background and Aims: Objective monitoring and effective early treatment using a treat-to-target approach are key to improving therapeutic outcomes in IBD patients. This study aimed to assess adherence to objective monitoring (clinical, biomarkers, and endoscopy) and its impact on clinical outcomes.

Methods: A prospective, multicenter study included consecutive IBD patients starting on adalimumab therapy between January 2019 and December 2020. Disease activity, assessed by the Harvey-Bradshaw index (HBI), partial Mayo, C-reactive protein (CRP), fecal calprotectin (FCAL), and endoscopy were evaluated at adalimumab initiation and 3, 6, 9 and 12 months. Therapeutic drug monitoring, changes in treatment, drug sustainability, and clinical outcomes were assessed.

Results: 104 IBD patients were enrolled (78.8% CD, median age 34.3 years, disease duration 9 years). During the 12 months follow-up, high adherence to clinical activity assessment was observed in both CD (81.3%- 87.7%) and UC patients (76.5-90.9%). CRP measurement decreased over time in both CD (37.3%-54.9%) and UC (29.4%-50.0%). The adherence to serial FCAL monitoring was low in CD (22.7-31.3%) and UC patients (17.6-56.0%). UC patients had higher adherence to early endoscopic assessment (<6 months) compared to CD patients (40.9% vs. 21.5%). Adherence to early combined clinical and biomarkers resulted in earlier dose optimization in CD and UC (log-rank<0.001), but drug sustainability was not different. The patients with early combined adherence had a significantly higher clinical remission rate at 1 year compared to non-adherence (70.2% vs. 29.8%, p=0.007) but no significant difference in UC patients.

Conclusions: The adherence to early objective monitoring with combined clinical and biomarkers assessment in IBD patients starting adalimumab therapy led to dose optimization and improved 1-year clinical remission in CD but did not change drug sustainability and clinical remission in UC.
Low Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) Ratio Associated with Increased Cardiovascular Disease and its Risk Factors in Healthy Japanese Population
Authors: Higashitani Michiaki , Mizuno Atsushi , Kimura Takeshi , Shimbo Takuro , Yamamoto Kazuki , Tokioka Sayuri , Kobayashi Daiki
Published: December 2022

Aims: This study aimed to evaluate the association between aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and cardiovascular disease, and risk factors in a healthy Japanese population.

Methods: A retrospective cohort study was conducted at St. Luke’s International Hospital, Tokyo, Japan, between 2005 and 2018. We included all participants who visited the hospital for voluntary health checkups. Our primary outcome was the development of cardiovascular disease, and the secondary outcomes were cardiovascular risk factors. We grouped the participants into quartiles (Qs) according to their baseline AST/ ALT ratios and examined the outcomes of patients in each group.

Results: 87,740 participants were included in this study. The mean age of the participants was 44.9 years [standard deviation (SD): 12.1], and 43,191 (49.2%) were men. The mean AST and ALT levels were 21.7 IU/L (SD 10.0) and 22.4 IU/L (SD 16.5), respectively, resulting in a mean AST/ALT ratio of 1.1 (0.4). During the median follow-up of 1,829 days (interquartile range 756–3,470), 1,493 (1.7%) participants developed cardiovascular disease, 831 (1%) experienced ischemic heart disease, and 723 (0.8%) experienced strokes. Those in the Q1 AST/ALT ratio group had significantly higher hazard ratios compared to those in the Q3 AST/ ALT ratio group [adjusted hazard ratio (HR)=1.32, 95% confidence interval (CI): 1.12-1.56 for cardiovascular disease; HR=1.36, 95%CI: 1.09-1.68 for ischemic heart disease; HR=1.28, 95%CI: 1.00-1.65 for stroke]. However, those belonging to the Q4 or Q5 AST/ALT ratio groups was not statistically different for primary outcomes compared to the Q3 AST/ALT ratio group. In contrast, the adjusted HRs for all secondary outcomes decreased in a dose-dependent manner as the AST/ALT ratio increased.

Conclusions: A Q1 AST/ALT ratio was associated with an increased risk of cardiovascular disease compared to the Q3 AST/ALT ratio in the Japanese population, which is in contrast with the Western population. In our study, Q4 or Q5 AST/ALT ratios were not associated with cardiovascular disease compared to the Q3 AST/ ALT ratio. As for cardiovascular risk factors, the risk decreased as the AST/ALT ratio increased.
Do Patient Delay and Diagnostic Delay Influence Long Term Survival in Patients with Gastric Cancer?
Authors: Puia Aida , Schlanger Diana , Fetti Alin , Popa Calin , Necula Alexandru , Al Hajjar Nadim
Published: December 2022

Background and Aims: Gastric cancer is one of the most common malignancies, with an aggressive evolution and a poor long-term prognosis. No screening program is available in Europe for this pathology; therefore, the delay from the appearance of the first symptom until the initiation of treatment might influence the prognosis of gastric cancer patients. We aimed to investigate the impact on the prognosis of the delay in the presentation and diagnosis in patients with gastric adenocarcinoma.

Methods: Our study is a retrospective, single-center, observational cohort study, based on patients diagnosed with gastric adenocarcinoma and operated in our institution between 2013 and 2021. We have defined patient delay as the time from the onset of symptoms to the first encounter with a health care provider and diagnosis delay as the time from the first consultation with a health care provider to the establishment of the final diagnosis.

Results: A total of 671 patients were included in our study. The survival rate at 5 years was 55% for the patients operated with curative intent and 7.4% for the patients operated with palliative intent. Patient delay and diagnosis delay were not correlated with the overall survival. A lower survival was observed for patients admitted through transfer (p<0.001) or the emergency department (p<0.001). No statistically significant relationship was identified between patient delay or diagnosis delay and the age, gender or area of origin of patients. Patients that experienced melena or hematemesis had a shorter patient delay, with a highly significant statistical relationship (p<0.01). Patients that experienced nausea, epigastric pain, palpable epigastric tumor mass or anorexia also had a highly significant statistical relationship between the symptoms and the patient delay interval.

Conclusions: The overall survival is not influenced by the patient delay or diagnosis delay. An earlier presentation was correlated with some specific exhibited symptoms: upper gastro-intestinal bleeding, abdominal pain, palpable epigastric tumor, nausea.
Replacement of Adalimumab Originator to Adalimumab Biosimilar for a Non-Medical Reason in Patients with Inflammatory Bowel Disease: A Real-life Comparison of Adalimumab Biosimilars Currently Available in Italy
Authors: Tursi Antonio , Mocci Giammarco , Cuomo Antonio , Ferronato Antonio , Elisei Walter , Picchio Marcello , Maconi Giovanni , Scaldaferri Franco , Papa Alfredo , Italian group for switch of biologics - , Allegretta Leonardo , Aragona Giovanni , Bianco Maria Antonia , Colucci Raffaele , Della Valle Nicola , Faggiani Roberto , Forti Giacomo , Gaiani Federica , Giorgetti GianMarco , Graziani Maria Giovanna , Lofano Katia , Lorenzetti Roberto , Larussa Tiziana , Penna Antonio , Bassotti Gabrio , Cazzato Alessia Immacolata , Chiri Stefania , Clemente Valeria , Cocco Andrea , De’ Angelis Gianluigi , Donnarumma Laura , Graziosi Camilla , Le Grazie Marco , Luzza Francesco , Meucci Costantino , Monterubbianesi Rita , Pagnini Cristiano , Perazzo Patrizia , Pica Roberta , Pranzo Giuseppe , Rodino’ Stefano , Sacco Rodolfo , Sebkova Ladislava , Scarcelli Antonella , Serio Mariaelena , Napolitano Daniele , Pugliese Daniela , Schiavoni Elisa , Turchini Laura , Armuzzi Alessandro , Zampaletta Costantino
Published: December 2022

Background and Aims: Adalimumab (ADA) biosimilars have been included into the therapeutic armamentarium of inflammatory bowel disease (IBD); however, comparative data on the efficacy and safety of the different ADA biosimilars after replacing the ADA originator for a non-medical reason remains scarce. We aimed to compare in a real-life setting the efficacy and safety of four ADA biosimilars SB5, APB501, GP2017, and MSB11022 in IBD patients after replacing the originator for a non-medical reason.

Methods: A multicenter retrospective study was performed on consecutive IBD patients, analyzing clinical, laboratory, and endoscopic data. The primary endpoints of the study were maintenance of clinical remission and safety of the different biosimilars.

Results: 153 patients were enrolled, 26 with UC and 127 with CD. Clinical remission was maintained in 124 out of 153 (81%) patients after a median (IQR) follow-up of 12 (6–24) months, without any significant difference between the four ADA biosimilars. ADA biosimilars dosage was optimized in five patients (3.3%). Loss of remission was significantly higher in UC patients (10/26 patients, 38.5%) than in CD patients (19/127 patients, 14.9%, p<0.025). Adverse events occurred in 12 (7.9%) patients; the large majority were mild.

Conclusions: No difference in efficacy and safety was found between ADA biosimilars when used to replace the ADA originator for a non-medical reason. However, in UC patients the replacement of ADA originator for this reason should be carefully assessed.
Integration of optometry at the national health system: the case of the first optometrists in Mozambique
Authors: Bambamba Joel , Antonio Ramos , Latorre Sergio , Brito Isaura , Vilanculos Anselmo , Shah Kajal , Gonzalez Diana
Published: December 2022

Introduction: In the last two decades an increasing number of African countries have established Optometry training to tackle the largely unmet eye health needs of the population. However not sufficient evidence exist on how the profession is integrated and contributing to national health systems. In Mozambique, the optometry program started under the Faculty of Health Sciences in the public Lúrio University in 2009. From 2012 to 2016, 23 graduates were employed by the National Health System (NHS). Objective: The aim of this research is to document the integration of Optometrists at the National Health System in Mozambique. Methods: This is a descriptive, quantitative and cross-sectional study. Questionnaires and structured interviews were administered to all participants. Results: The response rate was 100% and the Optometrists were found practicing in 10 of the 11 provinces of the country distributed among primary, secondary and tertiary health facilities, providing refraction and managing common ocular pathologies along with the Ophthalmic Technicians, resolving the majority of patient needs and needing to refer 28% of cases to other professionals. The lack of equipment was the main expressed barrier to the provision of effective eye care services. According to them, the optometry curriculum responds well (91%) to the competencies required at the workplace. Areas for improvement training and provision of services were identified and presented in the study Conclusion: Optometrists are providing effective services needing to work closely and in coordination with other professionals. This research revealed the need for equipment provision and continuing education.
Diagnosis and management of serpiginous choroiditis
Authors: Lucy Jeanie C
Published: December 2022

Purpose: Serpiginous choroiditis (SC) is a rare, bilateral, idiopathic inflammatory disorder that causes geographic destruction of the retina and choroid often in healthy middle-aged patients. Symptoms include blurred vision, central and paracentral scotomas. SC is part of a group termed white dot syndromes which involves inflammation of the retina and choroid with the appearance of white dots in the fundus. SC requires a thorough workup prior to treatment to rule out other inflammatory autoimmune or infectious etiologies. Early stages are challenging to diagnose. Treatment includes corticosteroids and immunosuppressive therapy. The exact cause of Serpiginous Choroiditis is not known, yet HLA-B7 is typically positive indicating an autoimmune response in these patients. Choroidal neovascularization and cystoid macula edema are side effects, so close monitoring is important. This case presents a holistic clinical picture of SC to aid in better clinical diagnosis and understanding of this condition for the primary care eye clinician. Results: Presentation of a young otherwise healthy 37-year-old male patient to our clinical service revealed a serpentine shaped retina presentation absent of anterior chamber or vitreous inflammation. Fundus photos, fluorescein angiography, and ocular coherence tomography revealed serpiginous choroiditis. Primary care workup to rule out systemic conditions was unremarkable. Initial treatment with monitoring included intravitreal triamcinolone 2 mg/0.05 mL OU with oral chlorambucil therapy immediately afterwards. Active lesions resolved over the next 3 weeks, yet visual acuity showed no improvement as the foveal was already involved. The goal of chlorambucil therapy for 3 months was to induce sustained remission. Conclusion: Prognosis of SC is less favorable when the macula is involved (macular SC). Upon clinical presentation of serpiginous choroiditis, it is important to establish etiology of non-infectious autoimmune disorders or infectious disorders before classification of idiopathic SC and aggressive treatment to address underlying systemic conditions.
The compatibility between optical coherence tomography and fundus fluorescein angiography in the detection of macular edema involving the fovea
Authors: Turgut Burak , Aydogan Selahattin Semih
Published: December 2022

Objective: To investigate the compatibility between optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) in the detection of macular edema (ME) excluding subretinal fluid (SRF) involving the fovea. Materials and methods: In this retrospective study in the Ophthalmology Department at our university hospital, interpretation of OCT and FFA images was performed for 200 eyes that underwent simultaneous FFA and OCT to rule out ME. The cases having SRF were excluded from the study. Results: Of 200 eyes, 193 eyes (96.5%) had the finding of ME confirmed by both techniques. There were 2 eyes (1%) for which FFA revealed ME involving fovea with hyperfluorescence in the macula while OCT demonstrated no intraretinal edema or subretinal fluid in the macula. For 5 eyes in the study (2.5%), OCT revealed intraretinal edema in the fovea, while these were not detected by FFA. Conclusion: This study suggests that FFA and OCT are highly sensitive techniques for the detection of ME and they correlate with each other. The little discrepancy between OCT and FFA for determining ME may be due to intracellular or extracellular edema and fast or slower development of retinal edema.
Edoxaban in patients with bioprostetic valve
Authors: Fazio Giovanni , Milana Gaspare , Schirò Piero
Published: December 2022

Background: Nowadays the treatment with Direct Oral Anticoagulants (DOACs) and in particular with edoxaban in patients with Bioprosthetic Aortic Valve (BPAV) is unsupported by consistent data. We analyzed retrospectively our experience in this group of patients. Methods: The data of the present study were retrospectively obtained from 24 consecutive patients with BPVA evaluated for AF in a high-volume Italian cardiological center. We analyzed the data pulled from reports of patients with Nonvalvular Paroxymal Atrial Fibrillation (NVAF), that we entered in the Italian Registry of Drugs (AIFA registry). All patients were treated with edoxaban 60 mg for AF. At the time of the data collection, the average follow-up in valvular patients was 36 ± 3 months, with a median follow-up of 33 ± 6 months. Results: There were no major bleedings, strokes, systemic embolisms, or cardiovascular deaths reported. A single case of transitory ischemic event (6,25%) and a case of minor bleeding (6,25%) were reported during the follow-up. The complication rate was similar in patients with BPAV compared to that of the whole group of patients with fibrillation and there were no statistical differences (2.08% vs 1.37%; p: 0.36). Although the number is too small, transient ischemic attack appears to be more frequent in patients with BPAV than in the control group (p: 0.0046). Conclusion: In our experience, we used edoxaban in a group of 36 subjects with BPAV and AF: the event rate of this subpopulation was not different from that of all patients with AF included in the control group. Therefore, the results suggest that the use of edoxaban for AF in patients with BPVA appears to be safe and effective.
Prevalence of motor tests in autism spectrum disorder people
Authors: Reis Quedas Carolina Lourenço , Queiroz Honda Rodrigo Takashi de , Santos Costa Camila Carla , Guedes de Sá Karina Santos , Henrique Corrêa Flávio , Macedo de Mattos Ygor Carrozzini , Irineu Gorla José
Published: December 2022

In autism spectrum disorder, studies have in social communication, in their interest, education and social/educational inclusion with children and adolescents with aspects studied for this even larger audience is very scarce, observing a gap in the literature regarding this population. This work aims through a bibliographic survey to describe the tests that are being used in autism, as their advantages and objectives, are shown as evidence of study among them. The research was carried out in the Bireme and Pubmed databases with the descriptors “assessing motor autism”, “assessing motor skill performance and autism” and “assessing the development of physical fitness and autism”. the search resulted in 846 studies, after excluding duplicates, 823 articles remained. After reading the titles and abstracts, 703 studies were excluded and after applying the inclusion and exclusion criteria, 16 articles were included in this review. have similarities with each other, such as some ages and some tests such as: delineating the trail, basting a cord that is manual dexterity, grabbing and dribbling a ball and very similar tests such as walking under a line, jumping on one foot only in displacement, among others. We conclude that the tests available in the market are expensive for professionals and that each one evaluates more a specific skill for gaps in the estimates.
Effects of an intervention on adolescents with overweight / obesity
Authors: Ayres Rossini Guilherme , Pires Iyusuka Adelaide Margarida Lucatelli , Augusto Maria Durvanei
Published: December 2022

The amount of patients which develop chronic irreversible illness rises as the life expectancy grows among countries. When cancer patients step into final stages of their illness the complexity of questions and situations is evident. Frequently, terminally ill cancer patients choose to use unprescribed therapies at their own risk to alleviate suffering. When a generalist doctor comes across these situations, bioethical questions tend to raise among physician’s minds when assisting the patient and family. In this paper we argue about phosphoethanolamine supplement scenario: the different points of view of regulatory agencies; bioethical considerations; theoretical aspects of the molecule as phospholipid precursor; the biological importance the relation to others systems in different levels; pre-clinical and clinical safety data.
Use of psychoactive substances among nursing and medical students
Authors: da Encarnação Jhonatta Pereira , Camuso Barros Carmen Silvia Silva , Andrade Gundim Vivian , Cardoso de Souza Rozemere
Published: December 2022

Introduction: The use of psychoactive substances has been a worldwide problem that also affects university students. This study aimed to raise patterns of psychoactive substances used among Nursing and Medical students of a public institution of higher education. Materials and methods: Cross-sectional study of quantitative approach, conducted between September and November 2020 in the context of a public higher education institution in southern Bahia, Brazil. The sample consisted of 202 university students. Data were collected using an online questionnaire and the scale of screening for the use of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The descriptive statistical analysis was performed. Results: Most university students from nursing and medical courses (77.7%, n=156) have already used any of the PAS in lifetime. Among those who have used some substances, the highest frequency of use was alcoholic beverages (nursing 56%; medicine 43.4%), followed by marijuana (nursing 17.6%; medicine 23.6%) and tobacco (nursing 13.7%; medicine 10.4%). There was no use of hallucinogens and cocaine/crack by nursing students. Conclusion: The high incidence of PAS use (alcohol, tobacco, marijuana and hypnotics/sedatives) among students, in isolation or poly-use, represents risks that should be considered as a warning to the necessity of developing mental and academic health strategies regarding the use of PSA.
Gut-brain axis as a key aspect of clinical conditions
Authors: Rodrigues Sarah de Oliveira , Garcia Pádua Alice , Gonçalves Lima Clara Mariana , Oliveira Rodrigues Rebecca de , Bacelar de Assis Isabela , Pagnossa Jorge Pamplona
Published: December 2022

The brain-gut axis evidences the interactions between the gastrointestinal system and the brain in a general context. This physiological system is a mutual balance connection between two individual organs of the body in response to internal and external changes. It is extremely important to appreciate the current concepts that involve this system to understand brain-gut interaction, as well as to highlight the insertion of the axis today, using clinical conditions, neuropsychiatric disorders, intestinal microbiota, immunomodulators, and scientific evidence to verify and highlight axis activity in the human body. In this sense, there is a consistent background in literature supporting the physiological development and shaping of the gut in brain disorders by a constant interplay mediated by the several products originating from the microbiota.
Knowledge and attitudes that nursing students have regarding the consumption of psychoactive substances
Authors: Amell Gloria Lastre- , Mackenzie-Constante Carmen-Isabel , Prada Reyes Sandra , Andueza-Vergara María-Alejandra , Atencia-Meza Heydis Paola , Charris-Padilla Natalya Vanessa- , Tamara-Olaya Norlis-Del amparo
Published: December 2022

Objective: To determine the knowledge and attitudes that nursing students have about psychoactive substances from a private university in Barranquilla 2019 – 2020. Methodology: Cross-sectional descriptive study, the sample was 29 underage nursing students, located in the first three semesters, applying a survey type Likert scale. Results: The entire population belonged to the female gender, 86.21% were 16 years old, located mostly in the second semester, 55.17% belonged to strata 1 and 2, the 26.7% said they had knowledge about psychoactive substances, 48% had a positive attitude of not consuming. Conclusion: It will be concluded that students have knowledge about the consumption of psychoactive substances, that there is a generalized rejection of consumption, to which is added a refusal against consumption.
Pre-hospitalization dysphagia and its relation with hospital length of stay
Authors: Vanessa P Giglio , Adriana L Oda , Adriana CL Daianese
Published: December 2022

Purpose: Motivated by the reports of difficulties in feeding experienced by patients before neurological impairment, this study sought to investigate whether the previous complaint of dysphagia of patients admitted to the stroke unit at Hospital Universitário Maria Aparecida Pedrossian - UFMS impacted the increase in hospital length of stay when compared to patients without a history and complaints of dysphagia before hospitalization. Methods: This regards an observational, prospective, longitudinal, quantitative and qualitative field research. The sample included adult patients of both sexes, over 18 years old with or without complaints of dysphagia, who responded to the screening where data were collected indicating the presence or not of dysphagia before hospitalization. After speech therapy evaluation and establishment of the FOIS scale, patients were followed up until the moment of hospital discharge. Results: Oropharyngeal dysphagia (DOF) was identified in 80% of the patients evaluated in this study. There was a significant association between not having a DOF and the absence of a previous complaint, as well as not having a DOF and an initial NIHSS score of less than 10 points. There was no association between length of hospital stay and the presence or absence of a previous DOF complaint. Conclusion: It is concluded that the investigation of the previous complaint of dysphagia in patients affected by Stroke can provide guiding data to support the speech therapist during the functional evaluation of swallowing, however, in isolation, it does not demonstrate a statistically significant relationship between presenting a previous complaint and the length of hospital stay.
Knowledge, attitudes and practices in health personnel who provide care to patients with SARSCOV2
Authors: Martinez Lorena , Y Portela Nancy , R Campos Nelson , R Urrego Jose , A Mendez Karol , Corredor Danny Wilson Sanjuanelo , Tacuma Prada Claudia Patricia
Published: December 2022

Objective: To identify knowledge, attitudes and practices in health personnel who provide care to patients with SARS-COV2. Materials and methods: A cross-sectional, descriptive study was carried out that included 362 participants, discriminated against health professionals (213) and health technicians (149) who provided first-line health services for the care of suspected or positive patients for SARS Cov 2, the technique Sampling was at convenience, the questionnaire they answered to participate was self-completed electronically using the Google Docs tool after designing, validating and applying a KAP (Knowledge, Attitudes and Practices) survey. An analysis with descriptive statistics was performed, bivariate associations were made using the Chi-square test where p<005 was taken as the level of significance. Results: In the KAP (Knowledge, Attitudes and Practices) survey, factors, protective and risk behaviors emerged; In these results, it is important to highlight that some of them vary in the responses of the participants, because what for some may constitute a risk factor or behavior, for others it may be a risk or protective factor. Conclusion: For the participants Having security in knowledge, personal coping resources, availability of personal protection elements and resources for care, at the time of carrying out the interventions in the patients they become protective behaviors, and the participants' perception of risk was influenced by values, beliefs, feelings, knowledge and their sources. It is important to highlight that some of them vary in the responses of the participants, because what for some may constitute a risk factor or behavior, for others it may be a risk or protective factor. conclusions. For the participants Having security in knowledge, personal coping resources, availability of personal protection elements and resources for care, at the time of carrying out the interventions in the patients they become protective behaviors, and the participants' perception of risk was influenced by values, beliefs, feelings, knowledge and their sources. It is important to highlight that some of them vary in the responses of the participants, because what for some may constitute a risk factor or behavior, for others it may be a risk or protective factor. conclusions. For the participants Having security in knowledge, personal coping resources, availability of personal protection elements and resources for care, at the time of carrying out the interventions in the patients they become protective behaviors, and the participants' perception of risk was influenced by values, beliefs, feelings, knowledge and their sources.
Use of the deltopectoral flap for reconstruction of a complex cervical defect: case report
Authors: Manfro Gabriel , Freiria de Oliveira Gabriel Alves , Fechine Feitosa Roney Gonçalves
Published: December 2022

We present a case report of a patient who underwent complex reconstruction of the pharynx and esophagus with microsurgical anterolateral thigh flap and deltopectoral flap for reconstruction of an extensive defect in the cervical region. We will discuss a little about the deltopectoral flap, which was the first choice for the reconstruction of cervical defects in the past, but nowadays it is still an important tool for head and neck defect reconstruction.
How to innovate in health area?
Authors: Fechine Feitosa Roney Gonçalves , Montano Pedroso Juan Carlos , Bueno Garcia Elvio , Sabino Neto Miguel , Masako Ferreira Lydia
Published: December 2022

Companies, markets, and consumption patterns are all part of daily life, particularly in health area. It is the responsibility of the pharmaceutical industry and patients to develop pertinent solutions (innovations) that are based on human needs. Design Thinking (DT) is a tool for innovating, and it should put people first. The answer has the power to transform people's lives or address their problems. The purpose of this work is to propose DT concepts for application in health area innovation. Empathy, Collaboration, and Experimentation are the three primary pillars of Design Thinking, a human-centered paradigm of thought. The four steps of this innovative development technique are Discover, Define, Develop, and Commercialize. Discover, Define, Develop, and Deliver are the four distinct steps of this innovative development technique. The DT creative process is collaborative and incorporates consumers from the outset. Users of DT look for products that offer value that can be quickly tested, verified, and deployed on the market or for the user's advantage. To vastly enhance the experiences of healthcare consumers, DT is broadly applicable in the field of health area and to all acts that directly or indirectly involve the prevention and/or treatment of illnesses. Because the major emphasis is on the individual/patient/customer/service, combining this technique with conventional scientific methods might boost health innovation.
Photosensitivity and cholestatic hepatitis: the dermatologist contribution for the diagnosis of erythropoietic protoporphyria
Authors: Molozzi Bruna , Reuwsaat Paul Ingrid , Volnei Dorn Timotio , Giunta Funchal Gabriella Di , Moreira Amorim Gustavo
Published: December 2022

We report a case of erythropoietic protoporphyria (EPP) in a young male adult, who was admitted to the hospital due to abdominal pain and jaundice. Complementary exams showed elevation of liver and canalicular enzymes and choledocholithiasis. The patient also had pronounced photodamaged skin and a history of significant photosensitivity since childhood. The dermatology team, based on the clinical and histological findings, gave the diagnosis of EPP and treatment with cholestyramine was instituted.
Dynamic infrared thermography aiding in flaps
Authors: de Andrade Lucas , Freiria de Oliveira Gabriel Alves , Silva de Araújo Rafael , Fechine Feitosa Roney Gonçalves , Ching An Wan , Masako Ferreira Lydia
Published: December 2022

Background: The selection of the best vessels is of utmost importance in reconstruction surgeries. This will reduce operative time, decrease complication rates, and ensure a better overall result. It is observed that dynamic infrared thermography (DIRT) has been increasingly used in reconstructive microsurgery to evaluate flap viability and locate perforators. DIRT measures the rate and patterns of rewarming after cooling. The sensor detects heat irradiation and forms a thermogram where the temperature of each spot can be recognized. This article aims to conduct a systematic review of the clinical applications of DIRT imaging in plastic surgery. Methods: The search was performed in MEDLINE, LILACS, Cochrane, and Scielo databases using the following terms: "thermography", "thermometry", "surgical flaps", "reconstructive surgical procedures" and "microsurgery". Articles published from January 2006 to October 2021 were included. The primary search provided 115 matches in MEDLINE, 0 in LILACS, 6 in Cochrane, and 0 in Scielo. After removing duplicates, 115 articles were considered. Results: After reading the titles and abstracts and removing duplicates, a total of 38 publications were found. These were read in full and evaluated against the inclusion and exclusion criteria. After full reading and analysis, a total of 25 publications met the inclusion criteria. Conclusion: The use of DIRT shows promise for flap monitoring in reconstructions in Plastic Surgery.
Protective immunity in broiler chickens elicited by live commercial coccidia vaccines (LCV) against recent field isolates and vaccines
Authors: Timmons Jennifer , Whyte Celia , Fitz-Coy Steve , Mwangi Samuel
Published: December 2022

Use of live commercial coccidia vaccines (LCV) have proven to be important for control of coccidiosis in broilers, however LCV from different companies can vary. The objectives of this study were to measure the level of protection provided by five LCV against homologous and heterologous challenges at 20, 26 and 33 days of age and measure the level of protozoa parasite infection for each isolate in coccidia naïve chickens via wet mount smears. A Randomized Complete Block design with six vaccine treatments (a non-vaccinated, Con and vaccines A-E) was used. The dependent variables were weight gain and microscopic parasitic scores (MS). Vaccination was performed via coarse spray (d0). Birds were challenged on 20, 26, and 33 d of age with 3-5 field isolates and a homologous antigen. Four to five birds were challenged for each field isolate and homologous antigen. MS were determined 6 d post challenge. The d 26-32 and d 33-39 average gains of the Con treated broilers were lower (P ≤0.05) compared to the gain of broilers from the LCV treatments. The MS of the birds that were immunized with vaccines C, D, and E and challenged on d 20 with E. tenlla were 96, 83, and 92% numerically reduced, however this reduction was not significant. Similar results of MS were detected from the d 26 and 33 challenges. The average gain of broilers may be improved when LCV are used, however protection varies depending on Eimeria species challenged and the age of the broilers.
A descriptive study to assess the level of study skills of the undergraduate nursing students at selected nursing colleges of district Gurdaspur, Punjab, India, 2019
Authors: Kaur Harjinder , Kumari Ramesh
Published: December 2022

Background of the study: A Skill is a type of effort, slog or project which needs particular drill and mastry or cognition. Students learn substantially with guides who consider students uniqueness and individuality, it is helpful to understand the fact that every student is different and everyone learns differently. The nursing profession and curriculum is made up of very tight schedule for the trainee nurses so by adopting a healthy study skills and habits will help the Nursing students to achieve academic goals.
The practical philosophy of Hryhorii Skovoroda in the light of our experience
Authors: Yermolenko Anatoliy
Published: December 2022

The article deals with the practical philosophy of Hryhorii Savych Skovoroda from the point of view of the leading trends of modern philosophical thought: the «rehabilitation of practical philo- sophy» and the communicative turn in philosophy, the components of which are the neo-Socratic dialogue, the philosophy of communication, and the ethics of discourse. The interpretation of Skovoroda’s philosophy is carried out not only in accordance with the principle «know yourself» as a method of knowledge, but primarily in the dimension of the Socratic dialogue, when the methods of morals and elenctics are used in the joint search for truth, solving moral problems. The dialogic nature of Skovoroda’s method consists in searching for the truth together with other people through argumentation, the truth that also appears as a moral category. The article shows the actualization of Skovoroda’s philosophy in the pre-Soviet, Soviet and modern periods of the study of his work in independent Ukraine. The main thesis of the work consists in the statement that Skovoroda did not reduce philosophy to life, but raised life itself to philosophy. Philosophy was his life — a practical philosophy of life that formed his dialogical habitus. Socratic dialogue appears in philosophy, in everyday practices of communication with people, in particular, in the itinerant habitus of the thinker. Traveling is an important element of his philosophy, his life, and his habitus. The itinerant nature of Skovoroda’s habitus takes his dialogues beyond epistemology, transferring the dialogue to a practical, or rather, moral-practical plane. Skovoroda as an educator, relying on the habitus of Ukrainian culture and dialogic practices, transcends this habitus, elevating it to the habitus of reason. The work asserts the opinion about the need and necessity to develop and practice neo-skovorodinian dialogue as a component of the worldwide trend of development of dialogic practical philosophy and dialogic civilization. The article shows not only the significance of Skovoroda’s philosophy as a historical-philosophical phenomenon, but also its role in modern philosophical research in Ukraine, as well as the national liberation struggles of the Ukrainian people in the fight against Russia’s aggressive policy.
Study of the heritage of Hryhorii Skovoroda in Germany. A brief overview
Authors: Pietsch Roland
Published: December 2022

The article analyzes the main directions and cases of research and reception of the creative heri- tage of Hrygorii Skovoroda in Germany. Even though Dmytro Chyzhevskyi introduced German scientists to Skovoroda’s work back in the 1930s, its actual reception, according to the author, began only in the 1980s. The article analyzes the research of three authors who carry out such a reception today. First, Elizabeth von Erdmann examines Skovoroda’s work in the context of philosophia perennis. Instead, Roland Pietsch began his study of Skovoroda’s work by translating his works into German and later focused on demonstrating the unity of mysticism and metaphysics in Skovoroda’s phi- losophy, according to how this unity was ensured in his doctrine of self-knowledge. Pietsch demonstrated this unity in his interpretation of the Narcissus dialogue. Another essential aspect of Skovoroda’s work, explored by Pietsch, is the philosopher’s symbolic metaphysics. Pietsch’s latest works are devoted to another important issue — establishing Skovoroda’s place in European intel- lectual history, in particular, based on a comparative analysis of the concepts of Hrygorii Skovo- roda, Johann Georg Hamann, and Franz von Baader. Another German researcher who studies Skovoroda’s work today is Slavologist and theologian Günter Kollert, who has been engaged in the philosophy of Skovoroda and Pamfil Yurkevich for several years and has translated the works of Skovoroda and Mykhailo Kovalynskyi into German. The author of the article concludes that new interesting independent studies of Skovoroda’s work will appear in Germany, which will make it possible to more accurately define Skovoroda’s place in the historical-philosophical process, to think more profoundly and describe this process, as well as to pave the way to possible abandonings and comparisons of Ukrainian works thinker with other famous figures in the history of philosophical thought.
Effect of the length of truncated nozzle with a tip on its thrust characteristics
Authors:   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine, Ternova K.V.
Published: December 2022

Nowadays, for solving new problems, rocket engine nozzle developers are increasingly turning to non- traditional nozzle configurations that differ from the classic Laval one. A relatively new line in the design of supersonic nozzles is the development of the so-called bell-shaped nozzle, which, unlike the classical Laval nozzle, has a larger angle of entry into the supersonic part of the nozzle. In this case, dual bell nozzles, which have two flow expansion sections in their supersonic part, are considered. However, the effect of the length ratio of the two flow expansion sections of a truncated nozzle on its characteristics has not yet been studied. The goal of this work is to determine the effect of the length of the upstream conical supersonic section on the static pressure distribution in the nozzle and its thrust characteristics with the shape of the bell-shaped tip kept unchanged. The nozzle characteristics were studied using the ANSYS Fluent computing package. It was shown that the flow patterns in the nozzle (velocity fields) change with the length of the conical part upstream of the tip and the underexpansion degree. Under terrestrial conditions (Pн = 1 bar), all variants show a developed separation zone that starts from the corner point where the tip is connected to the conical part. In this case, the pressure on the nozzle wall is nearly equal to the ambient pressure. At a large flow underexpansion degree (P0 = 300 bar) and in low-pressure conditions conditions (Pн =0.1 bar), the flow in the tip is adjacent to the wall. At a large flow underexpansion degree, the pressure in the nozzle increases from the corner point to the tip exit, and the pressure at the tip exit increases with decreasing tip length. The nozzle thrust coefficient decreases with increasing flow underexpansion degree, and it reaches a constant value after the flow becomes adjacent to the tip wall downstream of the corner point where the tip is connected to the nozzle. At high flow underexpansion degrees, the nozzle thrust coefficient is higher for a nozzle with a longer conical part. The calculated results are in good agreement with experimental data on nozzles of this type.
Effect of a functionally graded material inclusion on the stress concentration in thin plates and cylindrical shells with a circular opening
Authors:   Oles Honchar Dnipro National University, Hart E.L. , Hudramovich V.S. ,   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine, Terokhin V.I. ,   Oles Honchar Dnipro National University
Published: December 2022

ology, in particular, space-rocket engineering, oil-and-gas engineering, power engineering, construction, etc. The presence of openings in their plate and shell components leads to a sharp increase in local stresses, which, under certain conditions, may trigger destructive processes. The use of functionally graded materials (FGMs) with certain mechanical properties can significantly reduce the stress concentration in the vicinity of local concentrators in the form of openings, cutouts, fillets, grooves, etc. This paper presents the results of computer simulation and finite element analysis of the stress and strain fields of thin plates and thin-walled cylindrical shells with a circular opening and an annular FGM inclusion surrounding it. The effect of the dimensions of the FGM inclusion and the law of variation of its elastic modulus on the stress and strain concentration in the vicinity of the opening was studied. The stress and strain intensity distribution in local stress concentration zones was obtained. It was found that an annular FGM inclusion with certain mechanical properties can reduce the stress concentration factor by more than 30%. In this case, a proportional decrease in strain intensity in the vicinity of the opening is also observed. The law of variation of the elastic modulus of the FGM inclusion and the inclusion width have a significant effect not only on the level of stress and strain concentration, but also on the stress and strain pattern. The results of the large-scale computational experiments show that an FGM annular inclusion reduces both the stress and the strain intensity around the opening. Therefore, the use of annular FGM reinforcements in plates and cylindrical shells with openings makes it possible to control the distribution and magnitude of the stress and strain intensities in local stress and strain concentration zones.
Passenger car wheel profile for the operation on the Ukrainian and European railways
Authors:   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine, Mokrii T.F. , Malysheva I.Yu. ,   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine, Lapina L.G. ,   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine, Bezrukavyi N.V. ,   Institute of Technical Mechanics of the National Academy of Sciences of Ukraine and the State Space Agency of Ukraine
Published: December 2022

The relevance of this work stems from the urgent need for the modern development of the Ukrainian railway transport and the acceleration of Ukraine's integration into the European railway transportation. Currently, the most effective way to travel across borders between countries with different track gauges is the use of gauge-changeable wheelsets, a system that can change from one gauge to another when moving through special gauge changing facilities. The use of cars with gauge-changeable wheelsets on the Ukrainian and European railways calls for assuring a good compatibility of the wheel-rail pair on tracks of both gauges. The goal of this work was to develop a unified wheel profile for the operation on the domestic and European railways and predict the safety of cars with that wheel profile, the ride quality, and processes of wheel-rail dynamic interaction for tracks with different parameters. Use was made of methods of deformable solid mechanics, statistical dynamics, and numerical integration. A family of wheel profiles was constructed, and the effectiveness of their use in passenger car wheelsets on the Ukrainian (1520 mm gauge) and European (1435 mm gauge) railways was evaluated. For each profile, the spatial problem of wheel?rail contact was solved, and the interaction parameters were analyzed, including the dimensions and location of the contact patches. Calculations were also made for a car negotiating a circular curve of a small radius (R = 300 m) and moving at different speeds on tangent track sections. The choice among the constructed profiles was made according to two criteria: wheel flange wear and car dynamic stability. Based on the studies conducted, a new wear-resistant wheel profile, ITM-73EP, was proposed. Its use in gauge-changeable wheelsets of passenger cars will provide reasonable indices of wheel–rail interaction both on the Ukrainian and on the European railways without sacrificing car dynamic performance.