bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise Comparativa Epidemiológica da Cirurgia de Esofagectomia Realizada por Via Transtorácica e por Via Minimamente Invasiva
Authors: Vidal Belo Giovanna , Garcia Ferreira de Oliveira Michelle , Soares Viana Lívia , Vidal Spinelli Julia , Aguiar de Souza Suzane , Rodrigues Ferraz Adriana
Published: June 2020

Diversas patologias que acometem o esôfago, como tumores, acalasia e megaesôfago, são corrigidas cirurgicamente através da esofagectomia, um procedimento baseado na remoção parcial ou total do esôfago. A esofagectomia distal retira apenas parte do esôfago e existem duas técnicas para sua execução: a esofagectomia com toracotomia (ECT), com abertura da caixa torácica, ou a esofagectomia sem toracotomia (EST), feita através do endoscópio, apresentando vantagens com relação à ECT. O objetivo do estudo foi analisar comparativamente os diversos aspectos epidemiológicos da ECT e EST. Trata-se de um estudo observacional e transversal, a partir de dados coletadas no SIH/SUS entre Janeiro de 2014 a Abril de 2019, analisando número de óbitos e internações, taxa de mortalidade, complexidade e valor de cada procedimento em cada região do Brasil, comparando os dados obtidos aos achados bibliográficos. Os dados foram analisados por meio dos testes de T-Student e Correlação de Pearson. De acordo com as informações encontradas, foram realizadas 544 internações, sendo a maioria delas decorrentes de EST, realizadas no regime público e todas em média complexidade. Apesar da menor amostra na ECT, as maiores taxas de mortalidade ocorreram na EST, ainda que a diferença não tenha sido estatisticamente significativa. A média da permanência hospitalar foi menor na ECT, mas a diferença não foi estatisticamente significativa, o que não é compatível com a literatura, que indica recuperação mais rápida na EST. Assim, não houve diferença significante entre os dados estatísticos e epidemiológicos na morbimortalidade dos procedimentos, corroborando para escolha do tratamento individualizado de cada paciente.
ERITEMA MULTIFORME INDUZIDO POR HIDROXICLOROQUINA: RELATO DE CASO
Authors: Maleck Marise , Bruno João Pedro A. , Bezerra Maria Olivia de Lima
Published: June 2020

As farmacodermias possuem uma incidência em torno de 5 a 30%, dentre 3 a 6% de todas as admissões hospitalares. As reações medicamentosas adversas (RMA) estão entre as principais causas de morte em vários países. O objetivo deste estudo foi relatar o caso de uma paciente com quadro clínico de Eritema Multiforme após o uso de Hidroxicloroquina em terapia para Chikungunya (CHIKV). O caso evoluiu para um exantema generalizado. Após a remissão das lesões cutâneas, foi diagnosticado como Artrite Reumatóide (AR) soronegativa. Prosseguiu-se a terapêutica com corticoide e metrotexato com significativa melhora do quadro. Este estudo concluiu a importância no cuidado com o diagnóstico diferencial pelo CHIKV e na elucidação do efeito colateral em consequência do uso de Hidroxicloroquina.
Midazolam: aspectos farmacológicos e seu uso em diferentes níveis de sedação
Authors: Tostes Frazão Vinícius
Published: June 2020

A sedação caracteriza-se por depressão do nível de consciência, que pode variar desde um estado de tranquilidade com consciência preservada até a inconsciência. Um agente sedativo ideal deve ter efeito imediato, sedação somente durante o procedimento, rápida recuperação da consciência, eficácia comprovada e mínimos efeitos colaterais. Neste contexto, o midazolam surge como uma importante droga na anestesiologia, com papel destacado na sedação pré, intra e pós-operatória, sendo utilizado tanto na sedação consciente quanto na profunda para a indução e manutenção da anestesia. A importância de uma sedação eficaz durante estes procedimentos justifica a realização deste estudo de revisão de literatura. O objetivo do estudo é analisar o mecanismo de ação, os aspectos farmacológicos e clínicos, doses, principais utilizações e comparação com outros sedativos, com o intuito assim, de agregar ainda mais conhecimento acerca desta temática. Conclui-se que o Midazolam é um benzodiazepínico com propriedades hipnóticas, sedativas e relaxantes, que possui rápida absorção, ação e eliminação. Apesar dos cuidados que devem ser abordados pelos médicos no que tange dose, idade, comorbidades, peso, interações medicamentosas, sedação desejada e vias de administração, o midazolam é considerado um medicamento eficaz, benéfico e seguro.
Discite secundária à infecção urinária: relato de caso
Authors: Nagib Thalita , Nogueira Carvalheiro Carla Maria , Suckow Custódio Thaísa , Cordeiro de Souza Girley
Published: June 2020

Discite por definição trata-se de um processo inflamatório, em sua grande maioria infeccioso, que acomete os discos intervertebrais, causando como principal sintoma a dor, que pode localizar-se na coluna ou irradiar para locais como abdome, quadris, membros inferiores ou virilha devido a compressão das raizes nervosas. É uma causa relativalmente rara de lombalgia no adulto, afetando mais o sexo masculino e predominando na faixa etária entre 50 e 60 anos. Sintomas como febre acompanhada de calafrios e sudorese noturna são comemorativos importantes na história clínica do paciente que ajudam a alcançar o diagnóstico. O relato de caso trata de um idoso de 74 anos, com história de hipoestesia e paraparesia importante em membros inferiores, associado a febre e calafrios raros, diagnosticado com discite secundária à uma infecção urinária por Enterococcus spp, baseado na história do paciente, sintomas clínicos e achados de imagem. Destaca-se a importância e o desafio do diagnóstico precoce, indicando os sintomas muitas vezes inespecíficos, que necessitam estar acompanhados de uma coleta rigorosa da história clínica do paciente, com o manuseio correto dos exames de imagem e laboratoriais, identificando o agente infeccioso implicado para um tratamento eficaz e conduzido pela cultura, fornecendo um melhor prognóstico clínico e maior sobrevida dos pacientes.
A Prevalência da insônia no meio médico e o uso de substâncias relacionadas
Authors: Fiore Schumann Taianne , Lima De Falco Mariana , César Pires Oscar , Pereira de Souza Priscila
Published: June 2020

A insônia é o distúrbio do sono mais frequente da população geral, sabe-se que ela é perpetuada por fatores de condicionamento, como poucas horas dormidas e alternância entre sono noturno e diurno. Essa é uma realidade vivenciada no meio médico. Nesse contexto, o debate dessa temática é relevante frente a esses profissionais, visto que, além de prejudicar a qualidade de vida, o distúrbio pode proporcionar a adoção de hábitos inadequados. Este trabalho visa demonstrar a prevalência da insônia entre os médicos e do uso de substâncias relacionadas através de estudo observacional transversal, desenvolvido a partir de um questionário de aplicado a médicos especialistas da Universidade de Taubaté. Dos 34 médicos avaliado, 47,06% são insones, valor superior ao descrito por estudos que avaliaram a recorrência desse transtorno na população geral. Ademais, foi constatado que o sintoma mais relatado e relacionado à insônia foi a fadiga. Quanto ao uso de substâncias, verificou-se que 62,5% da amostra informou ingerir cafeína com a finalidade de promover a vigília, ao passo que 43% referiu fazer uso do álcool como indutor do sono. Outras substâncias utilizadas para proporcionar a vigília ou o sono foram relatadas, tais como Anfetaminas, fármacos e drogas fitoterápicas. Portanto, é válido discutir a insônia e o uso de substâncias associadas a ela no meio médico, uma vez que esse transtorno do sono tem impacto estatístico, além de afetar a saúde física e mental desses indivíduos, acarretando prejuízos no exercício da profissão.

Palavras chave: Insônia; Sono; Médicos; Substâncias; Fadiga.
Análise epidemiológica de pacientes com infoma de hodgkin nos últimos cinco anos no estado do Rio de Janeiro
Authors: Teixeira freitas Felipe , Lopes Dias Juliana , Cezario Costa Reis Bruno
Published: June 2020

O linfoma de Hodking constitui uma doença que resulta em uma neoplasia maligna que se dissemina por via linfática e afetando principalmente gânglios cervicais e o mediastino. Essa patologia tem como sua principal forma a linfocítica nodular e é um dos tipos mais curáveis, com radioterapia e quimioterapia. O presente estudo faz uma análise da epidemiologia dessa doença dando ênfase principalmente na faixa etária, número de óbitos e taxa de mortalidade relacionando-os ao perfil socioeconômico dos doentes em questão ao longo do período analisado. Sendo assim, os resultados tiveram como pontos principais as baixas incidência e taxa de mortalidade, além da conclusão de que se trata de uma doença complexa que precisa de um diagnóstico precoce visando o sucesso do tratamento com radioterapia e quimioterapia.
Microwave-assisted One-pot Synthesis of Amide Bond using WEB
Authors: Kamanna Kantharaju , Khatavi S.Y. , Hiremath P.B.
Published: June 2020

Background:

Amide bond plays a key role in medicinal chemistry, and the analysis of bioactive
molecular database revealed that the carboxamide group appears in more than 25% of the existing
database drugs. Typically amide bonds are formed from the union of carboxylic acid and
amine; however, the product formation does not occur spontaneously. Several synthetic methods
have been reported for amide bond formation in literature. Present work demonstrated simple and
eco-friendly amide bond formation using carboxylic acid and primary amines through in situ generation
of O-acylurea. The reaction was found to be more efficient, faster reaction rate; simple work-up
gave pure compound isolation in moderate to excellent yield using microwave irradiation as compared
to conventional heating.

Methods:

Developed one-pot synthesis of amide compounds using agro-waste derived greener catalyst
under microwave irradiation.

Results:

Twenty amide bond containing organic compounds are synthesized from carboxylic acid
with primary amine catalyzed by agro-waste derived medium under microwave irradiation. First, the
reaction involved carboxylic acid activation using EDC.HCl, which is the required base for the neutralization
and coupling. The method employed natural agro-waste derived from banana peel ash
(WEB) for the coupling gave target amide product without the use of an external organic or inorganic
base.

Conclusion:

In the present work, we demonstrated that agro-waste extract is an alternative greener
catalytic medium for the condensation of organic carboxylic acid and primary amine under microwave
irradiation. The method found several advantages compared to reported methods like solventfree,
non-toxic, cheaper catalyst, and simple reaction condition. The final isolated product achieved
chromatographically pure by simple recrystallization and did not require further purification.
Fuzzy Digital Filter Device Study for the Robot Manipulator
Authors: Bobyr M. V. , Milostnaya N. A. , Bulatnikov V. A. , Luneva M. Yu.
Published: June 2020

Рurpose of research. Situations that reduce the accuracy of links positioning often arise due to the drab of contacts during the operation of robot manipulator. One of this problem solutions is signal filtering. Modern digital filtering algorithms have a rather complex mathematical structure. Data processing in such filters takes long time. So the purpose of this work is to develop fast-acting fuzzy digital filter device capable to eliminate the problem of contact scrapping when positioning the links of robot manipulator.

Methods. Generalized mathematical model was used in the development of digital filter device. This model is implemented by using fuzzy logic theory. Generalized mathematical model of the fuzzy digital filter includes a model determining a support of fuzzy output variable, a model for determining coefficients of fuzzy digital filter and a model for converting the output voltage into a rotation angle of robot manipulator servo drive. This mathematical model makes it possible to recalculate the voltage supplied to the input of fuzzy digital filter using two control coefficients thereby improving the positioning accuracy of robot manipulator links.

Results. During experimental studies, comparative analysis of developed fast-acting device of fuzzy digital filter with Kalman filter was carried out. The RMSE standard error for two filters was calculated. The average RMSE value of the fuzzy digital filter was 0.0185 of Kallman's filter was 0.0193.

Conclusion. Generalized mathematical model of fuzzy digital filter device consisting of three models is described. Device implementing determination of caliper of fuzzy output variable, experimental model of robot manipulator, experimental research and proposed mathematical model are presented.
An Algorithm of Image Segmentation Based on Persistent Homology for Solving Defects Searching Problems
Authors: Eremeev S. V. , Romanov S. A.
Published: June 2020

Purpose of research is to develop an image segmentation algorithm based on the persistent homology for solving problems of searching and classifying defects. The algorithm is aimed at improving the quality of products at enterprises with continuous production (metallurgy, woodworking, and others).

Methods. To segment an image, it is proposed to specify links between pixels in the image. In the future, during the iterative breaking of links, as their weights increase, pixels will be combined into groups called holes. Pixels that are in a single group have both their original characteristics and characteristics common for the entire group, and they also change the weights of their links with representatives of other groups. This creates a history of the formation of separate groups of pixels which can be specified as segments with a time-based characteristic of the change.

Results. The result of the research is the development of an algorithm designed to search for and classify defects in various materials. The optimal algorithm for applying the principle of persistent homology to images has been developed, and factors determining the transition boundaries of image objects have been analyzed and selected. The segmentation algorithm was tested on metal images obtained from sheet rolling equipment. The results of comparing the proposed algorithm with the K-means and Mean-Shift segmentation algorithms for different parameters are provided in the article.

Conclusion. Using persistent homology in image segmentation tasks can enable creating a tool that can be applied to materials with different structures without any need for significant changes. The software implementation of the segmentation process based on the principles of computer topology has shown high flexibility due to the storing of the history of segment changes.
Improving Gear Milling Efficiency by Creating Prefabricated Cutters with Replaceable Cutting Carbide Plates
Authors: Artamonov E. V. , Kireev V. V. , Zyryanov V. A.
Published: June 2020

Today, when machining domestic-made worm milling cutter according to GOST 9324-80, a problem arises in their durability at the roughing stage. Russian tool companies engaged in the manufacture of metal cutting tools do not currently offer prefabricated worm tools with cutting elements made of hard alloy tools for machining large-modular gears.

Purpose of research. Creation of prefabricated structures for machine-building enterprises with replaceable cutting carbide plates (RCHAP). Due to this, the productivity of equipment already available at the enterprise is increased several times, the economic efficiency of introducing high-quality metal-cutting tools makes it possible to purchase modern equipment and make the work of machine operators at machine-building enterprises more efficient and less time-consuming. In this paper, we propose a fundamentally new technical solution, which makes it possible to increase the efficiency of machining gears with a metal-cutting tool, with the arrangement of replaceable carbide cutting plates in the prefabricated initial contour of the manufacturing rail in worm milling cutters.

Methods. The research method is the use of graphic simulation, which allows you to determine the size of the crosssectional area of the cut layer for the cutting elements of the worm tool.

Results. Improving the processing efficiency will be achieved by implementing a group cutting scheme in a prefabricated worm milling cutter by using a larger number of main and side carbide cutting inserts on an Archimedean tool worm, which allow sequentially cutting the machining allowance and reducing the feed rate to the cutting insert, to ensure milling uniformity throughout the processing stage, and also reduce the magnitude of shock loads on cutting carbide elements of a precast tool.

Conclusion. The use of replaceable carbide plates in a group cutting scheme increases the durability and reliability of a precast worm cutter.
Implementation of Contact-Condensation Hardening Theory Mechanisms when Forming Building Composites
Authors: Stepanova M. P. , Sotnikova O. A.
Published: June 2020

Purpose of research is to study cheaper composite materials for building structures such as cement-free ones without heat treatment, which will undoubtedly allow finding their application in building industry. To achieve this goal it is necessary to identify patterns of structure formation of clinker-free contact condensation hardening composite materials in which portlandite crystals act as a matrix, and the physicochemical active component of natural origin acts as a filler.

Methods. In accordance with the purpose set, one of the main tasks of the work was to be solved; it involved study-ing the patterns of structure formation of contact-condensation hardening systems relying on the basic principles of materials science, which include studying the influence of the composition, structure and state of the starting com-ponents on the properties of a composite material. In this work, we studied the role of the physicochemical activity of raw materials and the possibility of ‘combining’ a portlandite matrix with filling mechano-physicochemical active raw materials capable of producing new structures. To form the composite material, a compaction pressing technique at elevated specific pressures was used, which made it possible to implement the mechanisms of contact condensation technology of structure formation. The formation of physicochemical bonds of portlandite and aluminosilicate filler of various types is also possible with certain ratios of their mass fractions and V/I ratios the optimization of which was one of our objectives.

Results. The result of this work is to assess the impact of raw material characteristics and technology parameters on the properties of the resulting material, namely, the improvement of the compacting pressure and the amount of filler when getting a compacted composite.

Conclusion. The development of a technology of producing clinker-free contact condensation composites based on portlandite with aluminosilicate filler will expand the raw material base of local building materials, reduce their cost and energy consumption, that is, solve key issues of resource saving in the building materials production.
Two-Way Text Messaging to Support Self-Care and Delivery of an Online Sexual Health Service: Mixed Methods Evaluation
Authors: Shanks Sarah , Morelli Alessandra , Ardines Elena , Holdsworth Gillian , Baraitser Paula
Published: June 2020

Background

Digital health care is increasingly used to improve health service accessibility and reduce costs. Remote health care requires a significant self-management role for service users, and this generates information provision and support needs that should be reflected in service planning. SMS text messaging offers a convenient and low-cost method of communication and is increasingly used across digital health care services to provide remote support.

Objective

The aim of this study was to quantify the number of messages generated through user interaction with a two-way SMS text messaging support service within an online sexual health service and to thematically explore the content of the messages and type of support required to facilitate self-management.

Methods

The content of all SMS text messages received by an online sexual health service was analyzed from April 4, 2018, to July 5, 2018. Messages were classified as being either administrative or clinical in nature and service or user initiated. For those messages that were both clinical and user initiated, a qualitative thematic analysis was completed to fully describe the content of the interactions.

Results

A total of 267 actionable messages were generated per 1000 orders requested through the service. Of the 8562 messages, 5447 (63.62%) messages were administrative and 3115 (36.38%) were clinical. Overall, 4306 of the 8562 messages (50.29%) responded to service-generated queries reflecting the public health and clinical responsibilities of an online provider, and 4256 (49.71%) were user-generated queries, demonstrating a willingness by users to proactively engage with a two-way SMS text messaging support service. Of the 3115 clinical messages, 968 (31.08%) clinical messages were user initiated and shared personal and complex clinical information, including requests for help with the self-testing process and personalized clinical advice relating to symptoms and treatment.

Conclusions

This study demonstrates the willingness of users of an online sexual health service to engage with two-way SMS text messaging and provides insight into the quantity and nature of the support required to facilitate service delivery and self-care. Further work is required to understand the range of clinical problems that can be managed within this medium.
Public Health in the Information Age: Recognizing the Infosphere as a Social Determinant of Health
Authors: Morley Jessica , Cowls Josh , Taddeo Mariarosaria , Floridi Luciano
Published: June 2020

Since 2016, social media companies and news providers have come under pressure to tackle the spread of political mis- and disinformation (MDI) online. However, despite evidence that online health MDI (on the web, on social media, and within mobile apps) also has negative real-world effects, there has been a lack of comparable action by either online service providers or state-sponsored public health bodies. We argue that this is problematic and seek to answer three questions: why has so little been done to control the flow of, and exposure to, health MDI online; how might more robust action be justified; and what specific, newly justified actions are needed to curb the flow of, and exposure to, online health MDI? In answering these questions, we show that four ethical concerns—related to paternalism, autonomy, freedom of speech, and pluralism—are partly responsible for the lack of intervention. We then suggest that these concerns can be overcome by relying on four arguments: (1) education is necessary but insufficient to curb the circulation of health MDI, (2) there is precedent for state control of internet content in other domains, (3) network dynamics adversely affect the spread of accurate health information, and (4) justice is best served by protecting those susceptible to inaccurate health information. These arguments provide a strong case for classifying the quality of the infosphere as a social determinant of health, thus making its protection a public health responsibility. In addition, they offer a strong justification for working to overcome the ethical concerns associated with state-led intervention in the infosphere to protect public health.
Decrease in Stroke Diagnoses During the COVID-19 Pandemic: Where Did All Our Stroke Patients Go? (Preprint)
Authors: Dula Adrienne Nicole , Gealogo Brown Gretchel , Aggarwal Aarushi , Clark Kal L
Published: June 2020

UNSTRUCTURED

Despite the evidence suggesting a high rate of cerebrovascular complications in patients with SARS-CoV-2, reports have indicated decreasing rates of new ischemic stroke diagnoses during the COVID-19 pandemic. The observed decrease in emergency department (ED) visits is unsurprising during this major crisis, as patients are likely to prioritize avoiding exposure to SARS-CoV-2 over addressing what they may perceive as mild symptoms of headache, lethargy, difficulty speaking, and numbness. In the central and south Texas regions where we practice, we suspect that patient admission, treatment, and discharge volumes for acute stroke treatment have decreased significantly since COVID-19–related shelter-at-home orders were issued. Symptoms of stroke are frequently noticed by a family member, friend, or community member before they are recognized by the patients themselves, and these symptoms may be going unnoticed due to limited face-to-face encounters. This possibility emphasizes the importance of patient education regarding stroke warning signs and symptoms during the current period of isolation and social-distancing. The south Texas population, already saddled with above-average rates of cardiovascular and cerebrovascular disease, has a higher stroke mortality rate compared to Texas and U.S. averages; however, the number of patients presenting to EDs with acute ischemic stroke diagnoses is lower than average. In our viewpoint, we aim to present the relative literature to date and outline our ongoing analyses of the highly affected and diverse stroke populations in San Antonio and Austin, Texas, to answer a simple question: where did all our stroke patients go?
Health Beliefs Associated with Preventive Health Behaviors for COVID-19: Findings in a Sample Drawn from a Major City in Iran (Preprint)
Authors: Araban Marzieh , Mesri Mehdi , Karimy Mahmood , Rouhani Mohammad Rreza , Stein LAR
Published: June 2020

BACKGROUND

Background: To date, in the absence of effective treatment and successful vaccines, the COVID-19 pandemic has become the most important threat to public health.

OBJECTIVE

Objectives: This study was conducted in Saveh city, of Iran, in 2020. Of interest were how health beliefs (taken from the Health Belief’s Model [HBM]), demographic characteristics, and general health behaviors (e.g., smoking) relate to COVID-19 preventative behaviors (e.g., hand-washing).

METHODS

Methods: In this descriptive-analytic study, a multi-stage randomized sampling method was used and 486 people (250 males and 236 females) recruited from health centers in Saveh city, Iran, participated. Data were collected through a self-administered multi‑part questionnaire, which included sociodemographic information, health behaviors, and constructs associated with HBM. Data were analyzed using independent t-tests, ANOVA, and multiple regression in SPSS version 21.

RESULTS

Results: Perceived disease susceptibility (β=0.44, p<0.001), self-efficacy to enact preventative behaviors (β=0.24, p<0.01), education (β=0.20, p<0.001), non-smoking status (β=0.14, p<0.01), marital status (β=0.10, p<0.03), and perceived barriers to disease preventative behaviors (β=-0.10, p<0.04) were important predictors of prevention practices for COVID-19. Perceived susceptibility, self-efficacy, barriers, and socio-demographic constructs (education, smoking, and marital status) accounted for 61.4% (adjusted R2) of the variance associated with preventive behavior for COVID-19.

CONCLUSIONS

Conclusion: To improve control strategies for the COVID-19 pandemic, public health initiatives are needed to enhance perceived susceptibility to the disease and improve self-efficacy to perform preventative behaviors in spite of perceived barriers.
The Electronic Medical Record and Nephrology Fellowship Education in the United States
Authors: Yuan Christina M. , Little Dustin J. , Marks Eric S. , Watson Maura A. , Raghavan Rajeev , Nee Robert ,   for the Nephrology Education Research and Development Consortium—NERDC
Published: June 2020

Background and objectives

An unintended consequence of electronic medical record use in the United States is the potential effect on graduate physician training. We assessed educational burdens and benefits of electronic medical record use on United States nephrology fellows by means of a survey.

Design, setting, participants, & measurements

We used an anonymous online opinion survey of all United States nephrology program directors (n=148), their faculty, and fellows. Program directors forwarded survey links to fellows and clinical faculty, indicating to how many they forwarded the link. The three surveys had parallel questions to permit comparisons.

Results

Twenty-two percent of program directors (n=33) forwarded surveys to faculty (n=387) and fellows (n=216; 26% of United States nephrology fellows). Faculty and fellow response rates were 25% and 33%, respectively; 51% of fellows agreed/strongly agreed that the electronic medical record contributed positively to their education. Perceived positive effects included access flexibility and ease of obtaining laboratory/radiology results. Negative effects included copy-forward errors and excessive, irrelevant documentation. Electronic medical record function was reported to be slow, disrupted, or completely lost monthly or more by >40%, and these were significantly less likely to agree that the electronic medical record contributed positively to their education. Electronic medical record completion time demands contributed to fellow reluctance to do procedures (52%), participate in conferences (57%), prolong patient interactions (74%), and do patient-directed reading (55%). Sixty-five percent of fellows reported often/sometimes exceeding work-hours limits due to documentation time demands; 85% of faculty reported often/sometimes observing copy-forward errors. Limitations include potential nonresponse and social desirability bias.

Conclusions

Respondents reported that the electronic medical record enhances fellow education with efficient and geographically flexible patient data access, but the time demands of data and order entry reduce engagement in educational activities, contribute to work-hours violations, and diminish direct patient interactions.
Cost–effectiveness of empagliflozin compared with liraglutide based on cardiovascular outcome trials in Type II diabetes
Authors: Ramos Mafalda , Ustyugova Anastasia , Hau Nikco , Lamotte Mark
Published: June 2020

Aim:
Cost–effectiveness (CE) analysis of empagliflozin+standard of care (SoC) compared with SoC and liraglutide+SoC, in patients with Type II diabetes and established cardiovascular disease, was conducted using evidence from cardiovascular outcomes trials.
Methods:
The IQVIA Core Diabetes Model was calibrated to predict same outcomes observed in EMPA-REG OUTCOME and LEADER trials. Three-year observed cardiovascular events of SoC, empagliflozin+SoC and liraglutide+SoC were derived from EMPA-REG OUTCOME trial and an indirect comparison. Time horizon was 50 years and the UK payer perspective was taken.
Results:
Empagliflozin+SoC dominated liraglutide+SoC with greater quality-adjusted life years and reduced costs. Base-case incremental CE ratio of 6428 GBP/QALY was observed for empagliflozin+SoC versus SoC.
Conclusion:
Results suggest that empagliflozin+SoC is cost effective versus SoC and liraglutide+SoC.
ASSOCIATION OF SYNALPHEUS (CRUSTACEA, DECAPODA, ALPHEIDAE) WITH THE SPONGES FROM PARQUE MARINO NACIONAL SISTEMA ARRECIFAL VERACRUZANO, SW GULF OF MEXICO
Authors: Cházaro-Olvera Sergio , Vázquez-López Horacio
Published: June 2020

We assessed the association between five Synalpheus shrimp species (Synalpheus brevicarpus, Synalpheus fritzmuelleri, Synalpheus minus, Synalpheus scaphoceris, and Synalpheus towsendi) and five sponges (Amphimedon compressa, Aplysina fistularis, Ircinia fistularis, Ircinia. strobilina, and Sidonops neptuni) from parque marino nacional Sistema Arrecifal Veracruzano. Abundance of shrimp in each sponge species collected was noted. The Jaccard index (J) of association was applied to verify this association in six reefs in the park. Further, the correlation between shrimp carapace depth and sponge canal diameter was assessed. The total number of shrimps collected was 102, with the highest number of individuals (n = 62) for S. fritzmuelleri. The highest association was noted between S. towsendi and A. compressa (J = 1), followed by S. fritzmuelleri and I. fistularis (J = 0.88) and S. minus and I. strobilina (J = 0.66). The largest carapace depth (3.40 ± 0.20 mm) was observed for females of S. minus. A positive and significant correlation was noted between shrimp carapace depth and sponge canal diameter (P < 0.001).
AMEBAS PATÓGENAS DE VIDA LIBRE DEL GÉNERO ACANTHAMOEBA EN AGUAS RECREATIVAS EN LA HUASTECA POTOSINA, MÉXICO
Authors: Ortiz Ortega Ricardo , Vilches Flores Alonso , Rodríguez Monroy Marco Aurelio , Bonilla Lemus Patricia
Published: June 2020

Studies accomplished in freshwater demonstrate the importance of identify the presence of
protozoa like free living amoebae (FLA). In particular, the genera Acanthamoeba is associated with
severe infections in man, as the Granulomatous Amebic Encephalitis (GAE). The most important
factor for the development of these organisms is the high temperature of the water body. The
region of the Huasteca Potosina in Mexico, with a tropical climate and great aquatic resorts, like
rivers, waterfalls and pools of thermal waters, that allows the development of amoebae. In this
study we evaluated the presence of amoebas in the most visited places on the Huasteca Potosina.
Samples of a liter were taken in nine sites during the rainy and dry season. 54 strains of amoebas
were identify, 46 belong to the genera Acanthamoeba, resulting 30 of them pathogenic in the
animal tests. The pathogenic isolated amoebas were present in the most attended resorts by the
people in the waterfalls or pools of the places sampling. Temperature turned out to be the most
important factor for the presence of amoebae.
Instrumento para valorar la capacidad de afrontar las prácticas clínicas de estudiantes de Enfermería, basado en la teoría de modelos y modelado de roles
Authors: González-Adonis Francisca , Guerrero-Nancuante Camilo , Cataldo-Ponce Adrián , Loézar-Hernández Mariana , Bettancourt-Ortega Lorena
Published: June 2020

La disciplina de enfermería, a lo largo del tiempo ha logrado desarrollarse en torno a la investigación y al uso de teorías propias, siendo una disciplina sustentada teórica y empíricamente, aspecto que se relaciona directamente con la formación de los y las estudiantes de enfermería, quienes durante este proceso adquieren competencias técnicas y de razonamiento clínico que resultan ser experiencias prácticas significativas para el desarrollo de habilidades propias de la profesión. En este contexto, se genera una relación entre cuerpo docente y el estudiantado, donde se comprometen emociones, procedimientos, humanización y un ambiente de aprendizaje complementado con la teoría. Por consiguiente, el presente artículo tiene como propósito reflexionar, sobre la importancia de aplicar las teorías de enfermería en los y las estudiantes que asisten a práctica clínica, utilizando especialmente sus recursos en el ámbito de la valoración. A partir de ello, se propone la realización de un instrumento de apoyo al desarrollo de competencias en el área práctica, basado en la Teoría de Modelos y Modelado de roles, cuyo propósito, es que las y los estudiantes se transformen en sujetos de cuidado para el cuerpo docentes, contribuyendo así en sus procesos de aprendizaje.
SANITASI DAN AIR MINUM DI DAERAH PERKOTAAN DAN PEDESAAN DI PROVINSI BENGKULU (ANALISIS DATA POTENSI DESA 2018)
Authors: Nurzanah Tri Noviyanti , Zakianis Zakianis , Wispriyono Bambang , Anwar Athena
Published: June 2020

ABSTRACT

 

Bengkulu Province is the fourth-lowest province in Indonesia for sanitation facilities and drinking water availability. The difference in socioeconomic conditions and very low access to sanitation in Bengkulu Province poses a major challenge to ensuring water and sanitation services for all, so as to attempt to control a large number of infectious diseases. The purpose of this study was to determine the description of sanitation and drinking water between urban and rural areas in Bengkulu Province. Data analyzed were Village Potential data (PODES) in 2018 and the sample were 148 villages. Research results show that sanitation facilities and the availability of clean water in urban areas are better than in rural areas. In rural areas the majority of sewage is unsanitary or without latrines/open defecation, garbage disposal is carried out by dumping it into the pit of natural soil or being burnt, the sewage is still open, the water source is still a dug well as a source of clean water. In conclusion, there are still gaps in terms of access to sanitation in rural areas and urban safe drinking water. An evaluation is needed to increase community access to sanitation in rural areas and drinking water in cities.

 

Keywords: Saniation, drinking water, urban areas, rural areas

 

 

ABSTRAK

 

Provinsi Bengkulu merupakan salah satu provinsi dengan sarana sanitasi dan ketersediaan air minum ke empat terendah di Indonesia. Perbedaan kondisi sosial ekonomi dan akses sanitasi yang sangat rendah di Provinsi Bengkulu menimbulkan tantangan besar untuk memastikan layanan air dan sanitasi bagi semua, sehingga membantu mengendalikan sejumlah besar penyakit menular. Tujuan penelitian ini adalah untuk mengetahui gambaran sanitasi dan air minum antara wilayah perkotaan dan perdesaan di Provinsi Bengkulu. Data yang dianalisis adalah data Potensi Desa (PODES) tahun 2018 dengan unit analisis desa. Jumlah sampel sebesar 148 desa di daerah perkotaan dan perdesaan di Provinsi Bengkulu. Hasil analisis menunjukkan bahwa sarana sanitasi dan ketersediaan air bersih di wilayah perkotaan lebih baik daripada di wilayah perdesaan.  Di wilayah perdesaan mayoritas pembuangan tinja tidak saniter atau tanpa jamban/buang air besar sembarangan, pembuangan sampah dilakukan sdengan membuang ke dalam lubang tanah atau dibakar, saluran pembuangan air limbah masih terbuka, dan sumber air adalah  sumur gali sebagai sumber air bersih. Dapat disimpulkan bahwa masih terdapat kesenjangan dalam hal akses sanitasi dan air minum antara di perdesaan dan  perkotaan. Perlu adanya evaluasi peningkatan akses masyarakat terhadap sanitasi di pedesaan dan air minum di perkotaan.

 

Kata kunci: Sanitasi, air minum, perkotaan, pedesaan
BELIEF SYSTEM, SISTEM PENGENDALIAN DIAGNOSTIK, SISTEM PENGENDALIAN INTERAKTIF, INOVASI, KINERJA ORGANISASI (STUDI PADA PERUSAHAAN MANUFAKTUR DI JAWA BARAT)
Authors: Chairunisa Mariyam
Published: June 2020

This study aims to examine impact of Management Control System  on organizational performance mediated by innovativeness. Contingency and Levers of Control  theories are used in this research with data collection and judgment sampling method on manufacturing companies. The data are represented by managers and assistant managers as respondents in West Java Area. The data is collected by post, electronic mail and direct survey from January 27, 2016 to March 2016. Result of this study indicates that management control system consisting belief system and interactive control system have a positive effect and significant on innovativeness and innovativeness ultimately have a positive and significant impact to organizational performance. However, diagnostic control system does not have significant influence to innovativeness. This study solely relies on construct of innovativeness capability.
DEVELOPMENT OF SHU CALCULATION AND DEVELOPMENT SYSTEMS (REMAIN BUSINESS RESULTS) ON EMPLOYEE COOPERATIVES “PERDANA ASIA” PT. BANK CENTRAL ASIA, TBK
Authors: Sesaphing Onne , Wijayanti Anita , Dewi Riana Rachmawati
Published: June 2020

The purpose of this study is to find out the system of calculation and distribution of SHU (Remaining Business Results) on employee cooperatives "Regional Regulation of Asia" and then develop a system of calculation and distribution of the remaining operating results that are correct and in accordance with the standard calculation of the remaining results of savings and loan cooperatives. this is research and development (R & D) research, where the research subject is the Prime Asia Employee Cooperative and the object of research is a system of calculation and division of the remaining results of the business. The method of data collection consists of interviews and observations. The analytical method used is data reduction by analyzing the existing system then the presentation of data in the form of a comparison of systems that are being used with the development of the system that will be used which will then provide results that are appropriate to the requirements and in accordance with applicable standards. and the distribution of the remaining proceeds to the cooperative of the Asian prime employees, the SHU funds received by members are more accurate because all the data has been confirmed correctly and the calculation has been adjusted to the standard calculation of the remaining savings and loan cooperatives.
Efeito de técnicas alternativas de polimento sobre a rugosidade superficial de resinas acrílicas
Authors: Meirelles Cogo Deborah , Viégas Cremonese Renato , Moraes Rangel Samantha , Werner Samuel Susana Maria
Published: June 2020

Em uma primeira etapa deste trabalho, buscou-se desenvolver uma técnica de polimento químico de resinas acrílicas que utilizasse o forno de microondas LG Modelo MB (315m1- 1.000watts) para o aquecimento de líquidos para polimento. A potencia do forno de microondas e o tempo necessários para aquecer os líquidos para polimento ate uma temperatura de 81 ± 5°C — intervalo de temperatura equivalente ao obtido na polidora elétrica- foram 900 watts (90% da potencia máxima) e 90 segundos. A seguir, foram confeccionados 100 corpos-de prova, 50 amostras de resina acrílica quimicamente ativada e 50 de resina acrílica ativada por energia de microondas, os quais foram submetidos a cinco diferentes técnicas de polimento: 1) polimento mecânico- controle, 2) polimento químico com liquido para polimento em polidora elétrica, 3) polimento químico com monômero de resina acrílica em polidora elétrica, 4) polimento químico com liquido para polimento aquecido em forno de microondas, 5) polimento químico com monômero de resina acrílica aquecido em forno de microondas. Eles foram comparados, quanto a eficacia da técnica, usando como parâmetro a rugosidade superficial das resinas acrílicas. Para essa avaliação foi usado um rugosímetro SJ-201 (Mitotoyo - Japan). Os resultados foram submetidos a analise de variância e as medias comparadas pelo teste de Tukey (a = 1%). Os resultados mostraram que todas as técnicas de polimento geraram valores de rugosidade com diferença estatística significativa quando comparados com a técnica de polimento mecânico (controle), a qual apresentou valores de rugosidade superficial abaixo do limiar de Ra, estabelecido como 0,2 um. Não houve diferença estatisticamente significante entre as quatro técnicas de polimento químico.
Hiperpigmentação da mucosa bucal causada pelo uso prolongado de fármaco antimalárico
Authors: Dias da Silveira Heloísa Emília , Francisco de Quadros Onofre , Dal Moro Maito Fabio Luiz , Giordani Suiane
Published: June 2020

Algumas terapias medicamentosas podem ser responsáveis pelo surgimento de alterações pigmentares na mucosa bucal. Os agentes antimaláricos estão frequentemente relacionados a hiperpigmentações e, por exercerem atividade imunossupressora e anti-inflamatória, são utilizados no tratamento de condições mediadas imunologicamente. Os autores apresentam dois casos de pigmentação por agente antimalárico (cloroquina) em mucosa de palato duro, chamando atenção para a necessidade de familiarização do cirurgião-dentista com essas hiperpigmentações a fim de facilitar o diagnostico diferencial com as diversas alterações que promovem mudança de coloração na mucosa bucal.
O medo do paciente ao tratamento odontológico
Authors: Benites de Morais Eleuza Regina
Published: June 2020

Conceito de medo. Experiencias e pesquisas práticas para detectar se existe um índice de medo das pessoas aos procedimentos clínicos dentários. Quais os fatores que possam causar este problema. Sinais e manifestações do medo que interessam ao cirurgião dentista. Relação entre o medo de ir ao dentista com a imagem social deste profissional junto a sua possível clientela. Citação de alguns recursos que possam ajudar no controle do medo.
Perfil dos pacientes geriátricos portadores de prótese total
Authors: Coelho Goiato Marcelo , Miesse Ana Carolina , Gennari Filho Humberto , Salviato Fajardo Renato , Gonçalves Assunção Wirley
Published: June 2020

Este estudo teve como propósito avaliar uma amostra geriátrica de 240 prontuários de pacientes, atendidos pela disciplina de Prótese Total da Faculdade de Odontologia de Arkatuba- UNESP, no período de 1980 a 2001, considerando-se que cada individuo apresentava sessenta anos ou mais na época de seu atendimento.As características de cada paciente foram analisadas quanto a cidade de origem, o sexo, o estado civil, estado de sande geral,a cor dos dentes selecionados e o tipo de prótese confeccionada. Concluiu-se que a maioria dos pacientes pertenciam ao sexo feminino, que a doença mais frequente foi a hipertensão arterial e que o tipo de Prótese mais confeccionada foi a bimaxilar.
Prevalência e severidade da doença periodontal e acúmulo de biofilme dentário em crianças da Clínica de Odontopediatria da UFPB
Authors: Dantas de Almeida Rossana Vanessa , De Morais Beltrão Érika , Bezerra Cavalcanti Nóbrega Carolina , Gondim Valença Ana Maria
Published: June 2020

Este trabalho objetivou verificar a prevalência e a severidade da doença periodontal em pacientes da Clinica de Odontopediatria da Universidade Federal da Paraíba, relacionando os níveis de doença com o gênero e o acumulo de biofilme. Compils a amostra 64 crianças na faixa etária de 09 a 11 anos que estavam em atendimento na referida Clinica. Foram coletados, por uma unica examinadora, índices de biofilme dentário (IHOS e O'leary) e doença gengival (ISG), e registradas a presença de recessão gengival e de bolsa periodontal. Os dados foram analisados com o auxilio do programa SPSS e tratados estaticamente pelos testes do Qui-quadrado e Exato de Fisher (p
Uso da estereologia como método na pesquisa histológica
Authors: Miguel Amenábar José , Pereira Padilha Dalva Maria , Neves Hugo Fernando , Medeiros Fossati Anna Christina
Published: June 2020

Na pesquisa em Biologia Bucal frequentemente são realizados estudos morfométricos de linguá, mucosa, glândulas salivares e zonas de osseointegração. Para a realização de medições de proporções envolvendo área, volume, numero de estruturas, etc, o método estereológico e de grande utilidade. 0 objetivo deste artigo a descrever um método utilizado para determinação de pontos amostrais em uma grade, e sua aplicação na analise de imagens em pesquisa histológica. Para tal, utilizaram-se 3 cortes histológicos de 3 glândulas salivares submandibulares de camundongos como exemplo para explicar o método. A estereologia, quando bem indicada, é uma ferramenta que proporciona excelentes resultados; e sua utilização, quando respeitados os critérios para determinação do número de pontos amostrais para avaliação de estruturas e tecidos, permite a obtenção de dados confiáveis quando da analise quantitativa de material de origem histológica.