bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy complicated by iron deficiency anemia: does the problem have a solution?
Authors: Solovyeva A. V. , Aleynikova E. Yu. , Gulenkova K. A. , Kuznetsova O. A. , Ermolenko K. S.
Published: April 2023

Introduction. The problem of iron deficiency anemia by pregnant women remains relevant due to the wide spread of this complication (up to 40%) and requires the search for effective drugs with a minimum number of side effects.

Aim. To improve perinatal outcomes in patients with iron deficiency anemia.

Materials and methods. A retrospective analysis was done for 2020 of the medical records of patients, including an exchange card and birth histories. The patients were selected by a continuous sampling method. The study was conducted at the clinical base of the Department of Obstetrics and Gynecology with the course of perinatology of the Peoples’ Friendship University of Russia (Head of the Department, Corresponding Member of the Russian Academy of Sciences, Professor V.E. Radzinsky). All the patients (n = 114) were divided into three groups: the first group (n = 54) – a study group, which included pregnant women who had iron deficiency anemia in the II or III trimesters and received antianemic treatment; the second group (n = 30) – pregnant women with iron deficiency anemia (diagnosed in the 2nd trimester) who did not take iron supplements, the third group (n = 30) – a control group of women with normal hemoglobin levels during pregnancy and delivery.

Results. The use of ferrous sulfate (Sorbifer durules) at a dose of 200 mg per day by pregnant women with IDA led to the fact that the weight-height parameters in newborns did not differ from those of children from healthy puerperas. At the same time, the volume of blood loss was greater in patients with IDA, however, there were no massive bleedings and moderate IDA in the postpartum period. The level of hemoglobin was significantly higher in women in labor who received ferrous sulfate (Sorbifer Durules) from the II trimester compared with pregnant women who had IDA in the III trimester. Thus, further research and the search for optimal dosages are required, as well as determining the most effective period for the use of iron supplements.

Conclusions. Good tolerability and high efficacy of Sorbifer Durules in relation to a significant increase in hemoglobin and the absence of severe complications of pregnancy and childbirth associated with anemia allow us to recommend it for the treatment of IDA in pregnant women and puerperas.
The effects of hormone replacement therapy: а window of opportunity for the cardiovascular system
Authors: Yakushevskaya O. V.
Published: April 2023

Coronary artery disease and stroke make up the greater part of the pattern of cardiovascular diseases (CVD). Their prevalence is increasing primarily due to death rates decline and life expectancy increase. However, CVDs remain the leading cause of death in both high/middle and low income countries (WHO, 2008). The burden of coronary heart disease and stroke is determined both by a significant decrease in patients’ quality of life and the economic expenditures of healthcare aimed at treating these conditions and managing their complications. The overall CVD risk is more or less the same in men and women, but a detailed analysis shows a clear dependence on the patient age. The CVD risk in men is comparable to the CVD risk in women of younger age groups, i.e. CVD incidence rates in women are about ten years behind such rates in men. CVDs are of major concern for women who enter menopause. The changing endocrine profile predisposes to an increase in the cardiovascular event rates due to a combination of risk factors such as visceral obesity, atherogenic dyslipidemia, impaired glucose regulation, homeostasis disorders, and vascular dysfunction. However, an independent association between age-related degenerative changes in the ovaries and CVD risk has been established primarily in women with premature and early menopause (<40– 45 years). Menopause hormone therapy (MHT) significantly reduces most CVD risks. The effectiveness of the prevention of irreversible effects of oestrogen deficiency is ensured by the timely MHT start during the very first pathological changes in female health or in the late stage of the menopausal transition/early postmenopausal stage (><60 years or within ten years after the last menstrual period). The concept of prescribing MHT within the “window of therapeutic opportunity” produces a  favourable benefit-risk ratio for patients.>˂40– 45 years). Menopause hormone therapy (MHT) significantly reduces most CVD risks. The effectiveness of the prevention of irreversible effects of oestrogen deficiency is ensured by the timely MHT start during the very first pathological changes in female health or in the late stage of the menopausal transition/early postmenopausal stage (˂60 years or within ten years after the last menstrual period). The concept of prescribing MHT within the “window of therapeutic opportunity” produces a  favourable benefit-risk ratio for patients.
Psycho-emotional state of women during the perimenopausal transition
Authors: Markova E. A. , Khashukoeva A. Z.
Published: April 2023

A woman’s health during the perimenopausal transition is not irrelevant because of the risk zone in which this category of women falls. Mature patients often have complaints associated with the menopausal syndrome. The increase in life expectancy of women, their active lifestyle that they want to maintain, which is not always possible due to the presence of a number of adverse factors such as the environment, stress factors, the presence of chronic diseases that tend to frequent exacerbations, all this aggravates the overall condition of women and primarily has a negative impact on their psycho-emotional health. The menopausal syndrome, which can debut during the perimenopausal transition, further complicates the woman’s condition. The job of a specialist gynaecologist is to help and manage these patients. It would seem that there is no question: the clinical guidelines and protocols are clearly prescribed algorithms for the management and therapy of such patients, where it is stated in black and white about the prescription of menopausal hormone therapy, which is pathogenetic and justified in the development of the menopausal syndrome and the complaints associated with it. But the prescription of this therapy is associated with a set of risks and side effects. Non-hormonal therapy is a good alternative in the treatment of menopausal disorders, given that hormonal treatment is contraindicated in a number of women. This article presents a cross-section of the literature data on the results of prescribing a dietary supplement MENSE® (Aquion JSC, Russia) in women with psycho-emotional tension during menopause. MENSE® complex contains an impressive range of components (β-alanine, 5-hydroxytryptophan, phytoestrogens – soy isoflavones, B vitamins, folic acid, vitamins E and C) favorably affecting the female body and improves the quality of her life during perimenopause. This complex can be recommended for patients with menopausal syndrome as an effective therapeutic agent for the period of selection of menopausal hormonal therapy or the presence of contraindications to it. MENSE® is an effective complex for improving the quality of life of perimenopausal women against the background of psycho-emotional conditions.
Metabolic dysfunction correction as a method of restoring the function of the reproductive system in women
Authors: Chernukha G. E. , Pronina V. A.
Published: April 2023

Insulin resistance is the main pathogenetic component of many metabolic diseases, including obesity, type 2 diabetes mellitus, gestational diabetes mellitus, and polycystic ovary syndrome (PCOS). Despite the fact that to date the mechanisms of insulin resistance formation have not been established, one of the promising directions at present is the search for potential therapeutic strategies for its correction, due to the fact that this also improves the course of the concomitant underlying disease. Insulin sensitizers are a generally recognized method of PCOS therapy due to their safety and effectiveness in normalizing the metabolic and endocrine profile of patients with polycystic ovary syndrome. The leading position in this direction is occupied by the combination of myo-inositol (MI) with D-chiro-inositol (DHI) in a ratio of 40:1, which, according to the conducted studies, is comparable to the concentration of inositols in the blood plasma of healthy women. This ratio of MI/DHI is effective both for normalization of the metabolic profile, and for regulation of the menstrual cycle and overcoming anovulatory infertility. An analysis of the literature has shown that a number of biologically active substances, such as folic acid, vitamin D and alpha-lipoic acid, in combination with insulin sensitizers, have additional advantages, which gives grounds for continuing research on their significance as components of combined treatment, as well as in the search for the optimal dose and duration of such therapy.
Intrauterine adhesions: from pathogenesis to effective coping technologies
Authors: Orazov M. R. , Mikhaleva L. M. , Khamoshina M. B. , Ismayilzade S. Ya.
Published: April 2023

Intrauterine adhesions (IUDs) are one of the unresolved and unsolved problems of modern reproductive medicine worldwide. Adhesive lesions lead to partial or complete obliteration of the uterine cavity and/or cervical canal. The main clinical manifestations of IUDs are menstrual irregularities, cyclical pain, infertility and other various reproductive disorders. Reproductive outcomes in women with IUDs remain poorly understood and difficult to verify. At the same time, there is currently no understanding of the basic mechanisms of IUD development, including the processes explaining the failures of the above complications. The problem of overcoming IUD recurrences after adhesiolysis remains far from being finally resolved. The gold-standard treatment for IUD is hysteroscopic adhesiolysis, which, however, is associated with a high frequency of complications and relapses, highlighting the need for preventive approaches to the management of IUD. The drugs with enzymatic activity inhibiting abnormal connective tissue include bovhyaluronidase azoximer created by the Russian developers back in 2005. The drug consists of two components – hyaluronidase and azoximer bromide. The former is an enzyme, and the latter is a stabilizer that prolongs the action of hyaluronidase. Several studies have shown that bovhyaluronidase azoximer causes the destruction of intrauterine adhesions and restores the endometrium status in inflammatory pelvic diseases. Due to prolonged antifibrotic effect of bovhyaluronidase, azoximer can be used to treat women with IUDs to reduce the risk of the subsequent development of adhesive process in the uterine cavity.
Multidisciplinary approach in the treatment of uterine fibroids
Authors: Slyusareva O. A. , Markarov A. E. , Apresyan S. V. , Dobrokhotova J. E. , Khlynova S. A. , Dimitrova V. I. , Papoyan S. A. , Markova E. A.
Published: April 2023

Introduction. The efficacy of preoperative therapy with Gynestril in the treatment of symptomatic uterine fibroids and anaemia of various degrees of severity was studied in the prospective, comparative cohort study.

Aim. To evaluate the efficacy of preoperative therapy with mifepristone in patients with uterine fibroids and chronic iron deficiency anaemia of various degrees of severity.

Materials and methods. The study included 70 women who were scheduled to undergo the organ-preserving surgical treatment due to symptomatic uterine fibroids from January 1, 2017 to December 31, 2022. 50 patients received Gynestril at a dose of 50 mg/day (1 tablet) from day 1 of the menstrual cycle for 3 consecutive months. Due to contraindications to its use, 20 patients refused to administer the drug in the preoperative period and received symptomatic haemostatic therapy, and were included in the control groups. The patients of both groups received anti-anaemic therapy with iron(III)-hydroxide polymaltose tablets, 250– 300 mg/ day orally. 40 patients underwent the organ-preserving surgery depending on the size, number, type and localization of uterine fibroids according to the FIGO 2011 classification and patients’ motivation to preserve their reproductive function.

Results. The analysis of changes in the laboratory test results revealed that hemoglobin levels in the groups after Gynestril therapy reached reference ranges in all women, averaging 123.4 ± 8.2 g/l as compared to the baseline value 84.3 ± 6.7 g/l, p < 0.05. It was also noted that ferritin levels increased significantly, averaging 12.2 ± 1.9 µg/l compared to the pre-treatment level 8.8 ±  0.8 µg/l, serum iron levels reached 12.8 ± 1.0 compared to the pre-treatment level 8.0 ± 0.8, and TIBC level reduced to 72.1 ± 3.5 compared to the pre-treatment level 96.7 ± 4.8 (p < 0.05).

Conclusions. A comprehensive multidisciplinary approach to the treatment of uterine fibroids, including preoperative therapy with Gynestril, myomectomy using occlusive and X-ray endovascular techniques preserved the reproductive function in 50 patients with symptomatic uterine fibroids and anaemia of various degrees of severity.
А rare clinical case of pregnancy and childbirth in a patient with an implanted neurostimulator for Оppenheim torsion dystonia (DYT-1)
Authors: Tkach A. V. , Sulima A. N. , Tkach V. V. , Babich T. Yu. , Suleymanova S. R.
Published: April 2023

The problems of planning, follow-up of pregnancy and childbirth in women with inherited extrapyramidal neurological disorders, including torsion dystonia, are represented by isolated cases and receive little literature coverage. Dystonia is a rare disease, the incidence of its various types is 300–400 patients per million (0.03%). Idiopathic torsion dystonia is a group of genetically determined hyperkinetic disorders, which refers to an extrapyramidal pathology of the central nervous system with a progressive course of the disease. This article presents the case follow-up of pregnancy and childbirth in a patient with torsion dystonia and chronic neurostimulation 1.5 years after implantation of the ActivaRC neurostimulation system without drug therapy. The patient has given birth via elective caesarean section while receiving neurostimulation via the ActivaRC system. This clinical observation shows that the physiological course of pregnancy in patients with this diagnosis is possible in case of its advance planning and correction of the DBS programming. A multidisciplinary approach to the management of a patient with generalized torsion dystonia and chronic neurostimulation made it possible to achieve a favourable pregnancy outcome for both mother and fetus. Follow-up of pregnancy in such patients requires a correction of the DBS programming and choosing the optimal timing and method for delivery. The routine follow-up clinical examination by a neurologist should be carried out both in the planning stage and throughout the entire period of pregnancy (end of the first trimester, weeks 21–23, 32–34), as well as in the postpartum period.
The estriol use in the perioperative period by patients with genital prolapse
Authors: Khashukoeva A. Z. , Nosova L. A. , Dmitrashko T. E. , Beslangurova Z. A. , Lyafisheva D. M. , Shokulova Z. Kh.
Published: April 2023

Introduction. Postmenopausal women in a state of oestrogen deficiency often experience pelvic prolapse with underlying genitourinary menopausal syndrome, when the progression of atrophic processes in the vaginal mucosa comes to the forefront.

Aim. To evaluate the results of the use of topical hormonal therapy in the perioperative period to improve the vaginal epithelial surface appearance in postmenopausal women who need surgical treatment of pelvic prolapse.

Materials and methods. A comparative prospective randomized clinical trial included 60 postmenopausal patients aged 60 to 69 years with a postmenopausal period of 10 to 20 years, suffering from POP-Q stage II–IV pelvic prolapse (ICS, 1996). All patients were recommended surgical treatment using vaginal approach. The treatment group (Group 1) included 30 patients who received topical hormonal therapy with an estriol drug (Ovestin cream, 1 mg/g) within 1 month before reconstructive plastic surgery. The comparison group (Group 2) included 30 patients who did not receive hormonal treatment in the perioperative period.

Results. No complications were observed in the treatment group after reconstructive plastic surgery in the early and late postoperative periods. In the comparison group, natural urination was not achieved in 9 of 30 (35.0%) women on Day 2 after surgery, in 4 of 30 (13.3%) patients on Day 3. Also in that group, 4 of 30 (13.3%) patients experienced infectious and inflammatory complications in the postoperative period, the mucous membrane healing in 5/30 (16.6%) patients took a long time, over 1 month.

Conclusions. The use of topical hormonal therapy with an estriol drug in the perioperative period in patients who require surgical treatment of pelvic prolapse results in the relief of vulvovaginal atrophy symptoms and adequate regeneration of the vaginal mucosa, which helps reduce the likelihood of complications in both early and late postoperative periods.
Comparative evaluation of test systems for determining premature rupture of membranes
Authors: Baev O. R. , Babich D. A. , Gaydarova A. R.
Published: April 2023

Introduction. Preterm premature rupture of the membranes (PPROM) is one of the most common pregnancy complications. PPROM as а cause of infectious complications poses the greatest danger with increasing duration of period without amniotic fluid (i.e., watchful waiting) in full-term pregnancy.

Aim. Comparative evaluation of  test systems for  the diagnosis of  premature rupture of  the membranes  (PROM) based on the determination of the pH of the vaginal contents, the detection of placental alpha macroglobulin-1 (PAMG) or insulin-like growth factor-binding protein 1 (IGFBP-1).

Materials and methods. The study included 52 patients at 22–41 weeks of gestation in whom, according to the clinical examination, it is impossible to exclude/confirm PROM. All women were examined for the detection of PROM using test systems: nitrazine pH test, immunochromatographic test for the detection of IGFBP-1 or PAMG-1. The sensitivity, specificity, accuracy, predictive value of positive and negative results were calculated.

Results. As a result of the study, premature rupture of the membranes was confirmed in 25 cases, and this diagnosis was excluded in 27 cases. In three observations, additional observation and examination were required due to the questionable interpretation of  the result due to a  test error. Sensitivity and specificity were 64.0  and 66.7% for  the nitrazine test, 95.8  and 92.3% for IGFBP-1, and 95.8 and 96.3% for PAMG-1.

Conclusion. The nitrazine test has low sensitivity and specificity, therefore, for the diagnosis of PROM, test systems based on the determination of PAMG-1 and IGFBP-1 should be used, which improves the quality of diagnosis, reduces the risk of complications and ensures the timely start of a set of measures appropriate to the clinical situation. A negative test result avoids unnecessary hospitalization and unnecessary interventions, which is important both from a medical and economic point of view.
Barriers and ways to overcome them when using an etonogestrel implant for contraception
Authors: Oboskalova T. A. , Vorontsova A. V. , Rosyuk E. A. , Koval M. V.
Published: April 2023

Introduction. One of the ways to increase adherence to contraceptives is to switch to prolonged contraceptives that do not require daily use.

Objective. Identify barriers to the use of Implanon by doctors and patients.

Materials and methods. At the first stage, we analyzed the results of using LARC with etonogestrel with 44 patients in the period from 2016–2019. Then, using Google-Forms, we conducted an online survey of 36 women of reproductive age (18–49 years old). At the third stage, we evaluated the results of a survey of 27 obstetricians and gynecologists who were trained in the “Clinical training program for  the introduction and removal of  a  subcutaneous contraceptive implant  (radiopaque implant, 68  mg of etonogestrel)” in Yekaterinburg. Microsoft Office Exel 2016 application software packages were used for statistical data processing.

Results. The majority of women – 80% (32) – wished to use implant with etonogestrel repeatedly. Women lack complete and real information about a subcutaneous implant with etonogestrel, which reduces the possibility of its use as a highly effective method of contraception. After the Implanon insertion/removal training, only 2 doctors (7.4%) voiced concerns about self-administration of the drug, and 25 (92.6%) cadets were ready for the introduction of a subcutaneous implant in practice and did not experience anxiety and fears before manipulation.

Conclusions. The main barrier in choosing an implant with etonogestrel n among women was low awareness of the mechanism of action, benefits and possible side effects of an implant with etonogestrel. Preliminary training-training of obstetricians and gynecologists with the possibility of self-administration of the drug on a dummy in conditions close to real, significantly increases the commitment of specialists to the use of the drug.
Echosonography’s accuracy of intrauterine pathology’s diagnostics in reproductive-age women
Authors: Ivanov I. A. , Kostуukov K. V. , Chernukha G. E.
Published: April 2023

Introduction. Accuracy of  transvaginal sonography  (TVS) is substantial as the  first-line approach of  intrauterine pathology diagnostics. However, TVS has some limitations and factors that reduce its accuracy have not been definitively determined.

Aim. To evaluate the diagnostic accuracy of echography in intrauterine pathology and identify factors affecting it. Materials and methods. The study included 250  women who underwent hysteroscopy with endometrial biopsy: 128  with endometrial polyps  (EP), 33  with endometrial hyperplasia  (EH), 28  with chronic endometritis  (CE) and 60  women without endometrial pathology.

Results. The sensitivity and specificity of ultrasound in diagnosis of EP was 64.8% and 77.9%, respectively, EH – 64.7% and 89.8%, CE – 39.3% and 90.1%. Cumulative intrauterine pathology’s sensitivity reached 94.7%, and the specificity – 15.0%, which indicates a significant amount of false positive results. The lowest accuracy was in CE, EP less than 0.6 cm and in the absence of abnormal uterine bleeding.

Conclusions. TVS has limitations in verifying a specific diagnosis and characterized by both hyper- and hypodiagnosis. The clinician should take into account the size of the EP and the presence of symptoms for choosing optimal management.
A case of successful delivery in a patient with large uterine leiomyoma
Authors: Yashchuk A. G. , Fatkullina D. A. , Yanbarisova A. R. , Berdigulova E. F. , Gurova Z. G. , Iskandarova A. R. , Gainanova Z. F.
Published: April 2023

Uterine leiomyoma occurs in women over 35 years of age in 25–30% and in pregnant women in about 3–12%. However, in 10% of pregnant women, it turns out to be an accidental finding and is detected by ultrasound examination in the first trimester of pregnancy Approximately 10–30% of pregnant women with uterine leiomyoma have complications during pregnancy, childbirth and the postpartum period. The article demonstrates a case of successful delivery in a patient with uterine myoma at full-term pregnancy with preservation of reproductive function in a maternity hospital of the 3rd level. In the period of 38–39 weeks, the patient was hospitalized in the maternity hospital. By the decision of the council, the pregnant woman was prepared for a planned operative delivery. A lower median laparotomy was performed for adequate access. Performed caesarean section in the lower segment according to Defler. During the operation, a live, full-term girl weighing 3600 g and height 53 cm, 7/8 points on the Apgar scale was extracted. On the left, along the anterior surface of the uterus in the bottom area, a subserous myomatous node on a pedicle is determined, measuring 300*220*150 mm. Blunt and sharp dissection of adhesions was performed, followed by removal of a myomatous node weighing more than 1 kg. The postoperative period was uneventful. The patient was discharged on the 5th day. In our clinical case, a successful myomectomy was performed during a planned caesarean section. This type of surgery can be considered a safe option in carefully selected cases and a cost-effective method. However, this method should be performed by experienced surgeons who are skilled in the technique and take into account the size and location of the myomatous node.
Gestational diabetes mellitus: state of art
Authors: Pletneva S. A. , Enkova E. V. , Khoperskaya O. V. , Shamarin S. V. , Enkova V. V.
Published: April 2023

Gestational diabetes mellitus (GDM) is a disease characterized by hyperglycemia, first established during pregnancy, while the concentration of venous plasma glucose should not exceed 6.9 mmol/l. As a rule, after childbirth, the disease regresses, but it does not pass without a trace for either the mother or the child. The consequences of gestational diabetes include an increased risk of cardiovascular diseases in the mother and type 2 diabetes, as well as diabetic fetopathy of the fetus and complications during pregnancy and childbirth: the threat of termination of pregnancy, premature birth, preeclampsia, polyhydramnios, high frequency of operative delivery and birth trauma. There is also a long-term risk of developing obesity, diabetes and cardiovascular diseases in a child. Gestational diabetes affects approximately 16.5% of pregnant women worldwide, an increase in the incidence is predicted due to an increase in the percentage of obese women. Gestational diabetes mellitus is a complication of gestation that is not easily diagnosed and poorly predicted, and therefore potentially threatening to any pregnancy, requiring, given the list of perinatal and long – term consequences for mother and child, pre-gravidar prevention, thorough diagnosis and mandatory treatment with permanent control of glycemia levels, ketonuria and instrumental monitoring: cardiotcography and ultrasound. A competent approach to pregnancy planning, the implementation of a screening program for GDM and timely correction in case of its detection is the key to the health of a woman and her unborn child.
Assessment of Saudi MEDs framework competence in performing clinical and practical skills by final-year medical students
Authors: Abdulghani Hamza Mohammad , Alrashid Rashid , Alhussain Fahad Abdulhakim , Alawbathani Turki Ali , Almutrafi Faisal Bander , Aldekhayel Waleed Dekhayel , Aljohani Sami Saeed , Alammari Salem Ali , Ahmad Tauseef
Published: April 2023

Clinical examinations and practical clinical skills are essential to guide diagnosis and treatment. Competency-based medical education (CBME) is high on today’s medical education agenda, and competence has become the unit of medical education planning in many countries. With the rise of medical education in Saudi Arabia, The Saudi MEDs initiative began as a means of achieving national consensus and developing necessary learning outcomes for medical schools. The aim of this study is to evaluate the final-year medical students’ core clinical competencies and identify the gaps between clinical skills in the Saudi MEDs framework and students’ actual achievement. Online data collection from all fifth-year medical students, to assess their clinical and procedural skills by using Objective Structured Clinical Examination (OSCE) scores and using a self-administered questionnaire that has been developed based on the Saudi MEDs framework. Eight clinical competencies were chosen out of the 17 after consulting the experts in this field. OSCE scores were checked for correlation with their self-assessment scores. The total OSCE scores of 323 students were evaluated which showed 93% of students have passed all eight competencies. Also, 304 students responded to the self-administered questionnaire in the current Saudi MEDs competencies 323 (response rate=94.11). The students were confident in the majority of the eight clinical competencies of the Saudi MEDs framework. Saudi MEDs framework has ensured that Saudi medical or health care education adapted to changing demands, critical competencies are not overlooked, teaching and learning, and evaluation are appropriate at medical schools by implementing the competency framework.
NIIF andamiaje normativo de la contabilidad de costo en la gestión financiera de las Pymes
Authors: Soto Aguirre Neirys , Falconí Mónica
Published: April 2023

El IASB (International Accounting Standards Board) creo las Normas Internacionales de Información Financiera (NIIF) para minimizar a través de la  homogeneización las múltiples diferencias presentes en los países, estas regulaciones estandarizados aplican en todas las ciencias contables, incluyendo la contabilidad de costo, esa que permite cuantificar los valores de los recursos utilizados, cuyas técnicas proveen el orden de la información monetaria,  dotando  a la gestión del análisis sobre la actividad económica y  la dirección en la que debe ir si desea mejorar su eficiencia económica, ahora bien, es necesario cumplir con las regulaciones contables, razón por la cual, el presente trabajo tiene como objetivo principal describir y categorizar de las normas contables NIIF para Pymes vinculadas con la contabilidad de costos, para esto realizamos una investigación de carácter documental, soportada en un estudio exploratorio realizado en el año 2022, de carácter descriptivo, en el contexto local del Ecuador. Como hallazgos principal se determinó que aún hay pymes que no aplican las NIIF.  Llegándose a determinar cómo consideración final, la necesidad de superar la debilidad procedimental, normativa y de regulaciones  que presentan algunas pymes en el Ecuador mediante el entendimiento y la praxis de estas normas relacionados con los costos, la intención es contribuir tanto al crecimiento como la formación  de los gerentes de las Pymes.
Modelo de gestión de talento humano para el sector turístico
Authors: Cárdenas Guananga Adriana , Alarcón Quinapanta Mónica
Published: April 2023

El Talento Humano constituye uno de los ejes fundamentales en las empresas, sin embargo, se identifican necesidades acuciantes que limitan el desarrollo organizacional, entre las que se aprecian: la inadecuada asignación de recursos, carencia de incentivos, reconocimientos, deficiente capacitación, entre otros. Dado que, los trabajadores son la clave del crecimiento y logro de objetivos empresariales, se propone mejorar la gestión del personal del sector, alcanzar la satisfacción laboral y así, generar un adecuado ambiente de trabajo en procura de elevar la productividad en las organizaciones turísticas. Por tanto, el objetivo de la investigación es desarrollar un modelo de gestión del talento humano basado en procesos para la adecuada administración de empresas turísticas. Por lo que, la investigación es de tipo descriptiva, con enfoque mixto, además de aplicar métodos analíticos sintéticos, históricos lógicos e inductivos deductivos. Así, como vincularlos a técnicas e instrumentos para la recolección de datos y su respectiva interpretación. En tal sentido, el modelo de gestión incorpora componentes de planificación, dirección y control que coadyuvan con la mejora del trabajo de los empleados, con un enfoque de procesos que lo convierte en una herramienta eficaz que facilite la consecución de resultados positivos en las empresas turísticas.
acuerdo multipartes Unión Europea - Ecuador: una perspectiva imbabureña de la inversión extranjera directa
Authors: Revelo Portilla Irene , Coronel Pinduisaca Marcela , Andrade Ortega Alfonsina
Published: April 2023

El acuerdo comercial multipartes entre Ecuador y la Unión Europea, es motivo de análisis respecto a la conveniencia o no de su firma una vez entrada en vigencia en el 2017, específicamente en el sector de la inversión extranjera directa. Existen diversos análisis a nivel de país y a nivel de sectores sobre este tema, sin embargo, se ha visto necesario analizarlo desde la visión de expertos imbabureños directos e indirectos; esta investigación es de corte descriptiva no experimental con la aplicación de entrevistas, así como con la recopilación documental con fines comparativos. Como resultado concuerdan los entrevistados en que los inversionistas se enfrentan a amenazas de índole tributario, político, laboral y medioambiental, por lo que el Estado debe fortalecerse en materia de inversiones y hacer más atractivo a sectores no tradicionales como el de la construcción y extracción minera.
sostenibilidad turística en el contexto Covid-19. Impresiones de los turistas que visitan la ciudad creativa UNESCO Portoviejo
Authors: Vera Vera Rafael , Veloz Camejo Fernando
Published: April 2023

Esta investigación tuvo como propósito analizar la impresión de los visitantes de la Ciudad Creativa UNESCO Portoviejo sobre la sostenibilidad turística en el contexto del COVID-19. Inicialmente se realizó una contextualización geográfica y multidimensional del área destino, seguida de una encuesta a los visitantes con cinco grupos de preguntas (perfil del visitante, potencial de las diversas formas de turismo en el destino, preferencia sobre actividades turísticas, factores que inciden en la decisión de viaje en el contexto de la pandemia y grado de conocimiento sobre “sostenibilidad turística”) cuatro grupos fueron analizados mediante el SPSS y los datos derivados de la pregunta abierta, se procesaron mediante el software de análisis cualitativo Atlas.ti. 9.1. La gastronomía resultó como el elemento más significativo; como principal actividad el esparcimiento; el 71,4% de los encuestados indicó que tiene una impresión negativa sobre el manejo de desechos generados en la pandemia y las estadísticas de contagios fueron el factor más decisivo para la visita. Se encontró que la mayoría de los visitantes poseen un nivel de conocimiento bajo sobre sostenibilidad turística y orientado a la dimensión ambiental. Se concluye que la demanda turística debe sensibilizarse más sobre las implicaciones teórico-prácticas de la sostenibilidad en el turismo.
A Trainable Open-Source Machine Learning Accelerometer Activity Recognition Toolbox: Deep Learning Approach
Authors: Wieland Fluri , Nigg Claudio
Published: April 2023

Background

The accuracy of movement determination software in current activity trackers is insufficient for scientific applications, which are also not open-source.

Objective

To address this issue, we developed an accurate, trainable, and open-source smartphone-based activity-tracking toolbox that consists of an Android app (HumanActivityRecorder) and 2 different deep learning algorithms that can be adapted to new behaviors.

Methods

We employed a semisupervised deep learning approach to identify the different classes of activity based on accelerometry and gyroscope data, using both our own data and open competition data.

Results

Our approach is robust against variation in sampling rate and sensor dimensional input and achieved an accuracy of around 87% in classifying 6 different behaviors on both our own recorded data and the MotionSense data. However, if the dimension-adaptive neural architecture model is tested on our own data, the accuracy drops to 26%, which demonstrates the superiority of our algorithm, which performs at 63% on the MotionSense data used to train the dimension-adaptive neural architecture model.

Conclusions

HumanActivityRecorder is a versatile, retrainable, open-source, and accurate toolbox that is continually tested on new data. This enables researchers to adapt to the behavior being measured and achieve repeatability in scientific studies.
Few-Shot Learning for Clinical Natural Language Processing Using Siamese Neural Networks: Algorithm Development and Validation Study
Authors: Oniani David , Chandrasekar Premkumar , Sivarajkumar Sonish , Wang Yanshan
Published: April 2023

Background

Natural language processing (NLP) has become an emerging technology in health care that leverages a large amount of free-text data in electronic health records to improve patient care, support clinical decisions, and facilitate clinical and translational science research. Recently, deep learning has achieved state-of-the-art performance in many clinical NLP tasks. However, training deep learning models often requires large, annotated data sets, which are normally not publicly available and can be time-consuming to build in clinical domains. Working with smaller annotated data sets is typical in clinical NLP; therefore, ensuring that deep learning models perform well is crucial for real-world clinical NLP applications. A widely adopted approach is fine-tuning existing pretrained language models, but these attempts fall short when the training data set contains only a few annotated samples. Few-shot learning (FSL) has recently been investigated to tackle this problem. Siamese neural network (SNN) has been widely used as an FSL approach in computer vision but has not been studied well in NLP. Furthermore, the literature on its applications in clinical domains is scarce.

Objective

The aim of our study is to propose and evaluate SNN-based approaches for few-shot clinical NLP tasks.

Methods

We propose 2 SNN-based FSL approaches, including pretrained SNN and SNN with second-order embeddings. We evaluate the proposed approaches on the clinical sentence classification task. We experiment with 3 few-shot settings, including 4-shot, 8-shot, and 16-shot learning. The clinical NLP task is benchmarked using the following 4 pretrained language models: bidirectional encoder representations from transformers (BERT), BERT for biomedical text mining (BioBERT), BioBERT trained on clinical notes (BioClinicalBERT), and generative pretrained transformer 2 (GPT-2). We also present a performance comparison between SNN-based approaches and the prompt-based GPT-2 approach.

Results

In 4-shot sentence classification tasks, GPT-2 had the highest precision (0.63), but its recall (0.38) and F score (0.42) were lower than those of BioBERT-based pretrained SNN (0.45 and 0.46, respectively). In both 8-shot and 16-shot settings, SNN-based approaches outperformed GPT-2 in all 3 metrics of precision, recall, and F score.

Conclusions

The experimental results verified the effectiveness of the proposed SNN approaches for few-shot clinical NLP tasks.
Impact of GPT on the Academic Ecosystem (Preprint)
Authors: Cai Yudong , Deng Qiyue , Lv Ting , Zhang Wan , Zhou Yi
Published: April 2023

UNSTRUCTURED

In recent months, GPT-like technologies such as OpenAI's ChatGPT, Microsoft's New Bing, and Google's Bard have sparked lively discussions in various industries, from Internet companies to traditional education. What impact will the advent of GPT have on the academia? In this retrospective and forward-looking review, the authors not only reviewed and discussed the history and impact of GPT technology on the academic ecosystem, but also propose that creative questions posed to GPT can become a new way of acquiring knowledge, allowing individuals to contribute to the process of knowledge accumulation. For academic researchers, GPT can improve academic writing by generating high-quality natural language drafts and reduce the burden of language issues, especially for non-native English speakers. Its integration with existing data processing software can make complex tasks accessible to researchers without programming skills. In addition, GPT can make scientific knowledge more accessible to the general public and help share research results. For journal editors, GPT can be integrated into various aspects of academic publishing, such as manuscript classification, literature generation, manuscript reviewing and fundamentally change the way of journal editing. For academic services, GPT can provide more precise suggestions based on user's fuzzy needs. It can also assist in meta-analysis tasks by automatically generating abstracts and summaries. Furthermore, GPT can improve academic integrity by comparing results and spotting fake data. Overall, GPT has the potential to significantly impact the academic ecosystem, but further optimization and careful implementation are needed to address concerns and fully realize its benefits.
Risk of Subsequent Primary Cancers Among Adult-Onset 5-Year Cancer Survivors in South Korea: Retrospective Cohort Study (Preprint)
Authors: Choi Yoon Young , Lee Myeongjee , Kim Eun Hwa , Lee Jae Eun , Jung Inkyung , Cheong Jae-Ho
Published: April 2023

BACKGROUND

The number of cancer survivors who develop subsequent primary cancers (SPCs) is expected to increase.

OBJECTIVE

We evaluated the overall and cancer type–specific risks of SPCs among adult-onset cancer survivors by first primary cancer (FPC) types considering sex and age.

METHODS

We conducted a retrospective cohort study using the Health Insurance Review and Assessment database of South Korea including 5-year cancer survivors diagnosed with an FPC in 2009 to 2010 and followed them until December 31, 2019. We measured the SPC incidence per 10,000 person-years and the standardized incidence ratio (SIR) compared with the incidence expected in the general population.

RESULTS

Among 266,241 survivors (mean age at FPC: 55.7 years; 149,352/266,241, 56.1% women), 7348 SPCs occurred during 1,003,008 person-years of follow-up (median 4.3 years), representing a 26% lower risk of developing SPCs (SIR 0.74, 95% CI 0.72-0.76). Overall, men with 14 of the 20 FPC types had a significantly lower risk of developing any SPCs; women with 7 of the 21 FPC types had a significantly lower risk of developing any SPCs. The risk of developing any SPC type differed by age; the risk was 28% higher in young (<40 years) cancer survivors (SIR 1.28, 95% CI 1.16-1.42; incidence: 30 per 10,000 person-years) and 27% lower in middle-aged and older (≥40 years) cancer survivors (SIR 0.73, 95% CI 0.71-0.74; incidence: 80 per 10,000 person-years) compared with the age-corresponding general population. The most common types of FPCs were mainly observed as SPCs in cancer survivors, with lung (21.6%) and prostate (15.2%) cancers in men and breast (18.9%) and lung (12.2%) cancers in women. The risks of brain cancer in colorectal cancer survivors, lung cancer in laryngeal cancer survivors, and both kidney cancer and leukemia in thyroid cancer survivors were significantly higher for both sexes. Other high-risk SPCs varied by FPC type and sex. Strong positive associations among smoking-related cancers, such as laryngeal, head and neck, lung, and esophageal cancers, were observed. Substantial variation existed in the associations between specific types of FPC and specific types of SPC risk, which may be linked to hereditary cancer syndrome: for women, the risks of ovarian cancer for breast cancer survivors and uterus cancers for colorectal cancer survivors, and for men, the risk of pancreas cancer for kidney cancer survivors.

CONCLUSIONS

The varying risk for SPCs by age, sex, and FPC types in cancer survivors implies the necessity for tailored prevention and screening programs targeting cancer survivors. Lifestyle modifications, such as smoking cessation, are essential to reduce the risk of SPCs in cancer survivors. In addition, genetic testing, along with proactive cancer screening and prevention strategies, should be implemented for young cancer survivors because of their elevated risk of developing SPCs.
Fairness and Bias in Artificial Intelligence: A Brief Survey of Sources, Impacts, and Mitigation Strategies (Preprint)
Authors: Ferrara Emilio
Published: April 2023

BACKGROUND

The significant advancements in applying Artificial Intelligence (AI) to healthcare decision-making, medical diagnosis, and other domains have simultaneously raised concerns about the fairness and bias of AI systems, particularly in areas like healthcare, employment, criminal justice, and credit scoring. Such systems can lead to unfair outcomes and perpetuate existing inequalities. This survey paper offers a succinct, comprehensive overview of fairness and bias in AI, addressing their sources, impacts, and mitigation strategies.

OBJECTIVE

We review sources of bias, such as data, algorithm, and human decision biases, and assess the societal impact of biased AI systems, focusing on the perpetuation of inequalities and the reinforcement of harmful stereotypes. We explore various proposed mitigation strategies, discussing the ethical considerations of their implementation and emphasizing the need for interdisciplinary collaboration to ensure effectiveness.

METHODS

Through a systematic literature review spanning multiple academic disciplines, we present definitions of AI bias and its different types, and discuss the negative impacts of AI bias on individuals and society. We also provide an overview of current approaches to mitigate AI bias, including data pre-processing, model selection, and post-processing.

RESULTS

Addressing bias in AI requires a holistic approach, involving diverse and representative datasets, enhanced transparency and accountability in AI systems, and the exploration of alternative AI paradigms that prioritize fairness and ethical considerations.

CONCLUSIONS

This survey contributes to the ongoing discussion on developing fair and unbiased AI systems by providing an overview of the sources, impacts, and mitigation strategies related to AI bias.
Вплив обсягу резекції на віддалені хірургічні результати при дифузній астроцитомі II ступеня: ретроспективне дослідження
Authors: Chaulagain Dipak , Smolanka V. , Smolanka A. , Havryliv T.
Published: April 2023

Актуальність. Дифузні астроцитоми (ДА) — це повільно зростаючі первинні дифузні пухлини головного мозку, що походять з гліальних клітин. У складі гліоми низького ступеня злоякісності ДА II ступеня є пухлиною з нечіткими межами; невеликі скупчення пухлинних клітин мають тенденцію поширюватися в прилеглі здорові тканини та проникати в них. Основні дебати точаться навколо прогностичного значення обсягу резекції (ОР) при ДА. Щоб оцінити вплив ОР на результати хірургічного втручання при ДА II ступеня в довгостроковій перспективі, ми провели ретроспективний аналіз. Зокрема, метою було оцінити кореляцію між до- та післяопераційними розмірами пухлини та загальною виживаністю (ЗВ). Матеріали та методи. Пацієнти з діагнозом дифузної астроцитоми, установленим між 2010 і 2020 роками, які перенесли операцію з видалення пухлини, а потім знаходилися під спостереженням до січня 2022 року, були включені в наш ретроспективний огляд. ОР визначали як передопераційний об’єм мінус післяопераційний об’єм, поділений на передопераційний об’єм, помножений на 100 %, а потім класифікували в п’ять груп на основі результатів магнітно-резонансної томографії, отриманих через 72 години після втручання. Існує п’ять категорій: 1) > 99 % — тотальна резекція; 2) 91–99%— майже тотальна резекція; 3) 70–90 % — субтотальна резекція; 4)70%— часткова резекція; 5) біопсія. Незалежний зв’язок між ОР та наступною ЗВ аналізували за допомогою багатовимірної регресійної моделі пропорційних ризиків. ­Результати. Зрештою, ми включили до нашого дослідження 18 випадків. Усі пацієнти мали середню виживаність 35,33 місяця: 38 місяців у чоловіків (n = 12, середній вік 40,83 року) і 22 місяці в жінок (n = 6, середній вік 32 роки). Ми розділили спостережувані періоди виживання пацієнтів на п’ять різних класів на основі ОР. Виявлено, що вищий показник ОР передбачає кращий прогноз у дорослих осіб із дифузною астроцитомою. Не було статистично значущої кореляції між до- або післяопераційним об’ємом пухлини та ЗВ, як визначено регресійним аналізом. Висновки. Вищий показник ОР вказує на кращий прогноз у пацієнтів із дифузною астроцитомою. Наші результати підтверджують необхідність переоцінкі хірургічної ефективності при дифузній астроцитомі та підтримують використання максимальної резекції як початкового методу лікування. Виживаність пацієнтів, напевно, не залежить від розміру видаленої пухлини.