bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the body balance of patients with complete adentia
Authors: Черкашин Б.Ф. , Фурцев Т.В. , Федорова Д.Д. , Ондар В.С.
Published: December 2023

В данной статье рассмотрены данные статокинезиограмм пациентов с полной вторичной адентией, прошедших успешную реабилитацию полными съемными протезами, изготовленными различными способами. Проведено исследование баланса тела в основной стойке человека методом стабилометрии у пациентов с протезами, изготовленными по различным методикам, в контрольной и основной группах. Для исследования использовали компьютерный стабилоанализатор с биологической обратной связью (МБН, Москва). При двух различных методиках протезирования получены различные данные об изменении площади статокинезиограммы, скорости перемещения отклонения от общего центра давления (ОЦД) и среднем отклонении ОЦД во фронтальной и сагиттальной плоскостях. Среднее ОЦД в основной группе в среднем в 2 раза меньше, чем в контрольной. Протезы, изготовленные различными способами, также различно влияют на постуральный баланс больного.

In this article discusses the data of statokinesiograms of patients with complete secondary adentia who underwent successful rehabilitation with full-removable dentures made in various ways. . The study of body balance in the main human’s stand was carried out by stabilometry on patients with dentures witch were made by different methods, in the control and experimental groups. For the study, a computer stabiloanalyzer with biofeedback (MBN, Russia) was used. . Two different prosthetic techniques yielded different data on statokinesiogram area change, rate of movement of deviation from the common center of pressure (CCD), and mean CCD deviation in the frontal and sagittal planes. The mean CCD in the main group was approximately 2 times less than in the control group. . Prostheses fabricated in different ways also differentially affects the patient’s postural balance.
Oral virome: the beginning of the path (review)
Authors: Балмасова И.П. , Царев В.Н. , Гветадзе Р.Ш. , Мустафаев М.Ш. , Царева Т.В. , Малова Е.С. , Арутюнов Д.С. , Тимощенко М.В. , Харах Я.Н. , Арутюнов С.Д.
Published: December 2023

Виром полости рта человека — составная часть микробиома как сообщества микроорганизмов, населяющих полость рта, включает вирусы эукариот, персистирующие в организме человека, и вирусы прокариот (бактериофаги). Виром выполняет важнейшие физиологические функции по защите организма человека от патогенов через контроль состава микробиома, влияние на формирование биопленок, иммуномодулирующие эффекты, играет огромную роль в эволюции человека в целом, но нередко служит источником тяжелых заболеваний. Среди вирусов, населяющих полость рта, ведущая роль в развитии патологических состояний этой локализации, в частности заболеваний пародонта, принадлежит герпесвирусам (вирусу Эпштейна—Барр, цитомегаловирусу), этиопатогенетическое значение которых расшифровано лишь отчасти и его предстоит уточнить. С другой стороны, вирусы можно использовать как полезные агенты в борьбе с заболеваниями полости рта, в частности перспективно применение бактериофагов, хотя условия и варианты их использования нуждаются в дальнейшем изучении.

The human oral virome is a part of the microbiome as a community of microorganisms inhabiting the oral cavity, includes eukaryotic viruses that persist in the human body and microbial viruses (bacteriophages). Virome performs the most important physiological functions to protect the human body from pathogens through the control of the microbiome composition, the impact on the formation of biofilms, immunomodulatory effects, plays a huge role in the human evolution as a whole, but often serves as a source of serious diseases. Among the eukaryotic viruses inhabiting the oral cavity, the leading role in the development of pathological conditions of this localization, in particular, periodontal diseases, belongs to herpesviruses (Epstein—Barr virus, cytomegalovirus), the etiopathogenetic significance of which is only partially deciphered and it remains to be clarified. In the fight against diseases of the oral cavity, the use of bacteriophages is promising, although the conditions and variants for their use need further study.
Analysis of modern approaches in the treatment of inflammatory diseases of the oral cavity (review)
Authors: Рыжова И.П. , Погосян Н.М. , Гонтарев С.Н. , Чуев В.В. , Гонтарева И.С. , Чуева А.А.
Published: December 2023

Воспалительные процессы являются достаточно частым явлением в практике врача-стоматолога. Причиной их возникновения может быть как неудовлетворительная самостоятельная гигиена полости рта, так и последствие терапевтических, хирургических и ортопедических манипуляций. В связи с этим поиск путей быстрого, эффективного и максимально безопасного купирования воспаления является важной актуальной профессиональной задачей и рекомендацией для индивидуального решения конкретного пациента. В статье проведен анализ литературы, посвященной использованию медикаментозных и растительных препаратов как в общем, так и в местном лечении воспалительных заболеваний полости рта. Описаны важные фармакологические и клинические эффекты от применения различных подходов в профилактике, лечении и реабилитации стоматологических пациентов.

Inflammatory disease could be often manifestations in the oral cavity. The reason of this process are allergic reactions, trauma, and also consequence of surgical, prostethic and terapia treatment. Poor oral hygiene, biofilm of teeth, crowns and implants could be a main reason of inflammatory processes. But the reason of inflammatory diseases also could be a medicament treatment, especially treatment of oncodiseases. As we know bisphosphate therapy is a main cause of chemical osteonecrosis. The traditional methods to the treatment of this pathology is mechanical and local drug treatment of the affected area with antiseptic solutions, and in some cases local antibacterial therapy is connected. Also, one of the most common methods of treatment, as well as prevention, is the use of herbal preparations. In this regard, the search for ways to quickly, effectively and maximize the relief of the inflammatory process is an important urgent professional task.
Denticles: study diagnostic and perspectives of treatment (a review, part II)
Authors: Осипова В.А. , Молокова В.А. , Антонова И.Н. , Коляда А.А.
Published: December 2023

Проблема образования кальцификатов, дентиклей в пульпе, была описана еще в XIX в. Первоначально использовался термин «узелки» пульпы зуба (dental pulp nodules), позже он был изменен на «камни пульпы» («pulp stone») или «дентикли» («denticle»). В современных зарубежных исследованиях используются термины «pulp stone» и «denticle». Благодаря новым методам исследования стало возможно изучение химического состава, формы и строения дентиклей. В последние годы были усовершенствованы методы диагностики, появились способы безопасного извлечения дентиклей в процессе эндодонтического лечения. Актуальность исследования обусловлена недостаточным числом отечественных исследований, посвященных диагностике и лечению дентиклей. Цель — обзор исследований, посвященных современным методам диагностики и лечения дентиклей. Знания о клинических проблемах, связанных с дентиклями, современных методах диагностики и лечения помогут практикующему стоматологу в достижении успешных результатов. Диагностика камней пульпы может быть полезна для раннего выявления кальцификаций в других частях тела, включая сердечно-сосудистую систему и почки.

The problem of the formation of calcifications, denticles in the pulp, was described as early as the 19th century. Initially, the term “dental pulp nodules” was used, later it was changed to “pulp stones” or “denticles”. In modern foreign studies, the terms “pulp stone” and “denticle” are used. Thanks to new research methods, it became possible to study the chemical composition, shape and structure of denticles. In recent years, diagnostic methods have been improved, and methods for safely extracting denticles during endodontic treatment have appeared. The relevance of the study is due to the insufficient number of domestic studies on the diagnosis and treatment of denticles. The purpose of the study is to review studies on modern methods of diagnosis and treatment of denticles. . Knowledge of the clinical problems associated with denticles, modern methods of diagnosis and treatment can help the dental practitioner achieve successful results. Diagnosis of pulpal stones may be useful for early detection of calcifications in other parts of the body, including the cardiovascular system and kidneys.
Opinions of Intern Nursing Students About Being a Peer Educator in Nursing Skills Laboratory
Authors: KORKUT Sevda , BAŞER Mürüvvet
Published: December 2023

This research was conducted to determine the opinions of intern nursing students about being a peer educator in the nursing skills laboratory. This descriptive study was carried out with 119 intern nursing students who participated as peer educators in the nursing skills laboratory. The data were collected at the end of 2018-2019 academic year. The data of the research were collected using the Individual Characteristics Form and Peer Education Opinion Form. The majority of the intern students who participated in the nursing skills laboratory as peer educators stated that they were satisfied with this teaching method. The students stated that this method had a positive effect on their cognitive, psychomotor and affective development. 90.8% of the students stated that they had good relations with their peers and 80.7% of them wanted to be a peer educator again. It is recommended to use peer education method in nursing education by integrating it with existing teaching methods.
Online İntörnlük Stajının Hemşirelik Öğrencilerinin Duygusal Zeka Düzeylerine Etkisi: Tek Gruplu Yarı Deneysel Çalışma
Authors: ÇİNGÖL Nurhan , ZENGİN Seher , KARAKAŞ Mehmet , ÇELEBİ Ebru
Published: December 2023

Çalışmanın amacı intörnlük stajının hemşirelik dördüncü sınıf öğrencilerinin duygusal zeka düzeylerine etkisini belirlemektir. Araştırma, ön test ve son test kullanılarak yapılan tek gruplu yarı deneysel tasarımda bir çalışmadır. Çalışmanın verileri 2019-2020 Eğitim-Öğretim yılı bahar döneminde hemşirelik bölümünde intörnlük stajına çıkan 90 öğrenci ile, Tanıtıcı Bilgi Formu ve Duygusal Zeka Değerlendirme Ölçeği kullanılarak toplanmıştır. Çalışmada tüm intörnlük alanlarında Duygusal Zeka Değerlendirme Ölçeği ön test–son test puanları açısından istatistiksel olarak anlamlı farklılık tespit edilmiştir (p
Kronik Hastalığı Olan Bireylerin COVID-19 Korkusu ve Kronik Hastalıklara Uyumları Arasındaki İlişki
Authors: ATAMAN BOR Neşe , YURTÇİÇEK EREN Saliha , YILDIRIM Ömer
Published: December 2023

Araştırma, kronik hastalığı olan bireylerin COVID-19 korkusu ve kronik hastalıklara uyumları arasındaki ilişkiyi belirlemek amacıyla planlandı. Tanımlayıcı tipte olan araştırmanın, evrenini Hakkari İli'nde yaşayan en az bir kronik hastalığı olan bireyler, örneklemini ise kolayda örnekleme yöntemi ile araştırmacıların kendi sosyal medya hesaplarına ekli en az 1 kronik hastalığı olan gönüllü 419 birey oluşturdu. Etik kurul izni alınan çalışmada veriler, Kişisel Tanıtıcı Bilgi Formu, COVID-19 Korkusu Ölçeği (COVID-19 KÖ) ile Kronik Hastalıklara Uyum Ölçeği (KHUÖ) kullanılarak toplandı. Araştırmadaki bireylerin yaş ortalaması 32,35±17,45, %59,4'si kadındır. Katılımcıların %41,8'i nörolojik, kalp damar ve kanser gibi hastalıklarının olduğunu, %24,3'ü kendileri ve %75,5'i yakınlarının COVID-19 geçirdiğini bildirdi. Yine katılımcıların COVID-19 KÖ puan ortalaması 19,10±7,53 ve KHUÖ puan ortalaması 73,75±18,85’tir. Katılımcıların yaşı arttıkça COVID-19 korkusunda da anlamlı bir artış olduğu saptandı. Kadınların COVID-19 KÖ ve KHUÖ fiziksel uyum alt boyut puan ortalamasının erkeklere göre anlamlı düzeyde yüksek olduğu bulundu (p
Voleybol Oyuncularında Öz Şefkat ile Öz Eleştiri Arasındaki İlişki
Authors: ŞENEL Ebru , KARAKUŞ Kaan , ÇAKICI Hacı Ali
Published: December 2023

Bu araştırmanın amacı, profesyonel voleybol oyuncularında öz eleştirileri ile öz şefkat düzeyleri arasındaki ilişkiyi incelemektedir. Çalışmada, ilişkisel tarama modeli kullanılmıştır. Çalışma grubu (72 erkek, 52 kadın) 124 sporcudan oluşmaktadır. Veri toplama araçları olarak ‘‘Sporcu Durumluk Öz Eleştiri Ölçeği’’, ‘‘Sporcu Öz Şefkat Ölçeği’’ ve kişisel bilgi formu kullanılmıştır. Verilerin analizinde Bağımsız Örneklem T-Testi, Tek Yönlü Varyans Analizi (ANOVA) testi ve Pearson korelasyon analizi kullanılmıştır. Analiz sonuçlarında sporcu durumluk öz eleştiri puanlarında, cinsiyet ve spor yılı değişkenine göre anlamlı farklılık olduğu tespit edilmiştir. Yaş değişkenine göre durumluk öz eleştiri puanları arasında anlamlı farklılık saptanmamıştır. Sporcu öz şefkat puanlarında, cinsiyet değişkenine göre anlamlı farklılık belirlenmemiştir. Yaş ve spor yılı değişkenlerine göre öz şefkat puanlarında anlamlı farklılık görülmüştür. Korelasyon analizi sonucuna göre sporcularda öz eleştirileri ile öz şefkat düzeyleri arasında anlamlı ilişki saptanmamıştır. Sonuç olarak, voleybol oyuncularında öz eleştiri ile öz şefkat düzeyleri arasında bir ilişki olmadığı görülmektedir.
Obezite Hastalığına Sebep Olan Faktörlerin Analitik Hiyerarşi Prosesi (AHP) Yöntemiyle Değerlendirilmesi
Authors: BOLAYIR Banu , ÖLÇER Dilara , TEKBIYIK Bora , KARA Gökdeniz , ÇATUK Hülya
Published: December 2023

Bu çalışmada, obezite hastalığına sebep olan faktörlerin önem sıralamasının yapılmasıyla yeterli, dengeli ve sağlıklı beslenmenin önemini vurgulamak, toplumda sağlıklı beslenme bilinci oluşturmak ve obezite hastalığı konusunda farkındalık oluşturmak amaçlanmaktadır. Çalışmada obezite hastalığına sebep olan ana faktörleri ve bu ana faktörlere ait alt faktörleri belirlemek için literatür araştırması yapılmış ve bu konuda uzman olan beslenme ve diyetetik alanındaki akademisyenlerin görüşleri alınmıştır. Belirlenen ana faktörler ve alt faktörlere göre ikili karşılaştırmalı bir anket formu hazırlanmıştır. Anket formu, çalışma için belirlenen 7 uzmana doldurtulmuştur. Anket formlarından elde edilen verilerin analizinde Microsoft Excel programı kullanılarak Analitik Hiyerarşi Prosesi (AHP) yöntemi uygulanmıştır. Analiz sonuçlarına göre ana faktörler arasında obezite hastalığına sebep olan faktörlerin en fazla önemliden en az önemliye doğru önem sıralaması; beslenme alışkanlıkları, fiziksel aktivite, sağlıklı beslenme bilinci, genetik hastalık ve metabolik hastalık, cinsiyet, yaş, psikolojik etkiler, sosyokültürel ve çevresel etmenler olarak bulunmuştur. Ayrıca obezite hastalığına sebep olan her bir ana faktörün alt faktörleri için de ayrı ayrı önem sıralamaları yapılmıştır. Buna göre önem sıralamaları bakımından ana faktörler içindeki en önemli alt faktörler; fiziksel aktivite yetersizliği, yağlı ve karbonhidrat ağırlıklı beslenme, kadın, fastfood tüketim bilinci, genetik hastalık, yaşla birlikte azalan enerji gereksinimi, yoğun tedavi gerektiren kronik hastalıklar, gelir durumu olarak bulunmuştur.
Taraftarın Marka Çağrışımları: Gümüşhanespor Örneği
Authors: BAYRAKDAROĞLU Yeşim , ALBAYRAK Ahmet Yilmaz , ULUTAŞDEMİR Nilgün , TEKİN Ali
Published: December 2023

Bu çalışma, Gümüşhanespor taraftarı olan katılımcıların spor kulüplerinin marka çağrışımlarını nasıl tanıdıklarını ve marka çağrışımlarının belirli demografik özelliklere göre nasıl farklılaştığını araştırmıştır. Çalışmaya Gümüşhane sporunu seven 350 kadın ve 897 erkek gönüllü olarak katılmıştır. Araştırmada "Futbol Takımlarında Marka İlişkilendirme Ölçeği" kullanılmıştır. İlgili istatistik programı yardımıyla çeşitli testler yapılmış ve sonuçlara ulaşılmıştır. Çalışma sonuçlarını yorumlamak için çeşitli değişkenler kullanılmıştır. Ayrıca futbol taraftarlarının stadyumla ilgili marka çağrışımlarının orta seviyenin altında, teknik direktör ve yönetim ile ilgili marka çağrışımlarının orta düzeyde olduğu; başarı, yıldız oyuncu, kulüp geçmişi, marka notları, mesafe, taraftar sözleşmesi, sosyal etkileşim marka çağrışımları orta seviyenin üzerinde olduğu saptanmıştır.
Futbolcularda Kas Kuvveti ve Anaerobik Gücün Şut Hızına Etkisi
Authors: AYDIN Mustafa , CAN İbrahim , BAYRAKDAROĞLU Serdar
Published: December 2023

Bu çalışmanın amacı, Gümüşhane ilindeki amatör futbolcuların ayaküstü vuruş tekniği kullanarak farklı mesafelerden gerçekleştirdikleri vuruşlar esnasındaki şut hızlarının kas kuvveti ve anaerobik performans parametreleri ile ilişkisinin araştırılmasıdır. Bu amaç doğrultusunda, Gümüşhanespor U19, Kösespor ve Gümüşhane Üniversitesi futbol takımı oyuncularından toplam 23 erkek futbolcu çalışmaya gönüllü olarak katılmıştır. Çalışmada, katılımcıların alt eksremite ölçümü için tam squat hareketinde bir tekrarlı maksimal (1TM) kuvvet testi, anaerobik performanslarını ölçmek için Wingate anaerobik güç testi (WanT) testi uygulanmıştır. Katılımcıların şut hızları ise ayaküstü vuruş tekniği kullanılarak farklı mesafelerden (9m, 11m ve 13 m) gerçekleştirilmiştir. Verilerin analizinde; normallik testi, pearson korelasyon analizi ve çoklu regresyon analizi kullanılmıştır. Analiz sonuçlarına göre, tam squat hareketindeki 1TM değeri ile 9 ve 11 metre mesafeden gerçekleştirilen ayaküstü vuruş sırasındaki şut hızları arasında pozitif yönde ve istatistiksel olarak anlamlı bir ilişki olduğu elde edilmiştir. 9 metre mesafeden gerçekleştirilen vuruşlardaki şut hızı ile mutlak zirve güç (ZG) ve ortalama güç (OG) değerleri arasında; 11 metreden gerçekleştirilen vuruşlardaki hız değerleri ile mutlak OG ve hem mutlak hem de relatif ZG değerleri arasında; 13 metrelik mesafeden gerçekleştirilen vuruşlardaki şut hızları ile hem mutlak hem de relatif ZG ve OG değerleri arasında pozitif yönde ve istatistiksel olarak anlamlı bir ilişki olduğu elde edilmiştir. Bunun haricinde, şut hızları ile diğer parametreler arasında istatistiksel olarak anlamlı bir ilişkinin olmadığı elde edilmiştir. Sonuç olarak, topa vuruş mesafesi arttıkça kas kuvveti etkisinin azaldığı ama anaerobik performansın daha önemli bir bileşen olarak öne çıktığı ileri sürülebilir.
Üniversite Öğrencilerinin E-Öğrenme Tutum Düzeylerinin İncelenmesi: Spor Bilimleri Fakültesi Örneği
Authors: AKGÜL Aygün , GÖKSEL Ali Gürel , YARAŞ Abdurrahman
Published: December 2023

Etkili ve verimli bir eğitim sisteminin oluşturulması için her bir öğrenciye ulaşılması gerekmektedir. Gerekli alt yapının oluşturulmasından sonra e-öğrenme aracılığıyla bireyler, zaman ve mekân fark etmeksizin istedikleri zamanda ve yerde ulaşmayı amaçladıkları bilgilere erişim sağlayabilmektedir. İstenen verimin sağlanması adına öğrencilerin öğrenme ortamına katılmalarını sağlayan istek ve arzularının bilimsel çalışmalarla incelenmesi ve ulaşılan sonuçların literatüre kazandırılması önem arz etmektedir. Bu düşünceden hareketle çalışmanın amacı, Spor Bilimleri alanında öğrenimlerine aktif olarak devam eden öğrencilerin e-öğrenme tutum düzeylerinin farklı değişkenler açısından incelenmesidir. Araştırma kapsamında MSKÜ Spor Bilimleri Fakültesinin tüm bölümlerinde aktif öğrenim hayatlarına devam eden 115’i kadın, 231’i erkek toplamda 346 öğrenci çalışmanın örneklemini temsil etmiştir. Araştırmada veri toplamak amacıyla araştırmacılar tarafından oluşturulan tanımlayıcı bilgi formu ve Yarayan, Fakazlı ve İlhan (2022) tarafından geliştirilen E-Öğrenme Tutum Ölçeği: Üniversite Öğrencileri Formu (EÖTÖÜÖF) kullanılmıştır. Araştırma sonucunda, öğrencilerin cinsiyet değişkeni açısından e-öğrenme tutumları arasında anlamlı farklılık tespit edilmiştir. Ulaşılan sonuçlara göre öğrencilerin e-öğrenme tutum düzeyleri düşük seviyededir. Diğer sonuçlar incelendiğinde cinsiyet değişkeni açısından anlamlı farklılığa ulaşılırken, yaş, bölüm, sınıf, genel not ortalaması ve uzaktan eğitimde kullanılan araç değişkenleri açısından ise anlamlı farklılık tespit edilmemiştir.
Sezonluk (Kombine) Bilet Sahipleri Memnuniyet Ölçeği: Türkçe Geçerlik ve Güvenirlik Çalışması
Authors: ÇİNİ Nurettin Göksu , GÜZEL KUYUCU Ebru
Published: December 2023

Spor organizasyonları, devasa boyutlara ulaşan bir endüstri ve ekonomik faaliyet alanı olarak göze çarpmaktadır. Spor ürünlerini tüketen insanlar da bu endüstrinin en önemli paydaşı konumundadır. Sezonluk bilet sahibi taraftarların en sadık müşteriler olduğu ve kulüp gelirlerinin önemli bir kısmını sağladığı düşünüldüğünde spor organizasyonları açısından hayati öneme sahiptirler. Bu noktadan hareketle çalışmada, profesyonel spor kulüpleri için sezonluk bilet paketi bileşenlerini taraftarların memnuniyetlerine göre belirleyen bir ölçme aracı olarak McDonald vd. (2013) tarafından geliştirilen, Sezonluk (Kombine) Bilet Sahipleri Memnuniyet (Season Ticket Holder Satisfaction) Ölçeği (SBSMÖ) Türkçe formunun geçerlik ve güvenirliğinin incelenmesi amaçlanmıştır. Araştırmaya 298 sezonluk (kombine) bilet sahibi taraftar katılmıştır. Hizmet, saha performansı, kişisel katılım, kulüp yönetimi, ev sahibi alt boyutlarından oluşan ölçek, 17 madde ve 5’li Likert tipi değerlendirmeye sahiptir. Ölçeğin yapı geçerliğini belirlemek için yapılan Doğrulayıcı Faktör Analizi (DFA); benzeşim ve birleşim geçerlikleri için Ortalama Açıklanan Varyans (AVE), Bileşik Güvenirlik (CR); ayrışım geçerliği için Maksimum Paylaşılan Varyansın Karesi (MSV) ve Paylaşılan Varyansın Karesinin Ortalaması (ASV) değerleri hesaplanmıştır. Ölçeğin güvenirliğini sınamak için Cronbach’s Alpha ve Spearman Brown analizleri yapılmıştır. Analizler sonucunda “Sezonluk (Kombine) Bilet Sahipleri Memnuniyet” ölçeğinin geçerli ve güvenilir bir ölçme aracı olduğu görülmüştür.
Acromegaly and Bone: An Update
Authors: Giustina Andrea
Published: December 2023

Since our discovery in 2006 that acromegaly is associated with an increased risk of vertebral fractures, many authors have confirmed this finding in both cross-sectional and prospective studies. Due to the high epidemiological and clinical impact of this newly discovered comorbidity of acromegaly, this topic has progressively become more important and prominent over the years, and the pertinent literature has been enriched by new findings on the pathophysiology and treatment. The aim of this narrative review was to discuss these novel findings, integrating them with the seminal observations, in order to give the reader an updated view of how the field of acromegaly and bone is developing, from strong clinical observations to a mechanistic understanding and possible prevention and treatment.
Investir em inovação é garantir o futuro
Authors: Alberto De Negri João
Published: December 2023

Este livro foi preparado para dar suporte às discussões sobre indicadores de inovação tecnológica do Brasil e de outros países e refletir sobre quais lições contemporâneas podemos extrair da inovação tecnológica no Brasil, quando o comparamos com os países desenvolvidos que estão na fronteira tecnológica. Esta é a pergunta inicial e ela foi motivada pela necessidade de comparar a estrutura de inovação do Brasil com as economias mais inovadoras e extrair lições para ações empresariais e para a proposição de políticas de inovação tecnológica. As reflexões deste texto podem nos ajudar a pensar sobre o futuro, em especial no período de recuperação econômica.
Laparoscopic treatment of recurrent gastroesophageal reflux disease and hiatal hernia after two failed fundoplications: a clinical case.
Authors: Gololobov G. Yu. , Erin S. A. , Ovchinnikova U. R. , Abumuslimov K. K. , Khusainov I. R. , Kitieva A. A. , Gallyamov E. A.
Published: December 2023

Aim: identification of the main causes of failures of previous surgical interventions and methods of their prevention during the primary surgical treatment of hernia of the esophageal orifice of the diaphragm.

Material and methods. To address the scientific inquiry, an extensive review was conducted across global scientific literature focused on the treatment of primary and recurrent hernias of the esophageal orifice of the diaphragm (GPOD). Additionally, a clinical observation is provided, detailing a surgical intervention performed on a patient who had undergone correction for hernia and gastroesophageal reflux disease (GERD) on two prior occasions.

Results. The scientific literature reports limited instances of successfull correction of the recurrence of gastroesophageal reflux disease (GERD) and gastroesophageal orifice di- aphragmatic hernias (GPOD) in patients after two fundoplications. The term ‘failed fundo- plication’ is introduced, a concept not yet described in domestic literature. Eliminating the incorrectly formed antireflux mechanism, which leads to a programmed recurrence of GPOD, and implementing technically correct antireflux interventions allow for the achievement of a pronounced clinical effect in patients who have undergone one or more fundoplications, provided there is adequate peristalsis of the esophagus and stomach. In the presented clin- ical case, the surgical procedure is based on the principles of mitigating the consequences of the previous intervention through repeated intervention primarily focused on eliminating gastroesophageal reflux.

Conclusion. Repeated antireflux surgical interventions pose a significant challenge in surgical treatment, attributable to multiple factors concurrently. Identifying technical errors during ear- ly antireflux surgical interventions, eliminating them, and establishing an adequate antireflux mechanism contribute to the success of repeated interventions. Standardization of antireflux interventions is imperative, as adherence to the technical aspects of primary surgical interven- tions represents the most effective means to diminish the risk of disease relapse and the fre- quency of subsequent revision antireflux operations.
Modified multilayer alloplasty of complicated inguinal hernias.
Authors: Balatskii E. R. , Klimenko V. A. , Zhuravleva J. I. , Konovalenko A. V. , Voitenko S. V.
Published: December 2023

Aim.To enhance the treatment outcomes of complicated inguinal hernias (characterized by a high inguinal gap, a large hernia orifice, a weakened posterior wall of the inguinal canal, or recurrence) through the implementation of a developed technique involving multilayer alloplasty.

Materials and Methods. Within the overall cohort of 396 patients who underwent inguinal hernia surgeries between 2019 and 2023, the prevalence of complicated hernias was investigated. The main study group comprised 28 patients with complicated inguinal hernias who underwent surgery following the proposed method utilizing a two-layer prosthesis.

Results.Complicated inguinal hernias, necessitating additional reinforcement of the posterior wall of the inguinal canal, predominantly manifest in patients with a large hernia orifice size (W3 — 6.57 ± 1.25 %), a significant inguinal gap (13.13 ± 1.70 %), and a history of relapses (8.59 ± 1.41 %). An associated condition complicating hernioplasty and elevating the risk of recurrence (0.618) is obesity (61.76 ± 8.33 % in the recurrent hernia group). The application of the developed hernioplasty method shows no significant difference in terms of complication risk and subjective sensations compared to the Lichtenstein method. Notably, no hernia recurrences were observed with the utilization of the duplication plasty technique.

Conclusion.The suggested duplication design of the prosthesis proves effective in providing ex- tensive reinforcement for the inguinal gap in cases of problematic hernias. It is easy to position and is associated with minimal discomfort, as reported by the subjective sensations of patients.
Minimally invasive procedures in diagnostics and treatment of complications following cholecystectomy in acute cholecystitis.
Authors: Gallyamov E. A. , Galimov O. V. , Karkhani Hiwa M. H. , Khanov V. O. , Shalygin A. B. , Emelyanov A. Yu. , Rahimova D. R.
Published: December 2023

In the hierarchy of acute abdominal diseases, acute cholecystitis holds the third position, surpassing both acute appendicitis and acute pancreatitis. Despite advancements in laparoscopic cholecystectomy, intraabdominal complications following cholecystectomy for acute cholecystitis remain pertinent, and their prevalence increases with open cholecystectomy, contributing to elevated mortality rates. This underscores the critical need for timely diagnosis and comprehensive understanding of the development of postoperative intraabdominal complications. This article is a literature review encompassing various randomized clinical trials sourced from open-access journals worldwide. Leveraging electronic libraries such as PubMed, Scopus, Web of Science, elibrary.ru, Cochrane Library, and others, we explore different approaches to the diagnosis and treatment of complications arising after cholecystectomy for acute cholecystitis over the past decade. The primary objective of this review is to discern the most contemporary diagnostic methods and surgical approaches employed in the treatment of patients experiencing diverse postoperative complications.
Сlinical experience with the modified rehabilitation protocol after trapeziometa- carpal joint resection suspension interposition autotendoplasty.
Authors: Egiazaryan K. A. , Parsadanyan G. K. , Greben A. I. , Kiriaku P. M. , Ershov D. S. , Rafikov V. O. , Ratiev, A. P. , Afanasiev A. V.
Published: December 2023

Aim. The aim of this study is to assess the effectiveness of a modified postoperative rehabilitation protocol in patients who underwent their first carpometacarpal joint resection suspension interposition autotendoplasty.

Materials and Methods. The study included 52 patients treated for trapeziometacarpal joint osteoarthritis stage II—IV according to the Eaton-Littler and Kellgren-Lawrence classification in the Upper Limbs Surgery Department of the Bauman City Clinical Hospital from 2017 to 2022. All patients underwent trapeziometacarpal joint resection suspension interposition autotendoplasty and a course of rehabilitation. The evaluation of surgical treatment and rehabilitation results was carried out based on indicators on the VAS, DASH, and hand grip strength scales 12 months after surgery.

Results. The complex treatment resulted in the complete restoration of hand function. Twelve months after surgery, there was a significant improvement in hand functional parameters. According to the DASH scale, the improvement was 80 % compared to the preoperative level (p = 0.000). The pain syndrome, according to the VAS scale, decreased by 84 % from the baseline (p = 0.000). Affected hand grip strength reached its maximum value of 26.2 kg, exceeding the preoperative level by 67 % (p = 0.006).

Conclusion. The modified rehabilitation protocol used after performing trapeziometacarpal joint resection suspension interposition autotendoplasty in clinical practice enabled the full restoration of affected hand function.
Periprosthetic fractures in patients with consequences of shoulder joint traumas.
Authors: Egiazaryan K. A. , Ershov D. S. , Milenin O. N. , Pimanchev O. V. , Kondyrev N. M. , Badriev D. A. , Rafikov V. O.
Published: December 2023

Complications of shoulder joint traumas stand as a significant concern in modern traumatology. Various forms of endoprosthetics offer the potential to restore lost function resulting from fractures or dislocations of the proximal humerus. In the context of a significant deficiency in the rotator cuff of the shoulder (RC) in elderly patients with notably aged injuries, reverse endoprosthetics (RE) emerges as a justifiable choice. The accrued experience from the widespread adoption of anatomical arthroplasty of the shoulder joint (PS) has significantly influenced the evolution of this approach. Complications and progressive failures with short-term outcomes prompted the quest for solutions to the challenges posed by complex fractures and dislocations through the method of reverse arthroplasty, originally devised for treating rotatory arthropathy of the shoulder. However, the extensive application of RE has not consistently yielded excellent and good results in all cases of post-fracture and dislocation consequences. Mechanical complications, particularly periprosthetic fractures, are prevalent in RE and occur three times more frequently than in anatomical total arthroplasty of the shoulder joint. The urgency of this problem, considering the diminished rehabilitation potential of patients against the backdrop of intraoperative or postoperative fractures of the humerus and scapula, leading to a persistent deficit in the function of the shoulder joint, underscores the necessity of this study.
Paradox of Health in Times of Conflict
Authors: Chakravorty Indranil
Published: December 2023

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Implications of Axillary Lymphadenopathy Following COVID-19 Vaccination for Breast Cancer Screening
Authors: Jamal Saad , Pingali Vivek , Farooq Mir Umar
Published: December 2023

Aim: We conducted a systematic review to study cases of women who reported abnormalities on mammograms following COVID-19 vaccination, and evaluate the proportion of cases that warranted further investigations to rule out breast cancer. Through this, we aimed to evaluate the need for further follow-up radiological investigations such as sonography etc. before invasive investigations were carried out to rule out breast malignancy.
 
Methods: Electronic Databases of PubMed, and Medline were searched on 18th July 2022, to extract published articles with the keywords: COVID-19 vaccination, Lymphadenopathy, and Mammogram. The publication timeframe of included studies ranged from November 01, 2019, to July 18, 2022. Studies that were published in languages other than English were not considered for this systematic review. In vitro studies, In vivo studies, review articles and short communications were not considered for this systematic review. However, references of reviews were cross-checked for relevant publications.
 
Results: We identified 20 published results and 9 publications were selected after eliminating reviews, communication articles, and non-research articles 1048 patients were included in the systematic review. with 287 patients reporting significant abnormalities on mammography findings, which would warrant further invasive investigations according to NHS, UK protocols [9]
Provision of Timely Alternative Multidisciplinary Protocols for Patients Refusing Blood or Blood Products
Authors: Melamed Naomi
Published: December 2023

Blood components and products are life-saving therapeutics but with inherent, life-threatening risks. There are patients who do not accept blood products for different reasons, including fear of blood borne viruses, transfusion reactions and religious beliefs. It is important to determine the standard of care and outcomes for such patients, within any clinical setting. The aim of this audit was to evaluate adherence to the agreed standard of care for patients who do not accept blood transfusion.
Methods
All patients who refused transfusions between 2019 and 2021 were included.  Scanned forms and Electronic Patient Records were used to gather data. Expected care standards were: (1) a multidisciplinary team (MDM) led alternative care plan, agreed at least 3 weeks prior to the intervention/ procedure, to prepare for blood loss, and (2) that the MDM should involve: either a surgeon or physician, anaesthetist (if the treatment is surgical or antenatal), haematologist or transfusion practitioner and the patient.
Results
There were 195 patients referred to MDMs, of which 105 were surgical (54%), 52 were interventional (27%) and 38 were antenatal (19%). Of these, 188 (96%) were sent before a procedure (or birth) with the remaining 7 (4%) referred for ongoing treatment of medical patients, i.e. with severe anaemia. In 72 patients (38%) the MDM did take place ≥3 weeks before the procedure (similar to the results from the first cycle of the audit, in 2017-18 = 40%). Almost 85% (165) of MDM included all relevant stakeholders.
Discussion
The delay in timely referral for MDM led alternative care plan was likely due to a lack of awareness of transfusion policies, and potentially could lead to cancellation of the procedure or unavailability of alternative protocols in an emergent scenario during surgery or intervention.
Conclusion
Improvement was required for safer procedures and outcomes, by investment in training, regular refreshers/ updates for staff and electronic protocols/ prompts.
Vitamin B12 Deficiency in Type 2 Diabetes Patients on Metformin
Authors: Bora Nayanika , Shriram Vanishree , Asirvatham Adelyne Reena , Mahadevan Shriraam
Published: December 2023

Type 2 Diabetes mellitus is a chronic metabolic disorder with complications of microangiopathies, macroangiopathies, neuropathy and nephropathy. Metformin is often the first line treatment in type 2 diabetes. There is evidence of a higher prevalence of vitamin B12 deficiency observed among patients on metformin. It is believed that Metformin may cause vitamin B12 malabsorption which aggravates neuropathy and anaemia.
Methods
A cross-sectional study was designed with randomly selected type 2 diabetes patients attending a tertiary diabetes clinic in Southern India, recruited over a period of 3 months, divided in 2 groups (control and study groups) based on their use of metformin. They were assessed for serum B12, Folic acid levels and mean corpuscular volume. Clinical manifestations of neuropathy, anaemia and vitamin B12 deficiency were documented on clinical examination.
Results
There were 100 patients recruited, showing those on metformin had a higher prevalence of vitamin B12 deficiency (58.3% vs 33.3%, p<0.05), however, folic acid deficiency was lower (16.7% vs 37.5%, p<0.05).
Conclusion
Patients with type 2 diabetes on metformin required protocols for monitoring and replacement of vitamin B12 as necessary, to prevent onset of neuropathy.
A Rare Case of Freiberg's Disease
Authors: Jose Tom , Shakeel Dr Kashif , Mathew Dr Thomas , Oguntade Dr Ayotunde , Wayawa Dr Charles
Published: December 2023

Freiberg's disease is a rare disease of the bone affecting the head of the second metacarpal in young females in the second decade resulting from osteonecrosis due to a multifactorial aetiology [1]. In this study, we present a case of Freiberg's disease affecting the head of the third metacarpal bone in a 43-year-old female with characteristic X ray findings, to increase its awareness as early diagnosis and treatment can limit disability.
Suicide and Mental Illness Amongst the Medical Profession
Authors: Chakravorty Triya A
Published: December 2023

This paper highlights the critical issue of mental health and suicide risk among doctors amidst healthcare system challenges. Despite job security, doctors face a heightened risk of mental health problems and suicide, exacerbated by various factors including profession-related traits and burnout. Stigma and professional fears hinder support-seeking.
The paper emphasizes the need for systemic changes, early intervention, and robust support systems to address these challenges, underlining the importance of safeguarding healthcare professionals' mental well-being.
Supporting Acute Neonatal and Paediatric Care Quality in Nepal
Authors: McQuaige Fiona , Shah Arvind
Published: December 2023

The RCPCH Global Health programme has been working for over 20 years in many middle- and low-income countries to help improve the quality of child health worldwide.  In 2021, RCPCH Global launched a new programme in Nepal working in partnership with Nepal Paediatric Society (NEPAS) the Nepal Ministry of Health and United Nations International Children’s Emergency Fund (UNICEF). This report outlines the component of the programs and highlights the success in improving neonatal and paediatric emergency care.
Triangular algebras with nonlinear higher Lie n-derivation by local actions
Authors: Liang Xinfeng , Zhang Mengya
Published: December 2023

This paper was devoted to the study of the so-called nonlinear higher Lie n-derivation of triangular algebras $ \mathcal{T} $, where $ n $ is a nonnegative integer greater than two. Under some mild conditions, we proved that every nonlinear higher Lie n-derivation by local actions on the triangular algebras is of a standard form. As an application, we gave a characterization of higher Lie $ n $-derivation by local actions on upper triangular matrix algebras, block upper triangular matrix algebras and nest algebras, respectively.
A new family of positively based algebras $ {\mathcal{H}}_n $
Authors: Lin Shiyu , Yang Shilin
Published: December 2023

In this paper, we introduce a new family of algebras $ {\mathcal{H}}_n $, which are generated by three generators $ x, y, z $, with the following relations: (1) $ x^{2n} = 1, \ y^2 = xy+y, \ xy = yx; $ and (2) $ z^2 = z, \ xz = zx = z, \ zy = 2z. $ First, it shows that $ {\mathcal{H}}_n $ is a positively based algebra. Then, all the indecomposable modules of $ {\mathcal{H}}_n $ are constructed. Additionally, it shows that the dimension of each indecomposable $ {\mathcal{H}}_n $-module is at most $ 2 $. Finally, all the left (right) cells and left (right) cell modules of $ {\mathcal{H}}_n $ are described, and the decompositions of the decomposable left cell modules are also obtained.
Mathematical modeling the gene mechanism of colorectal cancer and the effect of radiation exposure
Authors: Li Lingling , Hu Yulu , Li Xin , Tian Tianhai
Published: December 2023

Cancer is the result of continuous accumulation of gene mutations in normal cells. The number of mutations is different in different types of cancer and even in different patients with the same type of cancer. Therefore, studying all possible numbers of gene mutations in malignant cells is of great value for the understanding of tumorigenesis and the treatment of cancer. To this end, we applied a stochastic mathematical model considering the clonal expansion of any premalignant cells with different mutations to analyze the number of gene mutations in colorectal cancer. The age-specific colorectal cancer incidence rates from the Surveillance, Epidemiology and End Results (SEER) registry in the United States and the Life Span Study (LSS) in Nagasaki and Hiroshima, Japan are chosen to test the reasonableness of the model. Our fitting results indicate that the transformation from normal cells to malignant cells may undergo two to five driver mutations for colorectal cancer patients without radiation-exposed environment, two to four driver mutations for colorectal cancer patients with low level radiation-exposure, and two to three driver mutations for colorectal cancer patients with high level radiation-exposure. Furthermore, the net growth rate of the mutated cells with radiation-exposure was is higher than that of the mutated cells without radiation-exposure for the models with two to five driver mutations. These results suggest that radiation environment may affect the clonal expansion of cells and significantly affect the development of tumors.
The WuC-Adam algorithm based on joint improvement of Warmup and cosine annealing algorithms
Authors: Zhang Can , Shao Yichuan , Sun Haijing , Xing Lei , Zhao Qian , Zhang Le
Published: December 2023

The Adam algorithm is a common choice for optimizing neural network models. However, its application often brings challenges, such as susceptibility to local optima, overfitting and convergence problems caused by unstable learning rate behavior. In this article, we introduce an enhanced Adam optimization algorithm that integrates Warmup and cosine annealing techniques to alleviate these challenges. By integrating preheating technology into traditional Adam algorithms, we systematically improved the learning rate during the initial training phase, effectively avoiding instability issues. In addition, we adopt a dynamic cosine annealing strategy to adaptively adjust the learning rate, improve local optimization problems and enhance the model's generalization ability. To validate the effectiveness of our proposed method, extensive experiments were conducted on various standard datasets and compared with traditional Adam and other optimization methods. Multiple comparative experiments were conducted using multiple optimization algorithms and the improved algorithm proposed in this paper on multiple datasets. On the MNIST, CIFAR10 and CIFAR100 datasets, the improved algorithm proposed in this paper achieved accuracies of 98.87%, 87.67% and 58.88%, respectively, with significant improvements compared to other algorithms. The experimental results clearly indicate that our joint enhancement of the Adam algorithm has resulted in significant improvements in model convergence speed and generalization performance. These promising results emphasize the potential of our enhanced Adam algorithm in a wide range of deep learning tasks.
Functional Aspects of the Obesity Paradox in Patients with Severe Coronavirus Disease-2019: A Retrospective, Multicenter Study
Authors: Kim Jeongsu , Jang Jin Ho , Kim Kipoong , Park Sunghoon , Lee Su Hwan , Park Onyu , Kim Tae Hwa , yeo Hye Ju , Cho Woo Hyun ,   On behalf of Korean Intensive Care Study Group
Published: December 2023

Background: Results of studies investigating the association between body mass index (BMI) and mortality in patients with coronavirus disease-2019 (COVID-19) have been conflicting.Methods: This multicenter, retrospective observational study, conducted between January 2020 and August 2021, evaluated the impact of obesity on outcomes in patients with severe COVID-19 in a Korean national cohort. A total of 1,114 patients were enrolled from 22 tertiary referral hospitals or university-affiliated hospitals, of whom 1,099 were included in the analysis, excluding 15 with unavailable height and weight information. The effect(s) of BMI on patients with severe COVID-19 were analyzed.Results: According to the World Health Organization BMI classification, 59 patients were underweight, 541 were normal, 389 were overweight, and 110 were obese. The overall 28-day mortality rate was 15.3%, and there was no significant difference according to BMI. Univariate Cox analysis revealed that BMI was associated with 28-day mortality (hazard ratio, 0.96; p=0.045), but not in the multivariate analysis. Additionally, patients were divided into two groups based on BMI ≥25 kg/m2 and underwent propensity score matching analysis, in which the two groups exhibited no significant difference in mortality at 28 days. The median (interquartile range) clinical frailty scale score at discharge was higher in nonobese patients (3 [3 to 5] vs. 4 [3 to 6], p<0.001). The proportion of frail patients at discharge was significantly higher in the nonobese group (28.1% vs. 46.8%, p<0.001).Conclusion: The obesity paradox was not evident in this cohort of patients with severe COVID-19. However, functional outcomes at discharge were better in the obese group.
Distribution of Phlebotomus argentipes Annandale & Brunetti, 1908 in the Anuradhapura district, North Central Sri Lanka
Authors: Nayakarathna NMNG , Gunathilaka RAKM , Ganehiarachchi GASM
Published: December 2023

Background & objectives:

Phlebotomus argentipes Annandale & Brunetti, 1908 (Diptera: Psychodidae) is the main vector responsible for the transmission of Leishmania donovani (Laveran & Mesnil, 1903) Ross, 1903 in the subcontinent of India. It is the potential vector of cutaneous leishmaniasis in Sri Lanka. The present study determined ecological factors that influence the abundance of P. argentipes in areas with high disease prevalence in the Anuradhapura district, North Central Sri Lanka.

Methods:

CDC light traps and yellow sticky traps were used for sampling, and abundance was recorded throughout 12 months with selected environmental parameters namely, relative humidity, wind speed, and temperature. The relationships between the abundance of P. argentipes with mean temperature, % relative humidity, and wind speed were tested with regression analysis. The temporal distribution of the vector population was tested with a time series analysis.

Results:

The study identified the most preferable microhabitats of P. argentipes: shrubs, unclear areas, gardening areas, wet soil areas with leaf litter, and termite hills. The results indicated that the abundance of P. argentipes was highly dependent on mean temperature (P = 0.00, R2 = 68%), and a high number of P. argentipes was recorded for a low mean temperature range of 24.7–27.3°C. Furthermore, the abundance of P. argentipes exhibited an increasing trend with high humidity levels of 72–88% (P = 0.00, R2 = 91.6%).

Interpretation & conclusion:

These findings may help predict the temporal variation of the potential vector population with studied ecological parameters and contribute to a successful vector management strategy with thorough knowledge of the behavioral pattern of P. argentipes.