bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy delivery guided by indirect calorimetry in critically ill patients: a systematic review and meta-analysis
Authors: Duan Jing-Yi , Zheng Wen-He , Zhou Hua , Xu Yuan , Huang Hui-Bin
Published: February 2021

Background

The use of indirect calorimetry (IC) is increasing due to its precision in resting energy expenditure (REE) measurement in critically ill patients. Thus, we aimed to evaluate the clinical outcomes of an IC-guided nutrition therapy compared to predictive equations strategy in such a patient population.

Methods

We searched PubMed, EMBASE, and Cochrane library databases up to October 25, 2020. Randomized controlled trials (RCTs) were included if they focused on energy delivery guided by either IC or predictive equations in critically ill adults. We used the Cochrane risk-of-bias tool to assess the quality of the included studies. Short-term mortality was the primary outcome. The meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity.

Results

Eight RCTs with 991 adults met the inclusion criteria. The overall quality of the included studies was moderate. Significantly higher mean energy delivered per day was observed in the IC group, as well as percent delivered energy over REE targets, than the control group. IC-guided energy delivery significantly reduced short-term mortality compared with the control group (risk ratio = 0.77; 95% CI 0.60 to 0.98; I2 = 3%, P = 0.03). IC-guided strategy did not significantly prolong the duration of mechanical ventilation (mean difference [MD] = 0.61 days; 95% CI − 1.08 to 2.29; P = 0.48), length of stay in ICU (MD = 0.32 days; 95% CI − 2.51 to 3.16; P = 0.82) and hospital (MD = 0.30 days; 95% CI − 3.23 to 3.83; P = 0.87). Additionally, adverse events were similar between the two groups.

Conclusions

This meta-analysis indicates that IC-guided energy delivery significantly reduces short-term mortality in critically ill patients. This finding encourages the use of IC-guided energy delivery during critical nutrition support. But more high-quality studies are still needed to confirm these findings.
Advanced machine learning for predicting individual risk of flares in rheumatoid arthritis patients tapering biologic drugs
Authors:   on behalf of the RETRO study group, Vodencarevic Asmir , Tascilar Koray , Hartmann Fabian , Reiser Michaela , Hueber Axel J. , Haschka Judith , Bayat Sara , Meinderink Timo , Knitza Johannes , Mendez Larissa , Hagen Melanie , Krönke Gerhard , Rech Jürgen , Manger Bernhard , Kleyer Arnd , Zimmermann-Rittereiser Marcus , Schett Georg , Simon David
Published: February 2021

Background

Biological disease-modifying anti-rheumatic drugs (bDMARDs) can be tapered in some rheumatoid arthritis (RA) patients in sustained remission. The purpose of this study was to assess the feasibility of building a model to estimate the individual flare probability in RA patients tapering bDMARDs using machine learning methods.

Methods

Longitudinal clinical data of RA patients on bDMARDs from a randomized controlled trial of treatment withdrawal (RETRO) were used to build a predictive model to estimate the probability of a flare. Four basic machine learning models were trained, and their predictions were additionally combined to train an ensemble learning method, a stacking meta-classifier model to predict the individual flare probability within 14 weeks after each visit. Prediction performance was estimated using nested cross-validation as the area under the receiver operating curve (AUROC). Predictor importance was estimated using the permutation importance approach.

Results

Data of 135 visits from 41 patients were included. A model selection approach based on nested cross-validation was implemented to find the most suitable modeling formalism for the flare prediction task as well as the optimal model hyper-parameters. Moreover, an approach based on stacking different classifiers was successfully applied to create a powerful and flexible prediction model with the final measured AUROC of 0.81 (95%CI 0.73–0.89). The percent dose change of bDMARDs, clinical disease activity (DAS-28 ESR), disease duration, and inflammatory markers were the most important predictors of a flare.

Conclusion

Machine learning methods were deemed feasible to predict flares after tapering bDMARDs in RA patients in sustained remission.
Evaluating a tylosin dosage regimen for treatment of Staphylococcus delphini infection in mink (Neovison vison): a pharmacokinetic-pharmacodynamic approach
Authors: Ronaghinia Amir Atabak , Birch Julie Melsted , Frandsen Henrik Lauritz , Toutain Pierre-Louis , Damborg Peter , Struve Tina
Published: February 2021

Staphylococcus delphini is one of the most common pathogens isolated from mink infections, especially dermatitis. Tylosin (TYL) is used frequently against these infections, although no evidence-based treatment regimen exists. This study aimed to explore the dosage of TYL for infections caused by S. delphini in mink. Two animal experiments with a total of 12 minks were conducted to study the serum pharmacokinetic (PK) characteristics of TYL in mink after 10 mg/kg IV and oral dosing, respectively. The concentration of TYL in serum samples collected before and eight times during 24 h after TYL administration was quantitated with liquid chromatography quadrupole time-of-flight mass spectrometry, and the TYL disposition was analyzed using non-linear mixed effect analysis. The pharmacodynamics (PD) of TYL against S. delphini were studied using semi-mechanistic modeling of in vitro time-kill experiments. PKPD modeling and simulation were done to establish the PKPD index and dosage regimen. The disposition of TYL was described by a two-compartmental model. The area under the free concentration–time curve of TYL over the minimum inhibitory concentration of S. delphini (fAUC/MIC) was determined as PKPD index with breakpoints of 48.9 and 98.7 h for bacteriostatic and bactericidal effect, respectively. The calculated daily oral dose of TYL was 2378 mg/kg, which is 238-fold higher than the currently used TYL oral dosage regimen in mink (10 mg/kg). Accordingly, sufficient TYL concentrations are impossible to achieve in mink plasma, and use of this drug for extra-intestinal infections in this animal species must be discouraged.
Discipline and distinction in the age of the Internet: a sociological study of the fitness practice
Authors: Tang Jun , Xie Zilong
Published: March 2021

This article examines popular fitness sports and home fitness software in China. Drawing on Michel Foucault’s theory of discipline, Norbert Elias’ study on civilization, and Jean Baudrillard’s study on the consumer society, the authors reveal the formation of a new body discipline mechanism against the background of the Internet society and the consumer society. On the one hand, the external disciplinary strategies have been upgraded, including the spatial strategy of liquidity and visibility, the linear and rhythmic time strategy, and the knowledge strategy. On the other hand, different from Foucault’s discussion of discipline, we introduce positive self-discipline. As a unique consumption practice, fitness practices promote a new form of self-discipline among practitioners who also pursue distinctive social positions. The core content of the self-discipline strategy includes code manipulation, time consumption, moral display, and self-writing. In addition, with the continuous infiltration of Internet technologies in daily life, the space-time boundaries of physical discipline gradually blur, whereas the micro-distribution of power changes into a daily distribution form.
Remaking Relationships
Authors: Hill Alexandra M. , Weiger Sarah
Published: March 2021

How should we teach a class on family in the twenty-first century, when the meaning and makeup of “family” are under attack from all political angles? This article relates an attempt to rethink the family course as interdisciplinary, thematically arranged, heavily dependent on student engagement, and collaborative. From course conception to pitfalls and retrospection, this article provides an overview of a course implemented by the authors and their students as part of the honors program at the University of Portland. At the center of the course was a common curiosity for the material that emerged in hallway conversations at the intersection of different disciplines, at the intersection of ecocriticism and feminist theory, and at the intersection of popular media and personal life. The authors argue that collaborative teaching and intersectionality led to more productive classroom discussions and destabilized assumptions for all the course participants, instructors included.
Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery
Authors: Jonker Leonie T. , Lahr Maarten M. H. , Oonk Maaike H. M. , de Bock Geertruida H. , van Leeuwen Barbara L.
Published: February 2021

Background

Postoperative home monitoring could potentially detect complications early, but evidence in oncogeriatric surgery is scarce. Therefore, we evaluated whether post-discharge physical activity, vital signs, and patient-reported symptoms are related to post-discharge complications and hospital readmissions in older patients undergoing cancer surgery.

Methods

In this observational cohort study, we monitored older patients (≥65 years of age) undergoing cancer surgery, for 2 weeks post-discharge using tablet-based applications and connected devices. Outcome measures were post-discharge complications and readmissions; physical activity and patient-reported symptoms over time; and threshold violations for physical activity (step count <1000 steps/day), vital signs (temperature <36°C or >38°C; blood pressure <100/60 mmHg or >150/100 mmHg; heart rate <50 bpm or >100 bpm; weight −5% or +5% of weight at discharge); and patient-reported symptoms (pain score greater than the previous day; presence of dyspnea, vomiting, dizziness, fever).

Results

Of 58 patients (mean age 72 years), 24 developed a post-discharge complication and 13 were readmitted. Measured parameters indicated 392 threshold violations out of 5379 measurements (7.3%) in 40 patients, mostly because of physical inactivity. Patients with readmissions had lower physical activity at discharge and at day 9 after discharge and violated a physical activity threshold more often. Patients with post-discharge complications had a higher median pain score compared with patients without these adverse events. No differences in threshold violations of other parameters were observed between patients with and without post-discharge complications and readmissions.

Conclusion

Our results show the potential of telemonitoring older patients after cancer surgery but confirm that detecting post-discharge complications is complex and multifactorial.
Clinical spectrum of chronic liver disease with final outcome in children at a tertiary centre: A single - centre study
Authors: Seerat Iqtadar , Khan Eitzaz UD Din , Atique Muhammad , Aujla Usman Iqbal
Published: February 2021

Background and Objectives: Chronic liver disease (CLD) in children present a broad spectrum of symptoms. Limited resources in Paediatric Hepatology in developing countries like Pakistan present considerable challenges in investigating and treating children with chronic liver disease in a timely fashion. This study aimed to determine the spectrum and outcomes of CLD other than chronic hep B & C virus (HBV& HCV) liver disease in children.

Methods: This retrospective descriptive study was conducted at the Paediatric Gastroenterology and Hepatology Department, Pakistan Kidney and Liver Institute and Research Centre in Lahore, Pakistan. The duration of the study was from August 2019 to January 2020. A total of 162 children of CLD were seen during this period of time. Of 162 there were 130 children with chronic HBV & HCV who were excluded from this study. 32 children aged 15 years or younger with chronic liver disease were included. The referrals were received from primary and secondary health care centres in different parts of the country. The data were collected from hospital electronic medical records database and then incorporated into a spreadsheet for analysis. The statistical analysis was performed by applying t-test with p value determined.

Results: Of 32 children autoimmune hepatitis (n=11; 34.3%) was the most common cause for chronic liver disease referrals, followed by progressive familial intrahepatic cholestasis type-2, (n=7; 21.8%), post Kasai for biliary atresia, (n=4; 12.5%), glycogen storage disease type-1 (n=5; 15.6%), Wilson disease (n=3; 9.3%) and primary sclerosing cholangitis (n=2; 6.2%). The diagnosis was principally established with the assistance of liver ultrasound, liver biopsy, magnetic resonance cholangiopancreatography and genetic testing.

Conclusion: Autoimmune hepatitis was the most common chronic liver disease. Our systematic approach, in addition to an extensive workup, helped us to diagnose and then initiate an appropriate treatment, which resulted in a more optimal outcome. Prompt referrals to tertiary centres are recommended where resources and expertise are available to reduce patient morbidity and mortality.

doi: https://doi.org/10.12669/pjms.37.3.3862

How to cite this:Seerat I, Khan ED, Atique M, Aujla UI. Clinical spectrum of chronic liver disease with final outcome in children at a tertiary centre: A single - centre study. Pak J Med Sci. 2021;37(3):680-683. doi: https://doi.org/10.12669/pjms.37.3.3862

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case Report: A 73-year-old suspected COVID-19 patient with severe dyspnea fully recovers after reciting nine true words from Falun Gong
Authors: Dong Yuhong , Trey Margaret , Hsu Kai-Hsiung
Published: March 2021

Background: The most common severe symptoms of coronavirus disease 2019 (COVID-19) are breathing difficulty and respiratory failure. Unfortunately, mortality of COVID-19 patients with severe breathing difficulties is high.

Clinical finding and diagnosis: This report describes the case of a woman in her seventies, who could not taste anything except a metallic taste, had pains all over, low-grade fever, and who soon developed severe breathing difficulties in 15 days. At the time, her doctors described her as having suspected COVID-19 and advised her to self-quarantine at home.

Interventions and outcomes: When the patient had her initial symptoms, her treating physician prescribed Tylenol which she took for 13 days. The patient initially felt better, but then developed severe fatigue, achiness within a week, and then severe breathing difficulties. The patient was sometimes unable to breathe and could not walk from her bed to the bathroom. She started feeling fearful of death after 15 days had lapsed. She then started to recite the nine Chinese characters "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao” daily. After she started reciting these nine true words (NTW) frequently and sincerely, the patient felt her lungs opened and she was able to breathe longer and deeper. Within three days of constantly reciting the NTW, her breathing returned to normal and all symptoms ceased.

Conclusions: This suspected COVID-19 patient gained significant clinical benefits after sincerely reciting the nine-character true words from Falun Gong.
Academic essays part 8: managing the literature
Authors: Fowler John
Published: February 2021

John Fowler, Educational Consultant, explores academic writing
Changing practice for neuraxial applications using NRFit™ small-bore connectors to improve patient safety
Authors: Cannons Karin , Shaw Ian
Published: February 2021

Clinical staff always aim to offer the best care for their patients while striving to minimise the risk of errors. The worldwide adoption of the NRFit™ system for neuraxial and regional block procedures is a major step forward. This article discusses the history of neuraxial needles and the experience of a major teaching hospital in adopting non-luer equipment for neuraxial procedures. References are made to resources that are available for other hospitals in the process of implementing the change to the NRFit system, which should result in the reduction of harm to patients.
Knowledge translation platforms to support African evidence-informed policies: challenges and progress
Authors: Adu Joseph , Gyamfi Sebastian , Martin-Yeboah Ebenezer
Published: February 2021

Background:

An effective health system that ensures availability and access to quality healthcare produces active human capital. Responsive health systems are the results of evidence-informed policy practice which is mostly seen in advanced countries. Deficiencies in most African health systems are due to the ineffective use of health research to reinforce public health policymaking.

Key points for discussion:

This paper discusses the progress and challenges faced by Knowledge Translation Platforms (KTPs) in African evidence-informed policymaking among healthcare systems. Large gaps exist between research evidence and policymaking in Africa due to inefficiencies of the KTPs and the lack of political will to use sound ethical research outcomes to inform health policies. Activities of KTPs in Africa are most often curtailed by many obstacles, but not limited to the following; lack of infrastructure, human and financial capital, high turnover among top-level policymakers, and lack of collaboration between academia and industry.

Conclusions and implications:

Evidence informed policymaking is crucial to the achievement of the health-related Sustainable Development Goals by 2030.
Population genetic structure and association mapping for iron toxicity tolerance in rice
Authors: Pawar S. , Pandit E. , Mohanty I. C. , Saha D. , Pradhan S. K.
Published: March 2021

Iron (Fe) toxicity is a major abiotic stress which severely reduces rice yield in many countries of the world. Genetic variation for this stress tolerance exists in rice germplasms. Mapping of gene(s)/QTL controlling the stress tolerance and transfer of the traits into high yielding rice varieties are essential for improvement against the stress. A panel population of 119 genotypes from 352 germplasm lines was constituted for detecting the candidate gene(s)/QTL through association mapping. STRUCTURE, GenAlEx and Darwin softwares were used to classify the population. The marker-trait association was detected by considering both the Generalized Linear Model (GLM) and Mixed Linear Model (MLM) analyses. Wide genetic variation was observed among the genotypes present in the panel population for the stress tolerance. Linkage disequilibrium was detected in the population for iron toxicity tolerance. The population was categorized into three genetic structure groups. Marker-trait association study considering both the Generalized Linear Model (GLM) and Mixed Linear Model (MLM) showed significant association of leaf browning index (LBI) with markers RM471, RM3, RM590 and RM243. Three novel QTL controlling Fe-toxicity tolerance were detected and designated asqFeTox4.3,qFeTox6.1andqFeTox10.1. A QTL reported earlier in the marker interval of C955-C885 on chromosome 1 is validated using this panel population. The present study showed that QTL controlling Fe-toxicity tolerance to be co-localized with the QTL for Fe-biofortification of rice grain indicating involvement of common pathway for Fe toxicity tolerance and Fe content in rice grain. Fe-toxicity tolerance QTLqFeTox6.1was co-localized with grain Fe-biofortification QTLsqFe6.1andqFe6.2on chromosome 6, whereasqFeTox10.1was co-localized withqFe10.1on chromosome 10. The Fe-toxicity tolerance QTL detected from this mapping study will be useful in marker-assisted breeding programs.
Guideline Formalization and Knowledge Representation for Clinical Decision Support
Authors: Oliveira Tiago , Neves José , Novais Paulo
Published: March 2021

The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate theseoccurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.
Healthier? More Efficient? Fairer? An Overview of the Main Ethical Issues Raised by the Use of Ubicomp in the Workplace
Authors: Nihan Céline Ehrwein
Published: March 2021

The development of Ambient Intelligence (AmI) will radically transform our everyday life and social representations. These transformations will notably impact the working environment. The objective of this paper is to offer a first survey of the main ethical issues raised by the development of intelligent working environments (IWEs). It especially focuses on the capacity of such environments to collect and handle personal medical data. The first two sections of this paper aim to clarify the methodology (2) as well as the object (3) of the research. We then point out some of the main ethical issues raised by IWEs and their capacity to collect and handle medical data. The final section attempts to offer some elements of reflection regarding the ethical principles that should guide the development of IWEs in the future.
Optimal Intermittent Dose Schedules for Chemotherapy Using Genetic Algorithm
Authors: Alam Nadia , Sultana Munira , Alam M.S. , Al-Mamun M. A. , Hossain M. A.
Published: March 2021

In this paper, a design method for optimal cancer chemotherapy schedules via genetic algorithm (GA) is presented. The design targets the key objective of chemotherapy to minimize the size of cancer tumor after a predefined time with keeping toxic side effects in limit. This is a difficult target to achieve using conventional clinical methods due to poor therapeutic indices of existing anti-cancer drugs. Moreover, there are clinical limitations in treatment administration to maintain continuous treatment. Besides, carefully decided rest periods are recommended to for patient’s comfort. Three intermittent drug scheduling schemes are presented in this paper where GA is used to optimize the dose quantities and timings by satisfying several treatment constraints. All three schemes are found to be effective in total elimination of cancer tumor after an agreed treatment length. The number of cancer cells is found zero at the end of the treatment for all three cases with tolerable toxicity. Finally, two of the schemes, “Fixed interval variable dose (FIVD) and “Periodic dose” that are periodic in characteristic have been emphasized due to their additional simplicity in administration along with friendliness to patients. responses to the designed treatment schedules. Therefore the proposed design method is capable of planning effective, simple, patient friendly and acceptable chemotherapy schedules.
Fenntartható jövő tervezésére vállalkoztunk – Egy diákok körében végzett, több módszertanú kvalitatív kutatás eredményei a fenntartható fejlődés pedagógiájának nézőpontjából
Authors: Horváth Daniella Dominika , Horváth Dóra
Published: March 2021

A fenntarthatóság a kommunikáció kereszttüzébe került. Kiemelt kutatási kérdés, hogy a gondolatok ilyen irányú térnyerése miként és mennyi idő alatt fordul át a cselekedet szintjére, akár résztvevő, akár kezdeményező szerepkörben. Tanulmányunkban azt vizsgáljuk, hogy miért épp a fenntarthatóság jelenik meg a legnagyobb arányban egy általunk generált ismeretlen és innovatív szituációban. Mindemellett arra is keressük a választ, hogy ezt a pozitív eredményt a designkommunikáció módszertanának alkalmazása mellett hogyan lehet elmélyíteni és attitűd szinten is úgy hatást gyakorolni, hogy a gondolatok aktív cselekvéssé formálódjanak az oktatási kereteken belül. Több módszertanú kvalitatív kutatásunkat egy saját fejlesztésű workshop sorozathoz kapcsolódóan végeztük, melyet minden magyarországi megyében megvalósítottunk.
VARIOUS DIAGNOSTIC MEASURES OF FRAILTY AS PREDICTORS FOR FALLS, WEIGHT CHANGE, QUALITY OF LIFE, AND MORTALITY AMONG OLDER FINNISH MEN
Authors: Perttila N.M. , Pitkala K.H. , Kautiainen H. , Tilvis R. , Strandberg T.
Published: February 2021

Background: Frailty predisposes individuals to a variety of complications. However, there is no consensus on the definition of frailty. Objectives: To examine whether various frailty measures are equivalent in identifying the same individuals as being frail and whether the measures also predict similar outcomes. Design, Setting and Participants: The Helsinki Businessmen Study cohort, which is a long-term observational study of men born in 1919-1934, was used as the population. We investigated these men by their postal questionnaire responses in 2000 and 2005. The mean age of the men (N=480) was 73 years at the start of follow-up. Measurements: We compared two phenotypic frailty measures, the Helsinki Businessmen Study measure (HBS), the modified Women’s Health Initiative Observational Study (WHI-OS), and the Frailty Index (FI) comprising 20 items. All three measurements were applied to Helsinki Businessmen Study cohort data collected via simple postal questionnaire from 480 men. We investigated how effectively these three measures distinguished between the not frail, prefrail, and frail individuals, and predicted mortality, falls, weight change, and health-related quality of life (HRQoL, 15D instrument) during a 5-year follow-up. Results: The HBS and the modified WHI-OS identified 35 persons (7.3%) each as frail but their respective sets comprised different groupings of individuals that partly overlapped. The FI identified 86 persons (17.9%) as frail. One-hundred-and-two (21.3%) men were classified as frail by at least one of the measures. All three measures significantly predicted higher mortality, higher number of fallers, and lower HRQoL for frail participants. None of the measures showed different results for weight change between the frailty groups or frailty stages. Conclusions: All three measures identified somewhat different sets of participants as frail. They all predicted increased mortality, falls and reduced HRQoL for the frail groups.
Contrast Agents (Gadolinium)
Authors: S. Al-Showiman Sami
Published: March 2021

Contrast agents in medicine are chemical materials used to improve tissue and fluid contrast in the body during medical imaging. It is mainly used in improving the visibility of blood vessels and the gastrointestinal tract. Some types of contrast materials are used in a medical imaging examination and can be classified according to the imaging technique used. The first contract agent (Gadolinium) dates back to 1988 which is called gadopentetate dimeglumine (Magnevist) and was allocated for Magnetic Resonance Imaging (MRI)
Avaliação de Rótulos dos Tipos de Leite Integral da Classe Tipo C: Comercializados em Vitória da Conquista-BA / Evaluation of Whole Milk Type Labels Type C Class: Commercialized in Vitória da Conquista-BA
Authors: Rocha João Marcos Rodrigues , Souza Enzo Costa de , Santos Ednilson Dias , Aguiar Lahis Cardoso de , Moraes Milena
Published: March 2021

Resumo: O leite Tipo C com teor de 3% de gordura vem de rebanhos diferentes e sua ordenha é mecânica ou manual, sendo entregue aos laticínios na temperatura ambiente, podendo ser propicio a um elevado teor de bactérias antes da pasteurização, com tudo é um leite com tempo de prateleira muita curta. O objetivo deste trabalho é avaliar as características nutricionais do leite integral do tipo C, sendo comercializado no município de Vitória da Conquista-BA, comparando os resultados nutricionais de cada leite tipo C, assim como o seu teor de gordura com 3% de acordo com a legislação vigente. Foram analisados 5 tipos de leite Integra do tipo C, quanto à quantidade de gordura, carboidrato, valor energético, sódio, cálcio, o colesterol, fibras alimentares, além dos ingredientes de cada leite integral tipo C.
Programa de Aprendizagem e suas Implicações ao Acesso e Continuidade no Mercado de Trabalho: Um Estudo com Jovens Aprendizes / Learning Program and its Implications to Access and Continuity in the Labor Market: A Study with Young Learners
Authors: Magalhães Cintia Rosa , Granja Edna Mirtes Dos Santos
Published: March 2021

Essa pesquisa tem por objetivo entender a funcionalidade das Políticas Públicas voltadas para juventude, por meio do Programa de Aprendizagem regido pela Lei nº 10.097 de 19 de dezembro de 2000, problematizando as dificuldades ao acesso e continuidade no mercado de trabalho. A escolha da temática provém da relevância social e da importância da empregabilidade para os jovens nesta fase transitória para adultez. A pesquisa caracteriza-se de natureza básica, abordagem qualitativa do tipo exploratória e descritiva, como procedimento técnico utilizou-se um estudo de caso e pesquisa bibliográfica, aplicando as ferramentas de grupo focal para os 07 jovens aprendizes integrantes do campo de pesquisa, como também entrevista semiestruturada para 03 gestores tutores desses jovens. Entre os resultados, evidenciou-se a percepção dos jovens aprendizes sobre a dificuldade do ingresso no mercado de trabalho, devido à falta de experiência exigida pelo mercado, além da compreensão que o Programa de Aprendizagem é um facilitador para essas implicações, contribuindo com o desenvolvimento e a escolha de carreira desses jovens. Sobre o ponto de vista dos gestores tutores, o Programa é visto de forma positiva, compreendem a importância de sua intervenção para o desenvolvimento desses jovens, mas explicitaram que o Programa ainda requer melhorias, com relação ao acompanhamento e análise da assimilação do aprendizado por parte dos aprendizes. Portanto, entende-se que o Programa de Aprendizagem vem cumprindo o seu papel para os jovens que conseguem adentrar ao Projeto. Contudo, a sua abrangência precisa ser amplificada, a fim de melhorar o alcance da população juvenil. Desta forma, compreende-se que o plano traçado é eficaz, mas que ainda existe um longo caminho a seguir.
Escola e Família: Desafios e Harmonia Durante o Período Pandêmico de 2020 no Contexto dos Anos Iniciais / School and Family: Challenges and Harmony During the 2020 Pandemic Period in the Context of the Early Years
Authors: Barros Maria da Conceição Da Silva , Menezes Aurelania Maria De Carvalho
Published: March 2021

Resumo: O mundo sabe que o ano de 2020 foi repleto de problemas causados pela pandemia do Covid-19. O planeta se viu diante de um vírus que necessitava ser repelido. Outras pandemias já aconteceram, mas muitos que hoje vivem, jamais conheceram de perto os danos causados por uma. Entre tantos afetados, a educação precisou buscar altenativas para que o ano letivo não fosse prejudicado. Sendo assim, escola e família, como partes fundamentais para o desenvolvimento e trajetória de vida das pessoas, enfrentaram os desafios e se harmonizaram em prol de objetivos comuns. Neste trabalho, foram destacadas as contribuições da parceria entre escola e família no contexto dos anos iniciais, enfatizando o trabalho dos professores, o uso das (TICs) tecnologias de informação e comunicação, a nova realidade dos estudantes e a ausência de recursos para o acompanhamento das aulas remotas, assim como a falta de internet. Esta pesquisa tem como objetivo, analisar a parceria entre escola e família durante a pandemia de 2020.  Como metodologia, este trabalho é bibliográfico, com natureza qualitativa e descritiva.
Percepção do Núcleo de Apoio a Saúde da Família no Processo Interdisciplinar de Trabalho / Perception of the Family Health Support Center in the Interdisciplinary Work Process
Authors: Brito Alexandra Rosendo De Oliveira , Pereira Leice De Brito , Lobo Lorena De Souza , Nunes Ronaldo De Lima , Saraiva Maria Aparecida De Barros , Sousa Carmelita Maria Silva , Feitosa Pedro Walisson Gomes , Marque Cicera Leice Silva , Alves Janaina Brito , Santana Wilma José de , Luz Dayse Christina Rodrigues Pereira
Published: March 2021

Resumo: O presente estudo teve como objetivo analisar o processo interdisciplinar dos profissionais do Núcleo de Apoio a Saúde da Família na cidade de Juazeiro do Norte – Ceará. A princípio traçou-se o perfil dos profissionais, identificou-se as ferramentas utilizadas no NASF em sua organização de trabalho e verificou-se quanto a organização do processo de trabalho do NASF com foco nos territórios de suas responsabilidades como forma de priorizar ás ações de suas competências, acontecem de forma interdisciplinar entre as equipes de Saúde da Família. A amostra para o estudo foi composta por 13 profissionais das referidas equipes cujos resultados estão organizados em 5 categoria: 1. Capacitação profissional. 2. Trabalho interdisciplinar. 3. Percepção dos profissionais das unidades sobre as responsabilidades do NASF. 4. Avaliação e metas para o desenvolvimento do processo de trabalho do NASF, sob a ótica dos profissionais .5. Realização Profissional. Por fim, constatou-se mediante análise dos resultados que os participantes da pesquisa avaliam de forma positiva o trabalho interdisciplinar nas unidades e vêm como mecanismo importante de ajuda no desenvolvimento das ações e estratégias, proporcionando um trabalho com qualidade para os usuários e consequentemente melhores resultados para a qualidade de vida.
ECMO A Terapia Que Salva Vidas: Revisão Sistemática / ECMO Life-Saving Therapy: Systematic Review
Authors: Ribeiro Ágatha Patricia Rodrigues
Published: March 2021

Resumo: A circulação extracorpórea prolongada promovida a partir de um dispositivo mecânico de uso temporário podendo durar dias ou meses. Com o intuito de fornecer suporte ao coração e o pulmão até promoção de sua recuperação ou substituição. O objetivo deste estudo é explorar os aspectos mais relevantes da circulação extracorpórea e contribuir cientificamente evidenciando os estudos realizados por meio de uma revisão sistemática da literatura. Realizada conforme as recomendações do Preferred Reporting Intens for Systematic Reviews and Meta-Analyses (PRISMA). A busca pelos artigos científicos ocorreu nas bases de dados eletrônicos Extracorporeal Life Support Organization (ELSO), PubMed, Literatura Latino Americana e do Caribe em ciências da Saúde (LILACS) e Scientific Eletronic Library Online (SciELO), PEDro (Physiotherapy  Evidence  Database) e buscas manuais nas referências dos artigos incluídos. Foi discutido o surgimento e expansão da utilização do ECMO pelo mundo, formas de utilização, qualidade de vida das crianças que utilizaram o ECMO a partir de avaliação neurológica, os riscos de infecções hospitalares associados a terapia, custo-beneficio, comparou-se o ECMO a outras terapias convencionais e os parâmetros ventilatórios, a mobilização precoce e seus benefícios e por fim o desmame. Conclui- se que a ECMO é uma terapia eficaz no tratamento da SDRA ou outras causas de insuficiência respiratória em adultos e crianças aumentando a sobrevida dos pacientes, sendo considerada uma terapia de resgate principalmente em transplantes de pulmão e coração por promover tempo de recuperação e substituição dos órgãos com eficiência e a relação custo-utilidade associada ao uso de oxigenação por membrana extracorpórea no Brasil é potencialmente aceitável.
Papel do Médico de Família e Comunidade no Manejo da Hipertensão Arterial na Atenção Primaria à Saúde / Role of Family and Community Physicians in the Management of Hypertension in Primary Health Care
Authors: Nóbrega Thiago Fragoso , Sousa Milena Nunes Alves de
Published: March 2021

Resumo: As Linhas de Cuidado são conhecimentos que apresentam sua definição em conhecimentos específicos de promoção, proteção e prevenção de certas patologias, através de tecnologias e recursos que são necessários para enfrentar determinados riscos, agravos ou condições específicas do ciclo de vida ou de tratamentos específicos, a serem ofertados de forma oportuna, articulada e contínua pelo sistema de saúde. Tendo em vista essas eventualidades, o tema do presente trabalho foi traçado para demonstrar o papel e a importância do médico na Estratégia de Saúde da Família (ESF) de forma mais precisa, no controle da Hipertensão Arterial Sistêmica(HAS) e suas eventualidades. O objetivo do presente trabalho é de desenvolver uma revisão de literatura acerca do papel do médico inserido na atenção básica no tratamento da hipertensão arterial sistêmica. Coube ao pesquisador promover uma síntese de todo o material colhido, fazendo com que os produtos da mesma correspondam a um suporte e demostre de forma clara e sucinta as características do assunto abordado. O qual pode demonstrar de forma direta os objetivos aos quais foram propostos. A HAS é considerada um problema de saúde pública nos dias atuais. Também é considerada um dos principais fatores de risco para doenças cardiovasculares, que nos últimos anos foram causas de altas de taxas de mortalidade no mundo. Os fatores associados ao desenvolvimento da hipertensão arterial são envelhecimento, excesso de peso, baixa escolaridade, fatores socioeconômicos, tabagismo, etilismo, genética, sedentarismo e excesso de consumo de sódio na dieta. Os médicos de família, especialistas que atuam na ESF, implementada pelo Ministério da Saúde em 1994, são capacitados para identificar, controlar e prevenir a hipertensão, além de evitar complicações. A atenção básica também tem impacto positivo econômico, pois com o tratamento preventivo e detecção inicial de doenças, como a patologia em questão, evita agravos que podiam vir a impactar em demandas de emergências cardiovasculares que necessitassem de internações ou procedimentos terciários de alto custo.
Dificuldades no Acompanhamento de Portadores de Hipertensão Arterial Sistêmica Utilizando a Ferramenta de Monitoramento Residencial da Pressão Arterial / Difficulties in Monitoring Patients with Systemic Arterial Hypertension Using the Home Blood Pressure Monitoring Tool
Authors: Lima Josicleiton Morais de , Santos Amanda Camboim De Sá , Rafael João Paulo Soares , Galindo Victor Lucas Avelino , Sousa Milena Nunes Alves de
Published: March 2021

Resumo: O objetivo deste trabalho foi identificar as principais dificuldades encontradas no acompanhamento dos portadores de Hipertensão Arterial Sistêmica (HAS) utilizando a ferramenta MRPA, bem como as vantagens e eficácia do tratamento ao hipertenso. Foi realizado o levantamento dos artigos científicos nas bases de dados eletrônicas Google Acadêmico e Scientific Electronic Library Online. Após a inserção dos critérios de inclusão e exclusão foram selecionados dez estudos publicados entre 2005 e 2020 para compor a amostra. As dificuldades apontadas na literatura foram: o declínio do uso da ferramenta em longo prazo, dificuldade no manuseio do aparelho, número insuficiente de medidas pelos pacientes dos estudos e indução de estresse e ansiedade nos pacientes. Além disso, foram averiguadas vantagens do uso da ferramenta e a eficácia desse tipo de monitorização no tratamento ao portador de HAS. A ferramenta MRPA é eficaz no diagnóstico e acompanhamento de hipertensos, e para melhor usufruir dessa estratégia, é preciso que os profissionais estejam atentos às dificuldades apontadas e solucioná-las.
CAPS AD: A Relevância dos Serviços e as Contribuições da Psicologia / CAPS AD: The Relevance of Services and the Contributions of Psychology
Authors: Teixeira Paulo Tadeu Ferreira
Published: March 2021

Resumo: Este artigo apresenta conhecimento a respeito do centro de atenção psicossocial álcool e outras drogas (CAPS AD) e a contribuição do Psicólogo neste cenário de saúde mental. Esta modalidade de serviço é um ambiente terapêutico e multidisciplinar que proporciona acesso a direitos para além da saúde, buscando a promoção da saúde e qualidade de vida para os usuários assistido, assim também pelo desenvolvimento das novas reinserções sociais. Esta modalidade de assistência foi implantada no Brasil a fim de ser um serviço de portas abertas, no qual o usuário do serviço, em sua liberdade e autonomia, buscando o atendimento e percebendo o respeito sua demanda e sua história.  A elaboração deste artigo se faz de uma pesquisa de cunho qualitativo, descritivo e exploratório. Considera-se que para avanços e mudanças nos estudos sobre o uso abusivo de álcool e outras drogas, deve-se pensar em ações interventivas aos usuários, além da articulação de abordagens dos diversos saberes que insiram a essa temática de modo transversal o aprimoramento do desenvolvimento individual e psicossocial.
Elemental Analysis of Medicinal Plant Moringa stenopetela leaves by Atomic Absorption Spectroscopy
Authors: Bojago Tsegaye
Published: March 2021

The purpose of the current study is to analyze the concentration levels of selected trace metals: Ca, Cu, Fe, K and Zn in medicinal plant Moringa stenopetala grown in SNNPR, Ethiopia. A wet digestion procedure is used. Thus, the result showed that the concentrations of Ca, Cu, Fe, K and Zn in Moringa stenopetala grown in Gamo Gofa (Arbaminch) were;2.80±0.36, 0.866±0.134, 7.98±1.23, 3.02±0.63 and 84±0.92 mg/Kg, in Wolaita 3.28±0.28, 0.94±0.16, 7.13±1.32, 7.13±1.32 and 0.61±0.11mg/Kg and in Konso were; 2.97±0.67, 0.77±0.098, 6.79±0.73, 2.39±0.23 and 0.37±0.006mg/Kg respectively.
MODIFIED EQUATION FOR A CLASS OF EXPLICIT AND IMPLICIT SCHEMES SOLVING ONE-DIMENSIONAL ADVECTION PROBLEM
Authors: Bodnár Tomáš , Fraunié Philippe , Kozel Karel
Published: February 2021

This paper presents the general modified equation for a family of finite-difference schemes solving one-dimensional advection equation. The whole family of explicit and implicit schemes working at two time-levels and having three point spatial support is considered. Some of the classical schemes (upwind, Lax-Friedrichs, Lax-Wendroff) are discussed as examples, showing the possible implications arising from the modified equation to the properties of the considered numerical methods.
ON THE SENSITIVITY OF THE NONLINEAR TERM IN THE OUTFLOW BOUNDARY CONDITION
Authors: Neustupa Tomáš , Winter Ondřej
Published: February 2021

This paper studies the artificial outflow boundary condition for the Navier-Stokes system. This type of condition is widely used and it is therefore very important to study its influence on a numerical solution of the corresponding boundary-value problem. We particularly focus on the role of the coefficient in front of the nonlinear term in the boundary condition on the outflow. The influence of this term is examined numerically, comparing the obtained results in a close neighbourhood of the outflow. The numerical experiment is carried out for a fluid flow through the channel with so called sudden extension. Presented numerical results are obtained by means of the OpenFOAM toolbox. They confirm that the kinetic energy of the flow in the channel can be controlled by means of the proposed boundary condition.
MULTIVARIATE INTERPOLATION USING POLYHARMONIC SPLINES
Authors: Segeth Karel
Published: February 2021

Data measuring and further processing is the fundamental activity in all branches of science and technology. Data interpolation has been an important part of computational mathematics for a long time. In the paper, we are concerned with the interpolation by polyharmonic splines in an arbitrary dimension. We show the connection of this interpolation with the interpolation by radial basis functions and the smooth interpolation by generating functions, which provide means for minimizing the L2 norm of chosen derivatives of the interpolant. This can be useful in 2D and 3D, e.g., in the construction of geographic information systems or computer aided geometric design. We prove the properties of the piecewise polyharmonic spline interpolant and present a simple 1D example to illustratethem.
Numerical Modeling for Corrosion Rate between Heat-affected Zone and Unaffected Base Metal of Galvanized Steel Welded by Brazing
Authors: Pinyo Adisak , Bangyeekhan Sompong , Yingsamphancharoen Trinet , Rodchanarowan Aphichart
Published: March 2021

Brazing of galvanized steel causes decaying of the zinc coating and decreasing of corrosion resistant on heataffected zone (HAZ) and weldment. The corrosion rates among the HAZ, unaffected base metal (UBM), and weldment of galvanized steel welded by brazing were numerically modeled by COMSOL Multiphysics. The numerically modeled current density values from various zones, such as the couples between the HAZ and the UBM, between the weldment and the HAZ, and between the UBM and steel were used to calculate the corrosion rates. In this work, two different methods based on Faraday’s Law, the mixed potential theory and the Numerical modeling, were compared for calculations of the corrosion rates of each region. Using the mixed potential theory, the calculated corrosion rates of region I, II, III, IV, V and VI were 0.853, 0.284, 2.105,1.754, 2.028 and 0.554 mm/y, respectively. Where as based on the Numerical modeling, these rates of all regions were 0.918, 0.275, 2.198, 1.904, 2.151, and 0.566 mm/y, in orderly. These comparisons suggested that the corrosion rates obtained from two methods were similar. However, the results showed that the Numerical modeling method could predict the corrosion rate with less error.
Moral Licensing
Authors: Schuler Johannes , Burger Axel , Walikewitz Nadine
Published: March 2021

Wie kann die Dynamik von Rebound Effekten auf der individuellen Ebene erklärt werden? Das psychologische Konzept der Moralischen Lizensierung, also eines sogenannten Freifahrtscheins, gibt erste Hinweise auf die Zusammenhänge.
Evaluation of Plant-based Pesticide containing Neem Extract (Azadirachta sp.) to Control Anthracnose Growth in Chili Fruits
Authors: Paradisa Yashanti Berlinda , Wahyuni  , Mulyaningsih Enung Sri , Perdani Ambar Yuswi , Prianto Arief Heru
Published: March 2021

Cabai merupakan salah satu produk hortikultura yang banyak dikonsumsi di Indonesia. Antraknosa merupakan salah satu penyakit utama dalam budi daya cabai. Kehilangan hasil akibat antraknosa mencapai 35%. Penelitian ini bertujuan untuk menentukan efektivitas pestisida nabati dengan bahan utama ekstrak mimba dalam mengendalikan antraknosa pada cabai. Penelitian ini dilakukan di Pusat Penelitian Bioteknologi, LIPI. Pengujian in vitro dilakukan menggunakan rancangan acak kelompok faktorial yang diulang 4 kali dengan faktor pertama ialah cendawan Colletotrichum acutatum dan Colletotrichum gloeosporioides; faktor kedua ialah pestisida nabati dengan bahan aktif mimba (Agr I dan Agr II); serta faktor ketiga berupa 6 taraf perlakuan konsentrasi pestisida (0%, 0.5%, 1%, 2%. 3%, 4%, dan 5%). Pada pengujian in vivo dilakukan menggunakan rancangan acak kelompok faktorial dengan 4 ulangan. Faktor pertama ialah cabai besar dan cabai keriting; faktor kedua ialah C. acutatum dan C. gloeosporioides; dan faktor ketiga ialah 4 taraf konsentrasi pestisida Agr I (0%, 5%, 10, dan 15%). Berdasarkan hasil pengujian diketahui bahwa pestisida nabati Agr I dan Agr II dapat menghambat pertumbuhan cendawan secara in vitro dan Agr I lebih potensial untuk mengendalikan Colletotrichum spp. Namun pestisida nabati Agr I tidak mampu mengendalikan patogen yang telah berada di dalam jaringan tanaman.