bluuebunny/crossref_metadata_2025 huggingface dataset:
Trypsinolysis of Polyurethane Particles Based on Сyclodextrin with Encapsulated Moxifloxacin
Authors: Yakupova L.R. , Skuredina А.А. , Kudryashova Е.V.
Published: October 2021

Abstract-Moxifloxacin encapsulation in polymer cyclodextrin-based particles with an average hydrodynamic diameter of 150--200 nm has led to the formation of potential delivery systems with a degree of moxifloxacin inclusion of more than 80%. Cross-linking of the moxifloxacin-cyclodextrin complexes caused a pronounced slowdown in the release of the drug molecules in acidic media to less than 10% per day. In the presence of trypsin, the drug release was accelerated by 15--20% within 90 min. It was shown by Fourier-transform infrared spectroscopy that this acceleration was due to the partial enzymatic degradation of the urethane bonds of the polymer matrix near the surface of the particles. The results obtained are important for the development of highly effective oral dosage forms of prolonged action.

Key words: fluoroquinolones, cyclodextrins, FTIR spectroscopy, trypsin
Data-augmentation de dados de radiografia de torax no contexto de aprendizagem profunda
Authors: Nascimento Otto Tavares , Seixas José Manoel , Trajman Anete
Published: October 2021

Este artigo discute técnicas de aprendizagem profunda aplicadas ao problema de triagem de tuberculose ativa em radiografias de tórax. O objetivo é contribuir para a prevenção e para o tratamento desta doença infecciosa, propondo uma rede neural convolucional (CNN) classificadora de tuberculose ativa, tendo como dados de entrada um conjunto de radiografias de tórax de indivíduos com ou sem tuberculose. Para melhor ajustar os parâmetros da CNN, técnicas de data-augmentation, utilizando modelos generativos adversariais (GAN), são aplicadas e avaliadas.
Assessment of rainfall trend and variability of semi-arid regions of Upper and Middle Godavari basin, India
Authors: Aher Madhura Chetan , Yadav S. M.
Published: October 2021

Study of rainfall pattern and trend in the long term is essential from climatic change and socioeconomic perspectives. In the present study, monthly, seasonal and annual rainfall of semi-arid regions (Madhya Maharashtra, Marahwada and Vidarbha) of the Godavari basin is evaluated for the period of 1871–2016. The innovative trend analysis (ITA), Mann–Kendall test (MK) and Sen's slope estimator methods are used to check gradual change. A significant increasing or decreasing trend is not detected in the seasonal and annual rainfall series for any of the regions. The rainfall variability index indicates Madhya Maharashtra has received normal rainfall for 40% of the time, Marathwada for 36% of the time and Vidarbha region for 41% of the time. Very dry and very wet conditions are experienced by all three regions for 15% of the time. The spatial and temporal variation in the seasonal and annual rainfall is not significant in these regions. The results obtained from the study will be useful for water resource management of the Godavari basin.
Wogonin and Alleviation of Hyperglycemia via Inhibition of DAG
Mediated PKC Expression. A Brief Insight
Authors: Khan Shahzad
Published: October 2021

Protein kinase C (PKC) is a family of protein kinase enzymes that can phosphorylate
other proteins and influence their functions, such as signal transduction, cell survival, and death. Increased
diacylglycerol (DAG) concentrations, which are typically observed raised in hyperglycemic
situations such as diabetes mellitus, can also activate PKC enzymes (DM). On the other
hand, PKC isomers have been shown to play an essential role in diabetes and many hyperglycemic
complications, most importantly atherosclerosis and diabetic cardiomyopathy (DCM). As a result,
blocking PKC activation via DAG can prevent hyperglycemia and related consequences, such as
DCM. Wogonin is a herbal medicine which has anti-inflammatory properties, and investigations
show that it scavenge oxidative radicals, attenuate nuclear factor-kappa B (NF-κB) activity, inhibit
several essential cell cycle regulatory genes, block nitric oxide (NO) and suppress cyclooxygenase-
2 (COX-2). Furthermore, several investigations show that wogonin also attenuates diacylglycerol
DAG levels in diabetic mice. Since the DAG-PKC pathway is linked with hyperglycemia
and its complications, Wogonin-mediated DAG-PKC attenuation can help treat hyperglycemia and
its complications.
Chickpea Leaf Exudates: A Highly Efficient Natural Brønsted Acidic Medium for the Synthesis of Pyran-annulated Heterocycles
Authors: Mali Snehali R. , Shinde Sachinkumar K. , Patil Bhagyashree M. , Patil Rupesh C. , Patil Suresh S.
Published: October 2021

We reported Chickpea leaf exudates (CLEs) as a Brønsted acid, naturally available biodegradable, eco-friendly, and reusable reaction medium for highly efficient and facile one-pot synthesis of pyran-annulated heterocyclic systems, like 7-aryl-benzopyrano[4,3-b]benzopyran-6,8- diones,tetrahydrobenzo[b]pyran, and dihydropyrano[c]chromenes scaffolds. The analogous products were obtained via tandem Knoevengel-Michael addition and cyclo condensation reaction in ethanol at room temperature with 90-96% yields in a short reaction time. Moreover, the reaction media containing Bronsted acids can be easily recovered and reused up to five times, slightly decreasing product yields.
Cardiovascular disease in chronic kidney disease – a review of risk factors
Authors: Hassan Muzamil Olamide , Oguntola Stephen Olawale , Duarte Raquel , Naicker Saraladevi
Published: October 2021

Patients with chronic kidney disease (CKD) are at increased risk of cardiovascular disease (CVD), such that the risk of cardiovascular mortality is greater than the risk of progression to end-stage kidney disease. Despite the increased prevalence of traditional and non-traditional cardiovascular risk factors, patients with kidney disease have been mostly under-represented in previous cardiovascular outcome studies, thereby resulting in a paucity of data on the evidence-based management of CVD in CKD. In this review, we explore the evidence on the burden of CVD and its risk factors in patients with CKD, highlight various inflammatory biomarkers for predicting CVD and provide an overview on novel biomarkers for CVD.
Renal palliative and supportive care in South Africa – a consensus statement
Authors: Wearne Nicola , Krause Rene , Davidson Bianca , Brennan Frank
Published: October 2021

In South Africa, there is a high burden of end-stage kidney disease (ESKD). This is due to the burgeoning epidemics of communicable diseases like HIV/AIDS and non-communicable diseases, particularly hypertension and diabetes mellitus. One of the most difficult situations encountered by healthcare professionals dealing with patients with ESKD in South Africa is the management of a conservative or palliative care pathway for the many patients who have no other option. Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Many patients are managed in primary healthcare settings and either do not have access to palliative care or are not referred appropriately. Renal supportive and palliative care involves a multidisciplinary approach to managing patients with ESKD, to ensure that symptoms are managed optimally and to provide support during advanced disease. It aims to improve quality of life for patients and their families and must be provided alongside curative medical care. This support should include those unable to gain access to life-saving dialysis and it should also provide care for patients where dialysis is not the best option. The aim of this consensus statement is to assist healthcare providers to improve the management of symptoms and biosocial factors of patients with end-stage kidney disease in a South African context. The document was compiled through consensus building among healthcare professionals across South Africa. The professionals that are represented included nephrologists, palliative care physicians, social workers, nurses, paediatricians and hospital managers. We wish to acknowledge the contribution of Dr Frank Brennan, a leading expert in renal palliative and supportive care, who assisted greatly in the compilation of this document.
AFRAN guidelines on COVID-19 and the kidney
Authors: Were Anthony
Published: October 2021

COVID-19, a disease caused by the novel virus SARS-CoV-2, was declared a pandemic by the World Health Organization on 11 March 2020. It originated from Wuhan, the capital city of the Hubei province in central China. It has now spread to almost every country in the world and all the continents except Antarctica and has been associated with significant fatalities.COVID-19 infection has been documented in 47 countries in Africa, with almost 85,000 cases and 2,760 deaths as at 16 May 2020. The mortality is significantly lower in Africa than elsewhere for reasons that are still unclear. In the typical case, a patient presents with fever or respiratory symptoms such as cough or difficulty in breathing, usually within 14 days of coming into contact with an infected person. Acute kidney injury may occur as part of multisystem involvement in the very ill patient and is often managed in the intensive care unit. Our patients with chronic kidney disease, including those on chronic dialysis, will easily get infected with SARS-CoV-2 if exposed, due to their immunosuppressed state. Similarly, the immunosuppressed patient who has received a kidney transplant requires special precautions to prevent and manage infection with SARS-CoV-2. The transplantation operation itself also requires clear guidelines to prevent coronavirus infection.The executive committee of the African Association of Nephrology (AFRAN) convened a special project committee of senior nephrologists from across the continent to develop guidelines relevant to the African continent on the management of the renal complications of COVID-19 and on the management of COVID-19 in patients with chronic kidney disease. The guidelines include recommendations on the prevention and management of COVID-19 in patients receiving kidney replacement therapy with haemodialysis, peritoneal dialysis or a kidney transplant. The article, titled ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’, is published on page 109 of this issue and represents an impressive collaboration by African nephrologists. These guidelines will be of practical value across the length and breadth of the African continent, from the well resourced to the most disadvantaged settings. The guidelines will also be of value to other parts of the world with respect to COVID-19 and the kidney. On behalf of AFRAN, I wish to congratulate the colleagues who contributed to the development of these guidelines. We are sure that the information they contain will greatly benefit the management of COVID-19 in Africa. Anthony WerePresident, African Association of Nephrology.
How oral infections can influence chronic kidney disease – a review of the literature
Authors: Pontes Carla Cruvinel , Chikte Usuf ME
Published: October 2021

A healthy mouth is necessary for optimal health and quality of life. However, oral health is often compromised in adults with chronic kidney disease (CKD). The aim of this review was to present the scientific foundations behind the connection between oral diseases and chronic kidney disease (CKD) in adults, discuss common oral conditions and their systemic effects, investigate biological pathways through which oral infections affect the body and provide guidelines for physicians/nephrologists. Prevalence of oral disease is increased in CKD, including periodontal disease, oral mucosal lesions, edentulousness, xerostomia, gingival overgrowth in immunosuppressed patients and potentially caries. There is moderate to strong evidence to support a negative impact of oral infections in CKD, particularly periodontal disease, with systemic inflammation, bacteraemia of oral origin, endothelial function and gut dysbiosis being potential pathways for this interaction. Poor oral health can be a hidden source of infection and has been associated with increased mortality in CKD patients. Elimination of potential foci for oral infections is crucial before renal transplantation. Frequent dental monitoring is crucial for these patients and should be part of a multidisciplinary approach to manage CKD, with special attention to end-stage kidney disease.
Hepatitis C virus infection and global kidney health: the consensus proceedings of the International Federation of Kidney Foundations
Authors: Saadi Gamal , Kalantar-Zadeh Kamyar , Almasio Piero , Ashuntantang Gloria , Barsoum Rashad , Bruchfeld Annette , Doss Wahid , El-Fishawy Hussein , El Razik Maissa , El-Serafy Magdy , Fabrizi Fabrizio , Hafez Hany , Hassaballa May , Hammady Mona , Sheishaa Hussein , Abdelaziz Tarek Samy , Ulasi Ifeoma , Zakharova Elena
Published: October 2021

Hepatitis C virus (HCV) infection is an important cause of major morbidities including chronic liver disease, liver cancer, acute kidney injury and chronic kidney disease (CKD). Among patients with kidney disease who have HCV infection, the clinical outcomes are worse. The prevalence of HCV infection is exceptionally high among dialysis and kidney transplant patients throughout the globe. It is estimated that 5% to 25% or more of dialysis-dependent patients are affected. Almost half of all deaths in CKD patients, including HCV-infected patients, are due to cardiovascular disease, and HCV-infected patients have higher mortality. Given the importance and impact of the HCV epidemic on global kidney health, and the status of Egypt as the nation with the highest prevalence of HCV infection in the world along with its initiatives to eradicate HCV, the International Federation of Kidney Foundations convened a consensus conference in Cairo in December 2017. This article reflects the opinions and recommendations of the contributing experts and reiterates that, with the current availability of highly effective and well tolerated pharmacotherapy, CKD patients should be given priority for the treatment of HCV, as an important step towards the World Health Organization’s goal of eliminating viral hepatitis as a public health problem by 2030.
Strategies used by Kenyan patients on maintenance haemodialysis for coping with stress related to intradialytic events
Authors: Muthoka Lydia , Maina Dorcas , Kimani Samuel Thuo
Published: October 2021

Background: Patients on haemodialysis experience various challenges associated with their disease as well as complications related to therapy. Intradialytic events, such as cramping, hypotension and shivering, are major stressors for persons on haemodialysis. In an attempt to cope with stress associated with dialysis, most patients tend to adopt emotion-orientated coping strategies. This study aimed at evaluating the coping strategies used by patients at Kenyatta National Hospital, to deal with stress related to intradialytic events. Methods: A cross-sectional study was conducted among 96 participants undergoing maintenance haemodialysis. They were selected through convenience sampling. Data were collected using a researcher-administered questionnaire for demographic data, a visual analogue scale to assess stress, and the Jaloweic coping scale. Data were analysed using SPSS version 23. Results: The majority (62%) of the participants were male. Muscle cramps (55%), headaches (54%) and hypertension (47%) were the most commonly experienced intradialytic events. The mean level of stress on the Jaloweic scale was 5.1 ± 2.1. The commonly used coping strategies were confrontational (45%), fatalistic (46%) and supportive (48%). The level of stress explained 66% of the variance associated with the use of a coping style (P = 0.01). Conclusions: Intradialytic events were common among our participants and the majority used confrontational, fatalistic and supportive coping strategies. Tailored counselling services are recommended to reinforce effective coping.
Urine ‘picket fence’ crystals in ethylene glycol poisoning
Authors: Chothia Mogamat-Yazied , Bapoo Nabeel
Published: October 2021

A 46-year-old woman intentionally ingested ethylene glycol and overdosed on paracetamol. She had clinical and laboratory features suggestive of ethylene glycol poisoning, and examination of the urine revealed calcium oxalate monohydrate, or ‘picket fence’, crystals. She responded well to therapy that included haemodialysis. Clinicians should be aware that these crystals appear late during the evolution of ethylene glycol poisoning and, along with other clinical and laboratory findings, should prompt the initiation of haemodialysis.
Engaging the Private Sector for National Security
Authors: Gordon Robert
Published: October 2021

On November 23, 2020, Robert Gordon presented on the topic of Engaging the Private Sector for National Security at the 2020 CASIS West Coast Security Conference. The presentation was followed by a moderated question and answer period. Key points of discussion included: federal level engagement with the private cybersecurity sector, the level of the cyber threat environment that the private sector is dealing with, and the requirement for a collaborative approach in the national security environment.
Characterizing Vaping Industry Political Influence and Mobilization on Facebook: Social Network Analysis
Authors: Haupt Michael Robert , Xu Qing , Yang Joshua , Cai Mingxiang , Mackey Tim K
Published: October 2021

Background

In response to recent policy efforts to regulate tobacco and vaping products, the vaping industry has been aggressive in mobilizing opposition by using a network of manufacturers, trade associations, and tobacco user communities, and by appealing to the general public. One strategy the alternative tobacco industry uses to mobilize political action is coordinating on social media platforms, such as the social networking site Facebook. However, few studies have specifically assessed how platforms such as Facebook are used to influence public sentiment and attitudes towards tobacco control policy.

Objective

This study used social network analysis to examine how the alternative tobacco industry uses Facebook to mobilize online users to influence tobacco control policy outcomes with a focus on the state of California.

Methods

Data were collected from local and national alternative tobacco Facebook groups that had affiliations with activities in the state of California. Network ties were constructed based on users’ reactions to posts (eg, “like” and “love”) and comments to characterize political mobilization networks.

Results

Findings show that alternative tobacco industry employees were more likely to engage within these networks and that these employees were also more likely to be influential members (ie, be more active) in the network. Comparisons between subnetworks show that communication within the local alternative tobacco advocacy group network was less dense and more centralized in contrast to a national advocacy group that had overall higher levels of engagement among members. A timeline analysis found that a higher number of influential posts that disseminated widely across networks occurred during e-cigarette–related legislative events, suggesting strategic online engagement and increased mobilization of online activity for the purposes of influencing policy outcomes.

Conclusions

Results from this study provide important insights into how tobacco industry–related advocacy groups leverage the Facebook platform to mobilize their online constituents in an effort to influence public perceptions and coordinate to defeat tobacco control efforts at the local, state, and federal level. Study results reveal one part of a vast network of socially enabled alternative tobacco industry actors and constituents that use Facebook as a mobilization point to support goals of the alternative tobacco industry.
Transforming Anesthesia Data Into the Observational Medical Outcomes Partnership Common Data Model: Development and Usability Study
Authors: Lamer Antoine , Abou-Arab Osama , Bourgeois Alexandre , Parrot Adrien , Popoff Benjamin , Beuscart Jean-Baptiste , Tavernier Benoît , Moussa Mouhamed Djahoum
Published: October 2021

Background

Electronic health records (EHRs, such as those created by an anesthesia management system) generate a large amount of data that can notably be reused for clinical audits and scientific research. The sharing of these data and tools is generally affected by the lack of system interoperability. To overcome these issues, Observational Health Data Sciences and Informatics (OHDSI) developed the Observational Medical Outcomes Partnership (OMOP) common data model (CDM) to standardize EHR data and promote large-scale observational and longitudinal research. Anesthesia data have not previously been mapped into the OMOP CDM.

Objective

The primary objective was to transform anesthesia data into the OMOP CDM. The secondary objective was to provide vocabularies, queries, and dashboards that might promote the exploitation and sharing of anesthesia data through the CDM.

Methods

Using our local anesthesia data warehouse, a group of 5 experts from 5 different medical centers identified local concepts related to anesthesia. The concepts were then matched with standard concepts in the OHDSI vocabularies. We performed structural mapping between the design of our local anesthesia data warehouse and the OMOP CDM tables and fields. To validate the implementation of anesthesia data into the OMOP CDM, we developed a set of queries and dashboards.

Results

We identified 522 concepts related to anesthesia care. They were classified as demographics, units, measurements, operating room steps, drugs, periods of interest, and features. After semantic mapping, 353 (67.7%) of these anesthesia concepts were mapped to OHDSI concepts. Further, 169 (32.3%) concepts related to periods and features were added to the OHDSI vocabularies. Then, 8 OMOP CDM tables were implemented with anesthesia data and 2 new tables (EPISODE and FEATURE) were added to store secondarily computed data. We integrated data from 5,72,609 operations and provided the code for a set of 8 queries and 4 dashboards related to anesthesia care.

Conclusions

Generic data concerning demographics, drugs, units, measurements, and operating room steps were already available in OHDSI vocabularies. However, most of the intraoperative concepts (the duration of specific steps, an episode of hypotension, etc) were not present in OHDSI vocabularies. The OMOP mapping provided here enables anesthesia data reuse.
The Effectiveness of Mobile Phone Messaging–Based Interventions to Promote Physical Activity in Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis
Authors: Alsahli Mohammed , Abd-Alrazaq Alaa , Househ Mowafa , Konstantinidis Stathis , Blake Holly
Published: October 2021

Background

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. Physical activity (PA) is an important aspect of self-care and first line management for T2DM. SMS text messaging can be used to support self-management in people with T2DM, but the effectiveness of mobile text message–based interventions in increasing PA is still unclear.

Objective

This study aims to assess the effectiveness of mobile phone messaging on PA in people with T2DM by summarizing and pooling the findings of previous literature.

Methods

A systematic review was conducted to accomplish this objective. Search sources included 5 bibliographic databases (MEDLINE, Cochrane Library, CINAHL, Web of Science, and Embase), the search engine Google Scholar (Google Inc), and backward and forward reference list checking of the included studies and relevant reviews. A total of 2 reviewers (MA and AA) independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence evaluation. The results of the included studies were synthesized narratively and statistically, as appropriate.

Results

We included 3.8% (6/151) of the retrieved studies. The results of individual studies were contradictory regarding the effectiveness of mobile text messaging on PA. However, a meta-analysis of the results of 5 studies showed no statistically significant effect (P=.16) of text messages on PA in comparison with no intervention. A meta-analysis of the findings of 2 studies showed a nonsignificant effect (P=.14) of text messages on glycemic control. Of the 541 studies, 2 (0.4%) found a nonsignificant effect of text messages on anthropometric measures (weight and BMI).

Conclusions

We could not draw a definitive conclusion regarding the effectiveness of text messaging on PA, glycemic control, weight, or BMI among patients with T2MD, given the limited number of included studies and their high risk of bias. Therefore, there is a need for more high-quality primary studies.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42020156465; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=156465
Peer Review of “Offenders With Personality Disorder Who Fail to Progress: A Case-Control Study Using Partial Least Squares Structural Equation Modeling Path Analysis” (Preprint)
Authors: Sonnweber Martina
Published: October 2021

UNSTRUCTURED

This is a peer review report for ms#27907.
Using virtual representations in mHealth application interventions for health-related behaviour change: A systematic review (Preprint)
Authors: Taylor Lauren , Ranaldi Hannah , Amirova Aliya , Zhang Louisa , Ahmed Ayan , Dibb Bridget
Published: October 2021

UNSTRUCTURED

Many mobile health application interventions include virtual representations of the self in varying forms, such as agents, or avatars to initiate behaviour change. This review aimed to determine: (i) which virtual representations and digital features are effective in mHealth application interventions, and (ii) whether if any studies implemented specific mechanisms (the psychological causes of change) and BCTs implemented to influence positive behaviour change were identified. Following PRISMA guidelines, a narrative systematic review of empirical studies from ten different databases (ranging from MEDLINE to Cochrane Library) from inception to October 2021, published from any time point, which included a virtual representation mHealth app intervention that addressed and reported a variety of outcome health behaviours. Out of the 2,579 original hits, five eligible studies (total participants = 509), with low to moderate quality were included. It was found that customisable avatar or agent-based interventions that included mechanisms such as motivation, feedback, self-image, and BCTs such as goal setting, and self-monitoring were effective in encouraging behaviour change and app adherence. However, there is limited evidence available to determine to which these influences are a result of the virtual representations, or the intervention design.
Assessment of the eNutri personalized nutrition tool in Germany – Usability metrics and users’ experiences (Preprint)
Authors: Kaiser Birgit , Stelzl Tamara , Finglas Paul M. , Gedrich Kurt
Published: October 2021

BACKGROUND

Adequate dietary intake assessments are needed to determine the actual nutrition intake of a population. Paper-pen versions have long been used as validated dietary assessment tools, but in the age of digitalization, these tools are increasingly becoming converted into digital versions. We developed a validated Food Frequency Questionnaire (FFQ) integrated into the eNutri web application (app) to capture dietary intake tailored to a Western European population and provide dietary recommendations in a digital format.

OBJECTIVE

The primarily focus of this study was to evaluate the system usability and users’ feedback of the eNutri app.

METHODS

The app was piloted for four weeks by 106 participants from Germany divided into a Personalized Nutrition (PN) group and a control group. The groups differed according to the degree of personalization of dietary recommendations obtained.

RESULTS

An overall system usability score (SUS) of 78.4 (SD 12.2) was yielded, indicating an above average user experience. Mean completion time of the FFQ was 26.7 minutes (SD 10.6). Across subgroups (age, sex, screen sizes) no differences in SUS or completion time were found, indicating an equal performance for all users independent of the assigned experimental group. Participants´ feedback highlighted the need for more personalized dietary advice for control subjects. Further improvements of the eNutri app were suggested by the app users.

CONCLUSIONS

In total, eNutri provides a validated FFQ in a web-based graphical version, considering nutritional specificities of the German population. It was well received and supportive comments for further development of the digital diet assessment tool (e.g., more detailed dietary feedback) has been provided by the users.
Appeal of editor-in-chief
Authors: Nikonov V.V.
Published: October 2021

No abstract
Evaluation of the influence of individualized protective ventilation on the lung mechanical properties
Authors: Kuzmenko T.S. , Vorotyntsev S.I.
Published: October 2021

The work is devoted to the study of the influence of individualized protective ventilation support on pulmonary mecha-nics. The study included 47 patients who underwent open abdominal surgery under general anesthesia. All patients had a moderate to high risk of developing postoperative pulmonary complications by the ARISCAT scale. Intraoperatively, the impact of individualized protective ventilation on respiratory mechanics, namely Ppeak, Pplat, Pdrive, dynamic pulmonary compliance was assessed. Individualized protective respiratory support was ventilation with a tidal volume of 7 ml/kg of ideal body weight, with the selection of the optimal level of positive pressure at the end of exhalation (PEEP), focusing on dynamic pulmonary compliance and performing recruiting maneuver, and then in the case of a decrease in dynamic pulmonary compliance by more than 20 %, followed by re-selection of PEEP. The studied parameters were recorded before and after the recruiting maneuver, as well as on the 30th, 60th, 90th, 120th, 150th, 180th minutes after the recruiting maneuver, depending on the duration of the operation. The use of alveolar straightening techniques led to an improvement in pulmonary mechanics, namely, an increase in dynamic pulmonary compliance by 16 % and a decrease in Pdrive by 17 %. The intraoperative level of PEEP averaged 4 [4; 5] cm of water. No cases of hypoxemia or recurrence of recruiting maneuver were reported. The obtained results indicate that chosen technique of recruiting maneuver is effective and safe, and its use allows reducing the negative impact of mechanical ventilation. The study did not find a statistically significant correlation between the level of PEEP and the value of dynamic pulmonary compliance. Such data prove the need for individual selection of ventilation parameters according to the characteristics of the mechanical properties of each patient.
Improved intraoperative verification of parathyroid glands by determining their autofluorescence in the infrared spectrum
Authors: Gorobeiko M.B. , Dinets A.V. , Hoperia V.H. , Abdalla K.M.
Published: October 2021

Background. Detection of parathyroid glands by spectroscopy of their autofluorescence in the near-infrared spectrum (NIRAF) is considered a promising intraoperative tool in addition to their verification with visual identification. The study was aimed to evaluate the role of NIRAF by using two different imaging systems to confirm parathyroid glands during operations for benign and malignant thyroid and parathyroid tumors. Materials and methods. The study included 62 patients who underwent verification of NIRAF by using two different imaging systems equipped with a near-infrared (NIR) camera during surgery. Intravenous fluorophore of indocyanine green was applied to amplify the NIRAF signal. Results. Normal parathyroid glands were identified and mobilized after a visual inspection in 50 patients (80 %), which was subsequently confirmed by evaluation with NIRAF spectroscopy. Determination of NIRAF in the parathyroid glands and their differentiation from lymph nodes was achieved in 8 (13 %) patients with papillary thyroid carcinoma. In 3 (5 %) patients, the parathyroid gland was identified in the area of the postoperative scar, using NIRAF but not by the visual identification. In 2 (3 %) cases, the appearance of the signal was determined but with a decrease in the intensity of the NIRAF from the parathyroid glands during their unintentional removal. The strong NIRAF signal intensity was observed from the parathyroid gland after changing the position of the NIR camera when using the Fluobeam 800 device at an angle of approximately 45–65° to the area of the parathyroid gland location. The Fluobeam LX demonstrated a satisfactory NIRAF signal without any specific changes in camera position. NIRAF signal was determined in the tissue of toxic thyroid adenomas. NIRAF signal of the low intensity was detected in the invasion of thyroid carcinoma in a capsule of a thyroid gland. No NIRAF signal was observed from metastatic and normal lymph nodes. Conclusions. The use of NIRAF parathyroid spectroscopy technology allows impro-ving their imaging and verification as an additional method during surgery of the neck. The practical value of NIRAF spectroscopy of the parathyroid gland is increased in the case of reoperations due to the risk of accidental removal of the parathyroid gland as well as for differential diagnosis between the parathyroid gland and metastatic lymph nodes.
Characteristics of the type 2 diabetic patients with hypoglycemia in a tertiary referral hospital
Authors: Bilgin Satilmis , Aktas Gulali , Kurtkulagi Ozge , Atak Burcin M. , Kahveci Gizem , Demirkol Muhammed E. , Duman Tuba T.
Published: October 2021

Background. Hypoglycemia is an important complication of the treatment of type 2 diabetes mellitus, which constitutes a barrier in stringent diabetic control. Beside it constitutes nearly 10 % of emergency department admissions that caused by adverse drug events, it may also increase morbidities and mortality by inducing, cardiac arrhythmias, neurological impairment and ischemic events. Hypoglycemia is the most common side effect of insulin treatment, however, oral antidiabetic agents may also induce hypoglycemic complications. In present retrospective study, we purposed to observe general characteristics and laboratory data of the type 2 diabetic patients whom presented with mild or moderate/severe hypoglycemia. Materials and methods. Patients with type 2 diabetes mellitus whom presented to our institution with hypoglycemia between January 2019 and January 2020 were retrospectively analyzed. General characteristics and laboratory data of the subjects recorded. Patients grouped into two groups, group I consisted of subjects with mild hypoglycemia and group II consisted of patients with moderate/severe hypoglycemia. Data of the subjects in groups I and II were compared. Results. There were 15 subjects in group I and 23 in group II. HbA1c and other laboratory markers were not significantly different in study groups. Similarly diabetes duration and anti-diabetic treatment were not significantly different in study groups. The rate of geriatric patients was significantly higher in group II compared to group I (p = 0.04). Conclusions. Subjects with moderate/severe hypoglycemia tend to be more frequently in geriatric age and HbA1c not correlates with the degree of the hypoglycemia. Since neither duration of diabetes, nor anti-diabetic treatment were associated with the severity of the hypoglycemia, each case should be evaluated individually to prevent further episodes which could increase morbidity and mortality in diabetic population.
Subclinical Cushing’s syndrome: lots of questions — little answers
Authors: Rybakov S.І.
Published: October 2021

The literature review provides a definition of the essence of subclinical Cushing’s syndrome. Subclinical Cushing’s syndrome (subclinical hypercortisolism) is a pathological condition of the body characterized by an autonomous, excessive secretion of glucocorticoids, most often an adrenal cortex adenoma, suppression of the adrenocorticotropic function of the pituitary gland and the functional state of the opposite adrenal gland. Such a condition may be clini-cally asymptomatic or be accompanied by some nonspecific signs of hypercortisolism (arterial hypertension, diabetes mellitus, obesity, osteoporosis). Noteworthy is the large variability in the frequency of its detection, which is possibly due to the use of various criteria for assigning individual cases to this category. As a basic screening test for the detection of subclinical hypercortisolism, most researchers consider the most acceptable and effective night suppressive test with 1.0 mg of dexamethasone. Modern tactical and technical approaches to the treatment of subclinical Cushing’s syndrome are quite diverse and are more often based on pragmatic principles than on reliably substantiated ones. The author raises the question: could subclinical Cushing’s syndrome be the result of hyperfunction of normal or diffusely enlarged (hyperplastic) adrenal glands as a result of some disturbances in the hypothalamic-pituitary-adrenal hierarchy. And, finally, are the disorders “accompanying” subclinical Cushing’s syndrome a consequence of the overproduction of cortisol, although often insignificant, or can they be the cause of the onset of subclinical hypercortisolism? For the treatment of subclinical hypercortisolism, adrenalectomy is currently proposed, with the aim of reducing the intake of excessive amounts of glucocorticoids into the patient’s body, leading to the development of these disorders. Known drug methods of suppressing the function of the adrenal cortex — drugs chloditan, mitotane, ketoconazole.
Occupational Аccidents and Near-Miss Events in the Internal Medicine Services: Turkey Sample in University Hospital
Authors: Uymaz Pelin , Ozpınar Sinem
Published: October 2021

Background. Health institutions are considered occupational areas with high risk due to the need for human resources, including numerous specialists with distinct characteristics, use of intensive technology, and complex occupational processes. The importance of occupational health and safety, which aims to eliminate or minimize all these negativities, is increasing rapidly. The purpose of this study is to examine the frequency of exposure to occupational accidents and near-miss events of the nurses and physicians working in the internal ­medicine units of a university hospital, and their reporting status and factors affecting these characteristics. Materials and methods. This research is a descriptive study, and the data of the recent year have been evaluated. The research was carried out in internal medicine units of a university hospital in Istanbul. The data in this study were collected by using the “Evaluation Form for Occupational Accidents and Near-Miss Events” which was created by the researchers. Results. A total of 117 individuals, 83 women (70.94 %), and 34 men (29.06 %) participated in this study. Of the participants, 59 were nurses (50.43 %), and 58 were physicians (49.57 %). There was a significant moderate positive correlation (r = 0.305) between age and the number of occupational accidents (p = 0.039). The average number of occupational accidents experienced by nurses (1.31 ± 0.74) was found to be lower than physicians (2.80 ± 2.53) (p = 0.006). The number of near-miss incidents experienced by physicians (2.79 ± 4.30) was higher than the nurses (1.29 ± 83.00) (p = 0.032). Conclusions. Every workplace accident or near-miss event experienced by healthcare professionals should be reported and analyzed carefully to prevent future workplace accidents. Training of health professionals on health risks they may encounter and protective measures against occupational accidents have vital importance.
Endoscopic ultrasonography in the diagnosis of pathology of the gastrointestinal tract
Authors: Stepanov Yu.M. , Prolom N.V. , Konenko I.S. , Tarabarov S.O. , Nedzvetskaya N.V.
Published: October 2021

Endoscopic ultrasonography is a relatively new endoscopic method of examination to determine the invasion of tumors of the gastrointestinal tract, detection and sizing of pancreatic tumors, diagnosis of chronic pancreatitis, pathology of the biliary tract. The method combines the possibilities of two studies: endoscopic and ultrasound. The study is performed using a video endoscope, at the end of which is a scanning ultrasound sensor. The advantages of endoscopic ultrasound over traditional ultrasound examination through the anterior abdominal wall are that the ultrasound sensor under visual control through the lumen of the digestive tract can be carried out directly to the investigated object. The use of very high frequencies of ultrasound provides high image quality with a resolution of less than 1 mm, inaccessible to other research methods (ultrasound, computer tomography and magnetic resonance imaging, endoscopic cholangiopancreatography).
Catastrophic antiphospholipid syndrome (Asherson’s syndrome) caused by a suspected intestinal neuroendocrine tumor: a case report
Authors: Shypulіn V.P. , Cherniavskyi V.V. , Hvozdecka L.S. , Neverovskyi A.V. , Tishchenko V.V.
Published: October 2021

Background. Every year, the number of people with rare forms of the disease is increasing worldwide. One of these is the catastrophic antiphospholipid syndrome — Asherson’s syndrome. To date, it is being actively studied, but the pathophysiological mechanisms of its development have not yet been fully investigated. Our work is the first attempt to describe Asherson’s syndrome on the example of a clinical case in Ukraine. Objective: to determine the factors and mechanisms that led to the death of a patient with Asherson’s syndrome in Ukraine. Materials and methods. The structural-logical analysis and the clinical-statistical method were used. Results. Based on clinical and laboratory criteria, our medical team established a clinical diagnosis of systemic lupus erythematosus complicated by a catastrophic antiphospholipid syndrome (CAPS). Despite treatment with glucocorticoids and anticoagulants according to international guidelines, the patient died. The autopsy results showed that the immediate cause of death was a large blood clot that blocked the pulmonary artery and its main branches. Histological examination revealed thrombosis of small vessels of the kidneys and brain; a neuroendocrine tumor (G2; pT3pNxpM1b) of the small intestine with metastases to the liver, brain, myocardium and kidneys was suspected. An additional immunohistochemical study was performed to clarify the histological diagnosis. The morphological picture and results of immunohistochemical study mostly correspond to the moderately differentiated (G2) non-keratinizing squamous cell carcinoma (ICD-O code: 8070/3) with damage to the walls of the small intestine, liver, lungs, kidneys, myocardium and brain. Conclusions. These data emphasize that despite the rarity of Asherson’s syndrome, it is always necessary to consider its probability in the presence of signs of multiple thrombosis and multiple organ failure. Because its development is the result of serious diseases, including connective tissue diseases, malignancies, infections, the etiotropic and pathogenetic treatment can prevent the development of CAPS and death.
Estilos de liderazgo ambiental en la industria de autopartes de Querétaro
Authors: Paulín Larracoechea José Jaime , Carrillo Pacheco Marco Antonio
Published: October 2021

Objetivo: identificar los estilos de liderazgo ambiental de la alta dirección que emergen en la industria de autopartes de Querétaro (México), a partir del conocimiento y experiencia de los responsables ambientales y sus colaboradores en plantas del sector instaladas en dicho estado.Diseño metodológico: estudio cualitativo, de diseño transversal y con alcance explicativo en el que se usó la propuesta metodológica del configuracionismo planteado desde la sociología del trabajo. Se diseñó y aplicó la técnica de la entrevista semiestructurada a profundidad aplicada a doce informantes calificados.Resultados: los resultados arrojan tres estilos de liderazgo ambiental (solidario, indiferente e inconsecuente) presentes en el sector autopartista queretano, los cuales son distintos a la clasificación convencional de la teoría transformacional.Limitaciones de la investigación: 1) la necesidad de visitar un mayor número de instalaciones con diferentes actividades industriales; 2) el trabajo de campo se realizó los dos años anteriores al inicio de la pandemia provocada por el virus SARS-CoV-2, el cual afectó gravemente a las cadenas productivas de la industria automotriz estatal, regional y global, por lo que su posible impacto en los estilos de liderazgo ambiental deberán estudiarse posteriormente.Hallazgos: se encuentra que el estilo de liderazgo ambiental que ejerce la alta dirección es un elemento fundamental dentro del conjunto de relaciones que inciden en la gestión ambiental y el trabajo de los responsables ambientales de las empresas de autopartes.
Body dissatisfaction in interaction with self-esteem, peer influence and dietary restraint: A systematic review / Insatisfacción corporal en interacción con autoestima, influencia de pares y dieta restrictiva: Una revisión
Authors: Amaya Hernández Adriana , Alvarez Rayón Georgina L. , Mancilla Díaz Juan Manuel
Published: October 2021

Abstract. Several researches have been realized in order to understand the role of body dissatisfaction in the development of Eating Disorders (ED). Despite this, there are few reviews that permit have insight in what has been found and where future research should be addressed. So, the aim of this paper was to make a systematic review of those articles in which was evaluated body dissatisfaction in interactions with biopsychosocial factors. For this was done a search in the databases MEDLINE, PsycINFO and Science Direct, according to the inclusion and exclusion criteria established, 44 articles were analyzed. Women and teenagers were the major focus on research about body dissatisfaction, this review can also be noted that although body dissatisfaction has been widely studied, there are still inconsistencies between research, which can be explained by the age of the participants, the measures used, study design, among others. For this, it is considered appropriate to further expand the studies related to this issue not only in female adolescents, but also in those samples less studied, taking into account the failures methodological identified in this paper.Key words: Eating disorders, body dissatisfaction, self-esteem, peer influence, dietary restraint.Resumen. Diversas investigaciones se han realizado con la finalidad de conocer el papel de la insatisfacción corporal en el desarrollo de los Trastornos del Comportamiento Alimentario (TCA). A pesar de esto, son pocas las revisiones que permiten tener una visión de lo qué se ha encontrado y hacia dónde deben dirigirse futuras investigaciones. Por lo cual, el objetivo de este escrito fue hacer una revisión sistemática de aquellos artículos en los cuales se evaluó la insatisfacción corporal en interacción con factores biopsicosociales.  Para esto se realizó una búsqueda de artículos en las bases de datos de MEDLINE, PsycINFO y Science Direct, de acuerdo con los criterios de inclusión y exclusión establecidos, se analizaron 44 artículos. La población femenina y los adolescentes fueron los principales focos de atención en las investigaciones que abordan la insatisfacción corporal, además esta revisión permite observar que a pesar de que la insatisfacción corporal ha sido ampliamente estudiada, aún hay inconsistencias entre investigaciones, las cuales pueden ser explicadas a partir de la edad de los participantes, los instrumentos empleados, el diseño del estudio, entre otras. Es por ello que se considera pertinente seguir extendiendo los estudios relacionados a esta temática no sólo en mujeres adolescentes, sino también en aquellas muestras menos estudiadas, teniendo en cuenta las deficiencias metodológicas señaladas en este escrito. Palabras clave: Trastornos de la conducta alimentaria, insatisfacción corporal, autoestima, influencia de pares, dieta restrictiva.