bluuebunny/crossref_metadata_2025 huggingface dataset:
High concentration of estradiol has a negative correlation with free thyroxine during the second trimester of pregnancy
Authors: He Leqi , Li Xiaoying , Chen Zaoping , Wang Wei , Wang Kai , Huang Xinmei , Yang Qian , Ke Wencai , Liu Jun , Zha Bingbing
Published: August 2022

Objective

To explore the relationship between estradiol (E2) and thyroid function during the second trimester of pregnancy and the effect of E2 on sodium iodide transporter (NIS) expression in cultured thyroid cells.

Materials and methods

We analyzed relationships between E2 and thyroid function in 196 pregnant women during the second trimester. Multiple linear regression analysis was performed between E2 and thyroid function. The human thyroid Nthy-ori3-1 cells were cultured in different E2 concentrations, and the mRNA levels of NIS, estrogen receptor (ER)-α, and ER-β were measured by quantitative real-time PCR. Their protein levels were assessed by western blot.

Results

E2 was positively correlated with thyroid-stimulating hormone (TSH) and negatively correlated with free thyroxine (FT4) (P < 0.05). When we corrected for age, BMI, alanine aminotransferase, and serum creatinine, E2 was still negatively correlated with FT4 (P < 0.5) during the second trimester. In Nthy-ori3-1 cells treated with 10 nM E2, NIS and ER-β mRNA levels were significantly reduced, while ER-α mRNA level was not altered (P > 0.5). Moreover, 10 nM E2 significantly decreased protein levels of ER-β, phosphorylated versions of protein kinase A (p-PKA), phosphorylated versions of cAMP response element-binding protein (p-CREB), and NIS, while treatment with the ER-β inhibitor restored the expression of p-PKA, p-CREB, and NIS (P < 0.05).

Conclusion

High concentration of E2 has a negative correlation with FT4. High concentration of E2 can inhibit the NIS expression through the ER-β-mediated pathway, which may cause thyroid hormone fluctuations during pregnancy.
Risk factors associated with mortality among individuals with type 2 diabetes and depression across two cohorts
Authors: Rohde Christopher , Nielsen Jens Steen , Schöllhammer Knudsen Jakob , Thomsen Reimar Wernich , Østergaard Søren Dinesen
Published: August 2022

Objective

Depression has been linked to excess mortality in individuals with type 2 diabetes, but it remains unclear what drives this association. We examined if the association depends on unhealthy lifestyle and medical comorbidity.

Methods

We followed a clinically recruited cohort of Danish people with type 2 diabetes (n = 8175) with fine-grained clinical information and a population-wide register-based cohort of Danish individuals with HbA1c-defined type 2 diabetes (n = 87 500) representing everyday clinical practice. Antidepressant drug use prior to the onset of type 2 diabetes was used as a proxy for preexisting depression. In both cohorts, we first estimated the association between depression and 5-year mortality following type 2 diabetes, using a Cox proportional hazards model, yielding sex- and age-adjusted mortality rate ratios (MRRs). We subsequently examined how further adjustment for markers of unhealthy lifestyle (smoking, physical inactivity, obesity, alcohol abuse, and marital status) and medical comorbidity affected the association.

Results

Preexisting depression was associated with an approximately 50% increased age- and sex-adjusted all-cause mortality rate in both the clinically recruited- (5-year MRR: 1.46; 95% CI: 1.12–1.90) and the register-based type 2 diabetes cohort (5-year MRR: 1.51; 95% CI: 1.45–1.57). The excess mortality associated with depression almost disappeared when the analyses were adjusted for unhealthy lifestyle and medical comorbidity in both the clinically recruited- (MRR: 1.05; 95% CI: 0.72–1.52) and the register-based type 2 diabetes cohort (MRR: 1.14, 95% CI: 1.09–1.19).

Conclusions

A large fraction of the excess mortality associated with preexisting depression in type 2 diabetes is attributable to the unhealthy lifestyle and medical comorbidity accompanying depression.
МЕХАНІЗМИ НАЛЕЖНОГО ФІНАНСОВОГО ЗАБЕЗПЕЧЕННЯ БЮДЖЕТНИХ ПРОГРАМ
Authors: ЖИБЕР Тетяна , СОЛОПЕНКО Тетяна
Published: August 2022

Проаналізовано вплив запропонованих макроекономічних і організаційних чинників на рівномірність фінансового забезпечення заходів у затверджених бюджетних програмах за останні 10 років. Запропоновано і обґрунтовано показник рівномірного фінансового забезпечення як умова організаційної ефективності імплементації бюджетних програм їх виконавцями в контексті стійкого виконання бюджету і сталих публічних фінансів з виконанням державними органами всіх декларованих зобов’язань. Обґрунтовано і розраховано вплив чинників на рівень фінансового забезпечення бюджетних програм у попередні роки на прикладі програм видатків (без кредитування) державного бюджету на підставі аналізу динаміки показників, визначення кореляції між показниками впливу на рівномірність фінансового забезпечення кожної бюджетної програми, побудови кількафакторної моделі впливу на показник сталості з використанням регресії. За результатами дослідження проаналізовано показник рівномірності фінансового забезпечення бюджетної програми при фактичному здійсненні видатків за нею у 50% і більше від плану із змінами згідно із звітністю Державної казначейської служби України за три квартали бюджетного року з урахуванням щорічного виконання бюджету за доходами на 70% і більше за цей період. Запропоновано такі показники ймовірного впливу на рівномірність фінансового забезпечення заходів програм протягом бюджетного року: рівень виконання бюджетного плану в цілому; рівень видатків бюджету на обслуговування боргу; кількість бюджетних програм на кінець року (частина бюджетних програм затверджується протягом бюджетного року); кількість бюджетних програм, за якими впродовж року взагалі не розпочалися видатки; індекси споживчих цін і номінальної заробітної плати; рівень (централізація) перерозподілу номінального ВВП у бюджеті за видатками з трансфертами. Виявлено, що рівномірне фінансове забезпечення бюджетних програм не перевищувало 71% їх кількості за останніх 10 років і в окремі роки було меншим.
SEM Study of Hooks in the Acanthocephala with Emphasis on Structural-Functional Relationships
Authors: Amin O. M. , Heckmann R. A.
Published: August 2022

The retractable proboscis of acanthocephalans is equipped with hooks for attachment to the intestine of the definitive host. Throughout their evolutionary history, acanthocephalans have developed a variety of ways to maximize their anchoring to host gut and to avoid dislodgement. Hooks vary in their size and shape along the longitudinal axis of the proboscis, texture, structure, and hardness as well as in their contribution to the absorption of nutrients. Hooks also vary in their chemical composition, especially calcium, phosphorus, and sulfur, contributing to their hardness. Hook roots are paramount in anchoring them to the cuticular and subcuticular layers of the proboscis. Roots vary in size and shape and are often simple and directed posteriorly but often have anterior manubria or may be vestigial or absent especially posteriorly. The core layer of roots is usually continuous with that of the hook. Hooks often, but not always, maintain a similar pattern in families. Because of the inconsistencies and inadequacies in the description of hooks, especially in line drawings, in various groups of acanthocephalans, we have decided to provide the largest assortment of morphological and anatomical variabilities among the many species that we have studied over the years. We are, thus, reporting the SEM of hooks of 30 selected species of acanthocephalans in 13 families in an attempt to elucidate patterns and trends characteristic of acanthocephalan families.
Obiekty snycerskie o tematyce religijnej zrealizowane w kręgu Państwowego Liceum Sztuk Plastycznych im. Cypriana Kamila Norwida w Lublinie
Authors:   Zespół Szkół Plastycznych im. C.K. Norwida w Lublinie, Polska, Kierczuk-Macieszko Małgorzata
Published: August 2022

Since the 1990s, more than 50 different religious works, ranging from altars to single sculptures, have been created at the current Fine Arts School Group in Lublin. Some of these objects went to places of worship or religious institutions, while others remain the property of the school or their authors. This extensive collection is the result of a dual educational concept developed at the school. On the one hand, it is based on studying (copying, compiling) historical patterns; on the other, it offers freedom of artistic vision. In both cases the students follow the guidance of the same teachers, who introduce these concepts interchangeably, deliberately varying the tasks. Treated complementarily, they give interesting results both in the course of education and in the graduates’ independent work. The selection of works presented in this article does not aspire to be an exhaustive presentation of the presence of the sacred in woodcarving works created in the circle of the Lublin School. Nevertheless, their selection illustrates in a suggestive manner artistic solutions representative for each of the two educational currents.
A Fixed Reconstruction and Immediate Rehabilitation of Fully Edentulous Arch Using the All-on-Four Concept: Case Series
Authors: Choudhary Ashish , Vashist Shairy , Chopra Megha , Sharma Aparana
Published: August 2022

The implant survival largely depends on the mechanical setting in which they work as an independent entity. The implant design, number and position markedly affect the treatment plan. Deficient bone quantity and quality and presence of a vital anatomical landmark have often led the practitioners to conduct researches to find newer ways of implant insertion. One such technique is the 'All-On-4' concept, an alternative to the conventional implant therapy; lessens the amount of strain to the alveolar bone by increasing the antero-posterior spread with distal tilting the posterior implant. It is a cost-effective procedure that decreases the treatment time and the morbidity rate allowing a higher patient quality of life. The article demonstrates clinical cases describing rehabilitation of completely edentulous arches using the All-On-4 concept.
Active learning approach for online teaching of Engine Design course
Authors: Patil Yogesh S. , Shinde Rajaram M. , Mane Shirish S.
Published: August 2022

Covid-19 has appealed to teachers around the world to adopt a new era of online teaching-learning methods instead of traditional teaching methods. It is a challenge for teachers to engage students in the learning process and measure outcomes with proper tools. The use of online platforms forced every teacher to redesign teaching strategies. A teacher has to think about online learning platforms and design instructional strategies. Different tools are available to make online learning interactive. The selection and application of tools is a skill of the individual teacher. In the present work, outcomes of the course Engine Design (ED) are mentioned. The course is taught online using the MS-Teams platform. During course delivery, various instructional strategies like, Games, quizzes, Discussion forums, Polls, etc. are used. Outcomes, of course, taught using an online platform and active learning tools (batch 2020-21) are measured using attainment of course outcomes CO’s and course end survey (CES). A combination of active learning techniques with online teaching is helpful to deliver the subject effectively. The CO attainment and CES indicate improvement in student communication, perspective thinking, design and modeling skills. Keywords—Course outcomes (CO’s), Engine Design (ED), Course end survey (CES).
Phase Type Zero Truncated Poisson Lindley Distributions and their application in modeling Secondary Cancer Cases
Authors: Mwau Cynthia Mwende , Weke Patrick , Ntwiga Bundi , Ottieno Joseph  Makoteku
Published: August 2022

L'assurance des maladies chroniques dont le cancer gagne du terrain au Kenya peu à peu. Ce pendant le traitement de ces maladies, pouvant entrainer des changements d'organes humains, tend à coûter plus cher, et en conséquence, à augmenter les primes d'assurance notablement. La modélisation de ces primes ne peut plus se faire avec des distributions ordinaires. Les méthodes utilisant des distributons zero-tronquées sont utilisées en particulier. Dans ce papier, elles sont utilisées en rapport avec des distributions Pareto, Weibul etc. Nous procédons à une comparaison de ces distributions et en proposons deux qui sont les meilleures
Modelling Skewed and Heavy-tailed Data Using a Normal Weighted Inverse Gaussian Distribution
Authors: Maina Calvin , Weke Patrick , Ogutu Carolyne , Ottieno Joseph  Makoteku
Published: August 2022

The normal distribution is inadequate in capturing skewed and heavy-tailed behaviour of data taken over short time intervals. In addition the data can be leptokurtic. For this reason a normal weighted inverse Gaussian distribution is proposed as an alternative to the normal inverse Gaussian distribution to handle such data. The mixing distribution used in the normal variance mean mixture is a finite mixture of two special cases of Generalized Inverse Gaussian \((\textit{GIG})\) distribution. The two special cases and the finite mixture are weighted inverse Gaussian distribution. The motivation for this work is that a finite mixture is more flexible than a single/standard distribution. The \(textit{EM}\)-algorithm has been used for parameter estimation.
Líneas de acción en intervención social y educativa en contextos vulnerables para promover el desarrollo comunitario en la construcción de paz en Colombia
Authors: García-Yepes Karen
Published: August 2022

Este es un artículo de reflexión surgido a partir de una tesis doctoral. El objetivo de este artículo es realizar una reflexión crítica sobre las líneas de acción en intervención social y educativa en contextos vulnerables para promover el desarrollo comunitario en la construcción de paz. Para ello, se realiza una revisión bibliográfica y el análisis se complementa con referentes teóricos que sustentan las reflexiones realizadas. Como resultado, se sugiere que la escuela debe incidir en la construcción del proyecto de vida del estudiante y en los procesos de desarrollo comunitario. Para concluir, se plantea que esta debe convertirse en un espacio de incidencia social desde el que los estudiantes reconozcan sus realidades, problematicen sobre ellas, se posicionen críticamente frente a sus retos y desarrollen estrategias concretas para responder ante ellos de manera asertiva.
El currículo: la voz de los niños
Authors: Ramírez-Vanegas Laura Victoria , Taborda-Chaurra Javier
Published: August 2022

La investigación “El currículo: la voz de los niños” tuvo como objetivo comprender el sentido que dan los niños de una institución educativa a algunas nociones curriculares. El trabajo es de tipo cualitativo. La muestra de carácter teórico con la que se trabajó fue de 20 estudiantes. Se utilizó como instrumento un cómic pedagógico que permitió ir orientando preguntas y contra preguntas. Para efecto del análisis se recurrió a la semántica estructural de contenido. Como conclusiones, los sentidos encontrados señalan que: en relación con las finalidades de la educación, se estudia para ser alguien en la vida; la explicación se reconoce como el recurso que usan los maestros para enseñar, aparece para niñas y niños como el poder de los maestros, su repetición es considerada necesaria, aunque la cuestionan; los maestros más preciados serían aquellos que a los niños brindan confianza.
La categoría “problema” en las tesis de educación, vista desde la perspectiva de las movidas retóricas
Authors: Ochoa-Sierra Ligia , Cueva-Lobelle Alberto
Published: August 2022

Uno de los elementos esenciales de una investigación es el planteamiento del problema, en tanto es una categoría que determina en gran medida la pertinencia, la justificación, la delimitación y el impacto del trabajo. En esta investigación se analizaron 50 tesis de maestría y de doctorado en educación, con el fin de identificar la estructura retórica del apartado denominado “problema”. El análisis se hizo a partir de los conceptos de movida y submovidas, propuestos por Swales (2004). El análisis de los datos evidenció que la categoría “problema” tiene las siguientes movidas: justificación, objeto de estudio, meta, antecedentes y perspectivas; las dos primeras con una alta frecuencia, en contraste con las siguientes. Se encontró como submovidas, que se mantienen de manera constante, la pregunta, los hechos problemáticos y la importancia del problema. Otras submovidas presentan una mayor variación e indefinición, lo que genera problemas metodológicos y comunicativos.
La enseñanza y aprendizaje del boceto de diseño a través de mediadores tecnológicos
Authors: Angulo-Valenzuela Camilo , Ascuntar-Rivera María Cristina
Published: August 2022

El presente documento es el resultado de un ejercicio académico desarrollado como parte de procesos investigativos realizados por los autores de este artículo, en relación con las prácticas emergentes de los procesos pedagógicos del boceto en diseño industrial. El objetivo principal fue indagar en las potencialidades de los mediadores tecnológicos en la enseñanza y aprendizaje del boceto en diseño; de allí, se adoptó un enfoque de investigación mixto con alcance exploratorio descriptivo y se implementó una estrategia pedagógica de carácter remoto y asincrónico. Esta experiencia de aula se llevó a cabo entre estudiantes de diseño industrial en dos ciudades de Colombia: Bogotá y Pasto, un escenario académico que permitió articular el aprendizaje basado en proyectos y la enseñanza de la representación en diseño, a través del uso de artefactos tecnológicos y entornos digitales, concluyendo que la mediación tecnológica facilita el surgimiento de nuevas dinámicas pedagógicas para el boceto.
Apreciaciones sobre las experiencias significativas de los docentes de la Universidad Manuela Beltrán y la Corporación Educativa ITAE (Bucaramanga, Colombia)
Authors: Mendoza-Ariza Jennifer Natalia , Salazar-Carreño Robinson
Published: August 2022

El objetivo de este artículo es evidenciar los resultados del análisis de los relatos surgidos durante el proceso de sistematización al que se vincularon los docentes de la Universidad Manuela Beltrán y la Corporación Educativa ITAE. El diseño metodológico responde a un enfoque cualitativo-dialéctico articulado con técnicas como los grupos focales, el taller de sistematización y la redacción de narrativas pedagógicas que facilitaron análisis de las experiencias significativas de los docentes. Para abordar dichas narrativas se asume la perspectiva de la “lectura intratextual” que, a la luz de las categorías de impacto, percepción y representación, permitieron recuperar ese conocimiento de la práctica pedagógica nacido de la experiencia que permanecía implícito. Entre los hallazgos se destaca la conexión profunda facilitada por el docente al estudioso respecto a su relación con el conocimiento, ya que ambos se comprometen en el proceso de enseñanza-aprendizaje.
Dense Elements in B-Almost Distributive Fuzzy Lattices
Authors: V. Maheswari, V. Balaji K. Rekhalakshmi,
Published: August 2022

In this paper we define the concept of a dense element in a B-Almost Distributive Fuzzy Lattice BADFL   and prove that the set  of all dense elements of  is an implicative filter of . Also, we establish a fuzzy epimorphism of  into the set of all closed elements ofand prove the existence of an fuzzy epimorphism of  into . We prove that and are fuzzy isomorphic.
Fluorine excretion in children at various levels of exposure to emissions from aluminum production
Authors: Efimova Natalia V. , Lisetskaya Lyudmila G. , Savchenkov Mikhail  F.
Published: August 2022

BACKGROUND: To assess the risk of development of disorders caused by excess or lack of fluorine, information regarding the levels of exposure and excretion of fluorine by various routes of intake is important.
AIM: To determine the features of fluoride ion excretion in children exposed to different levels of fluorine compounds contained in emissions from aluminum production.
MATERIAL AND METHODS: Observation groups were formed from 245 and 148 people exposed to high and low levels of fluorine compounds, respectively. For comparison, a control group of 155 children living in cities who had no industrial sources of fluorine emission in their territory was created. Daily urine samples, which reflect the level of excretion, were used as a biomaterial. Analysis of fluoride ion content was conducted using the potentiometric method with a fluorine selective electrode. Means were compared using Student's t-test, whereas medians were compared using the MannWhitney U test with Bonferroni correction. Correlation with age was assessed using the Spearman coefficient.
RESULTS: No significant differences in the average urinary excretion of fluorine and proportion of children whose excretion exceeds the reference regional levels were observed among children living in the industrial centers of the Irkutsk region. A comparative assessment of fluorine excretion among children with the highest toxicant content showed that those in the high-exposure subgroup had a 1.4 times higher average fluorine content compared to the control group (p 0.001). The maximum values of fluoride ion excretion in children living in the areas affected by emissions from large aluminum production enterprises are 2.4 times higher than the maximum in the unexposed group.
CONCLUSION: Fluoride ion excretion via urine in children living within industrial centers was directly associated with the level of inhalation exposure but inversely associated with age.
The role of macroelements in the development and progression of a new coronavirus infection (literature review)
Authors: Romanov Alexei O. , Sharipova Maisiyat M. , Ivkina Maria V. , Arkhangelskaya Anna N. , Gurevich Konstantin G.
Published: August 2022

The article provides a brief overview of the data on the effect of changes in the content of the main macronutrients (sodium, calcium, potassium and magnesium) on the incidence and course of COVID-19. The features of imbalance of mineral substances in patients with new coronavirus infection were analyzed, the role of electrolyte disturbances in increasing the incidence of complications and increasing mortality among patients with COVID-19 was demonstrated. Possible mechanisms of macronutrient imbalance arising from infection with SARS-CoV-2 are described.
The search for publications on changes in the content of magnesium, potassium, calcium and sodium in patients with COVID-19, as well as their impact on the development and progression of the disease, was carried out using the Web of Science, Scopus, MedLine, The Cochrane Library, Embase, Global Health, CyberLeninka, RSCI databases. In addition, publications from journals peer-reviewed by the Higher Attestation Commission, as well as international and regional journals were analyzed.
Physiotherapy methods in the complex of cognitive rehabilitation of patients in the late recovery period in patients after ischemic stroke
Authors: Mikhailova Anna A. , Korchazhkina Natalia B. , Koneva Elizaveta S. , Kotenko Konstantin V.
Published: August 2022

BACKGROUND: For the purpose of early and late medical rehabilitation in recent decades, non-drug methods of physiotherapy have been actively used to restore patients who have had an ischemic stroke.
AIMS: substantiation of the inclusion of multimodal physiotherapeutic effects from the Alpha LED Ohu Light_Spa apparatus and low-frequency electrostatic massage from the Khivamat apparatus for the correction of cognitive impairment in patients who have suffered an ischemic stroke, with motor disorders in the form of hemiparesis, increased muscle tone by the type of spasticity in the late recovery period.
MATERIALS AND METHODS: The study included 120 patients who had an ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone in the form of spasticity in the late recovery period. Patients of group 3 (40 people) were prescribed standard drug therapy and medical rehabilitation, patients of group 1 (40 people in addition to standard therapy and rehabilitation, multimodal physiotherapeutic effects were used from the Alpha LED Oxy Light-Spa device and patients of group 2 (40 people) a low-frequency electrostatic massage from the Khivamat apparatus was added to the standard complex.
RESULTS: At all control points after the course of treatment, after 6 and 12 months, in addition to general clinical studies, we assessed indicators of cognitive functions (according to the Montreal Cognitive Assessment Scale) and psycho-emotional state according to the HADS scale. In dynamics, it was revealed that in groups 1 and 2, where the developed rehabilitation programs were carried out, there was a significant improvement in cognitive functions (attention, memory, fluency, generalization, etc.), to a greater extent in group 1, while in patients who, against the background of drug therapy, underwent standard medical rehabilitation, only a positive trend was noted.
CONCLUSION: The inclusion in the medical rehabilitation of patients who have suffered an ischemic stroke, to a greater extent, multimodal physiotherapeutic effects and to a somewhat lesser extent, low-frequency electrostatic massage contributes to a significant improvement in cognitive functions and a reduction in anxiety and depression.
Method of dynamic modeling of the femoral head
Authors: Mezhov Andrey  N. , Volkov Evgeny  E. , Kazakov Vladimir  F. , Kolbakhova Svetlana  N.
Published: August 2022

The mechanism of action of therapeutic exercises can be considered as a universal form of exercise. Therapeutic physical exercises can provide both a direct load on the contact and articular surfaces (walking and exercises with crutches), and muscle load (concentric muscle contractions, motor system). The high sensitivity of the bone to mechanical signals is the basis for non-drug interventions, including physical therapy.
The article presents the authors method of physical therapy for patients with femoral head aseptic necrosis. The gymnastics was based on a set of exercises for dynamic modelling of the femoral head, developed by Huang Keqin, a doctor of the Beijing Specialized Clinic for the Treatment of Femoral Head Necrosis, and modern concepts of bonne tissue biomechanics and physiology. The set includes 3 types of exercises. The first type is based on the principle of autogravity burden. The second type consists of the exercises with an accelerated rhythm of small amplitude. Type 3 is based on the muscles post-isometric relaxation principle.
In this article the recommendations are given regarding the exercises use depending on disease stage.
Principles of sanatorium-resort treatment of adult and pediatric patients who have undergone COVID-19
Authors: Borodulina Irina V. , Gerasimenko Marina Yu. , Poberskaya Valentina A.
Published: August 2022

Spa treatment plays an important role in the recovery process of both adult and pediatric patients after a coronavirus infection. Currently, medical rehabilitation programs of this stage are being worked out and, as the accumulated data show, an integrated approach with the inclusion of various methods is more effective. Sanatorium-resort care for patients who have undergone COVID-19 is provided on a planned basis and is based on the principles of phasing, continuity and continuity between medical organizations. Treatment of patients with the consequences of a coronavirus infection in sanatorium conditions is carried out in the late recovery period at the III stage of rehabilitation care. The main advantage of spa treatment is the use of natural therapeutic factors: climate, landscape, balneo- and peloidotherapy. An important part of the comprehensive treatment program is the methods of physical rehabilitation, which should be selected individually, taking into account the functional reserves and patient tolerance. Also, the program of spa treatment includes diet therapy, according to indications, hardware physiotherapy, psychotherapy.
The use of microneedling and laser therapy in patients with involutive skin changes
Authors: Kruglova Larisa S. , Avagumyan Mariya A. , Tamrazova Anait V.
Published: August 2022

BACKGROUND: Involutive skin changes are an urgent problem in the modern world, which leads to the need to find a comprehensive and effective treatment method aimed at reducing the activity of matrix metalloproteinases (MMPs) and transforming growth factor-2 (TGF-2), which are responsible for the degradation of extracellular matrix proteins.
AIMS: Determination of the degree of influence of microneedling monotherapy, fractional laser, as well as a combination of these methods on the content of MMP-2, MMP-3, MMP-12, TGF-2 in the skin of patients with involutive signs.
MATERIAL AND METHODS: In a single-center, prospective, parallel, non-randomized study, 82 patients with involutive changes in the facial skin took part, which were divided into 3 groups. 26 patients (Group 1) received microneedling monotherapy (3 treatments every 3 weeks), 27 patients (Group 2) received fractional laser monotherapy (3 treatments every 4 weeks) and 29 patients (Group 3) combined therapy of microneedling and fractional laser (3 procedures every 4 weeks). The study lasted 10 weeks, before and after the start of the study, a biopsy of the skin behind the ear was taken to determine the level of MMP-2, -3, -12 and TGF-2.
RESULTS: Comparative data of enzyme immunoassay with biotin monoclonal conjugates between the groups revealed a difference in the content of matrix metalloproteinases and TGF-: in group 1, there was less significant dynamics in all studied parameters compared to group 3: MMP-2 (p=0.0390), MMP-3 (p=0.0466), MMP-12 (p=0.0104) and TGF- (p=0.0080) and 2 group MMP-12 (p=0.0484) and TGF- (p=0.0367). When comparing groups 2 and 3, more significant dynamics was observed in group 3 in terms of MMP-2 (p=0.0290), MMP-12 (p=0.0511) and TGF- (p=0.0241). Thus, the most significant results were obtained in group 3.
CONCLUSION: Combined treatment using microneedling and fractional laser leads to a significant decrease in the level of MMP-2, -3, -12 and TGF-2, which allows us to consider this therapeutic complex as a promising way to correct involutive skin changes.
Sesgo de género en la inteligencia artificial: “de tal palo, tal astilla”
Authors: Freres Hellebaut Melanie Muriel
Published: August 2022

La inteligencia artificial fue concebida por el ser humano para facilitar tareas de procesamiento y clasificación de datos y dar soluciones rápidas a determinados problemas. No obstante, como su creador, es imperfecta y tiende a repetir patrones que pueden ser discriminatorios. Esta falla en el sistema se debe tanto a su construcción como a la información que la alimenta y, hasta nuestros días, no ha podido ser superada, pese a las diversas soluciones que se han planteado al respecto.
Sobre el proceso constituyente boliviano
Authors: Testa Ferreira Héctor , Amaya Perdomo Carlos Eduardo
Published: August 2022

El presente documento busca hacer una breve síntesis del proceso constituyente boliviano que tuvo lugar tras la victoria del Movimiento al Socialismo, en las elecciones del año 2005, y que desembocó en la promulgación de la Constitución Política de 2009 y en la refundación del hoy llamado Estado Plurinacional de Bolivia.
El escrito presenta una sencilla reseña histórica de los antecedentes económicos, políticos y sociales que fungieron como semilla de la nueva Constitución y del nuevo Estado, los cuales tienen como eje fundamental el reconocimiento del carácter plurinacional del país. Cuestión central de todo el nuevo andamiaje constitucional y jurídico, junto con la reivindicación del derecho a la soberanía y a la libre autodeterminación de los pueblos.
Según los acontecimientos ocurridos en octubre y noviembre del año 2019, que forzaron la renuncia del presidente Juan Evo Morales Ayma y de su fórmula vicepresidencial Álvaro García Linera, después de los comicios del 20 de octubre, debe indicarse que afloraron, con mayor claridad, las contradicciones existentes entre los sectores económicos, políticos y sociales afines y enemigos de la Constitución del Estado Plurinacional y del llamado “proceso de cambio”, las cuales datan y se remontan al propio desarrollo del proceso constituyente.
Por un lado, la reaccionaria y ultraconservadora oligarquía boliviana afincada principalmente en la Medialuna y adepta del federalismo y del orden neoliberal que empleó la fuerza de las armas para derrocar el gobierno legítimo de Morales y, por el otro, los movimientos sociales y los pueblos indígenas, originarios y campesinos impulsores de la Constitución del 2009, quienes defendieron, el pasado 18 de octubre, en las urnas los logros alcanzados en la refundación de Bolivia, y eligieron al actual presidente Luis Arce Catacora, del Movimiento al Socialismo.
Is pregabalin better than gabapentin in treatment of neuropathic pain? An observation-based study at tertiary care centre of North India
Authors: Shukla Mohit , Chaurasia Rakesh Chandra , Nim Dwividendra Kumar , Sonkar Kamlesh Kumar
Published: August 2022

Background: The present study was undertaken to assess the efficacy of pregabalin and gabapentin in treatment of neuropathic pain at a government tertiary care hospital of Uttar Pradesh, India. Due to indiscriminate use of drugs for treatment of neuropathic pain, selection of an effective drug is need of hour.Methods: Out of 130 patients, 62 patients were given pregabalin and 68 were given gabapentin. Douleur Neuropathique 4 questionnaire (DN4) which was used to diagnose patients of neuropathic pain. Efficacy of drug was based on their capability to decrease neuropathic pain at regular intervals.Results: On comparing the efficacy of drugs by their ability to decrease neuropathic pain, there was a significant difference when comparing pregabalin and gabapentin, pregabalin being statistically significant than gabapentin.Conclusions: On the basis present study efficacy of pregabalin 300 mg once daily brought better improvement of symptoms and sign than that of gabapentin 600 mg administered once daily dose. So pregabalin is a better drug than gabapentin.
Assessment of knowledge and awareness among the pregnant women about their medication use in a tertiary care hospital
Authors: Chacko Kuruvilla P. , Thomas Romy Susan , Varghese Ashely , Baiju Hanna Maria , Jacob Philip , Thomas Abel Abraham
Published: August 2022

Background: Pregnancy is a physiological state where drug therapy is of particular concern. The pertinent use of drugs during pregnancy is beneficial as it affects not only the health of the pregnant woman but also the developing fetus. The study was carried out to access the knowledge and awareness regarding the drug use among pregnant women.Methods: Cross sectional descriptive study was conducted among 150 pregnant women for six-month duration. All the information was acquired through direct interview with the subjects and from treatment chart of subjects which were then recorded in a data collection form.Results: Majority of the subjects were under the age group of 18-28 years (50%). Most of the subjects predominantly has tertiary level of education (69%). Furthermore, 57% of the subjects were at the third trimester of their pregnancy. Knowledge regarding use of their own medications were significantly high (95%), which suggest that the subjects were well aware of their medications. Besides, 82% of the subjects had knowledge about the medications that were not to be consumed during pregnancy. In addition, 89% of the pregnant women did not take any over the counter medications and about 92% of the subjects did not treat themselves with any ayurvedic or homeopathic medications.Conclusions: Significant number of subjects were aware about their medication use. They ensured themselves and their developing fetus a better health.
Immunosuppressants in Behcet’s disease: a boon or a bane?
Authors: Modi Krishna , Prajapati Vipul , Shukla Dhaiwat , Malhotra Supriya D.
Published: August 2022

Adalimumab is a disease-modifying antirheumatic drug and monoclonal antibody that works by antagonising tumour necrosis factor-alpha prescribed in many rheumatological conditions like Rheumatic arthritis, Ankylosing spondylitis and Behcet’s disease. Serious side effects with this drug include heart and liver failure, nervous and blood disorders, allergic and immune system reactions and opportunistic infections. A 27-year-old female patient, known case of Behcet’s disease presented to the hospital with complaints of fever, cough and breathlessness following administration of Adalimumab, six doses over three months. Chest X-ray and BAL-CBNAAT was suggestive of Tuberculosis. AKT was started and Adalimumab was suspended until patient recover.
Tocilizumab induced immunosuppression in a case of adult-onset still’s disease: are these newer biologics double edged sword?
Authors: Santoki Hirva S. , Shukla Dhaiwat M. , Sood Shikha V. , Malhotra Supriya D.
Published: August 2022

Adult-onset still’s disease (AOSD) is a rare multisystemic inflammatory disorder of unknown etiology characterised by high spiking fever, evanescent skin rash, arthralgias, arthritis, neutrophilic leucocytosis. Initial treatment strategy includes use of hands-on drugs like non-steroidal anti-inflammatory drugs, low dose corticosteroids, conventional DMARDs. But as the disease progresses to severe form, targeted and biologic DMARDs could be the option for management. Interleukin-6 being one among the many cytokines involved in the pathogenesis of AOSD, has made itself a target for the treatment of refractory cases. Tocilizumab, a recombinant humanized anti IL-6 monoclonal antibody, is one such biologic drug available in the market that has proven its therapeutic efficacy in several clinical trials. We are presenting a case of 37-year-old female patient, known case of AOSD for 4 years. Patient was initially maintained on low dose corticosteroid and conventional DMARD like hydroxychloroquine and methotrexate. Flare ups of the disease warranted the use of tocilizumab and tofacitinib in this patient. After clinical as well as pathological improvement with tocilizumab 2 years before, signs of immunosuppression were observed when tocilizumab was reintroduced for the treatment. Patient suffered from acute pyelonephritis, septicemia, shock, oropharyngeal candidiasis and bronchitis which could be owned to immunosuppressive action of tocilizumab. One can reduce the chances of infection and other adverse effects by careful periodic monitoring of various laboratory parameters like total W.B.C., total platelet count and liver enzymes. Cautious selection of the patient is needed for the treatment with newer biologic agents.
COVID-19 encephalopathy, presenting with Barco’s aphasia mimicking stroke
Authors: Bhardwaj Ankit , Sharma Atma Ram
Published: August 2022

Neurological manifestations are emerging as relatively frequent complications of coronavirus disease 2019 (COVID-19), including stroke and encephalopathy. Here we reporting a case of a young male presented with acute aphasia at the emergency department. The patient has a positive history of upper respiratory tract symptoms, subjective fever, and myalgias, a week before for which he was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse transcription polymerase chain reaction (PCR) on a nasopharyngeal swab. An electroencephalogram (EEG) demonstrated interictal epileptiform abnormalities over the left posterior frontal lobe. Magnetic resonance imaging (MRI) axial T2- weighted image shows focal area of altered intensity appearing hyperintense involving the left frontotemporal lobes pre-dominantly the pre-central gyrus. A subtle restriction on diffusion-weighted imaging (DWI), with a minimal drop on apparent diffusion coefficient images. In contrast, it shows gyriform enhancement with suspicious adjacent meningeal thickening and enhancement. Cerebrospinal fluid was negative for antibody. Intravenous immunoglobulin (IVIG) 400 mg/kg was given for 5 days. The patient responded well to the therapy without any major clinical side effects and revealed complete resolution after 2 months.
A short review on atogepant: recently approved first oral calcitonin gene-related peptide receptor antagonist
Authors: Agnihotri Akash , Kanimozhi M. , Samanta Subhash , Bidarolli Manjunath , Handu Shailendra
Published: August 2022

Migraine is the second leading cause of disability in terms of ‘years lived with disability’ and it affects globally about 12% of the general population. Currently available preventive therapies are not specific to migraine. After the discovery of calcitonin gene-related peptide’s (CGRP’s) role in migraine pathophysiology, CGRP receptor antagonist drugs were developed specifically for migraine. Atogepant is the only oral, selective, potent, second-generation CGRP receptor antagonist approved in September 2021 by Food and Drug Administration (FDA) for prophylaxis of episodic migraines and chronic migraines. It acts by blocking the α-CGRP receptor present on the vascular smooth muscle cell membrane of cranial arteries. It has the added advantage of oral administration, less hepatotoxicity, minimal drug–drug interactions (DDIs) with better efficacy, safety, and tolerability profile compared to the other CGRP receptor antagonists. This present review summarizes the physicochemical properties, pharmacokinetics-pharmacodynamics (PK-PD) parameters, uses, and drug-food interactions with the help of available current evidence.
A study on characterisation of antimicrobial resistance and antibiotic susceptibility pattern in late preterm and term neonates in a tertiary hospital, Imphal
Authors: Gurung Bishal , Joseph Dibin , Kambiakdik T. , Singh C. Shyamsunder , Singh K. Ibochouba
Published: August 2022

Background: Neonatal sepsis is defined as a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first four weeks of life. It may further be divided into two main classes: early onset sepsis, which presents within the first 72 hours of birth and late onset sepsis, which usually presents after 72 hours after birth. The pattern of organisms causing neonatal sepsis has been constantly changing and the indiscriminate use of antibiotics had resulted in the emergence of multidrug resistant and virulent organisms. This study aimed to evaluate neonatal infections and the antibiotic susceptibility patterns.Methods: An institution based cross sectional study in a NICU of a tertiary care hospital. Cases enrolled were both intra and extramural who got admitted during the study period. Informed consent was obtained from the parents/guardians.Results: There were a total of 138 participants in the study. All of them tested positive for sepsis screen. Neonatal sepsis was more common in late pre-terms (57.2%) than terms (42.8%). Gram negative bacteria were the main causative agents with E. coli (9.4%) being the most common isolate followed by Acinetobacter baumanii (8%) and Klebsiella (8%). The most common gram-positive organism isolated was budding yeast cells (Candida spp.). Among gram positive bacteria the most common isolates were methicillin-resistant Staphylococcus aureus (MRSA) (5.8%) and coagulase-negative Staphylococci (CONS) (3.6%). Tigecycline and colistin were most sensitive antibiotics showing the least resistance to all organisms.Conclusions: The antibiotic sensitivity patterns have changed and the morbidity load is higher in pre-terms compared to terms.
Isolated unilateral orbital myeloid sarcoma: a case report
Authors: Sonalika Chintakunta , Sneha Latha M. , Jayaraman Dhaarani , Backiavathy Varsha , Subramanian Krishnakumar , S. Sri Gayathri , John Christopher
Published: August 2022

Myeloid sarcoma (MS) is a rare solid tumor consisting of immature myeloid cells occurring at an extramedullary site. It can present before, with, or after the manifestation of acute myeloid leukemia or other myeloproliferative diseases, and a few patients never develop bone marrow infiltration. Only a few isolated cases of pediatric orbital MS have been reported, and they are often misdiagnosed. We report a rare case of pediatric isolated orbital MS in a 5-year-old boy who presented with unilateral proptosis. The patient was diagnosed with MS based on MRI and Immunohistochemistry results. Subsequently the patient underwent chemotherapy supported with radiotherapy and showed significant response. Isolated orbital MS presents with clinical and radiological features which are often misleading, making the diagnosis difficult. Therefore, MS should be considered in the differential diagnosis of orbital masses and proptosis even in the absence of acute myeloid leukemia (AML).
Benign paroxysmal positional vertigo in pediatric age group: a review
Authors: Swain Santosh Kumar
Published: August 2022

Vertigo is not common in the pediatric age group, but probably more often than was formerly thought. Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. It consists of the short duration of vertigo attacks found in a definite head position. The exact cause of BPPV is related to the idiopathic detachment of otoconia from the utricular membrane. The prevalence of BPPV in children is lower than in the adult age group. In children with BPPV, the symptoms consist of transitory rotational vertigo and torsional/ vertical/ horizontal or mixed nystagmus, depending on the position of the intra-labyrinthine otoliths, with latency and intensity in a typical crescendo-decrescendo pattern and it is exhaustible, reversible and fatiguing similar to adults. The diagnosis of BPPV can be accurately done by taking a detailed medical history, audiogram, and by use of positional testing. In children, BPPV can be successfully diagnosed and treated. In most cases, pediatric patients could not express details of their symptoms, and clinicians cannot always obtain adequate medical histories and determine their objective signs. So, it is not easy to study the BPPV in children. There are only a few articles describing BPPV in the pediatric age group, and therefore this subject is not well known to most otolaryngologists and clinicians. This review article discusses the epidemiology, etiopathology, clinical manifestations, diagnosis, and treatment of BPPB in the pediatric age group.
Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and one year survival of lung cancer in Sanglah hospital
Authors: Andikayasa Pande Made , Suryana Ketut , Dwi Kusumawardani Ida Ayu Jasminarti , Candrawati Ni Wayan , Arisanti Ni Luh Putu Eka , Sajinadiyasa I. Gede Ketut , Ngurah Rai Ida Bagus
Published: August 2022

Background: Lung cancer is ranked third as the most common cancer in Indonesia. The one-year survival rate of advanced-stage non-small cell lung carcinoma (NSCLC) patient is quite low, that is 24.6%. Effective and inexpensive prognostic markers need to be further studied due to an increasing incidence of cancer. Inflammation plays an important role in tumorigenesis and research showed an association of NLR and PLR values with poor prognosis in patients with various solid tumors, but current cut off values still vary. This study wanted to determine the value of NLR, PLR and their relationship with the survival rate of advanced stage NSCLC patients at Sanglah hospital.Methods: A retrospective cohort study using the medical record of 96 advanced-stage NSCLC patients who underwent treatment since January 2018 in Sanglah hospital, was closely monitored for a year since diagnosed. Analysis was performed with ROC, Kaplan Meier analysis, log rank test, and time independent cox regression model.Results: The one-year survival rate of advanced stage NSCLC patient is 14.6%, with median survival 3.26 months. Cut off NLR> 3.37, median survival 2.66, p=0.00. Cut off PLR>178.55, median survival 3.26, p=0.35. Multivariate analysis showed that NLR, HR=2.75 and performance status, HR=1.78 were associated with survival.Conclusions: NLR with cut off >3.37 is associated with one-year survival rate of advanced-stage NSCLC patient. PLR did not have any significant association with one-year survival rate of advanced-stage NSCLC patient.