bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the Effect of Stress Relaxation and Residual Deformation of Modern Polymer Materials to Protect the Surfaces of Parts From Wear
Authors:   Dnipro State Agrarian and Economic University, Puhach Andrii , Chernii Olexandr ,   Dnipro State Agrarian and Economic University, Kalhankov Yevhen ,   Dnipro State Agrarian and Economic University
Published: December 2023

Stress relaxation during compression of rubber and polymers is one of the indicators of their viscoelasticity. The purpose of the work is research on stress relaxation during compression and determination of the residual deformation of polymeric materials used in modern engineering for the production of protective coatings for machine parts. Experimental studies were carried out on a DM-30M laboratory unit with a ring dynamometer and a maximum compression force of 20kN. The DM-22M device is fixed on the press table.Samples for testing were cut from parts made of rubber produced by NVP «Valsa-GTV» and thermoplastic polyurethane with the trade name "Desmopan". During the test, the dependence of the stress drop in compressed samples of materials on time, the rate of stress relaxation was determined,the magnitude of the stress drop to the equilibrium value, the equilibrium modulus, as well as the residual deformation after the load is removed. The conducted studies established that at a constant relative deformation of 40%, thermoplastic polyurethane "Desmopan" is characterized by a lower tendency to stress relaxation, a higher modulus of elasticity under compression than lining rubbers, but has a larger residual deformation after unloading. Lining rubber, when comparing samples from new rubber and with about 9,300 hours of operation in difficult working conditions, showed itself as a material that is prone to internal structural transformations with an increase in the time of load perception. These transformations cause a change in the indicators of relaxation processes: the rate of stress relaxation decreases, the magnitude of the stress drop to the equilibrium state decreases, with a simultaneous increase in the modulus of elasticity.The results of the study can be used in the selection of material and calculations ofparts of protective coatings for performance and reliability.
PENGARUH PEMBERIAN BUKU SAKU TERHADAP PENGETAHUAN SKRINING FAKTOR RESIKO HIPERTENSI PADA REMAJA PUTRI SMA
Authors: Pamungkas Atik Mahmudah Aji , Hanung Allania , Nuraeni Nuraeni
Published: December 2023

The World Health Organization indicates that non-communicable diseases are by far the leading cause of death worldwide, representing 63% of all annual deaths. The number of new cases that occurred in Boyolali II was 8,444 people with hypertension. It is important to carry out early screening since adolescence, this is because women will experience pregnancy, and later if teenagers experience hypertension, during pregnancy they will be at risk of suffering from preeclampsia. The aim of this research was to see whether there was an effect of giving pocket books on knowledge of screening for hypertension risk factors among female students at SMA 2 Boyolali. This type of research is quantitative research using a pre-experimental design using the Wilcoxon bivariate test. The population in this study was female students at SMA 2 Boyolali for the 2021/2022 academic year, totaling 317 with a quota sampling technique of 90 people using the Slovin formula. The conclusion of this research is that health education has an influence on knowledge of screening for hypertension risk factors in teenage students at SMA 2 Boyolali (0.000<0.05). By providing health education as an effort to increase knowledge from an early age regarding screening for hypertension risk factors. It is hoped that the results of this research can provide input to young students, especially young female students at SMA 2 Boyolali, to gain more knowledge about hypertension so that they can help avoid things that should not be consumed or done to avoid hypertension from an early age.
TRADISI KEHAMILAN, PERSALINAN, DAN NIFAS MASYARAKAT BADUY SERTA DAMPAKNYA PADA KESEHATAN IBU: A SCOPING REVIEW
Authors: Nurlaili Helmi
Published: December 2023

The problems of reducing Maternal Mortality Rate (MMR) are geographical variations, lack of infrastructure, and cultural aspects. The Baduy community upholds their traditions by rejecting technology. They live in Kendeng mountain. Baduy region contributed the highest of Banten's MMR in 2022 with 6 cases. The researcher analyzed the traditions of pregnancy, childbirth, and postpartum of Baduy community. This scoping review study was conducted in Juni 2021 in the five databases. The scoping review stages include identifying research questions, searching for relevant research, selecting and choosing literature, extracting data, as well as compiling a synthesis and drawing conclusions. The article search used the keywords "Baduy AND health AND maternal OR mother AND pregnancy AND childbirth OR delivery AND postpartum". Baduy mothers check their pregnancy to paraji and get abdominal massage. They wear cutter (small knife) and needle amulet. Food restrictions are chili sauce, durian, petai, pineapple, hot cai, and peanuts. Childbirth takes place in home, without light, and not sterile. Mothers are forbidden to eating and drinking while waiting for the paraji. After that, they bath in the river and get abdominal massage. Postpartum blood is cleaned using cloth they worn. Mothers should not eat animal protein and use contraceptives. Some cultures have negative impact on mother. Health workers should educate the community continuously and always be ready if needed. Coordination between government and traditional leader is needed to monitor the road and bridges.
Nanocarriers for melatonin delivery
Authors: Ahmadi Jazi Amirreza , Mohammadzadeh Fatemeh , Amirkhanlou Saeed , Arab Bafarani Zahra , Mir Seyed Mostafa
Published: December 2023

More attention has been drawn to the drug delivery systems to achieve more precise and efficient treatment for patients with less doses of medicines. The use of nanoparticles for drug delivery system has emerged for this purpose. It can enhance the treatment efficiency by use of the drugs more selectively and precisely to deliver them to the targeted organs or tissues. Drug delivery systems can also help to reduce the side effects, especially for the chemotherapeutic agents that have severe toxicity. Melatonin (N-acetyl-5-methoxytriptamine) is a small indolamine molecule that is produced by most cells and can influence on circadian manner. Melatonin also has antiapoptotic and antioxidant actions depending on the microenvironment; these actions are enhanced when it is incorporated into nanocarriers. Although the therapeutic effects of melatonin are promising, to achieve its optimal results is required. Therefore, the use of nanocarriers of melatonin is of clinical interest. Different melatonin loaded nanocarriers such as lipid-based nanocarriers, hybrid nanocarriers, synthetic ones, etc. can be used to deliver melatonin more efficiently for prevention or treatment of various diseases. In this review, we summarize the treatment efficiency of melatonin when it is incorporated into different nanocarriers.
Digital and Clinical evaluation of temporomandibular disorders in full dentition and free end extension patients.
Authors: Adel Ahmed , Aswad Fawaz , Nusrath Muzzammil
Published: December 2023

Background: Temporomandibular disorders (TMD) Which are a subgroup of craniofacial pain disorders involving chronic pain, dysfunction of the temporomandibular joint (TMJ), masticatory muscles and associated musculoskeletal structures of the head and neck. Pain is one of the most frequent clinical features for these TMD in addition to the clicking, limitation of mouth opening and deviation. This study aimed to evaluate Digital evaluation of the occlusal instability parameters (Disclusion Time, Occlusion Time, trajectory of force Index and Occlusal Interferences).
Method:  the study including 180 patients with free end extension and full dentition (kennedy classification class I and II) their age was between (20-50) years old .they had either disc displacement or myofascial pain dysfunction syndrome according to shiffman criteria.and also examined by digital T scan.
Result: the result showed significant pain difference between free end extension and full dentition patients. 
Conclusion: The trajectory of force distribution is highly variable between the two major groups, the full dentition exhibit more posterior force while The free end patients tend to establish more anterior force which lead to a series of temporomandibular disorders.
Measuring the Amount of Apically Extruded Debris of Endosequence ESR, R-Motion, F6 SkyTaper and Endosequence CM Files in Curved Canals: An in Vitro Study
Authors: Adil Mohannad , M.Al-Zaka Iman
Published: December 2023

Aim of the study: Assessing the relationship between Endosequence ESR, R-motion, F6 sky taper and Endosequence CM files use in curved canals and the quantity of apically extruded debris.
Materials and methods: 60 curved mesial roots of lower molars with 20-30 degree curvature were selected for this study, The samples were then divided randomly into four groups (n = 15)-Group I: EndoSequence ESR, Group II: R-motion (RM), Group III: F6 SkyTaper and Group IV: EndoSequence CM. This research followed the protocol devised by Myers and Montgomery, wherein debris were collected in vials and weighed before and after instrumentation using a 0.00001-sensitive balance. The instrumentation of all groups was terminated at master apical file #25. Irrigation with 10 ml of deionized water was administered using a needle with a side vent. The collected debris weight was calculated by deducting each vial's pre-instrumentation weight from its post-instrumentation weight. The analysis of variance (ANOVA) and the honestly significant difference (HSD) tests were used to assess the statistical significance of the variation in debris levels across the groups under investigation, using a significance level of 0.05.
Results: The results revealed that all tested groups had produced apical debris in different amounts.
Conclusions: Under the purview of the present investigation, apical debris was produced in all tested groups. The EndoSequence CM produced less amount of debris than other tested groups. While the RM and F6 SkyTaper produced a comparable amount of apical debris. The EndoSequence ESR produced the most amount of apical debris.
Salivary antioxidents in relation to caries severity among a group of young adults
Authors: Faris Abdel Aziz Samara , Ali Jasim Wesal
Published: December 2023

Background: Saliva represents the body's stages of toxicological, hormonal, immunological, and markers of many infectious disease and disorders, so that it's an ideal tool for monitoring oral and systemic health.

Antioxidants help the body's defensive system by reducing oxidative stress.

 

Aims of the study: The study was directed to estimate the carious lesion experience (DMFS) in relation to salivary superoxide dismutase and total protein among adults by age and gender.

 

Materials and methods: Caries experiences was assessed according to DMFS index, after investigation eighty peoples of an age 19-22 years for both genders. Stimulated salivary samples were together and chemically assessed to detect selected salivary antioxidants (superoxide dismutase, total protein), under standardized condition. Total protein and superoxide dismutase were measured by spectrophotometric examination.

 

Results: With not-significant differences, total protein was found to be higher in the caries active group than in the caries free group, but salivary superoxide dismutase was the opposite. with statistically not-significant differences, females had a greater average of the salivary total protein than men, whereas men had a greater average of salivary superoxide dismutase than females. the first group (19-20 years) had a not-significant greater average salivary total protein and salivary superoxide dismutase than the second group (21-22 years).

Conclusion: Salivary superoxide dismutase is the important factor in dental caries prevention. As a result, alterations in salivary content are crucial in the development and progression of dental caries.
Osteopathic status and quality of life of healthy pregnant women
Authors: Davletshina L. T. , Nenashkina E. N.
Published: December 2023

Introduction. A number of sequentially occurring genetically determined adaptive changes in the body of a pregnant woman accompany her from the moment of conception to the birth of a child, affecting not only physical well-being, but also mental health, thus changing the level of quality of life of a woman. Along with this, physiological changes during pregnancy can serve as a background for the formation of somatic dysfunctions, the severity and level of manifestation of which are determined by the compensatory capabilities of the pregnant woman′s body. Pregnancy as a whole is a crisis period in a woman′s life, and it is during this period that the identification of functional changes and violations of the quality of life can contribute to the prevention of complications during pregnancy.

   The aim of the study was to study the osteopathic status and quality of life in pregnant women at different stages of pregnancy.

   Materials and methods. A cross-sectional cohort study conducted in the period from January 2022 to March 2023 on the basis of the maternity department of the State Medical Hospital № 16 and the medical center «Medexpert» of Kazan included 75 somatically healthy pregnant women aged 25–35 years who are in different stages of pregnancy. The average age of the subjects was 30 ± 3,8 years at the time of observation. A unified osteopathic examination was performed in all pregnant women with the formation of an osteopathic conclusion and the quality of life was assessed according to the criteria of the SF-36 questionnaire.

   Results. The analysis of the results of the conducted studies demonstrated that as pregnancy progresses, somatic dysfunctions of the regional level (pelvic region (p=0,01) and thoracic region (p = 0,03) come to the fore, and indicators of the level of both physical and psychological components of the quality of life significantly decrease (p = 0,02).

   Conclusion. Functional changes occurring in the body of a pregnant woman not only have specifics associated with the period of pregnancy, but also serve as a background condition predisposing to the formation of somatic dysfunctions, as well as worsen quality of life indicators.
The physical development of modern children and teenagers of the Nizhny Novgorod region
Authors: Kalyuzhny E. A. , Bogomolova E. S. , Mukhina I. V. , Kurnikova A. A. , Vorobiev V. G. , Mustafin R. N. , Batsevich V. F. , Gorbacheva A. K. , Fedotova T. K. , Khomyakova I. A.
Published: December 2023

Introduction. The physical development of the child population is traditionally one of the main indicators of its health and a marker of the social well-being of society. The total dimensions of the body are both hereditary and final effectors of long-term adaptation processes of the child′s body to the effects of the internal and external environment. The integral image of the proportions of the total body dimensions of the individualized and group orders is determined by the anthropometric habitus.

   The purpose of the study is to study the anthropometric habitus, characterize the intragroup features of the total body size of children and adolescents in the Nizhny Novgorod region.

   Materials and methods. In the cross-sectional observation in 2019–2021, 5 143 children and adolescents of the Nizhny Novgorod region aged 7–17 years old, 2 396 boys, 2 747 girls, took part. The program for observing the anthropometric indicators of students was approved by the local ethics committee of PIMU, carried out with the involvement of domestic, certified, trusted equipment.

   Results. The physical development of the population of children and adolescents of the Nizhny Novgorod region shows intra-group tendencies, differences by gender, in the general population array. The presence of three groups of different tempo somatotypes was shown: mesosomatic boys 58,2 % and girls 61,4 %, microsomatic boys 20,9 % and girls 19,7 %, macrosomatic boys 20,9 % and girls 20,9 %. The modern difference in the growth of physical development indicators from 7 to 17 years of age in the gradation of the tempo somatotype showed that: microsomatics increased body length by a greater percentage (by 45,8 %), whereas mesosomatics this percentage was 43,1 %, and macrosomatics 39,9 %; also, MiS increased body weight by a greater percentage (by 190,5 %), in months it is 179,9 % and in MaS 168,5 %; mesosomatics show a greater increase in the circumference of the chest (by 48,3 %), microsomatics by 43,7 %, macrosomatics by 43,5 %, variances of indicator distributions in habitus differentiation show statically significant differences (p < 0,01).

   Conclusion. Planned measures to monitor the anthropometric habitus should be carried out taking into account the belonging of individuals both to a certain age-sex group and to the tempo somatotype, that is necessary and sufficient condition for the successful planning and implementation of medical and preventive measures in the fields of pediatrics, hygiene, sports.
Features of the state of occlusion with partial loss of teeth (literature review)
Authors: Zhulev E. N. , Saakyan M. Yu. , Vel′makina I. V. , Bragina O. M. , Vokulova Yu. A.
Published: December 2023

This article provides an overview of literature sources devoted to the peculiarities of the state of occlusion in partial loss of teeth and modern methods of studying occlusive relationships. The clinical picture of partial tooth loss is quite diverse, while changes in occlusive relationships may occur due to the development of deformities of the dentition, the formation of traumatic occlusion, changes in the function of a group of teeth in the presence or absence of antagonists. An increase in the functional load on the preserved teeth entails a structural restructuring of occlusion, which at the initial stages of compensation manifests itself in the form of localized increased erasability of teeth with an increase in the area of occlusal contacts, enamel cracks, and then, as the reserve capabilities of the periodontal decrease, leads to the appearance of mobility and a change in the position of teeth.
Pathophysiological aspects of microgravity and gravity therapy in cardiovascular diseases
Authors: Pereshein A. V. , Kuznetsova S. V. , Petrova D. A. , Potemina T. E.
Published: December 2023

Deconditioning in space from gravity deprivation, the problems of the consequences of modern sedentary lifestyle, bed rest and changes observed in sedentary aging demonstrate similar mechanisms of development, which are interpreted as disorders of mechanotransduction. Tensegrity theory provides the framework for understanding how external and internal mechanical forces influence biological control at the molecular and cellular levels in conditions associated with a sharp and steady disappearance of the gravitational vector signal. Microgravity causes pathologies such as severe loss of bone density and skeletal muscle strength, loss of functional capacity of the cardiovascular system, immune system and other disorders. The effect on the human body for therapeutic and preventive purposes with various parameters of artificial gravity is a modern and highly effective technology of restorative medicine.

   The aim of this lecture is to summarize the most important findings about the effects of gravitational therapy in different, mainly vascular based pathologies according to literary sources.
A MULTIVARIATE LOGISTIC ANALYSIS ON FACTORS AFFECTING THE MARKET PARTICIPATION OF SMALLHOLDER INDIGENOUS GOAT FARMERS IN MAKUYA VILLAGE OF THE HAMAKUYA COMMUNITY, MUTALE LOCAL MUNICIPALITY, LIMPOPO PROVINCE
Authors: GEORGE THEWELI Samuel , POTSISO MOKHAUKHAU Jenny , NENGOVHELA Rudzani
Published: December 2023

Livestock farming, particularly indigenous goat farming, is essential for rural economies, providing food and income. The demand for goat products is growing, encompassing meat, milk, fibres, and skins. Nevertheless, there's limited participation by farmers in formal markets, with most transactions happening privately. The study examined 45 smallholder indigenous goat farmers in Makuya Village, located in the Mutale Local Municipality, Limpopo Province. Data analysis included descriptive statistics and a multivariate logistic model to explore factors influencing market participation. The findings highlighted the diverse community, with a notable presence of male smallholder goat farmers. Several factors affecting market participation were identified, including the age of the farmer, the number of goats owned, distance to the market, and the source of agricultural information. This research offers valuable insights for policymakers and stakeholders, supporting sustainable goat farming and enhanced market engagement in rural areas.
FAKTOR-FAKTOR YANG MEMPENGARUHI KEBERHASILAN USAHA KOPERASI DI KOTA BOGOR
Authors: RITONGA JUBAIDAH
Published: December 2023

The success of cooperatives can be measured through the roles they have played for the community or the surrounding environment. The purpose of this study was to determine the effect of the internal control system, size, type, and education level of employees on the success of cooperative businesses in the city of Bogor using quantified qualitative research methods, carried out on active cooperatives registered at the Bogor City Cooperative and UKM Service, namely 456 cooperatives. with 1 cooperative only 1 administrator who became a respondent. The study used a saturated sample (census) technique, so the study population was 528 or at least 46 respondents. Data analysis used multiple linear regression with hypothesis testing through the F test and t test. The results of the study show that the internal control system, size, type and education level of employees simultaneously influence the success of cooperative businesses in the city of Bogor. Partially the internal control system, type and level of education of cooperative employees have a significant effect on the success of cooperatives in Bogor city. While the size of the cooperative has no effect on the success of the cooperative business in the city of Bogor.
Effect of Cash Turnover, Receivables Turnover and Inventory Turnover on The Profitability of Pharmaceutical
Authors: Fajar Ilmiyono Agung
Published: December 2023

The business run by the company aims to create the highest possible profit, this profit is expected to continue to be generated in the short and long term. Investment is very necessary in achieving maximum profit. The investment consists of working capital such as: Cash, Accounts Receivable, and Inventory. In increasing profitability, it is followed by cash turnover, receivables turnover and inventory turnover which can rotate effectively every period. This study aims to examine the effect of Cash Turnover, Receivable Turnover and Inventory Turnover on the profitability of the Pharmaceutical Sub-sector companies listed on the Indonesia Stock Exchange. The sampling technique used in this study was purposive sampling method. The analysis model of this research is Multiple Linear Regression Analysis. The results of the study partially show that Cash Turnover, Accounts Receivable Turnover and Inventory Turnover have no significant effect on the profitability of the pharmaceutical sub-sector companies listed on the Indonesia Stock Exchange. Simultaneous research results show that cash turnover, accounts receivable turnover, and inventory turnover have no significant effect on the profitability of pharmaceutical sub-sector companies listed on the Indonesia Stock Exchange.

Keyword:  Cash Turnover, Inventory Turnover, Profitability, Receivable Turnover
DAMPAK COVID-19 TERHADAP KINERJA KEUANGAN PERBANKAN KONVENSIONAL DI INDONESIA
Authors: Wahyuni Iis
Published: December 2023

Pada awal tahun 2020, Covid-19 dinyatakan sebagai pandemi oleh Organisasi Kesehatan Dunia (WHO). Covid-19 telah berdampak pada berbagai sektor termasuk sektor perbankan, seperti yang terjadi pada bank konvensional di Indonesia, telah terjadi peningkatan kredit bermasalah, penurunan profitabilitas, tetapi juga terjadi peningkatan dana pihak ketiga dan likuiditas yang memadai. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat perbedaan kinerja keuangan bank konvensional dengan menggunakan variabel (DPK), Risiko Kredit (NPL), Likuiditas (LDR) dan Profitabilitas (ROA). Penelitian ini merupakan penelitian kuantitatif komparatif dan menggunakan data sekunder, populasi dalam penelitian ini adalah 46 bank konvensional yang terdaftar di BEI pada tahun 2018 – 2021, pemilihan sampel menggunakan metode purposive sampling. Pengujian data menggunakan uji normalitas dengan metode Shapiro Wilk. Metode analisis data menggunakan analisis statistik deskriptif dan untuk pengujian hipotesis menggunakan Wilcoxon Signed Rank Test. Pada penelitian ini hasil penelitian menunjukkan bahwa terdapat perbedaan yang signifikan antara DPK, LDR dan ROA sebelum dan selama pandemi Covid-19, namun tidak terdapat perbedaan NPL sebelum dan selama pandemi Covid-19.
PERBEDAAN FREKUENSI GELOMBANG ULTRASONIK TERHADAP PENURUNAN KEPADATAN LALAT DI KANTIN PT. X
Authors: Syiar Ramadhan Ganendra Yuval
Published: December 2023

Derajat kesehatan yang tinggi akan berpengaruh kepada kinerja tubuh yang prima. PT. X memberikan fasilitas untuk karyawan mengkonsumsi makanan di kantin. Kantin yang tidak mencapai saniter baik dapat berdampak kepada kesehatan. Serangga yang sering muncul dan berterbangan di area kantin yaitu lalat. Lalat merupakan vektor atau binatang penganggu dengan filum rthropoda dan ordo diptera. Tujuan mengetahui perbedaan frekuensi gelombang ultrasonik terhadap penurunan kepadatan lalat. Jenis penelitian kuasi eksperimen dengan pre-test post-test without control design. Populasi seluruh lalat yang berada di kantin, sampelnya adalah sebagian lalat yang hinggap pada flygrill di kantin dengan besar sampel sebanyak 6 kali pengulangan dengan 3 perlakuan, sehingga besarnya sampel 18 sebelum perlakuan 18 setelah perlakuan. Alat pengumpul data adalah fly grill, thermohygrometer, dan hand counter. Teknik pengumpulan data dengan melakukan pengukuaran kepadatan lalat, suhu dan kelembaban udara. Teknik pengambilan sampel insidental sampling. Analisis data menggunakan One-way Anova. Hasil: rata-rata penurunan kepadatan lalat setelah diberi perlakuan 45 kHz, 55 kHz, dan 65 kHz yaitu 23%, 36% dan 61%. Mengacu kepada PERMENKES No. 70 Tahun 2016 untuk standar baku mutu kepadatan lalat adalah ≤ 2 ekor. Terdapat perbedaan besar gelombang frekuensi ultrasonik terhadap penurunan kepadatan lalat. Saran: perlu penelitian lebih lanjut mengenai lama waktu pengukuran kepadatan lalat disesuaikan dengan aktivitas lalat minimal 3 jam dan menaikan besar gelombang frekuensi ultrasonik. Untuk industri dengan menambahkan lama waktu perlakuan agar hasil penurunan kepadatan lalat sesuai dengan acuan regulasi.
3D PRINTING AND THE EVOLUTION OF PARTIAL HAND PROSTHESES: MY JOURNEY FROM THEORY TO PRACTICE
Authors: Baschuk Christopher M
Published: December 2023

The world of prosthetics has been undergoing significant changes, with the evolution of materials, design techniques, and manufacturing methodologies converging to redefine the landscape. Central to this narrative is the imperative for a holistic approach, harmonizing the trinity of materials, design, and methodologies to yield optimal outcomes. This balance is especially pivotal for the overlooked yet significant segment of those with partial hand and finger differences. Historically, this demographic has been underserved, with rehabilitation and prosthetic innovations often falling short. The sheer prevalence of partial hand differences underscores the urgency of tailored solutions. Traditional fabrication methods like wet lamination have posed challenges, particularly in aligning and efficiency. The advent of additive manufacturing has been transformative. The case of designing and printing a partial finger socket for Point Designs, LLC's Point Partial finger highlights this paradigm shift. Where conventional techniques demanded hours, digital design and 3D printing have condensed the process to mere minutes, without compromising on quality. This is not merely a win in terms of time efficiency; the implications for the end users are profound, ensuring a more customized and efficient solution. The journey underscores the potential of blending technology and traditional prosthetic knowledge, pointing towards a future where prosthetics align more seamlessly with users' needs.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/42139/32198
How To Cite: Baschuk C.M. 3D printing and the evolution of partial hand prostheses: my journey from theory to practice. Canadian Prosthetics & Orthotics Journal. 2023; Volume 6, Issue 2, No.5. https://doi.org/10.33137/cpoj.v6i2.42139
Corresponding Author: Christopher M Baschuk, MPO, CPO, FAAOP(D)Point Designs, LLC, Bountiful, UT, USA.E-mMail: chris@pointdesignsllc.comORCID ID: https://orcid.org/0000-0002-9895-5897
Chronic pancreatitis in comorbidity with gastroesophageal reflux disease (features of the course of gastroesophageal reflux disease)
Authors: Khristich T. N. , Hontsariuk D. O.
Published: December 2023

In this article, the authors emphasize the relevance of studying the features of the course of gastroesophageal reflux disease (GERD) both in children and adults, and in old age (including chronic pancreatitis). Attention is drawn to the different important mechanisms of GERD development in children and adults. As it is impossible to collect anamnesis in children before they start speaking, it is necessary to ask the parents about the so-called “red flags” (frequent fountain-like vomiting, the child is badly gaining weight, repeated pneumonia, diarrhea, refusal to drink or eat). One of the important features is a child’s crying during 1–2 hours.

It is difficult to make a differential diagnosis in adults between GERD phenotypes, especially in comorbidity with chronic pancreatitis, which makes appropriate adjustments to the clinical picture (which the authors focus on). Differential diagnosis of non-erosive GERD, such GERD phenotypes as reflux esophageal hypersensitivity, functional heartburn, low and high grade reflux esophagitis, Barrett’s esophagus, regurgitation-dominant GERD, extraesophageal phenotype and reflux chest pain syndrome is carried out.

The authors agree with those provisions that indicate that GERD is a family of different syndromes that differ in the mechanisms of development, clinical picture and make up certain phenotypes of the disease, which require a differentiated approach to treatment tactics and strategies, secondary prevention (including chronic pancreatitis).
How I loved the life!
Authors: Gubergrits N. B. , Borodiy K. N. , Lukashevich G. M.
Published: December 2023

This publication is dedicated to the British Princess Marie Alexandra Victoria of Edinburgh, known after marriage as Marie of Romania. The beautiful, educated, talented, rich Queen not only held the hearts of contemporaries with her achievements in the literary field, painting, and dancing, but also with her sincere concern for ordinary people. During World War I, Marie, who was known as the “mother of the wounded”, took care of the wounded soldiers with cholera, day and night without a break, along with other nurses.

As contemporaries believe, Marie’s cause of death was pancreatic cancer, however, due to various circumstances, liver cirrhosis was considered the official cause of the Queen’s death. Unfortunately, medical workers of the 20th century could not significantly affect the course of the disease, but they tried to relieve pain syndrome and maintain the general condition of the national favorite. The last words of the Queen (not only by origin, but also by spirit) vividly emphasize the love of life, resilience and majesty of this woman: “How I loved life!”
Depressive syndrome in gastroenterology
Authors: Tsimmerman Ya. S. , Tsimmerman I. Ya.
Published: December 2023

Depression has recently expanded beyond psychiatry to become a general medical problem. Psycho-emotional stress is the main factor that provokes anxiety-depressive disorders. There is a two-way connection between the psyche and the somatics: mental disorders affect somatic functions, and somatic diseases, in turn, affect the state of the psyche.

In this article, the author pays attention to the most common gastroenterological diseases associated with mental disorders. They include: peptic ulcer, functional (gastroduodenal) dyspepsia syndrome, irritable bowel syndrome, functional forms of chronic duodenal obstruction syndrome, chronic cholecystitis and associated extrahepatic biliary dyskinesia.

As for the digestive system, psychosomatic disorders are manifested by nausea and vomiting, belching, flatulence, abdominal pain, rumbling and splashing in the intestines, constipation or diarrhea, dry mouth. Anxiety-depressive syndrome in patients is characterized by dyssomnia, chronic anxiety, bodily discomfort, hypothymia, synestopathy, somatoform disorders, frustration, alexithymia, etc.

The main criteria and diagnostic tools for depression are described (international classifications, self-assessment scales, diagnostic tests).

In addition to the basic individualized therapy for somatic diseases, patients usually need additional prescription of psychotropic drugs and psychological support. The main technique of treatment is psychotherapy (less often — hypnotherapy). Only upon the ineffectiveness of psychotherapy, doctors should resort to the appointment of psychotropic drugs of four different groups: anxiolytics, antidepressants, “small” antipsychotics, nootropics.
Prevention of emotional burnout in medical professionals
Authors: Trush E. N.
Published: December 2023

More than a third of doctors in Ukraine experience this problem, but most of them do not receive specialized help in this matter. Specialists who have the highest risk of EBS: urologists (54%), neurologists (53%), rehabilitation specialists (52%), therapists (49%), ambulance doctors (48%), family doctors (48%).

The main causes of EBS in physicians are a large number of bureaucratic tasks (59%), a lot of time at work (34%), digital workload (32%). With increasing age and length of service in the profession, indicators of burnout tend to increase. The most intensive EBS is observed in employees of outpatient clinics (45%) and health care institutions (49%).

There are physical, behavioral, emotional, intellectual symptoms of EBS. The most disturbing symptoms are personal deformity, pessimism, negativism, social self-isolation, loss of empathy, indifference to the loved ones, the environment and patients. Such doctors become not only unfit for work, but also professionally dangerous because of the risk of harm to patients.

To diagnose EBS in health professionals, the author of the article proposes to use the questionnaire “Professional (emotional) burnout”, developed on the basis of a three-factor model by K. Maslach and S. Jackson. The technique is designed to diagnose emotional exhaustion, depersonalization and professional achievement. The test contains 22 statements about the feelings and experiences associated with the performance of work activities. The obtained results can be used to develop measures to prevent loss of interest in professional activities.

The most popular measures to combat EBS: sports (48%), communication with family members and close friends (43%), self-isolation (41%). EBS is easier to prevent than to treat, so special attention is paid to prevention methods. To reduce the risks of EBS, it is necessary to increase psychological competence, give way to negative emotions, expand the range of interests, quickly resolve conflicts, do not delay in obtaining specialized help, do not look for negativity around you. The article also offers twelve “rituals” of emotional hygiene, which are recommended to be performed regularly.
On the features of the correction of intestinal dysbiosis in chronic pancreatitis (literature review)
Authors: Ferfetska K. V. , Hontsaryuk D. O. , Pits L. O. , Pits V. A.
Published: December 2023

The aim of the literature review was to analyze the modern approach to the correction of intestinal dysbiosis in patients with chronic pancreatitis, including the one combined with metabolic syndrome, coronary heart disease, and especially bacterial overgrowth syndrome.

Particular attention is paid to the peculiarities of drug therapy and the pharmacotherapeutic mechanisms of influence of various groups of pro-, pre- and synbiotics on the condition of the intestine, immunity, and inflammatory processes. The requirements for an adequate selection of drugs are considered. They must be useful for the human body; should not cause side effects during long-term use, but should have a minimal ability to translocate from the lumen of the intestine to internal organs; must be resistant to low pH values, the influence of bile acids, and antimicrobial substances produced by endogenous microflora; adhere well to the epithelium of mucous membranes; have a high rate of growth and reproduction in the intestines; and must have a clear physiological, biochemical, and genetic marking. Efficacy criteria are the probiotic effect proven in double-blind placebo-controlled studies. These requirements are met by B. bifidum, Lactobacillus acidophilus, Lactobacillus GG, Lactobacillus fermentum, Strepto(Entero)coccus faecium, Saccharomyces boulardii, which are components of many probiotics.

Interesting information is provided about the probiotic with level A evidence, called Enterol by the WHO experts: it is a self-eliminating probiotic, each capsule of which contains 250 mg of lyophilized cells of a selective strain of medicinal yeast, Saccharomyces boulardii. It is crucial that the drug prevents the growth of a wide range of pathogenic microorganisms and fungi and promotes their elimination (Clostridium difficile, Clostridium pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Candida crusei, Candida pseudotropical, Candida albicans, Salmonella typhi, Salmonella enteriditis, Escherichia coli, Shigella dysenteriae, Shigella flexneri, Klebsiella, Proteus, Vibrio cholera, Enthamoeba hystolitica, Enterovirus, Rotavirus).
Consequences of chronic pancreatitis and exocrine pancreatic insufficiency, or When leaves fall from trees
Authors: Gubergrits N. B. , Byelyayeva N. V. , Mozhyna T. L.
Published: December 2023

Aim. To analyze current literature data on the complications of chronic pancreatitis (CP) with exocrine pancreatic insufficiency (EPI).

Main statements. According to statistical evidence, the presence of CP is associated with an increased risk of death, while the concomitant EPI significantly increases the risk of death. EPI is a big independent risk factor for death in patients with CP, which emphasizes the need for adequate correction of EPI in order to reduce mortality in this group.

EPI is associated not only with an increase in mortality in CP patients but also with the development of various trophological defects. It has been stated that CP course is accompanied by a decrease in the level of albumin, malabsorption of fat-soluble vitamins (A, E, and D), carotenoids (beta-carotene, lycopene, cryptotaxin, and zeaxanthin), and the development of osteopenia and osteoporosis. CP course is linked to anxiety, depression, tumor pathology (pancreatic ductal adenocarcinoma, esophageal cancer, and stomach cancer), damage to the cardiovascular system, an increase in cardiovascular risk, and a high chance of myocardial infarction, stroke, and pancreatitis-induced thrombosis of the splenic vein. Modern enzyme replacement therapy makes it possible to compensate for some of the consequences of chronic EPI, reduce numerous signs of malnutrition, normalize the body mass index, and improve the quality of life of CP patients with EPI.
Clinical evaluation of the effectiveness of procalcitonin in diagnosing purulent septic complications of acute necrotizing pancreatitis
Authors: Rotar O. V. , Khomiak I. V. , Petryuk B. V. , Khomiak A. I. , Railianu S. I. , Barbu S.
Published: December 2023

Purulent septic complications seriously worsen the prognosis for patients with acute necrotizing pancreatitis. Early diagnosis is an important issue in establishing the effectiveness of their conservative and interventional treatment. Recently, procalcitonin (PCT) has been suggested as a diagnostic criterion for bacterial contamination of pancreatic necrotic tissue.

The aim of study is to estimate PCT efficacy for early diagnosis of purulent septic complications of acute necrotizing pancreatitis and to investigate its use for disease prognosis.

Materials and methods. A prospective cohort study of 151 patients with severe acute necrotizing pancreatitis was conducted. Clinical, laboratory, and bacteriological studies were carried out. Serum levels of PCT were determined during hospitalization, before intervening treatment, and in the postoperative period.

Results and discussion. Infected acute necrotizing pancreatitis was diagnosed in 89 (55.6%) patients. Local purulent complications were revealed in 27 patients, sepsis in 33, and septic shock in 29. PCT concentration was higher in 62 patients with sterile pancreatic necrosis than in healthy individuals, reaching 1.34±0.19 ng/ml (p=0.045). The development of infected acute necrotizing pancreatitis was accompanied by increased PCT levels in patients with sepsis (up to 5.03±1.38 ng/ml; p=0.001), septic shock (up to 7.21±1.91 ng/ml; p=0.001), and local purulent septic complications (up to 2.03±0.48 ng/ml; p=0.072). The PCT levels above 4.0 ng/ml were prognostically unfavorable for patient survival.

Conclusion. PCT levels in the blood serum are an effective criterion for diagnosing generalized purulent septic complications of acute necrotizing pancreatitis. Its levels above 4.0 ng/ml indicate an unfavorable prognosis for patient survival.
Controlling the quality of medical care: key aspects of a systematic approach and international experience
Authors: Trush O. M.
Published: December 2023

Safety, quality of life, and ensuring the best results for the health of patients are the main goals of healthcare institutions and the system as a whole. The modern approach to ensuring stable and reproducible quality of medical services was shaped in the last century, and has now reached a high degree of generalization. Control in this field is a multi-level process that covers all parts of the medical institution’s activities, from logistics to personnel management.

Indicators of the quality of medical services from the patient’s side range from potentially complex (postoperative morbidity and mortality) to simple (the frequency of hospital-acquired infections or surgical errors). When all of the clinic’s main business processes are clearly set up and improved as needed, this is called “process management.” This makes it possible to design quality by taking into account the indicators of meeting the requirements of technical documents. 

The ISO 9000 family of standards, which is successfully used and adopted worldwide in healthcare organizations, contains requirements, specifications, instructions, and tools for the provision of products and services. They simplify comparison, information exchange, big data aggregation, and privacy protection. Regarding the patients, the standards are designed to provide high-quality, safe, and reliable products and services. There are certain precautions about an overly technological approach during quality assurance and control, but now the greatest threat is considered to be the destructive impact of war and the disruption of habitual relationships and processes.

The state of medical care, the damage to the material fund, the depletion of human resources, and the lack of financial and other resources are all concerning. Fragmentation of healthcare and unequal access in different regions and social groups are potentially threatening. Examples of countries with long-term military conflicts on their territory indicate the “erosion” of activity standards, which are usually set by external actors in such conditions in response to the limited institutional, technical, and managerial capabilities of countries in a state of conflict. Complex measures to restore the functionality of the medical care system are organized at the level of communities, individual institutions, and their associations. In this case, the first steps are the most important, since they often determine the development for years and decades ahead. Therefore, the restoration, or sometimes the “reset,” of the domestic system is an exceptional opportunity to re-prioritize, correct shortcomings, and establish stronger ties with the global professional community.
Comments on the European Guideline on IgG4-related Digestive Disease
Authors: Gubergrits N. B.
Published: December 2023

The main aim of the comments is to point out the most significant aspects of diagnosis and treatment of immunoglobulin G4 (IgG4)-related gastrointestinal diseases (IgG4-AGD), as described in European guidelines. According to the guidelines, measuring the amount of IgG4 in the serum cannot be used to confirm a diagnosis of IgG4-AGD on its own. The diagnosis of this pathology is based on a comprehensive assessment of serological and imaging studies, histological and immunohistochemical studies, the assessment of other organs’ damage, and the effectiveness of systemic glucocorticoids. Oral glucocorticoids are administered for symptomatic patients (obstructive jaundice, abdominal pain, pancreatic pain, liver, bile duct, esophagus, stomach, small and large intestine lesions), as well as asymptomatic patients with persistent cholestasis against the background of IgG4-related cholangitis and the presence of a mass lesion according to imaging studies to exclude malignant neoplasia. A typical starting dose of glucocorticoids is 0.6–0.8 mg/kg/day, or 30–40 mg/day of prednisolone equivalent. This dose of steroid should be administered orally for one month to induce remission. Subsequently, a gradual decrease in the dose of glucocorticoids begins over 3–6 months. Evaluation of the effectiveness of initial therapy with glucocorticoids is carried out after 2–4 weeks of taking steroids based on a comprehensive analysis of physical data and the results of biochemical, instrumental, and histological studies. The systemic course of the disease, with multiple organ damage or relapses, suggests the use of glucocorticoid maintenance doses. If there are no changes in the course of the disease after three months of treatment, even if the dose of glucocorticoids is reduced or the drug is withdrawn, immunosuppressive drugs (rituximab) are prescribed to keep the disease in remission.