bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of ofatumumab and other disease-modifying therapies for relapsing multiple sclerosis: a network meta-analysis
Authors: Samjoo Imtiaz A , Worthington Evelyn , Drudge Christopher , Zhao Melody , Cameron Chris , Häring Dieter A , Stoneman Dee , Klotz Luisa , Adlard Nicholas
Published: October 2020

Aim:
To compare the efficacy of ofatumumab to other disease-modifying therapies (DMTs) for relapsing multiple sclerosis (RMS).
Materials & methods:
A network meta-analysis was conducted to determine the relative effect of ofatumumab on annualized relapse rate and confirmed disability progression at 3 months and 6 months.
Results:
For each outcome, ofatumumab was as effective as other highly efficacious monoclonal antibody DMTs (i.e., alemtuzumab, natalizumab and ocrelizumab).
Conclusion:
Ofatumumab offers beneficial outcomes for RMS by reducing relapse and disability progression risk.
Лазерная сварка разнородных металлов
Authors: Курынцев С.В. , Шиганов И.Н.
Published: October 2020

Представлен количественный и качественный анализ мировых тенденций в области лазерной сварки разнородных металлов за 2016–2019 годы. Определено, что лазерная сварка получила наибольшее распространение для соединений стали с алюминием, титана с алюминием, алюминия с медью. Представлен анализ основных техник и способов сварки разнородных металлов, результаты исследования их влияния на металлургию процесса, микроструктуру и механические свой­ства соединений. Акцент сделан на описании техники и способов лазерной сварки алюминия со сталью.
Оптическая ультраструктурная вирометрия и ее ограничения
Authors: Градов О.В. , Жуланов Ю.В. , Макавеев П.Ю.
Published: October 2020

Идентификации типоразмеров вирусных, агрегационных и иных частиц с помощью анализа потока вирионов по спектру светорассеяния и флуоресценции требует предварительной калибровки измерительного инструмента. Калибровка должна идти по конкретным геометрическим прототипам, имеющим определенные размеры. Однако размеры вирусов колеблются в широком диапазоне длин от нано- до субмикрометровых размеров. Это создает неопределенность измерений для широкого ряда вирусов. Программное обеспечение широко внедряемых оптических инструментов базируется на упрощенной интерпретации теории рассеяния света Ми, распространяя ее практически на весь диапазон размеров частиц, даже субмикрометровых. В обзоре рассмотрены метрологические проблемы оптической вирометрии, даны предложения решения вопросов калибровки инструментов.
ХОЛОДНОЕ СПЕКАНИЕ В ПРИСУТСТВИИ ВОДНОЙ СРЕДЫ: МЕХАНИЗМ И ПРИКЛАДНЫЕ АСПЕКТЫ. ОБЗОР. ЧАСТЬ 1
Authors: Смирнов А. , Ивакин Ю. , Тарасовский В. , Рыбальченко В. , Васин А. , Холодкова А. , Пахомов М. , Новиков С. , Столяров В.
Published: October 2020

Представлен краткий обзор современного состояния исследований нового процесса консолидации керамических порошков в водной среде при температурах ниже 500 °С, известного под названием «процесс холодного спекания».
РОБОТИЗАЦИЯ ОТДЕЛОЧНОЙ ОБРАБОТКИ ДЕТАЛЕЙ В МАШИНОСТРОЕНИИ
Authors: Вартанов М. , Власов А.
Published: October 2020

Рассмотрены перспективы применения промышленных роботов для выполнения механической отделочной обработки деталей в машиностроении. Приведены схемы построения операций с использованием роботов. Приведен состав ячейки для выполнения роботизированной отделочной обработки. Изложены результаты экспериментальных исследований, проведенных с целью нахождения оптимальных режимов резания, обеспечивающих требуемое качество обработки поверхности.
CRECIMIENTO Y ASPECTOS TROFICOS DEL PEZ LEON ROJO PTEROIS VOLITANS (SCORPAENIFORMES: SCORPAENIDAE) EN EL PARQUE NACIONAL SISTEMA ARRECIFAL VERACRUZANO (PNSAV), VERACRUZ, MÉXICO
Authors: Amador-Núñez Mariajosé Xhail , Morán-Silva Angel
Published: October 2020

The lionfish Pterois volitans, is an predator in coral system, whose diet is composed of small fish and crustaceans, impacting species of ecological and commercial importance. P. volitans is an exotic species in the Gulf of Mexico with high colonization capacity. The present study describes its population structure, type of growth and trophic dynamics. 97 organisms of the PNSAV were obtained, 64 females (185±6,7 mm LP; 257,6±27,8 g) and 22 males (183±15,8 mm of LP; 273,5±62,6 g). Whit the Battacharya model, four size classes were obtained for females (15,3; 25,3; 28,2, and 31,8 cm) and six for males (9,87; 17,95; 22,95; 26,95; 30,95 and 33,95), being the size class 1 for both sexes the most abundant. The length-weight relationship was of the potential type (r2=0,9643, b=3,1574 females, and r2=0,9843 and b=3,1089 males), and growth of allometric type for both sexes. The growth model that best adjusted to the data was that of Gompertz, (L∞=324 mm, k=0,99, t0=0,694 females and L00=379,4, k=0,468, t0=0,719 males). The families of fish identified in the stomach contents were Ophididae, Serranidae, Haemulidae, Pomacentridae, Beloniidae, Achiridae, and crustaceans Portunidae, Penaeidae, Squillidae and Diogenidae. Being Haemulon aurolineatum (Haemulidae) and Xiphopenaeus kroyeri (Penaeidae) the most important prey. The presence of lionfish in the PNSAV is recent, so the information presented in this research will allow us to understand its population dynamics and its adaptation to the PNSAV, contributing to its management and control.
VARIACIÓN ESPACIO-TEMPORAL DE TRES ESPECIES DE TANAIDÁCEOS (CRUSTACEA: PERACARIDA) EN EL SISTEMA LAGUNAR DE MANDINGA, VERACRUZ, MÉXICO EN EL PERIODO 2008-2015
Authors: Rodríguez-Varela Asela Del Carmen , Barreto-Segura Omar Alfredo , Vázquez-López Horacio
Published: October 2020

The increasing anthropogenic development of the Veracruz Metropolitan Area demands the updating and monitoring of the region’s biodiversity, particularly on the spatial-temporal dynamics of those potential indicator groups of any disturbance. We present the first study on the Tanaidaceans of the Lagunar System of Mandinga, Veracruz, Mexico. Seven collections were made on submerged vegetation and sediments in dry season from 2008 to 2015 and one in the rainy season of the first year. Organisms were collected with a dredger and a Renfro-like net on submerged vegetation. One species from the suborder Apsudomorpha, Discapseudes (Discapseudes) mexicanus Gutu, 2006 and two from the suborder Tanaidomorpha, Chondrochelia dubia (Krøyer, 1842) and Hargeria rapax (Harger, 1879). The former recorded the highest distribution and abundance during the study period, confirming that D. mexicanus is a tanaidacean characteristic of the coastal systems of the Gulf of Mexico and it is associated with environments with high organic content in the sediments, while the other species were collected with lower abundances. In general, the downward trend in its abundance is noticeable over time, a fact that can be attributed to the constant modifications and alterations that SLM has undergone throughout the study period.
Reconocimiento y percepción para la Maternidad y la Paternidad
Authors: Gonçalves dos Santos Gustavo
Published: October 2020

En el artículo se describe la percepción que tienen las mujeres embarazadas de los cuidados que prestan las enfermeras durante el curso que sirve para preparar a determinadas personas para el proceso de Maternidad y Paternidad y, según las categorías presentadas en el estudio, se deben considerar tres aspectos fundamentales: la supervisión, el reconocimiento y la enseñanza en materia de cuidados. Las personas que participan en el curso de preparación para el reconocimiento de la Maternidad y la Paternidad entienden los cuidados prestados por las Enfermeras, reconociéndolos como un aspecto fundamental, mediante la ejecución de acciones encaminadas al bienestar del embarazo, del niño y de la familia
Coronavirus and Globalization: Knowledge vs Concept
Authors: Chumakov A. N. , Yurchenko P. S.
Published: October 2020

The coronavirus pandemic has generated a lot of talk about the post-coronavirus future of the world community and has drawn close attention to the globalization process. The article notes that something similar in the public consciousness took place after the publication of the first report to the Club of Rome, when the awareness of the danger posed by global problems had quickly come. Now, one of the global problems — the coronavirus pandemic — has changed the usual life rhythm of the entire world community in a matter of weeks. The relevance of the topic is so high that even those who, before that, not only professionally, but even seriously were not interested in either the problems of medicine or global problems, actively joined its discussion. As a result, on the pages of many print and electronic publications, along with serious and verified information, all sorts of guesses and speculations about the nature and correlation of coronavirus and globalization are multiplied. Only knowledge can be opposed to this, according to the authors.
Comparative Analysis of the Legal Regulation of Civil Liability for Harm Caused to Human Life and Health
Authors: Shubina O. B. , Filippova K. A.
Published: October 2020

The purpose of this article is a comparative analysis of the legal regulation of civil liability for harm caused to human life and health by activities that create an increased danger to others in Russia and foreign countries. Due to the intensive development of new technologies and the emergence of new sources of increased danger, there is a need to specify the concept of «activities that create increased danger to others» in Russian legislation. The subject of the article is the norms of law of Russian and foreign legislation regulating the institution of civil liability for harm caused to human life and health by activities that create an increased danger to others. The article is written using General scientific, philosophical and special legal methods of cognition. Based on the results, the article assesses the specifics of regulating harm caused by activities that create an increased danger to others in foreign legislation. Based on the research, it is proposed to distinguish the concepts of «source of increased danger» and «activities that are associated with increased danger to others» in Russian legislation, adding a note to article 1079 of the Civil code of the Russian Federation, as well as to specify the list of sources of increased danger, including unmanned vehicles and fighting dogs.
Interdependence of the Interests of the United States, China and Russia in Central Asia
Authors: Toropygin A. V. , Mendagaziev A. E.
Published: October 2020

Central Asia is the union republics of former Central Asia and Kazakhstan, which became independent countries after the USSR collapse. The formation of new states and regions is associated with both internal challenges and the influence of external extra-regional forces. The purpose of the article is analyzing the interests and influence of the United States, China, and Russia on the Central Asia development, as well as the perception of these forces in the region. Various stages of this influence from the moment of its appearance to the present time are analyzed. The authors concluded that the countries of Central Asia during its independent existence perceived powers in the triangle USA — Russia — China differently, which was a prerequisite for the formation of their multi-vector foreign policy. The balance of interests of Russia’s, the United States’ and China’s presence in the region is vital for the Central Asian countries, it provides an independent foreign policy course and development of Kazakhstan, Uzbekistan, Kyrgyzstan, Turkmenistan and Tajikistan, contributing to a stable situation in the region.
On the Role of Ideology in the Development of the Eurasian Economic Integration
Authors: Glazyev S. Yu.
Published: October 2020

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Comercio intra-industrial y variaciones del empleo en la industria colombiana, 1991-2015
Authors: Hernandez Garcia Edwin Arbey , Raffo López Leonardo
Published: October 2020

El objetivo de la investigación es analizar la relación que existe entre el comercio intra-industrial (CII) y las variaciones del empleo para la industria colombiana durante el periodo 1991-2015, poniendo a prueba la Hipótesis del Ajuste Suave (HAS) por primera vez en Colombia. Para ello se hace uso del índice A de Brülhart que permite medir el comercio intra-industrial marginal y también de índices que discriminan la naturaleza vertical y horizontal del CII; también se estiman modelos de panel estáticos y dinámicos. Dentro de los principales resultados se obtuvo que las estimaciones son consistentes con la HAS, lo que en términos de política económica implica que a medida en que Colombia incremente sus intercambios comerciales a nivel intra-industrial los costos de ajuste serán menores.
Valoración de riesgo mediante modelos GARCH y simulación Montecarlo: evidencia del mercado accionario colombiano
Authors: Barbosa Camargo Maria Ines , Salazar Sarmiento Alejandra , Peñaloza Gómez Kelly Jhohana
Published: October 2020

Este documento evalúa el comportamiento de varios modelos de volatilidad en estimaciones de un día del valor en riesgo (VaR) de veinticuatro series de retornos de acciones en Colombia con diferentes distribuciones. Al considerar que todas las series de retornos presentan clúster de volatilidad y memoria de largo plazo, se utilizan modelos tipo GARCH que incluyen diferentes distribuciones: normal, T-Student y GED. Los hallazgos corroboran la dificultad de elegir un único modelo para el cálculo del VaR, pero validan el uso de modelos paramétricos con distribución normal y simulación Montecarlo en mercados financieros emergentes.
Marketing simbiótico. Una aproximación al concepto desde una revisión teórica
Authors: Montoya-Restrepo Luz Alexandra , Sánchez-Torres Javier , Montoya-Restrepo Iván Alonso
Published: October 2020

Se presentan los principales aportes académicos del concepto marketing simbiótico, se expone la definición del concepto de diferentes autores desde sus primeros aportes. Esta presentación se realiza mediante una metodología de búsqueda conceptual en la que se establecen los principales autores y las tendencias de estudio del concepto. Como principal conclusión se encuentra que es un tema que, si bien ya se ha desarrollado, ha pasado por diferentes explicaciones que conllevan baja claridad en su definición, se limita así la unificación y constancia en el reconocimiento de los principales aportes de los autores, lo que evidencia la necesidad de consolidar las contribuciones y de esta manera, reconocer y fortalecer los estudios empíricos de esta.
An attribution analysis of soybean price volatility in China: global market connectedness or energy market transmission?
Authors: Zhang Youwang , Li Chongguang , Xu Yuanyuan , Li Jian
Published: October 2020

This study examines the impact of international soybean price and energy price on Chinese soybean price. Applied to monthly data over the period of 2007-2017, results show that both international soybean price and energy price have significant impacts on Chinese soybean price, while the impact from global soybean market tends to be more profound. First, we find that in the long run the cumulative pass-through elasticity of Chinese soybean price to international soybean price is greater than the elasticity to international energy price. Second, in the short run, international soybean price shocks transmit more quickly to Chinese soybean price. Our results shed new light on the determinants of soybean price volatility in China, and provide meaningful implications on the price risk management for market participants and policy makers.
A novel Kind of the multi-index Beta, Gauss, and confluent hypergeometric functions
Authors: Ali Musharraf , Ghayasuddin Mohd , A. Khan Waseem , Nisar Kottakkaran Sooppy
Published: October 2020

This research article elaborates on a novel expansion of the beta function by using the multi-index Mittag-Leffler function. Here, we derive some basic properties of this new beta function and then present a new type of beta dispersal as an application of our proposed beta function. We also introduce a novel expansion of Gauss and confluent hypergeometric functions for our newly initiated beta function. Some important properties of our proposed hypergeometric functions (like integral representations, differential formulae, transformations formulae, summation formulae, and a generating relation) are also pointed out systematically.
O CAMINHO DO VIEJO REALES
Authors: Adoue Silvia Beatriz
Published: October 2020

Este artigo trata da representação cinematográfica da vida e lutas dos trabalhadores da cana-de-açúcar em Tucumán, Argentina, durante as décadas de 1960 e 1970. O objeto deste trabalho é o filme El camino hacia la muerte del Viejo Reales (1974), do cineasta tucumano Gerardo Vallejo, membro do grupo Cine Liberación. O encontro entre as lutas e o cinema como instância de reflexão e intervenção dos militantes sindicais e políticos dos canaviais naquele período histórico nos remete às possibilidades do cinema, mas também dos trabalhadores pensando a própria ação. O filme em questão é, na sua primeira parte, um trabalho de testemunho da família Reales sobre sua vida, com participação da família na encenação de situações que a simples entrevista não permitiria. A família aceita, inclusive, incluir elementos de ficção, cuja condição não é escamoteada do receptor. Isso facilita a passagem da história singular à história dos trabalhadores canavieiros tucumanos. Na segunda parte, traça um panorama histórico de Tucumán e a indústria açucareira, assim como da construção da Federación Obrera Tucumana de la Industria del Azúcar (FOTIA) através das suas lutas, pela voz dos seus próprios militantes. Ao organizar desta maneira o material fílmico, a montagem constrói um sentido e o coloca a serviço da organização dos trabalhadores, seja para a autorreflexão, seja como material da formação dos seus. 

 

Palavras-chave: Trabalhadores canavieiros. Tucumán-Argentina. Cinema político. Documentário.
MOVIMENTOS GREVISTAS DE OPERÁRIOS E TRABALHADORES RURAIS
Authors: Leite Lopes José Sérgio , De Menezes Marilda Aparecida , Santos Júnior Jaime
Published: October 2020

Apresentação do dossiê 52
SARS-CoV-2: generalidades bioquímicas y métodos de diagnóstico
Authors: Peña López Brigitte Ofelia , Rincón Orozco Bladimiro , Castillo León John Jairo
Published: October 2020

El 31 de diciembre de 2019 la comisión municipal de salud de Wuhan (provincia de Hubei, China) informa sobre un inusitado brote de casos de neumonía en la ciudad. Posteriormente se determina que se trata de un nuevo coronavirus designado inicialmente como 2019-nCoV y posteriormente, SARS-CoV-2. El SARS-CoV-2 infecta y se replica en los neumocitos y macrófagos del sistema respiratorio específicamente en el parénquima pulmonar en donde reside el receptor celular ACE-2. Esta revisión describe aspectos relacionados con la transmisión, prevención, generalidades bioquímicas del SARS-CoV-2 y métodos diagnósticos del COVID-19. Inicialmente se describe la forma de transmisión del virus y algunas recomendaciones generales para su prevención. Posteriormente, se hace una descripción detallada de los aspectos bioquímicos del SARS-CoV-2, su ciclo infeccioso y la estructura de la proteína S, la cual está involucrada con el proceso de ingreso del virus a la célula. Finalmente, se describen los métodos y pruebas de laboratorio para el diagnóstico del COVID-19.
Potenciales estrategias terapéuticas basadas en péptidos para mitigar la infección por SARS-CoV-2
Authors: Lozano Jiménez Yenny Yolanda , Sánchez Mora Ruth Mélida , Giraldo Quintero Sara Emilia
Published: October 2020

La nueva pandemia por SARS-CoV-2 ha incentivado la búsqueda de alternativas terapéuticas que reduzcan los índices de mortalidad. Dentro de estas, el uso de péptidos se destaca por su facilidad de síntesis, fácil producción a gran escala, especificidad en la respuesta inmunológica, versatilidad en la dosificación, alta pureza, economía, entre otros. Esto ofrece una excelente opción al enfoque tradicional, con lo que se resta la evaluación de su eficacia, eficiencia y seguridad a nivel clínico.
Alteraciones hematológicas en COVID-19
Authors: Villa Palacio María Isabel , López Henao Elizabeth
Published: October 2020

El SARS (síndrome respiratorio agudo grave) es el estadio grave de la COVID-19 ocasionado por el SARS-CoV-2, que causa infecciones respiratorias en humanos y cuya transmisión se da principalmente por contacto. El virus ingresa a la célula huésped por la interacción de la proteína S con la enzima convertidora de angiotensina II (ACE2), presente en el tracto respiratorio, así como en monocitos, macrófagos, células endoteliales, corazón y tracto gastrointestinal. El aumento de IFN frena la replicación viral y activa la respuesta inmune adaptativa. Así, las manifestaciones clínicas de la infección se presentan frecuentemente a nivel del tracto respiratorio; sin embargo, también pueden involucrar otros sistemas como el hematopoyético. En el hemograma se observan recuentos celulares alterados, principalmente leucocitos y plaquetas. La linfopenia y neutrofilia se asocian con enfermedad severa y la trombocitopenia se presenta de manera heterogénea en la infección. Entre las complicaciones se encuentra la coagulación intravascular diseminada, producida cuando los monocitos y las células endoteliales son activadas por la liberación de citoquinas; esto genera daño endotelial, con la síntesis del factor tisular, secreción de factor tisular, activación plaquetaria y liberación del factor Von Willebrand, así como una condición hiperfibrinolítica especialmente en estadios tardíos de la infección. Las pruebas de laboratorio como el dímero D, los productos de degradación de la fibrina (PDF), tiempo de protrombina (TP), tiempo de tromboplastina parcial activado (TTPA), entre otras, son fundamentales para el diagnóstico, seguimiento y pronóstico de la enfermedad.
Pneumocystis jirovecii y SARS-CoV-2; COVID-19
Authors: Giraldo Forero Julio César , Bernal Lizarazú María Consuelo , Guatibonza Carreño Andrea Milena , González Gómez Andrés Camilo , Fernández Manrique José
Published: October 2020

Pneumocystis jirovecii, es un agente fúngico oportunista causante de neumonía (pneumocistosis) que puede ser mortal en personas con condición de inmunocompromiso, incluyendo pacientes VIH con recuento de linfocitos T CD4+ < 200 céls/mm3 y en pacientes inmunocomprometidos por otras etiologías como trasplantes de órgano sólido y cáncer, entre otras. Muchas personas pueden ser portadoras sanas de este agente etiológico y actuar como reservorio y fuente de infección. Artículos relacionados con coinfección entre SARS-CoV-2 y los de carácter oportunistas como P. jirovecii y Aspergillus fumigatus empiezan a publicarse, donde se argumenta que esta infección viral tiene un alto riesgo de coinfección y se manifiesta la importancia de no excluir los patógenos respiratorios, como P. jirovecii, entre otros. La coinfección con P. jirovecii puede no ser detectada en pacientes con infección grave por SARS-CoV-2, dado que pueden compartir características clínicas comunes como infiltrados multifocales bilaterales e hipoxemia profunda entre otras. Por lo tanto, es necesario realizar pruebas diagnósticas adicionales para P. jirovecii en pacientes con infección por SARS-CoV-2, especialmente cuando se presenten otras características clínicas que pueden apoyar la coinfección, como hallazgos quísticos en la TC torácica y niveles elevados en sangre de 1,3-D-glucano, incluso en ausencia de factores de riesgo clásicos para P. jirovecii, para el diagnóstico de neumonía por Pneumocystis en pacientes con sospecha de infección por SARS-CoV-2.
Desafios da gestão nas escolas das águas
Authors: Nozu Washington Cesar Shoiti , Rebelo Andressa Santos , Kassar Mônica de Carvalho Magalhães
Published: October 2020

School management is related to both general administration issues and pedagogical aspects. This article aims to present the work of school management in the “Schools of Waters” (School in riverside areas), located in the Pantanal of Mato Grosso do Sul (Brazil). For its development, the qualitative perspective was adopted, with a study of documentation, observation and interviews with the school’s managers. The data were systematized and organized in two topics: a) Characterization and Functioning of the Schools of Waters; and b) Curricular Proposal and Monitoring of Pedagogical Work. It was found that the necessary autonomy to carry out the management work is hampered by the insufficient material conditions for work closer to the community.
Internacionalização como política educacional: a Universidade de Alcalá no Espaço Europeu de Educação Superior
Authors: Luis-Pascual Juan-Carlos
Published: October 2020

The new functions of the university in the integral development of the student suppose a strategy of continuous innovation to adjust, and even anticipate, to the prospective needs, both professionally and personally, of the citizens who will coexist in a global, interdependent and changing reality. The University of Alcalá integrates the historical tradition, the European geostrategic situation and its policy of flexibility, evaluation and constant adaptation to the company and society where it is located. Educational policy needs to have a clear purpose that allows the development of teachers' teaching competences to be combined with a perspective based on dialogical learning, formative and shared evaluation, collaborative work, inclusion and the management of uncertainty.
Qualidade e equidade na educação: uma visão desde as políticas e a gestão educacional
Authors: Anache Alexandra Ayach , Sebastián-Heredero Eladio
Published: October 2020

As políticas e gestão escolar, hoje mais do que nunca, precisam de uma abordagem global, internacional, interdisciplinar que dê resposta às novas necessidades que são demandadas desde as instituições educativas a todos os níveis do sistema educativo. Trazemos aqui as palavras de Aranda (2006) quem retoma o informe da Organização para a Cooperação e Desenvolvimento Econômico de 1996 onde já se afirmava que as rápidas mudanças da economia e os avances das tecnologias “poderiam fazer inútil uma formação orientada exclusivamente na direção do profissional, pois a evolução dos conhecimentos e a própria transformação das empresas estava voltando obsoleto o conteúdo que se transmitia nos centros acadêmicos” (p. 1) entendidos no sentido mais amplo, o que evidentemente se torna numa mensagem permanente para navegantes em todos os sentidos.
Health Care Transition in Youth With Type 1 Diabetes and an A1C >9%: Qualitative Analysis of Pre-Transition Perspectives
Authors: Tremblay Elise Schlissel , Ruiz Jessica , Buccigrosso Tess , Dean Taylor , Garvey Katharine C.
Published: October 2020

Objective. To explore expectations for transition to
adult care and experiences with transition planning among adolescents and young
adults with type 1 diabetes and an A1C >9% at a tertiary care U.S. pediatric
center.

 Methods.
We
conducted semi-structured interviews in a purposive sample of patients 14–23
years of age who had had type 1 diabetes for at least 1 year and had an A1C
>9%. A multidisciplinary team conducted iterative thematic analysis with
deductive and inductive coding aided by NVivo software.

 Results. Fourteen
subjects participated (nine adolescents and five young adults, mean age 17.1 ±
3.2 years, 57% male, 79% Caucasian, 14% Hispanic, diabetes duration 8.2 ± 4.6
years, mean A1C 10.0 ± 0.8% for adolescents and 10.1 ± 0.7% for young adults).
Qualitative analysis yielded four key themes. The first was lack of formal preparation; participants of all ages
demonstrated a lack of preparation for transition and ignorance about the
process, describing it as coming “out of the blue.” The second was a desire for
delayed and gradual transition; participants wanted to defer being “serious”
about transition to a later/uncertain date, with a preference to “wait until
I’m older” among all ages. Participants described ideal transition as a
gradual, process taking place “a little at a time.” The third was attachment to
pediatric providers; participants demonstrated a nearly universal attachment to
and “familiarity” with their pediatric diabetes care providers and expressed
worries about an “uncomfortable” transition to adult providers. The fourth was
concern about an impersonal adult care setting: participants perceived adult
care as “formal,” “scarier,” and “tougher,” with increased criticism about poor
control; participants expressed fear that adult providers would not “know me”
or appreciate “my diabetes journey.”

 Conclusion.
We
demonstrated a lack of transition preparation and anxiety about transition and
adult care among youth with type 1 diabetes and elevated A1C. Our results may
help guide early, iterative pediatric transition counseling, with a special
focus on addressing attachment and fears about adult diabetes care.
El trabajo de mujeres artesanas en el México rural y el enfoque de las economías comunitarias
Authors: Soto Alarcón Jozelin María , Díaz Vázquez Rosalba
Published: October 2020

El presente artículo analiza desde el enfoque marxista no esencialista de las economías comunitarias las prácticas de género de mujeres rurales y artesanas organizadas para generar sustento en dos latitudes de México: Guerrero e Hidalgo. Se privilegia la perspectiva etnográfica en la recolección y análisis de la información. Para examinar el aporte del trabajo de las mujeres en los hogares, los colectivos y la comunidad, el género se considera un proceso relacional y performativo. Al explorar las contribuciones de las investigaciones sobre el trabajo de mujeres rurales y la política pública de fomento a su labor, se distingue el papel de actores y las estrategias implementadas. Entre los hallazgos se destacan las contribuciones del trabajo remunerado y no remunerado de las mujeres en el sustento doméstico y comunitario. Se subraya, asimismo, el papel de la organización colectiva para propiciar espacios que valoricen el trabajo de las mujeres rurales a partir de prácticas culturales y ambientales situadas intersectadas por el género. También se destacan las restricciones que enfrentan en su trabajo: la excesiva carga, el limitado acceso a medios de producción, su desvalorización en el mercado y en los hogares y las restricciones estructurales vinculadas al mercado. Finalmente, se destaca la utilidad del enfoque y se sugieren recomendaciones para la política pública dirigida a la promoción del trabajo de las mujeres rurales artesanas.
La enseñanza y el aprendizaje desde el enfoque de proyectos integradores para la educación turística
Authors: Juan Vázquez Norma Patricia
Published: October 2020

El objetivo de este artículo es describir una estrategia didáctica que utiliza a los proyectos integradores como articuladores de los conocimientos cognitivos y metacognitivos para asegurar el aprendizaje del estudiante. Por lo anterior, será importante determinar si las estrategias didácticas empleadas se desarrollaron en las condiciones adecuadas para la vinculación de los aprendizajes. Los proyectos integradores son una herramienta didáctica cuyo objetivo es vincular los contenidos temáticos con la práctica. En esta investigación, se tomó como objeto de estudio a la Facultad de Ciencias de la Administración C-IV de la Universidad Autónoma de Chiapas, y en específico a algunos estudiantes de la licenciatura en Gestión Turística. La mayoría de las unidades de competencias que estructuran el séptimo, sexto y tercer semestre estuvieron involucradas. A partir de un total de 136 estudiantes, de ellos 69 % mujeres y 31 % hombres, se formaron 26 equipos y se les dio seguimiento desde agosto del 2016 al 2018.
Parentalidade: administrar a vida humana
Authors: Lovo Ordilei Arcangelo
Published: October 2020

A essência administrativa propulsa o ser humano, em esponsalidade, a ser, no mundo, o ato administrativo de Deus, e perpetuar a espécie humana. É notório que, na biologia da pessoa está a genealogia da pessoa com Deus. Propõe-se que o ser humano planeje a concepção e o nascimento da vida, inserindo-se no mistério de amor, dizendo com Deus ‘façamos o humano à nossa imagem e semelhança’. A proposta de narrar o ser humano administrador e cocriador da obra de Deus. Ser pai, ser mãe é o Dom que precede o ter filhos, isso implica reconhecer a importância do planejamento da parentalidade e, acima de tudo, que está nova vida seja regrada de amor e da devida formação, para que possa, em livre-arbítrio, se edificar enquanto administrador da obra de Deus.
CESAR, Constança Marcondes. Vivências filosóficas: três pesquisadoras: Gaston Bachelard no Brasil / Constança Marcondes Cesar, Elyana Barbosa e Marly Bulcão. – 1a ed. – Goiânia: Editora Espaço Acadêmico, 2020.
Authors: Nobre José Aguiar
Published: October 2020

O livro está assim subdividido: cada autora faz uma breve apresentação de suas trajetórias como educadoras, pensadoras e filósofas e, em seguida, escreve um capítulo a saber: (i) Uma trajetória filosófica: da descoberta da filosofia ao seu estudo sistemático (Constança Marcondes Cesar); (ii) Como fui apresentada a Gaston Bachelard (Elyana Barbosa); (iii) Fiel às paixões: andanças filosóficas e as contribuições de Gaston Bachelard (Marly Bulcão).
The Use of Selective Hemosorption of Lipopolysaccharides in the Complex Treatment of Sepsis
Authors: Bulava G. V. , Rey S. I. , Berdnikov G. A. , Nikitina O. V. , Shabanov A. K. , Borovkova N. V. , Salina N. N. , Godkov M. A.
Published: October 2020

Background Sepsis and septic shock are formidable and complications in surgery with mortality 20–50%. In the pathogenesis of sepsis, a significant role belongs to bacterial endotoxin (LPS - liposaccharide).

Aim of study Assessment of the efficacy of selective lipopolysaccharides hemosorption (SLH) in treatment of sepsis.

Material and methods We examined 65 patients with developed sepsis or suspected presence of gram-negative infection. Patients were retrospectively divided into two groups. In Group 1, 27 patients received Polymyxin B hemoperfusion using Toraymyxin cartridges. In Group 2 (38 patients), adsorber Alteco (LPSA) was used.

Results It was established that 28-day mortality was 11.1% in Polymyxin group and 28.9% in LPS group A, p = 0.091, 60-day mortality was 33.3 and 55.3%, respectively (p=0.065). The use of SLH contributed to a decrease in the activity of endotoxin (EAA) from 0.52 (0.39; 0.65) to 0.40 (0.36; 0.57) EU (p=0.330) in Polymyxin group and from 0.59 ( 0.42; 0.72) to 0.54 (0.40; 0.81) EU ( p = 0.981) in the LPS-A group. At the same time, the level of procalcitonin (PCT) in the blood statistically significantly decreased from 8.4 (3.6; 29.0) to 4.8 (1.9; 36.3) ng/ml (p=0.0117) only in the LPS-A group. The level of C-reactive protein (CRB) in the blood statistically significantly decreased only in the Polymyxin group, from 205 (154; 264) to 162 (106; 202) mg/L (p<0.001). After SPH procedures, there was a tendency to a decrease in the level of blood cytokines in both groups. 

Conclusion 1. The trend of better survival among patients was noted during hemoperfusion when using Polymyxin B in comparison with the results of adsorption of lipopolysaccharide with Alteco cartridges: so, 28-day mortality was 11.1 and 28.9%, respectively (statistically not significant).

2. As a result, the procedure of selective lipopolysaccharides hemosorbtion on hemosorbents with Polymyxin B in blood significantly decreased level of C-reactive protein (21%), there was statistically insignificant decrease in the level of endotoxin activity (23.1%), lipopolysaccharide binding protein (21.6%), procalcitonin (2.4 times), presepsin (20%), as well as the level of interleukin-6 (3.4 times) and interleukin-10 (1.6 times) . Adsorption of lipopolysaccharide with Alteco cartridges leads to a statistically significant reduction of procalcitonin in blood (1.8 times), and statistically insignificant decrease of: endotoxin activity (9.3%), lipopolysaccharide binding protein (28.6%), interleukin-6 (3.8 times), interleukin-10 (7.1 times) and soluble receptor to interleukin-2 (2.2 times).
Metabolic Disorders in Delirious Syndrome in Patients with Acute Poisoning with Gamma-Hydroxybutyric Acid and its Precursor
Authors: Sinenchenko A. G. , Lodyagin A. N. , Batotsyrenov B. V.
Published: October 2020

Abstract In 21 male patients aged 20 to 40 years, metabolic disorders in post-toxic delirious syndrome caused by gamma-hydroxybutyric acid poisoning and its precursors were studied. In the examined group of patients, hyperammonemia was detected in 71.4% of cases, metabolic lactic acidosis was revealed in 76.2%. The direct correlation between the severity of metabolic disorders and delirious syndrome according to DRS-R-98 scale was established. The statistically significant increase in capillary blood levels of lactate on day 3 of psychotic period was 4.9 mlmol/L and ammonia on day 5 was 187.0 mmol/L. The greatest severity of metabolic disorders was found in patients over the age of 27 years who systematically use the studied substances with narcotic effects for 7 months or more and combine their intake with other psychoactive substances.
Comparative Analysis of the Results of Various Methods for Pancreatic Head Resection in Chronic Pancreatitis
Authors: Propp A. R. , Degovtsov E. N.
Published: October 2020

Background In more than half of cases of chronic pancreatitis (CP), enlargement of the pancreatic head is diagnosed with the presence of complications that serve as an indication for organ resection. The development of an optimal method for the surgical treatment of CP with damage to the pancreatic head (PH) is one of the tasks of surgical pancreatology.

Aim of study To perform comparative evaluation of immediate and late results of different types of PH resection in CP.

Material and methods A prospective controlled study was conducted with a comparative analysis of the results of surgical treatment of 131 patients with CP with pancreatic head enlargement. In 29% (n=38) cases inflammatory complications were revealed, in 86.3% (n=113), they have been associated with compression of adjacent organs, jaundice also developed (n=60), as well as duodenal obstruction at the level of duodenum (n=43), regional portal hypertension (n=10). A total of 47 pancreatoduodenal, 58 subtotal, and 26 partial resections of the pancreas were performed.

Results Duodenum preserving pancreatic head resections had significantly better short-term results compared to pancreatoduodenal resections. Subtotal PH resection in the Bern’s version was superior to all other resections in terms of average duration of surgery, postoperative inpatient treatment, and intraoperative blood loss. The frequency of relaparotomy for intraperitoneal complications of hemorrhagic etiology was 8.2% (n=4). The frequency of the adverse effect according to pain preservation 5 years after duodenum preserving resection tract was 0.125; after pancreatoduodenal resection - 0.357 with a statistically significant relative risk (RR) of 0.350 (CI95% = 0.13–0.98). According to other indicators of clinical long-term surgical treatment depending on the various methods of PH resection, there were no statistically significant differences (p>0.05). The quality of life of patients 5 years after the operation according to the EORTC QLQ-C30 questionnaire was statistically significant (p=0.0228) by only two indicators: dyspnea (DY:8.3) and insomnia (SL:16.67; 27.4) with higher values after operations of Beger and the Bern’s version of the subtotal PH resection, respectively.
Prophylaxis of Ischemic Damage to the Ovaries, Taking Into Account Peculiarities of Blood Supply to the Uterus During Endovascular Treatment of Le Yo Fibroids
Authors: Kokov L. S. , Damirov M. M. , Oleinikova O. N. , Medvedev A. A. , Belozyorov G. Y.
Published: October 2020

SUMMARYUterine arteries embolization (UAE) is one of the modern trends in the treatment of uterine bleeding caused by uterine leiomyomas (UL). However, unfavourable results of this method of treatment are observed in 10–15% of cases. This is primarily concerned with the emerging ischemia of ovarian tissue after embolization.

Material and methodsComplex examination and treatment was performed in 48 patients admitted with UL complicated by the development of uterine bleeding. Patients with UL were divided into two groups. In the Group I of patients (n=29) standard embolization was performed, while the patients of the Group II (n=19) with diagnosed interarterial utero-ovarian anastomosis underwent separating technique of UA occlusion using different types of emboli.

Results and discussionThe features of the uterine blood supply in patients with UL were analyzed from the perspective of the effecacy and safety of endovascular intervention. A methodology of staged EUA was developed, which involved the staged aortography of the infrarenal aorta (for visualization of the ovarian arteries); pelvic arteriography (for evaluating the vascular anatomy of the pelvis and identifying utero-ovarian intearterial anastomoses); selective arteriography followed by UAE first with cylindrical emboli, and then with standard emboli in the form of microspheres. The application of the developed technique did not show dysfunction of the ovaries in both the short and long-term follow-up period up to 18 months in the Group II.

ConclusionThe separating UA occlusion is a safe and effective way of preventing ischemic damage in the presence of signoficant utero-ovarian inter-arterial nastomoses.
Organizational and Informational Support for the Treatment of Patients With COVID-19 in a Multidisciplinary Emergency Hospital
Authors: Petrikov S. S. , Tyrov I. A. , Perminov A. Y. , Fomenko N. S.
Published: October 2020

In modern conditions of global epidemiological challenges, a systematic approach to engineering (design) and reengineering (redesign) of treatment and diagnostic processes in hospitals acquires a special role for the state healthcare system.

In this case, the focus of special attention to the management of hospitals is solving a task of organizing the treatment of patients with COVID-19 in the absence of proven clinical practice and dynamically modify the corresponding information flow, as well as the need for optimization of resource support and enhance its efficiency in the face of strong growth in the number of new cases and lack of standard solutions for the reorganization of hospitals, especially of non-infectious profile.

In the paradigm of the systemic approach, effective management of the treatment and diagnostic process is not possible without a deep analysis of all its elements: from the moment the patient is admitted to the hospital until the completion of the treatment process. The recency of COVID-19 and the lack of clinical practice for the treatment of these patients have predetermined the need to develop comprehensive standards of clinical processes and their automation. It is the way of organizing the process to achieve the target state of the patient that forms the requirements for infrastructure and resource provision.

The article presents the experience of the N.V. Sklifosovsky Research Institute for Emergency Medicine in organizational and informational support of the process of diagnosis and treatment of patients with COVID-19.
Out-of-hospital Cardiac Arrest in the Republic of Crimea: Analysis of Epidemiology and Practice of Care
Authors: Birkun A. A. , Frolova L. P. , Buglak G. N. , Olefirenko S. S.
Published: October 2020

Introduction. Efficient organization of measures aimed at decreasing mortality from out-of-hospital cardiac arrest (OHCA) warrants a clear understanding of OHCA epidemiology and performance of the prehospital care system in such cases. The study was aimed at performing respective analysis and identifying the ways for improving prehospital management of OHCA in the Republic of Crimea.

Material and methods. Annual data from the Crimean OHCA and Resuscitation Registry for 2018 were utilized. All OHCA cases attended by emergency medical services (EMS) with attempted cardiopulmonary resuscitation (CPR) were included, regardless of cardiac arrest etiology or patients’ age (n=419). For ensuring conformity and comparability of the study results, data collection and analysis were executed in correspondence with the statements of the Utstein recommendations.

Results. The overall incidence of EMS-attended OHCA in the Republic of Crimea was 673.3 per 100,000 population per year, the incidence of OHCA with attempted CPR – 21.9 per 100,000 population per year, the proportion of CPR attempts out of all OHCA cases – 3.3%. Mean patient age was 66.9 years, and 52.7% were male. The etiology was cardiac in 42.5% cases. In 71.8% cases OHCA was witnessed by EMS, in 25.5% – by a bystander before EMS arrival. Bystanders initiated CPR in 5.7% cases. The initial rhythm was asystole in 80.4% of all cases. When excluding EMS-witnessed cases, the mean EMS response time was 13 min. 5.0% patients had a sustained return of spontaneous circulation at hospital admission. Survival was associated with lower EMS response time (p=0.027), administration of shock (p<0.001) and advanced airway management with endotracheal tube or laryngeal mask (p=0.047).

Conclusion. High incidence of OHCA, low rates of CPR commencement and low rates of survival from OHCA in the Republic of Crimea determine the necessity of implementing a comprehensive program to improve prehospital care in the region. Considering the critical relevance of early intervention in OHCA and the revealed low bystander CPR rate, the measures for involving community into the process of prehospital care should form the basis of this program.
Association of SP-A and SP-D Surfactant Proteins with the Severity of CommunityAcquired Pneumonia
Authors: Kharlamova O. S. , Nikolayev K. Y. , Ragino Y. I. , Voyevoda M. I.
Published: October 2020

Relevance. In current clinical practice, there is a need for research to find new diagnostic tests for the purpose of determining the patients with the highest risk of death from pneumonia. Surfactant proteins SP-A and SP-D play a key role in the pathogenesis of the response to microbial invasion of lung tissue, which participate in a cascade of reactions of both innate and adaptive immunity, and therefore proteins SP-A and SP-D may be considered as markers of the severity of community-acquired pneumonia (CAP).

Aim of study. To evaluate the associations of surfactant proteins SP-A and SP-D in blood plasma with the severity of CAP.

Material and methods. The study included 247 patients admitted to the therapeutic department. The group of patients with CAP (n=188) was divided into groups of severe (n=103) and non-severe (n=85) pneumonia. The comparison group (n=59) consisted of patients without acute and chronic diseases of the bronchi and lungs. The mean age (years, Me, 25th; 75th percentile) of patients was 55 (47; 68), 55 (47; 70), and 61 (37; 63) years, respectively. All patients underwent clinical, functional, diagnostic and laboratory studies (including determination of the content of SP-A and SP-D proteins by enzyme immunoassay).

Results. In the group of patients with severe pneumonia unlike mild pneumonia, and group of comparison higher levels of proteins SP-A and SP-D were observed. Correlation analysis described below revealed statistically significant connection: protein SP-D — direct relation with leukocyte levels (r=0.320, p<0.0001), erythrocyte sedimentation rate (r=0.331, p<0.0001), inverse relation with blood oxygen saturation (r=-0.407, p<0.0001), for SP-A protein — direct relation with body temperature (r=0.355, p<0.0001), erythrocyte sedimentation rate (r=0.369, p<0.0001) in the blood C-reactive protein (r=0.446, p<0.0001), SP-D (r=0.357, p<0.0001), and also relation with the duration of clinical symptoms (r=0.528, p<0.0001) and blood oxygen saturation (r=-0.401, p<0.0001). When conducting ROCanalysis for the surfactant protein SP-A, the area under the ROC- curve was 0.70, the optimal sensitivity for severe pneumonia was 68%, the specificity was 69% at the SP-A level in blood plasma equal to 42.9 ng/ml. When performing ROC analysis for the surfactant protein SP-D, the area under the ROC curve was 0.64 for severe pneumonia, the optimal sensitivity was 62%, and the specificity was 62% at the SP-D content in blood plasma equal to 319.2 ng/ml.

Conclusion. According to the results of this study, the SP-A and SP-D proteins are associated with clinical and laboratory signs that reflect the severity of CAP. Thus, SP-A and SP-D are new laboratory markers of CAP severity.