bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review
Authors: Bickton F. M. , Fombe C. , Chisati E. , Rylance J.
Published: October 2020

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in
PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used
in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated
exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available
in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education
regimens.
Introducing bedaquiline: experiences from the Challenge TB Project
Authors: Edwards C. G. , Wares D. F. , Dravniece G. , Gebhard A. , Tiemersma E. , van der Grinten E. , Gidado M. , van Weezenbeek K.
Published: October 2020

BACKGROUND: Drug-resistant tuberculosis (DR-TB) remains a global public health crisis. In 2013, the World Health Organization recommended the introduction of bedaquiline (BDQ) for eligible DR-TB patients.METHODS: We conducted a retrospective review and analyses of
project reports from 2016 to mid-2019 on the processes, activities implemented, available results on enrolment and interim treatment outcomes, across the 23 Challenge TB (CTB) supported countries.RESULTS: Initial introduction of BDQ-containing regimens in the 23 CTB-supported countries
took on average 2 years, with subsequent nation-wide scale-up achieved in Ethiopia and Kyrgyzstan within a short time period. Successful implementation required critical interventions including advocacy, revision of policies and guidelines, capacity building of health care workers, and strengthening
of laboratory networks. The number of countries providing BDQ increased from 9 to 23; 9398 patients were enrolled on bedaquiline containing regimens; 71% were culture-negative after 6 months of treatment; and the number of countries reporting serious adverse events increased (from 5 to 18).
Major challenges included limited in-country coordination with drug regulatory agencies, unrealistic quantification and drug ordering, weak laboratory networks and reporting systems for drug safety.CONCLUSION: BDQ introduction required a systematic and programmatic approach. The
initial time investment helped achieve initial introduction and scale-up of coverage, ownership and sustainability by National TB Programmes.
Bedaquiline and delamanid result in low rates of unfavourable outcomes among TB patients in Eswatini
Authors: Vambe D. , Kay A. W. , Furin J. , Howard A. A. , Dlamini T. , Dlamini N. , Shabangu A. , Hassen F. , Masuku S. , Maha O. , Wawa C. , Mafukidze A. , Altaye K. , Sikhondze W. , Gwitima T. , Keus K. , Simelane T. , Kerschberger B.
Published: October 2020

SETTING: Since 2015, Eswatini has been scaling up bedaquiline (BDQ) and delamanid (DLM) based drug-resistant TB treatment regimens under programmatic conditions.OBJECTIVE: Identification of factors associated with treatment outcomes in patients receiving BDQ and/or
DLM either as a new treatment initiation or drug substitution.DESIGN: This is a retrospective cohort study of patients receiving BDQ and/or DLM in Eswatini between March 2015 and October 2018. We describe factors associated with unfavourable treatment outcomes (death, lost to follow-up,
treatment failure and amplification of resistance) and culture conversion using multivariable flexible parametric survival and competing-risks regression analyses.RESULTS: Of 352 patients receiving BDQ and/or DLM, 7.8% and 21.2% had an unfavourable treatment outcome at 6 and 24
months, respectively. Predictors were age ≥ 60 years (adjusted hazard ratio aHR 4.49, 95%CI 1.61–12.57) vs. age 20–39 years, and a treatment regimen combining both drugs (aHR 4.49, 95%CI 1.61–12.57) vs. BDQ only. The probability of culture conversion was increased for
two health facilities and patients with a poly resistance profile (adjusted sub-hazard ratio 2.01, 95%CI 1.13–3.59) vs. multidrug resistance.CONCLUSION: Single use of BDQ or DLM was associated with low rates of unfavourable outcomes, suggesting that these medications may be
effectively adopted at scale under routine programmatic conditions. Combined use of BDQ and DLM was a risk factor for unfavourable outcomes and should prompt for collection of more data on the combined use of these medications.
Introduction and scaling up of new drugs for drug-resistant TB: experiences from the Americas
Authors: Bernal O. , Lopez R. , Montoro E. , Avedillo P. , Westby K. , Ghidinelli M.
Published: October 2020

The number of multidrug-resistant tuberculosis (MDR-TB) cases reported in the Americas has increased by 21.2%, from 3737 in 2016 to 4791 in 2018. The WHO has been recommending changes on the treatment of DR-TB, moving from long-duration treatment with injectables to a short oral regimen
with new drugs such as bedaquiline (BDQ) and delamanid (DLM), in selected cases and only under programmatic conditions. Injectables are no longer recommended by the WHO due to lower efficacy and the increasing seriousness of adverse events. The introduction of new oral drugs for DR-TB received
a boost with a global donation of BDQ to some eligible countries, which continues with the countries purchasing drugs through the Pan American Health Organization Strategic Fund. The main challenges in the scaling up of new drugs for DR-TB include low DR-TB detection rate, the slow pace in
transitioning to molecular testing and delays in the introduction of new oral short regimens for MDR-TB. The Americas need to accelerate the scale up of new oral treatments, improve detection rates, increase molecular diagnosis of resistance, and ensure the registration and introduction of
the shorter treatment regimen in national MDR-TB guidelines.
Setting up pharmacovigilance based on available endTB Project data for bedaquiline
Authors: Lachenal N. , Hewison C. , Mitnick C. , Lomtadze N. , Coutisson S. , Osso E. , Ahmed S. , Leblanc G. , Islam S. , Atshemyan H. , Nair P. , Kholikulov B. , Aiylchiev S. , Zarli K. , Adnan S. , Krisnanda A. , Padayachee S. , Stambekova A. , Sahabutdinova Y. , de Guadalupe S. , Moreno Perea , Kumsa A. , Reshid A. , Makaka J. , Abebe S. , Melikyan N. , Seung K. J. , Khan U. , Khan P. , Huerga H. , Rich M. , Varaine F.
Published: October 2020

SETTING: Active pharmacovigilance (PV) is recommended for TB programmes, notably for multidrug-resistant TB (MDR-TB) patients treated with new drugs. Launched with the support of UNITAID in April 2015, endTB (Expand New Drug markets for TB) facilitated treatment with bedaquiline
(BDQ) and/or delamanid of >2600 patients in 17 countries, and contributed to the creation of a central PV unit (PVU).OBJECTIVE: To explain the endTB PVU process by describing the serious adverse events (SAEs) experienced by patients who received BDQ-containing regimens.DESIGN:
The overall PV strategy was in line with the ‘advanced´ WHO active TB drug safety monitoring and management (aDSM) system. All adverse events (AEs) of clinical significance were followed up; the PVU focused on signal detection from SAEs.RESULTS and CONCLUSION: Between
1 April 2015 and 31 March 2019, the PVU received and assessed 626 SAEs experienced by 417 BDQ patients. A board of MDR-TB/PV experts reviewed unexpected and possibly drug-related SAEs to detect safety signals. The experts communicated on clusters of risks factors, notably polypharmacy and
off-label drug use, encouraging a patient-centred approach of care. Organising advanced PV in routine care is possible but demanding. It is reasonable to expect local/national programmes to focus on clinical management, and to limit reporting to aDSM systems to key data, such as the SAEs.
Strengthened capacity of India´s bedaquiline Conditional Access Programme for introducing new drugs and regimens
Authors: Sachdeva K. S. , Arora N. , Solanki R. , Singla R. , Sarin R. , Bhatnagar A. , Khanna A. , Atahavale A. , Shridhar R. , Barua S. R. , Parmar M. , Farooq S. I. , Ramachandran R. , Alavadi U. , Swamickan R. , Tonsing J. , Patel Y. , Singla N.
Published: October 2020

BACKGROUND: Addressing TB in India is critical to meeting global targets. With the scale-up of diagnostic networks and the availability of new TB drugs, India had the opportunity to improve the detection and treatment outcomes in drug-resistant TB (DR-TB).OBJECTIVE:
To document how the introduction of new drugs and regimens is helping India improve the care of DR-TB patients.DESIGN: In 2016, India´s National TB Programme (NTP) introduced bedaquiline (BDQ) under a Conditional Access Programme (BDQ-CAP) at six sites after providing extensive
training and strengthening laboratory testing, pre-treatment evaluation, active drug safety monitoring and management (aDSM) and follow-up systems.RESULTS: An interim analysis reflected earlier and better culture conversion rates: 83% of the 620 patients converted within a median
time of 60 days. However, 248 serious adverse events were reported, including 73 deaths (12%) and 100 cardiotoxicity events (16.3%). Encouraged by the evidence of safety and efficacy of BDQ, the NTP took steps to systematically expand its access to cover the entire population by 2018.CONCLUSION:
The cautious yet focused approach used to introduce BDQ under BDQ-CAP paved the way for the rapid introduction of delamanid, as well as the shorter treatment regimen and the all-oral regimen for DR-TB.
Overcoming barriers to the access and uptake of newer drugs for multidrug-resistant TB
Authors: Zabsonre I. , Thi S. S. , Cox V.
Published: October 2020

To improve the unsatisfactory treatment outcomes of multidrug-resistant TB (MDR-TB), it is essential we use new regimens based on newer drugs. To address challenges in the introduction of BDQ and the shorter treatment regimen (STR), the USAID has committed to support countries receiving
BDQ (through the USAID/Janssen Bedaquiline Donation Program), with targeted short-term technical assistance (TA). Six MDR-TB clinical consultants were recruited and provided TA to 17 countries between 2017 and 2019. Building on other in-country support, this short-term TA proved instrumental
in overcoming barriers, such as misconceptions about BDQ safety, inadequate clinical skills to manage patients and limited expansion plans to increase access to BDQ and the STR.
Effects of Probiotic Supplementation on Immune Response in Soldiers: A Randomized, Double-Blinded, Placebo-Controlled Trial
Authors: Noorifard Mahtab , Ebrahimi Elahe , Dabbagh Moghaddam Arasb , Asemi Zatollah , Hamidi Farahani Ramin , Mousavi Jazayeri Seyed Milad
Published: October 2020

Background: Athletic soldiers undergo strenuous and high-endurance training to prepare for competition. Stress and deprivation of proper nutrition can weaken the immune system in athletic soldiers. Therefore, enhancing the immune system function in addition to enhancing the performance of athletic soldiers can lead to a reduction in health costs for the military. Objectives: In this study, the effects of probiotic supplementation on the immune response of soldiers were assessed. Methods: In a randomized, double-blinded, placebo-controlled trial, 42 athletic soldiers were randomly divided into two groups of 21 members. Participants in the probiotic group daily received one glass of fruit juice containing Bacillus coagulans (2 × 109 CFU/g). The control group consumed the placebo at the same time. At the beginning and end of the study, as well as at specific times, IgA, CD4, lactate, and urea were measured in blood samples of all participants. Results: Probiotic supplementation increased the concentration of IgA (+115.7 ± 28.3 vs. -108.3 ± 25.7 mg/dL, P < 0.001) and CD4 levels (+129.1 ± 42.6 vs. -54.5 ± 114.6 cells/µL, P < 0.001) after three months in the test group. In addition, a significant decrease was seen in serum lactate (-5.7 ± 10.1 vs. +10.1 ± 7.4. mg/L, P < 0.001) and urea (-9.9 ± 6.7 vs. +2.3 ± 5.6 mg/dL, P < 0.001) concentrations following probiotic supplementation compared to the placebo. Conclusions: Probiotic consumption for 12 weeks has a positive effect on the immune response of soldiers.
Effect of Ramadan Fasting on Body Composition, Biochemical Profile, and Antioxidant Status in a Sample of Healthy Individuals
Authors: Urooj Asna , Pai Kotebagilu Namratha , Shivanna Lohith Mysuru , Anandan Satish , Thantry Akshatha Nagaraja , Siraj Syeda Farha
Published: October 2020

Background: Muslims fast during the month of Ramadan by abstinence from food and drink every day from dawn to sunset. Studies have reported contradictory results with respect to the changes in body weight and biochemical parameters. No study has been conducted on the association between fasting and body weight and biochemical parameters in the Indian setting on healthy Muslim subjects. Objectives: To assess the effect of fasting during Ramadan on biochemical parameters such as lipid profile, liver function test, renal function test, antioxidant status, random blood sugar, hemoglobin, body composition, and blood pressure in a sample of healthy individuals. Methods: In this study, 52 healthy free-living participants (25 males, 27 females, 21-64 years) who met the inclusion and exclusion criteria and completed both follow-ups (before and after Ramadan) were studied. Participants were fasting 12 hours a day for at least 21 days, including menstruating women. It was a free-living study with no dietary restrictions. Anthropometry, lipid profile, liver and renal function tests were measured by standard methods. Body composition was analyzed by bioelectrical impedance. Results: Significant beneficial changes in albumin, alanine aminotransferase, creatinine, and high-density lipoprotein (HDL) were observed, while total cholesterol, random blood sugar, aspartate aminotransferase, and alkaline phosphatase enzymes remained unchanged after Ramadan. Fasting did bring in some changes in body composition; among both men and women, mean weight loss ranged from 0.81 - 1.4 kg in majority of the subjects, which was due to loss in muscle mass. Moderate changes in intra- and extracellular water content was observed after fasting. Conclusions: Significant improvements were observed in HDL levels and liver function tests, which can be attributed to the loss of body weight. Improvement in liver function tests may be related to the changes in cytokines and alteration in sleep patterns. Ramadan-like fasting, along with the nutritional education prior to fasting, may be beneficial and effective in the spiritual and overall well-being.
The Association of Physical Activity Level and the Risk Factors of Nonalcoholic Fatty Liver Disease in the Elderly Female Patients
Authors: Hoseini Zahra , Behpour Nasser , Hoseini Rastegar
Published: October 2020

Background: Nonalcoholic fatty liver disease (NAFLD) is becoming more prevalent among elderly women. Sedentary lifestyle is an important etiological factor of NAFLD. Objectives: The present study aimed to investigate the association between physical activity level (PAL) and the risk factors of NAFLD in the elderly female patients. Methods: This study was conducted on 40 elderly women with NAFLD, who were aged 62.25 ± 1.97 years, weighed 86.70 ± 3.81 kilograms, and had the body mass index (BMI) of 34.54 ± 2.38 kg/m2. The women were selected from 90 volunteers. The PAL was measured using the rapid assessment of physical activity (RAPA) questionnaire. As the outcomes, we measured anthropometric indices, sitting systolic and diastolic blood pressure, lipid profile, glycemic indices, liver enzymes, and fatty liver grade in the fasting state. The outcome variables were statistically normalized and expressed as mean and standard deviation (SD). The association between the PAL and NAFLD risk factors was evaluated using Pearson’s correlation-coefficient. Results: The risk factors of NAFLD were inversely correlated with the PAL, except for high-density lipoprotein, which was positively correlated with the PAL (r = 0.495; P = 0.001). In addition, low PAL had a significant correlation with a higher fatty liver grade (r = -0.464; P = 0.003), while the PAL was inversely associated with the NAFLD risk factors. Conclusions: According to the results, the PAL and fatty liver grade had a significant correlation, which indicated the potential health benefits of adequate PAL for the elderly women with NAFLD.
Effects of Progressive Aerobic Training on Serum and Gastric Acylated Ghrelin, IGF-1 and Body Weight in Female Rats
Authors: Ghasemnian Agha Ali , Rahmani Ahmad , Parvizi Ahdieh
Published: October 2020

Background: It is generally believed that physical activity can lead to increased food intake, whereas some studies state that exercise can have inhibitory effects on appetite and calorie intake. Objectives: The purpose of this study was to examine the changes in the level of gastric and serum ghrelin, body weight, and serum IGF-1 after a period of progressive aerobic training (PAT) in female rats. Methods: After one week of familiarization with treadmill running, 16 adult female rats were randomly assigned to two groups: control (n = 8) and aerobic exercise (n = 8). The exercise protocol consisted of progressive aerobic running on the treadmill for three months (5 days a week). Forty-eight hours after the last exercise session, the animals were sacrificed. Serum levels of ghrelin, IGF-1, and ghrelin content in the gastric tissue were measured using the ELISA method. An Independent t-test was used for comparison of data between the two groups. Results: The results indicated that three months of PAT had no significant effect on gastric (P = 0.51) and serum acylated ghrelin (P = 0.15), weight changes (P = 0.42), and serum IGF-1 (P = 0.56) compared to the control group. Conclusions: Three months of PAT in female animals had no effects on ghrelin level, food intake and weight loss, and serum IGF-1 level. It seems that there are sex-specific hormonal and appetite responses to progressive aerobic training.
Critical time for weed removal in dicamba tolerant soybean as influenced by pre emergence herbicides
Authors: Jovanović Darko , Cuvaca Ivan , Scott Jon , Knežević Stevan
Published: October 2020

Field experiment was conducted in 2019 at Haskell Agriculture Laboratory, Concord, NE, USA. Goal of the study was to test the influence of PRE-EM herbicides on the Critical Time for Weed Removal (CTWR) in dicamba-tolerant soybean. The study was arranged in a split-plot design which consisted of four herbicide regimes as main plot treatments and seven weed removal timings as subplot treatments, with four replications. The herbicide regimes included: (1) no PRE and glyphosate, (2) acetochlor and dicamba as PRE and glyphosate as POST, (3) acetochlor and dicamba as PRE and glyphosate and dicamba as POST, and (4) acetochlor and fomesafen as PRE and acetochlor, glyphosate and dicamba as POST. The five weed removal times included the V1, V3, V6, R2 and R5, and there were also weedy and weed-free season long plots. By utilizing herbicide regimes, the CTWR was delayed to 632 GDD (until V4 soybean growth stage, 28 days after emergence) for acetochlor and dicamba as PRE and glyphosate as POST, 861 GDD (until V6 soybean growth stage, 32 days after emergence) for acetochlor and dicamba as PRE and glyphosate and dicamba as POST, and 1060 GDD (until R1 soybean growth stage, 42 days after emergence) for acetochlor and fomesafen as PRE and acetochlor, glyphosate and dicamba as POST.
Use of Raman spectroscopy for determining the effects of herbicides on the carotenoid content in Chenopodium album and Abutilon theophrasti leaves
Authors: Vranješ Filip , Pećinar Ilinka , Lević Steva , Vrbničanin Sava , Božić Dragana
Published: October 2020

Raman spectroscopy has so far proved to be a suitable method for the analysis of carotenoids in a wide range of plant samples. This study aimed to determine whether the influence of mesotrione on the changes in carotenoid content of leaves in treated weed species Chenopodium album and Abutilon theophrasti can be detected using Raman spectroscopy. When the plants reached the targeted growth stages (C. album: 4 leaves, A. theophrasti: 2 leaves), Skaut herbicide (a.i. mesotrione 480 g l-1, SC) was applied in the amount of 120 g a.i. ha-1 in the tank mix with the adjuvant Alteox wet 40 (a.i. mineral oil (500 g L-1) + polyoxy alcohol (500 g L-1)), in the amount of 1 L ha-1. Leaf analysis, using Raman spectroscopy, was performed four times: on the 1st, 2nd, 3rd, and 7th day after the application of mesotrione. The intensity of the bands in the obtained Raman spectra, at positions 1007, 1155, and 1522 cm-1 in untreated and treated plants was analysed to determine the relative carotenoid content. The obtained results have shown that changes in the relative carotenoid content in the leaves of treated C. album plants can be detected as early as 3 days after the application of mesotrione, compared to the leaves of untreated plants of the same age. Meanwhile, a statistically significant difference for the same parameter in the leaves of treated A. theophrasti plants was evident at a later stage than in C. album, on the 7th day after the application of mesotrione. Consequently, this study has confirmed that Raman spectroscopy can be used as an adequate method for the rapid detection of the effect of herbicides on the content of carotenoids in the leaves of treated weed species.
Student`s mobile learning in formal and informal environment: Some dilemmas and obstacles
Authors: Stanisavljević-Petrović Zorica , Jovanović Aleksandra
Published: October 2020

Mobile learning represents one step further in innovating the context of learning. In this article we view it as learning with the help of a mobile phone. The aim of this research is to examine students' attitudes about encouraging the use of mobile phones for learning in formal and informal environment, as well as the attitudes about disadvantages and obstacles in the process of mobile learning. The data were gathered by means of two five-degree scales of evaluation designed for the purpose of this research. The sample of the research comprises 185 secondary school students on the territory of the city of Niš. The results indicated that students did not have enough experience of mobile learning in formal and informal environment, that is, that teachers do not master this type of learning enough. Schools ought to encourage the development of digital competences, and one of the means is mobile learning, which would train students for informal, that is lifelong learning. In order for mobile learning to be more efficient, it is necessary to be thoroughly programmed and evaluated, considering the difficulties and obstacles in its realization.
Contribution of laboratory-experimental method to the quality of students knowledge
Authors: Maričić Mirjana , Cvjetićanin Stanko , Petojević Nataša , Anđić Branko
Published: October 2020

The aim of the paper is to analyze the contribution of the laboratory-experimental method (LEM) to the quality of students' knowledge of natural and inaccessible research. Papers were also selected to examine the comparative contribution to the quality of students' knowledge: LEM and other learning methods, that is, between student and demonstration experiments. Most of the research so far is focused on subject teaching and they are still rare in integrated science teaching. The research confirms the greater contribution of LEM than the traditional and other methods of learning about quality and durability of students' knowledge. Student experiments in most research contribute to the quality of students' knowledge more than the demonstration experiments. There is insufficient research which examines the impact of LEM on students' quality of knowledge at cognitive levels. In the teaching of most of the contents of natural science, priority should be given to the LEM method or it should be combined with other methods of learning.
Games in the classroom instruction of geometry
Authors: Vasojević Irena
Published: October 2020

The aim of this paper is to point out the importance and types of games in teaching mathematics, especially the classroom geometry. The advantages of the game as a means of learning in relation to traditional learning are emphasized. The methodological instructions for the implementation of didactic games are given as well as the examples of several original didactic games, whose teaching effects relate to students' intellectual activities and their spatial and visual orientation. In the aforementioned didactic games, it is insisted on independent work of students in order to successfully master geometric contents in the classroom of mathematics. It is insisted on the development of intuition, spatial and logical thinking among students. An analysis of didactic games in the classroom geometry was done from the aspect of their structure, content and functionality.
Nursing research
Authors: Despotović Mile , Despotović Milena , Kekuš Divna , Stanojević Čedomirka , Marinović Nela , Ilić Biljana
Published: October 2020

With the development of nursing education institutions, there emerged a need for continued education and expansion of the body of related scientific knowledge. After the introduction of nursing care and nursing into the university curricula, scientific research in this area became an inevitable part of the advancement of the profession. Nursing focuses on the care for others and deals with issues such as nutrition, security and safety, admission and care, hygiene issues and similar. Promoting the research and involvement of nurses in research teams is of great importance to the quality of nurses' work, as it encourages evidence-based and data-based work. Generally speaking, we can say that the history of nursing research begins together with modern nursing. Nurses involved in research are often faced with a lack of support from managerial nurses and misunderstanding from colleagues who believe that doing research has a negative impact on clinical practice. Such a situation suggests that research work should actually be encouraged during school. There are three major areas with regard to nursing research: nursing education, nursing practice, and nursing administration. When it comes to trends in nursing education, the emphasis is primarily put on the importance of quality research rooted in philosophy and humanism that is also able to provide practically usable results. In the field of nursing practice, the emphasis is on research that promotes health and healthy lifestyles. Finally, in the field of nursing administration, the most common is evidence-based research. The primary focus is placed on topics such as nursing, energy therapies, knowledge and attitudes, and spirituality. The relationship between care and treatment, symptoms management, quality of life and depression are the topics most commonly examined. In Serbia, nurses have only recently been given the opportunity to study at a university level. There is also an increasing number of nursing colleges. This situation speaks in favor of stimulating and fostering research work.
Komunikacija u fizioterapeutskoj praksi
Authors: Jovanović Stevan , Kekuš Divna , Stojanović-Jovanović Biljana
Published: October 2020

Communication is considered to be the most important aspect of the practice of healthcare professionals, and the communication relationship between the health care provider and the patient involves two groups of people who have different positions or roles that determine their interaction and relationship. The communication process between physiotherapist and patient is increasingly recognized as a therapeutic practice. Through communication interactions, physiotherapists can educate, motivate, empower, or release, express empathy or authority, show interest, or build confidence. In physiotherapy, as well as in other patient-oriented, biopsychosocial and related health care professions, a patient-centered communication approach has been established as guides and frameworks for practitioners to communicate with their patients. These communication models are used to share information as well as accountability but also to reduce power disparities between the physiotherapist and the patient. Accordingly, this communication model is specifically aimed at understanding the needs of patients and addressing them in order to maximize the perspective of each patient. Developing active patient-therapist collaboration creates a relationship defined as a "therapeutic alliance" characterized by empathy, trust, and respect. Many forms of treatment performed by physiotherapists cannot be successful without the patient's contribution and motivation to cooperate, both during and outside the communication interaction. communication skills have a positive effect on the patient's psychology and therefore physiology as they are inseparable, and the relationship between the physiotherapist and the patient during the rehabilitation process creates a sense of "companionship" on the path during which the patient is free from his or her physical, social and environmental limitations.
Paliative care as an integral part of nursing care
Authors: Đukanović Katarina , Bogdanović-Vasić Slobodanka
Published: October 2020

Palliative care involves a holistic approach in the treatment of patients with terminal illness with the aim of achieving the best possible quality of life and support for the patient and his family. It involves teamwork and the greatest responsibility is on the nurses because they spend the most time with patients and their family. Nursing interventions are aimed at early identification and treatment of pain and other psychological, physical and social suffering of this patients. In order for the nurse to successfully respond to all the challenges of daily work, it's necessary that she owns professional competencies which include communication, collaboration with other team members,understanding the disease and supporting the patient and family during of the illness.
Psychopharmaco therapy in the tretment of psychiatric disorderds in breast
Authors: Stojković-Ivković Mirjana
Published: October 2020

Contemporary research and clinical practice conform that half of oncologial patients have varions psychiatric comorbid disorders that require diagnosis and therapy. The aim of this paper is to highlight the need for the treatment of oncological patients at any stage of treatment, medication and psychotherapy, through a case report. CASE REPORT: Patient aged 44, married with two children (26, 20), unemployed, appearing for the first time one year after breast cancer surgery. She completed radiation and chemotherapy with a VI cycle. Comes flom unhappiness, sadness, tension,fears. 10 years ago, she was treated for depression. She has since been sporadically treated outpatienthy. Following pharmacological and psychotherapy treatment, withdrawal symptoms and recovery occurred. CONCLUSION: Breast cancer in half of the diseased patients was followed by comorbidity with psychiatrie disorders. For this reason, a psychiatrist is also present in the oncology team for the purpose of assessing the mental state and freating the diseased person.
Multisystemic langerhans-cell histiocytosis with dominant lesions of the lung parenchyma
Authors: Javorac Jovan , Živanović Dejan , Ilić Miroslav , Milenković Ana
Published: October 2020

Langerhans cell histiocytosis (LCH) is a rare disease of unknown aetiology characterized by abnormal monoclonal proliferation of CD1a+/ CD207+ myeloid dendritic cells (Langerhans cells) in various organs, including bones, skin, lymph nodes, liver, lungs, central nervous system (CNS). Pulmonary Langerhans cell histiocytosis (PLCH) may occur as single-system disease or the lungs may be affected within a multisystemic disease. This paper presents cases of two patients with multisystemic LCH, with predominant lung involvement. In the first patient, the disease is in the terminal stage, with chronic respiratory failure requiring long-term oxygen therapy at home and development of severe pulmonary hypertension, so the lung transplantation may be considered as the only potentially effective therapeutic procedure at this moment. The second patient is in the initial stage of the disease, with satisfactory pulmonary function for now, so it could be considered to use some new targeted therapy to prevent the progression of the disease. Thus, it is essential to consistently apply, as soon as possible, all available pharmacological treatments, as well as adequate palliative and health care, to ensure a decent quality of life for these patients.
Documenting of extravasation of cytotoxic agents
Authors: Savić Maja , Stanisavljević Sanja , Tadić Dušanka
Published: October 2020

As a potential complication of a systemic administration of cytotoxic agents, extravasation requires particular caution of all health practitioners involved in treatments of oncological patients. In the light of the fact that more than 100.000 doses of chemotherapy are indicated worldwide and more than 1.000.000 intravenous infusion of cytostatic drugs are administered on daily bases, it is upsetting that in the case of cytostatic administration through peripheral intravenous cannulas extravasation occurs in 0,5 to 6% of oncological patients, while in the case of administration through central venous lines it occurs in 6% of the cases. Each extravasation results in tissue damage and depending on type and features of the administered substance can be manifested in different forms, from skin reaction to tissue necrosis. By highlighting the multiple significance of documenting and accident reporting, the authors state the necessary elements and propose the form of a nurse documenting list for the cases of extravasation of cytostatic agents. A nurse must document the following data on an accident: patient's name and surname, date of birth, name of the clinics, primary oncological diagnosis, date and time of extravasation, name of the cytotoxic drug, symptoms and signs of extravasation and the measures undertaken. The accurate documenting and reporting of accidents are legally binding for health practitioners, particularly nurses, as a result of the need to map the risk factors of their occurrence, to assess compliance of the standard nursing procedures in administration of cytostatic therapy, to follow up the course of the management of complications, outcomes and the undertaken measures but also to improve the existing and develop new preventive strategies.
VULNERABILITY OF INFRASTRUCTURES TO CLIMATE EVENTS. ROAD FLOODING
Authors: TARRAGO GARAY NEREA , ROYO ABANCENS FRANCISCO JAVIER , TORREIRA DE LAS HERAS IGNACIO
Published: October 2020

The present study defines an original methodology for diagnosing the vulnerability of infrastructure to climatic events. Against existing approaches, this methodology increases the objectivity in the assessment and weighting of the aspects involved in a multicriteria procedure. In addition, it includes the automation and digitalization of the process.
For this purpose, concepts extracted from the MIVES methodology (Integrated Value Model for Sustainable Evaluation) are used, especially the Hierarchical Analytical Procedure, combined with the GIS (Geographical Information System) support of infrastructure and its environment information (geo-referenced spatial information with semantic information associated).
The procedure has been particularized for the case of road flooding. For its validation and optimization, it has been applied on two real cases: the A-92 between Seville and Almeria and the variant to the N-435 between the towns of Beas and Trigueros.
With all this, a procedure has been defined and validated to obtain a unique measurement / comparison index of the degree of vulnerability to flooding of the different units of analysis or sections into which the road infrastructure is previously divided.

Key Words: road, climate, vulnerability, multi-criteria analysis, GIS
DETECTION OF KIWIFRUIT DRY MATTER CONTENT BASED ON HYPERSPECTRAL TECHNOLOGY USING UNINFORMED VARIABLE ELIMINATION COUPLED WITH SUCCESSIVE PROJECTION ALGORITHM
Authors: XU LIJIA , ZHENG LINA , HUANG PENG , CHEN HENG , KANG ZHILIANG
Published: October 2020

The internal parameters of kiwifruit are mostly detected using traditional destructive physical–chemical methods, which are not only labor and time consuming but also inconvenient in operation. The hyperspectral imaging technique is now considered a new non-destructive method for detecting the quality parameters of kiwifruits. However, most studies focused on detecting the soluble solid content, hardness, and ripeness of this fruit. Thus, the detection precision of this imaging technique needs to be improved. Moreover, few of these techniques are involved in the detection of the dry matter content. A non-destructive detection method based on the hyperspectral imaging technique is proposed in this study to detect the dry matter content of kiwifruit online rapidly and precisely. First, the hyperspectral images of kiwifruit were analyzed, the interested regions therein were extracted, and denoising was preprocessed using the multiplicative scatter correction. Second, the redundancy of the 217 pieces of full-band spectral information was researched, and 66 characteristic spectral bands were initially screened out through uninformed variable elimination (UVE). The collinearity among these bands was eliminated using successive projection algorithm (SPA), and five characteristic spectral bands were extracted. Finally, the dry matter content of the kiwifruit was detected by taking least squares support vector (LSSVM) as the detector, by employing particle swarm optimization (PSO) to optimize LSSVM’s parameters, and by entering the five bands into the LSSVM later. Test results show that: (1) the redundancy and the collinearity of the full spectral bands can be eliminated effectively by combining SPA with UVE so that the extracted low-dimensional characteristic spectral bands can reflect the dry matter content of kiwifruit better. (2) The detection indicators of UVE+SPA+LSSVM to the training set is that the coefficient of correlation (R) = 0.91, root-mean-square error (RMSE) = 0.28, and the detection indicators to the prediction set is that R = 0.89, RMSE = 0.31, indicating that the detection precision is higher than the other methods. This study shows that the non-destructive detection method proposed in this paper can detect the dry matter content of kiwifruit rapidly and efficiently. This method serves as a theoretical basis for the industrialized classification of kiwifruit that is based on the internal parameters.

Keywords: Dry matter content, Uninformed variable elimination (UVE), Successive projection algorithm (SPA), Least squares support vector machine (LSSVM)
DESIGN TOOLS FOR OFFSHORE RENEWABLE ENERGY
Authors: VILLATE  MARTINEZ JOSE LUIS , RUIZ  MINGUELA PABLO , PEREZ MORAN GERMAN , NAVA VINCENZO , ROBLES EIDER
Published: October 2020

The crisis caused by the COVID-19 has awakened the fear of forgetting the fight against Climate Change coming up with a number of initiatives demanding to accelerate the European Green Deal, as the best way out of the crisis.
Offshore renewable energy sources, including offshore wind, wave power and tidal streams, might play a crucial role in meeting low-carbon energy scenarios, which is one of the six key principles of the Green Recovery, contributing at the same time to economic growth and job creation. However, continuous cost reduction is needed to achieve more efficient and competitive technologies in comparison to other energy sources. Design tools can help to accelerate cost reduction in early stages of technology development or deployment project planning.
This article shows some examples of design tools developed within four European funded R&D projects:
• DTOcean and DTOceanPlus provide advanced design tools for ocean energy systems innovation, development and deployment
• LIFES50+ proves cost effective technology for floating substructures for 10MW wind turbines at water depths greater than 50 m
• OPERA collects, analyses and shares open-sea operating data and experience to validate and de-risk several industrial innovations for wave energy
The design tools presented in this article cover different stages of technology or project development:
• Multi-physics numerical modelling tools for the design of floating offshore wind turbines
• Decision-making tools during the planning phase of offshore wind or ocean energy farms
• Structured innovation and stage gate tools for the evaluation of innovations for offshore renewables at early stages of development
The reader will be able to find out references to useful open source tools and public documents produced by these projects.

Keywords: design tools, offshore wind, wave power, tidal energy, numerical modelling, structured innovation, deployment project planning
FAULT DETECTION IN PHOTOVOLTAIC ARRAYS: A ROBUST REGULARIZED MACHINE LEARNING APPROACH
Authors: KILIC HEYBET , YILMAZ MUSA , GUMUS BILAL
Published: October 2020

In this paper, a robust data-driven method for fault detection in photovoltaic (PV) arrays is proposed. Our method is based on the random vector functional link networks (RVFLN) which has the advantage of randomly assigning hidden layer parameters with no tuning. To eliminate the effect of measurement noise and overfitting in the training process which reduce the fault detection accuracy, the sparse-regularization method is utilized which uses l2-norm with loss weighting factor to compute the output weights. To attain strong robustness against the outlier samples, the non-parametric kernel density estimation is employed to assign a loss weighting factor. Through rigorous simulation and experimental studies, we validate the performance of our proposed method in detecting the short and open circuit faults based on only the output current and voltage measurements of PV arrays. In addition to stronger robustness comparing with the least square-support vector machine, we also show that our proposed method provides 80% and 100% average detection accuracy for short circuit and open circuit, respectively.

Key Words: Canonical correlation analysis, fault detection, photovoltaic array, random vector-link network, sparse regularization
MODELLING AND DYNAMIC BEHAVIOR OF A VIBRATORY ROLLER FOR SOIL COMPACTING BASED ON LUMPED-PARAMETER METHOD
Authors: WANG YANG , BAI FAN , LI SHAOHUA , YANG YUELEI
Published: October 2020

The interaction between a roller and soil is a complex dynamic problem that has become an important theoretical requirement constraining roller design and the application of an advanced roller in the development of intelligence and informatization in the roller industry. To clarify the interaction mechanism between a drum and soil during the rolling process, a two-degree-of-freedom (DOF) lumped-parameter model for a vibratory roller-soil coupling system was established with consideration of the contact state of the soil and the drum. Based on the dynamic equation of the system, the effects of the soil and the excitation force on the dynamic behavior of the roller were revealed by introducing certain parameters. The results show that the natural frequencies of the system increase obviously from the beginning to the intermediate rolling stage, but the natural frequencies have only slight increases after the intermediate rolling stage, while the drum stays in contact with the soil. Compared with the beginning stage and the intermediate stage, it can be found that the first and second natural frequencies increase by 0.29 times and 0.43 times, respectively. With the increase of the soil compactness, the possibility of the vibration state of the roller changing from stability to chaos increases. Increasing the frequency of the excitation force and decreasing the amplitude of the excitation force can effectively improve the vibration of the system, and the dynamic behavior of the system is more sensitive to the frequency. The modeling and dynamic analysis of a vibratory roller are presented in this study. The model can be used for the theoretical analysis of the vibration recognition of the roller, and the conclusions provide a reference for the design and application of a roller.

Keywords: Vibratory roller, Lumped-parameter model, Dynamic behavior
ENERGY EFFICIENCY OF A RAILWAY CARRIAGE AIR CONDITIONING SYSTEM: PARAMETRIC ANALYSIS AND OPTIMIZATION THROUGH DoE TECHNIQUES
Authors: RAMOS  GONZALEZ JUAN CARLOS , ANTÓN REMIREZ RAÚL , ARAMBURU JORGE , SANCHEZ LARRAONA GORKA , RIVAS NIETO ALEJANDRO , FERNANDEZ FERNANDEZ JORGE
Published: October 2020

The air conditioning systems used in transport vehicles (railway passenger cars) are constrained by two issues: the consumed energy and the occupied space. In order to assess how both restrictions can be fulfilled a parametric analysis and an optimization have been carried out by means of Design of Experiments (DoE) techniques applied to a mathematical model of a real AC system. To evaluate the energy efficiency of the system four parameters have been used: the COP (Coefficient of Performance), the refrigeration power of the system and its dimensionless expression and the effectiveness of the evaporator. The occupied space of the AC system has been characterized through the dimensionless volume of the evaporator. The same compressor has been used in the analysis and the input parameters varied have been the dimensionless evaporator volume and four operating conditions: the evaporator inlet air temperature and mass flow rate, the condenser inlet air temperature and the air temperature increment in the condenser. Through a Central Composite Surface Response design, the regression equations of the four output energy efficiency parameters have been obtained in a wide range of operating conditions. Results show that the dimensionless refrigeration power is the best parameter because is independent of the operating conditions and only depends on the dimensionless volume of the evaporator: the lower the latter, the higher the former. An optimal dimensionless volume has been identified for the simultaneous optimization of the four output variables of the system that provides an increase of 26% in the dimensionless refrigeration power with respect to the baseline system.

Keywords: energy efficiency, air conditioning system, parametric analysis, optimization, design of experiments, dimensionless volume, dimensionless refrigeration power.
ENERGY AND CLIMATE CHANGE IN THE POST-COVID-19 SCENARIO
Authors: BLANCO ILZARBE JESUS MARIA , RAMOS  GONZALEZ JUAN CARLOS
Published: October 2020

After overcoming the economic crisis that originated in 2008, in recent years concern about the influence of Energy on Climate Change has reappeared. Society as a whole, governments and public administrations and companies in the energy sector, due to their involvement in the matter, were immersed in analyzing to what extent the effects of the current energy model on Climate Change could be reduced or eliminated.