bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introducing the brief version of the Dysfunctional Attitude Scale (DAS-14) based on a large clinical sample
Authors: Perczel-Forintos Dóra , Mészáros Veronika , Kulig Barbara , Antal-Uram Dóra , Rózsa Sándor 
Published: December 2021

Theoretical background: The Dysfunctional Attitude Scale (DAS) is a measurement tool that is commonly used to detect dysfunctional beliefs contributing to the emergence and onset of depressive symptoms. Although it has been primarily used for testing clinical populations, and various forms of the scale have been created, only a small body of literature has proved its psychometric adequacy on a clinical sample. Goals: Therefore, the current study aims to construct an updated, reliable and brief version of the DAS. Methods: For this purpose, besides the normal samples of adolescents (n = 195) and adults (n = 270), a heterogeneous clinical sample (n = 1077) was involved in cross-sectional research. Results: The overall results of parallel analysis and exploratory factor analysis suggested a bifactor structure with a general factor and three extracted subfactors (Dependence, Perfectionism and Entitlement), comprising 14 items altogether (χ2 = 157.26, DF = 63, p < 0.001, CFI = 0.970, TLI = 0.957, RMSEA = 0.036, RMSEA CI90 = 0.029–0.044). Convergent validity was tested by correlations with Beck Depression Inventory (r = 0.36, p < 0.001). Conclusion: Our study was based on the largest clinical sample in the field of psychometric analysis of the DAS so far. The findings suggest that DAS14 as a brief version of the original DAS has good psychometric properties, and it can be widely used as a measurement tool in the assessment of mood disorders.Elméleti háttér: A Diszfunkcionális Attitűd Skála (DAS) egy olyan pszichológiai kérdőíves eljárás, amely azon diszfunkcionális hiedelmek mérésére alkalmas, amelyek hozzájárulnak a depresszív tünetek kialakulásához és fennmaradásához. Annak ellenére, hogy már számos változata létezik és elsődleges használati területét a klinikai populáció jelenti, pszichometriai mutatóit klinikai mintán a kutatások szűk köre vizsgálta. Cél: Jelen tanulmány célja a DAS aktualizálása, rövidítése, megbízhatóságának és validitásának vizsgálata. Módszer: Keresztmetszeti kérdőíves vizsgálatunk keretében egészséges serdülő (n = 195) és felnőtt (n = 270) minta mellett heterogén klinikai mintát (n = 1077) alkalmaztunk. Eredmények: A parallelelemzés és a feltáró faktoranalízis eredményei a bifaktoros struktúrát igazolják. A 14 itemre egy általános és három alfaktor (Dependencia, Perfekcionizmus és Elvárások) illeszthető (χ2 = 157,26, DF = 63, p < 0.001; CFI = 0,970; TLI = 0,957; RMSEA = 0,036, RMSEA 90% CI = 0.029 – 0.044). A skála konvergens validitását a Beck Depresszió Kérdőívvel való korrelációja alátámasztja (r = 0,36;p < 0,001). Konklúzió: A DAS pszichometriai vizsgálatai közül ez idáig alkalmazott legnagyobb klinikai elemszámú vizsgálatát mutatja be a ta nulmány. Az eredmények alapján a DAS rövidített változata, a DAS-14 megfelelő pszicho metriai tulajdonságokkal rendelkezik alkalmazható a hangulatzavarok diagnosz tikájában.
A gyermekkori csonttörések kapcsolata az időskori osteoporosissal: véletlen vagy előrejelzés?
Authors: Hosszú Éva , Horváth Csaba , Mészáros Szilvia , Kovács Gábor 
Published: December 2021

Összefoglaló. A gyermekek közel fele szenved el csonttörést. Ez
lehet traumás esemény vagy a csontfejlődést megzavaró genetikus, hormonális vagy
egyéb eltérés a csontváz bármely részén. A leggyakoribb azonban az enyhe trauma
kapcsán jelentkező csuklótáji törés, amely többnyire a pubertas alatt fordul
elő. A jelenség alapja, hogy a serdülés során átmenetileg elválik egymástól a
csontok méretének gyors növekedése és a csonttömeg gyarapodása, ami a
longitudinális növekedést kb. egy év késéssel követi. Az így kialakuló átmeneti
csontgyengeség a gyermekkori csonttörés fő oka, aminek a hatásához az említett
genetikai, hormonális és életmódi rendellenességek is csatlakozhatnak. A
gyermekkorban előfordult kistraumás csonttörés a felnőtt férfiaknál az
osteoporosisos csonttörések fokozott rizikójával jár, ezért szűrővizsgálati
kérdésként is szolgál. Nők esetében ugyanez az összefüggés még bizonyításra vár.
Orv Hetil. 2021; 162(42): 1687–1692.
Summary. Bone fracture occurs nearly in half of the children. Some
fractures are severe traumatic events while others are the results of genetic or
hormonal or other alterations disturbing the normal development of bone.
However, the majority of fractures are associated with a mild trauma, dominantly
in the pubertal period. The basic pathology of the pubertal fractures is the
transient deviation of peak velocity of height growth from the gain velocity of
bone mass; the latter goes to peak 1 year later than height growth. This
difference has been resulted in a physiologic but transient weakening of bones
that can coincide with genetic, hormonal or life-style problems and all of these
factors together may cause the increased fragility of the pubertal bone.
Low-trauma fractures in childhood may be followed in high fracture risk of adult
and aging men, so the childhood fracture seems to be a useful screening question
for testing the osteoporosis in males. However, the same relation is still not
proved in aging women. Orv Hetil. 2021; 162(42): 1687–1692.
A szerzett haemophilia A sikeres kezelése
Authors: Kovács Andrea , Tajti Balázs , Szoboszlay István , Bereczky Zsuzsanna , Ilonczai Péter 
Published: December 2021

Összefoglaló. A szerzett haemophilia A ritka autoimmun betegség,
melyben gátlótest képződik a VIII. véralvadási faktor ellen. Az inhibitor
véralvadásra gyakorolt hatása súlyos, életet veszélyeztető vérzéses állapotot
idéz elő. A beteg élete a gyors diagnózison múlik: a jellemző klinikai kép
mellett a megnyúlt, normálplazmával nem korrigálható aktivált parciális
tromboplasztinidő megléte esetén a kórkép alapos gyanúja merül fel. Egy súlyos
vérszegénység miatt kórházunkba beutalt nőbeteg esetében a szerzett haemophilia
A a felvételt követő napon már diagnosztizálásra került. A vérzés
megszüntetésére aktivált protrombinkomplex-koncentrátumot alkalmaztunk, valamint
immunszuppresszív terápiát vezettünk be. A kórkép korai felismerése és a
megfelelő kezelés azonnali megkezdése a beteg gyógyulását eredményezte.
Esetünkkel arra szeretnénk felhívni a figyelmet, hogy a szerzett haemophilia A
gyors diagnózisa egyszerű, könnyen hozzáférhető véralvadási paraméter, az
aktivált parciális tromboplasztinidő meghatározásán és nem korrigálható
megnyúlásának felismerésén múlik. Orv Hetil. 2021; 162(49): 1977–1981.
Summary. Acquired haemophilia A is a rare autoimmune disorder, in
which antibodies are formed against coagulation factor VIII. The effect of the
inhibitor on blood clotting results in severe, life-threatening bleeding
diathesis. The patient’s life depends on the rapid diagnosis: besides the
characteristic clinical presentation, a prolonged activated partial
thromboplastin time, which is not corrigible with normal plasma, suggests the
existence of the disorder. In the case of the female patient who was referred to
our hospital due to severe anaemia, acquired haemophilia A was diagnosed
rapidly, the day after her admission. We used activated prothrombin complex
concentrate to stop the bleeding, and introduced immunosuppressive therapy. The
early recognition of the disease and immediate initiation of adequate treatment
resulted in the patient’s full recovery. With our case presentation, we would
like to draw attention to the fact that the rapid diagnosis of acquired
haemophilia A depends on the determination of a simple, easily accessible
coagulation parameter, the activated partial thromboplastin time and on the
immediate recognition of its incorrigible prolongation. Orv Hetil. 2021;
162(49): 1977–1981.
Az aortaív-anomáliák klinikai jelentősége a magzattól a felnőttkorig
Authors: Hartyánszky István , Bogáts Gábor 
Published: December 2021

Összefoglaló. Az intrauterin echokardiográfiás és MR-diagnosztika
fejlődése napjainkban jelentős szerepet tulajdonít már az első trimeszter
idejében kimutatható aortaív-fejlődési rendellenességeknek. Célunk volt
részletezni a vascularis gyűrűk megjelenési formáit, ezek különböző életkorokban
jelentkező tüneteit, sebészi kezelését, hogy hozzájárulhassunk a helyes
felvilágosításhoz, mely alapvető lehet a szülés helyének megválasztásában, így
meghatározhassák a magzat sorsát, perinatalis ellátását. A situs inversustól
eltekintve a jobb oldali aortaív jelenléte mindig felhívja a figyelmet
vascularis gyűrű, társuló szívhibák, genetikai betegségek, kromoszómaanomáliák
jelenlétére, tehát a magzat további vizsgálata szükséges. Kettős aortaív esetén
jelentkezhetnek olyan súlyos tünetek, melyek a megszületés után, kora
csecsemőkorban sebészi beavatkozást igényelhetnek (szükséges lehet a szülés
helyének megválasztása!). Az aberráns jobb arteria subclavia önállóan nem alkot
érgyűrűt, a ritkán társuló truncus caroticusszal csak későbbi életkorban okozhat
sebészi beavatkozást igényló enyhe tüneteket. Orv Hetil. 2021; 162(48):
1920–1923.
Summary. Nowadays, the development of intrauterine echocardiography
and MR diagnostics plays a significant role in aortic arch malformations
detected during the first trimester. Our aim was to detail the manifestations of
vascular rings, their symptoms at different ages and their surgical treatment
options in order to determine the fate of the fetus and its perinatal care.
Apart from situs inversus, the presence of the right aortic arch always draws
the attention to the possible presence of vascular rings, associated heart
defects, genetic diseases, or chromosomal abnormalities, therefore further
examinations of the fetus are necessary. In the case of a double aortic arch,
severe symptoms may occur, which may require surgery after birth and in early
infancy (it may be necessary to choose the place of birth!). The right aberrant
subclavian artery does not form a ring and may cause mild symptoms requiring
surgery at a later age with rarely associated truncus carotid. Orv Hetil. 2021;
162(48): 1920–1923.
Implantálható kardioverter-defibrillátor által sikeresen megszüntetett malignus kamrai ritmuszavar dystrophia myotonicában szenvedő betegben
Authors: Kupó Péter , Fődi Eszter , Debreceni Dorottya , Pál Endre , Faludi Réka , Tényi Dalma , Molnár Fanni , Lovadi Emese , Varga Dávid , Simor Tamás 
Published: December 2021

Összefoglaló. A dystrophia myotonica (DM) multiszisztémás,
autoszomális domináns módon öröklődő, többségében felnőttkori izombetegség,
melynek incidenciája 1 : 8000. A betegség kapcsán fellépő izomszöveti
degeneráció a harántcsíkolt izomszövet átépülése mellett a szívizomszövetet is
érinti, ami fontos oki szerepet játszik az érintett betegek csökkent várható
élettartamában. A DM-ben szenvedők halálozásának közel egyharmadáért a
cardiovascularis okok tehetők felelőssé. Esetriportunkban egy 52 éves, korábban
kritikus bradycardia és I. fokú atrioventricularis blokk miatt
pacemakerimplantáción átesett, DM-mel diagnosztizált nőbeteg kardiológiai
utánkövetését mutatjuk be. A hirtelen szívhalál rizikóstratifikációja céljából
elvégzett invazív elektrofiziológiai vizsgálat során kamrafibrilláció lépett
fel, így a korábban implantált pacemakerelektródák mellé sokkelektróda került
beültetésre, a pacemakerkészüléket implantálható kardioverter-defibrillátorra
(ICD) cseréltük. Az 1 éves ICD-kontrollvizsgálat során azt találtuk, hogy a
beültetés óta 22, tartós kamrai tachycardiával járó epizód lépett fel, melyek
közül a készülék valamennyit sikeresen terminálta. Az eset bemutatásával
szeretnénk rámutatni arra, hogy a magas cardiovascularis rizikócsoportba tartozó
DM-betegek azonosítása kiemelkedő fontosságú lehet a hirtelen szívhalál
megelőzése érdekében. Orv Hetil. 2021; 162(46): 1856–1858.
Summary. Myotonic dystrophy (DM) is one of the most frequent
adulthood diseases of the skeletal muscles, which develops multisystemic
features and shows autosomal dominant trait. In DM, tissue degeneration affects
not only the skeletal, but the cardiac muscle, too. In one third of the
patients, the cause of death is of cardiac origin. We report on our patient’s
case, who was diagnosed with DM at the age of 52, in whom episodes of critical
bradycardia with first-degree atrioventricular block was detected, resulting in
a pacemaker implantation. Invasive cardiac electrophysiological study was
performed, during which ventricular fibrillation was registered. A shock
electrode was added to the previously implanted pacemaker, enabling
defibrillation in case of detection of a sustained ventricular arrhythmia.
During the 1-year follow-up, 22 episodes of sustained ventricular tachycardia
were identified, with the device successfully terminating the malignant
arrhythmias. Our case shows that electrophysiological study and the succeeding
implantation of an implantable cardiac defibrillator is highly important in
identifying and terminating ventricular arrhythmias in high-risk DM patients.
Orv Hetil. 2021; 162(46): 1856–1858.
Cabo Pulmo y el Uróboro: un caso multiescalar de perspectivas socioambientales
Authors: Torres Alvarez Sebastian 
Published: December 2021

En este artículo se estudia el caso de Cabo Pulmo, localidad ubicada en Baja California Sur, México, cuyos habitantes transitaron de una economía basada en la pesca y la extracción perlera a una sostenida por el ecoturismo. El objetivo fue analizar de qué manera dicho proceso estuvo influenciado por personas e instituciones multiescalares. El trabajo etnográfico consistió, en primera instancia, en conversaciones informales con habitantes de la localidad. Luego se aplicaron entrevistas en profundidad con tres personas, con la intención de obtener sus historias de vida. Para analizarlas, se emplea una propuesta metafórica basada en la figura del Uróboro. La investigación se acerca a un grupo social particular inserto en el mundo globalizado, a una crisis ambiental con una respuesta adaptativa y relaciones multiescalares articuladas para consolidar un proyecto ecoturístico y de defensa del territorio contra grandes proyectos turísticos, impulsando también cambios socioculturales. Se sugiere que este caso es un ejemplo concreto de la forma en que los procesos multiescalares pueden incidir en escenarios locales para impulsar respuestas adaptativas, un tema asociado a las discusiones y los retos del cambio climático.
Abstract
This article presents the case study of Cabo Pulmo, a town located in Baja California Sur, Mexico, which went from an economy based on fishing and pearl extraction to one sustained by ecotourism. The objective is to analyze how this process was influenced by people and multiscale institutions. The ethnographic work consisted, first, in informal conversations with local inhabitants, followed by the application of in-depth interviews with three people, to obtain their life stories. To analyze the results, a metaphorical proposal based on the figure of the Ouroboros is used. The investigation focuses on a specific social group inserted in the globalized world, an environmental crisis with an adaptive response and articulated multiscale relationships for the consolidation of an ecotourism project and the defense of the territory against large tourist projects, also promoting socio-cultural changes. This case is considered a concrete example of how multiscale processes can influence local scenarios to promote adaptive responses, a topic associated with the discussions and challenges of climate change.
Concomitant diseases in COVID-19 and their impact on the risks of adverse outcomes
Authors: Ivanova N V , Belov V S , Samarkin A I , Tretyakevich Z N , Mikushev V M , Bruttan Yu V 
Published: December 2021

Aim. To analyze COVID-19 comorbidities and their impact on disease course and the risk for unfavorable outcomes.
Methods. This study examined a group of 110 patients aged 32 to 97 who were admitted to the intensive care unit of the Pskov Regional Infectious Diseases Hospital in the period from October 7, 2020 to March 23, 2021. The mean age of patients was 65 years, 51% (56 people) were male. The study recorded age, comorbidities on a binary scale (yes no), course of the disease, the degree of lung injury, hospital length of stay, treatment outcome. The impact of comorbidities on the disease severity and outcomes was assessed by using logistic regression analysis.
Results. It was shown that a regional sample of patients showed an increased hospital mortality rate compared with the data of the ACTIV registry (33.5 versus 7.6%). Chronic respiratory diseases in patients with COVID-19 regional cohorts affected the fatal outcome 2.7 times less than those registered in the Russian register. The presence of endocrine and thrombotic circulatory system diseases was generally close to the register. Concomitant cardiovascular diseases in patients of the regional cohort affected the mortality of COVID-19 outcomes two times less (in patients of the region, the risk of mortality increased by 2.066 times) than in the registry. The reliability of the conclusions is confirmed by testing statistical hypotheses and reliability coefficients below 5%.
Conclusion. The study shows the statistically significant effect of comorbidities on the COVID-19 outcomes; the specificity of the results related to the sampling characteristics and the regional component.
The use of digital technologies in the diagnosis of tumor diseases at the pre-medical stage
Authors: Cherenkov V G , Weber V R , Pasevich K G , Arendatelev I G 
Published: December 2021

Aim. To improve the effectiveness of tumors and risk factors detection in reducing time costs at the pre-medical stage using a robotic complex.
Methods. To achieve this goal, the previously created robotic complex with a program for self-questioning, taking into account gender, has been improved. A portable USB microscope was built into the complexs housing to transmit images of pathological changes of visible localizations to the touch screen. The survey and examinations were conducted by clinical residents and students of the case-control type in 1638 patients at the Novgorod Regional Clinical Oncological Dispensary (in 20192021) as part of the Doors Open Days. The average age of patients was 54.68.9 years, including 703 men and 935 women. Descriptive statistics methods of Statistica 6.0 software were used. Qualitative characteristics showed as absolute number and the relative value in percentage (%). The differences were considered statistically significant at p 0.05.
Results. The use of the complex allowed us to suspect cancer risk factors in 9.031.3% patients, of which 31.081.8%, or 2.82.1% (p=0.017) of the total patients with the further examination was able to confirm oncology-related findings. Patients complained of discomfort in the stomach (59 people) underwent a breath test built into the program of the complex, according to the results of which helicobacteriosis was detected in 29 patients. In 17 patients with fibrogastroscopy, intestinal metaplasia was subsequently established, in 4 gastric ulcers, 3 of which had malignancy.
Conclusion. The use of a robotic complex-2 saves the time of a doctor of a lean polyclinic and improves the effectiveness of identifying cancer risk factors and early-stage cancer.
A Proposed Model for Dental Services Management in Iran
Authors: Shahsavaran Hassan , Hajinabi Kamran , Houshmand Behzad , Mahmoudi  Majdabadi Farahani Mahmoud 
Published: December 2021

Background: Oral health is an integral part of general health and one of the necessities of a good life. Having a healthy mouth and teeth requires individual care, the development and implementation of community-based intervention programs, and professional care. The purpose of this study was to design a model for the management of dental services in Iran.
Methods: This was an applied research in terms of purpose, descriptive in terms of implementation method, and a survey research in terms of descriptive typology. The statistical population included dental experts. To conduct the study among policy makers, planners, managers, university professors and the staff of the dental services, dental experts were chosen using purposive non-probability sampling for in-depth interviews based on grounded theory method to collect indicators of dental services management for providing a suitable selection model. To reach theoretical saturation, the text of the interviews was analyzed, phrase by phrase and sentence by sentence, through constant comparative analysis. For analysis, the grounded theory method was used, and the collected data were coded in 3 steps. In order to assess the validity of the research regarding interviews, the participants' feedback and the opinions of colleagues were used. To ensure the reliability of the interviews, 2 methods of test-retest and double coding were used. In this study, Delphi method was used in designing the model.
Results: According to the obtained model, 29 factors were effective in managing dental services. The obtained indicators were included in the Delphi survey. During the Delphi stages, consensus was reached on 29 indicators which were classified into 5 dimensions (components) including planning, organizing, mobilizing of resources and facilities, guiding, monitoring and controlling.
Conclusion: The results of the study showed that a 5-component model is suitable for the management of dental services in Iran, and health planners and policy makers can use it to improve the delivery of dental services.
Identifying the Factors Affecting the Incidence of Medication Errors of Nurses in Teaching Hospitals of Shiraz University of Medical Sciences
Authors: Yusefi Ali Reza , Nikmanesh Parnian , Kavosi Zahra , Sadeghi Ahmad 
Published: December 2021

Background: Medication errors are one of the major causes of injury to patients while receiving medical care. This study aimed to investigate the effective causes of medication errors in nurses in educational hospitals affiliated with Shiraz University of Medical Sciences.
Methods: This descriptive-analytical and cross-sectional study was conducted in 2020 on 340 nurses from 10 educational hospitals affiliated to Shiraz University of Medical Sciences. The data collection tool was a questionnaire. Data were analyzed using t-test, ANOVA and Pearson correlation coefficient were analyzed using SPSS23 software .
Results: According to the results, human factors have been the most important factor in the occurrence of medication errors. The most important causes of medication errors with respect to human, managerial and environmental factors include fatigue due to overwork (3.13 ± 1.16), method of supervision (3.06 ± 0.98) ,and heavy workload (3.00 ± 1.19), respectively. There was a statistically significant relationship between human factors and age (p = 0.024), gender (p = 0.013), employment relationship (p = 0.016), and marital status (p = 0.027), and between management factors and employment relationship (p = 0.034) and the number of patients under observation (p = 0.011).
Conclusion: Considering the most important causes of medication errors, including fatigue due to overload, supervision methods, and heavy workload, using strategies to reduce fatigue due to workload, such as balancing nurses' work shifts and also holding workshops on supervision methods is recommended in order to improve the level of managerial competencies of nurses.