Use of Research in the Nursing Practice: from Statistical Significance to Clinical Significance / Uso de la investigación en la práctica de enfermería: de la significancia estadística a la significancia clínica / Utilização da pesquisa na prática de enfermagem: da significância estatística à significância clínica

Objective. Within the context of evidence-based practice, this article exposes the reflection on the understanding and usefulness of the information provided by the research findings shared in reports and research publications, exposing differences based on the interpretation of statistical significance and clinical significance. Content synthesis. Basic aspects of the meaning and use of the information reported by research on p value (statistical significance) and the value and usefulness of these results are analyzed and exemplified, contrasting the value for the practice of an additional judgment on clinical significance. In addition to establishing conceptual differences, the need is highlighted for nurses to have the competencies to differentiate and apply each of them according to the clinical contexts of their potential implementation. Conclusion. The real usefulness of research about interventions within the context of nursing care is given by its real application and reach for the practice and benefit for patients. For this to occur, nurses must interpret adequately the information provided by scientific publications and other research reports.

Objetivo. En el contexto de una práctica basada en evidencia, este artículo expone la reflexión sobre la comprensión y utilidad de la información que proveen los hallazgos de investigación reportados en informes y publicaciones de investigación, exponiendo las diferencias a partir de la interpretación de la significancia estadística y significancia clínica. Síntesis del contenido. Se analizan y ejemplifican aspectos básicos sobre el significado y uso de la información que reportan las investigaciones sobre valor p (significancia estadística) y el valor y utilidad de estos resultados contrastando el valor para la práctica de un juicio adicional sobre significancia clínica. Además de establecer diferencias conceptuales, se resalta la necesidad de que las enfermeras tengan las competencias para diferenciar y aplicar cada uno de ellos según los contextos clínicos de su potencial implementación. Conclusión. La real utilidad de la investigación sobre intervenciones en el contexto del cuidado de enfermería está dada por su real aplicación y alcance para la práctica y el beneficio para los pacientes. Para que ello ocurra, las enfermeras deben interpretar adecuadamente la información que proveen las publicaciones científicas y otros reportes de investigación.

Objetivo. No contexto de uma prática baseada em evidências, este artigo apresenta a reflexão sobre a compreensão e utilidade da informação fornecida pelos resultados da investigação relatados em relatórios de investigação e publicações, expondo as diferenças com base na interpretação da significância estatística e da significância clínica. Síntese de conteúdo. Aspectos básicos sobre o significado e uso das informações relatadas pelas pesquisas sobre valor p (significância estatística) e o valor e utilidade desses resultados são analisados e exemplificados, contrastando o valor para a prática de um julgamento adicional sobre significância clínica. Além de estabelecer diferenças conceituais, destaca-se a necessidade de o enfermeiro ter competências para diferenciar e aplicar cada uma delas de acordo com os contextos clínicos de seu potencial implementação. Conclusão. A real utilidade da investigação sobre intervenções no contexto dos cuidados de enfermagem é dada pela sua real aplicação e âmbito de prática e benefício para os pacientes. Para que isso ocorra, os enfermeiros devem interpretar adequadamente as informações fornecidas pelas publicações científicas e outros relatórios de pesquisa.

Systemic investigations in dry eye disease

The incidence of dry eye disease has increased manifold in the past few years with more patients presenting with these complaints to our clinics every day. In the more severe forms of disease, it is important to evaluate for any systemic association which could be driving the disease such as in Sjogren’s syndrome. Understanding the possible varied etiopathogenesis and knowing when to evaluate, form an important part of treating this condition effectively. In addition, it is sometimes confusing as to which investigations to order and how to prognosticate the disease in these situations. This article simplifies this into an algorithmic approach with insights from the ocular and systemic point of view

Relevância das fontes de informação no cenário brasileiro durante a pandemia de covid-19 / Relevance of the information sources in the Brazilian scenario during the covid-19 pandemic / Relevancia de las fuentes de información en el escenario brasileño durante la pandemia del covid-19

Este artigo apresenta os resultados de um estudo sobre a percepção que os usuários têm da relevância das fontes de informação utilizadas por eles para se elucidarem sobre a covid-19 no cenário brasileiro durante a pandemia dessa doença. Os dados coletados para o estudo foram obtidos mediante a aplicação de um questionário distribuído via e-mail, Facebook, Instagram e WhatsApp. Os resultados mostram atribuição de relevância predominante a fontes formais e institucionais, como a Organização Mundial de Saúde (OMS), artigos científicos, universidades, Agência Nacional de Vigilância Sanitária (Anvisa), hospitais e postos de saúde. Dentre as fontes consideradas menos relevantes destacam-se jornais e/ou revistas, o Ministério da Saúde (MS) brasileiro e canais de televisão. As redes sociais (Facebook, Instagram, YouTube, WhatsApp, Twitter etc.), os amigos e/ou colegas, os mecanismos de busca na Internet (Google, Yahoo, Bing etc.) e familiares também se destacam como fontes de informação menos relevantes

This paper presents the results of a study on the users' perception of information of the relevance of infor-mation sources used by them to elucidate about covid-19 in the Brazilian scenario during the pandemic of this disease. The data were collected with use of a questionnaire distributed by email, Facebook, Instagram and WhatsApp. The results demonstrated a predominant attribution of relevance to formal and institution-al information sources, such as the World Health Organization (WHO), scientific papers, universities, the Anvisa ­ Agência Nacional de Vigilância Sanitária (the National Health Surveillance Agency), hospitals, and health centers. Among the sources considered less relevant were highlighted newspapers and/or mag-azines, the Brazilian Ministry of Health, and television channels. Social networks (Facebook, Instagram, YouTube, WhatsApp, Twitter, etc.), friends and/or colleagues, Internet search engines (Google, Yahoo, Bing, etc.) and family members also stand out as less relevant sources of information

Este artículo presenta los resultados de un estudio sobre la percepción que tienen los usuarios de la relevancia de las fuentes de información utilizadas por ellos para enterarse de la covid-19 en el escenario brasileño durante la pandemia de esta enfermedad. Los datos recolectados para el estudio se obtuvieron mediante la aplicación de una encuesta distribuida a través de correo electrónico, Facebook, Instagram y WhatsApp. Los resultados muestran una atribución de relevancia predominante a fuentes formales e institucionales, como la Organización Mundial de la Salud (OMS), artículos científicos, universidades, la Anvisa - Agência Nacional de Vigilância Sanitária (Agencia Nacional de Vigilancia Sanitaria), hospitales y centros de salud. Entre las fuentes consideradas menos relevantes están periódicos y/o revistas, el Ministerio de Salud brasileño y canales de televisión. También se destacan como fuentes de información menos relevantes las redes sociales (Facebook, Instagram, YouTube, WhatsApp, Twitter, etc.), los amigos y/o compañeros, los motores de búsqueda en la Internet (Google, Yahoo, Bing, etc.) y los familiares.

The influence of autistic traits and ambiguous situations on the interpretation bias of senior high school students / 中华行为医学与脑科学杂志

Objective:To explore the changing characteristics of interpretive bias of senior high school students with different levels of autistic traits in ambiguous situations, and to investigate the consistency of interpretive bias across self/other relevant conditions.Methods:A survey of 1 080 senior high school students from a high school in Anhui province was conducted by using the autistic-spectrum quotient (AQ). According to the criteria of high scores and low scores of 27%, the subjects in the high autistic trait group ( n=266) and the low autistic trait group ( n=266) were selected.The ambiguous situation paradigm was used to measure the frequency of positive interpretation of ambiguous information by two groups of subjects under the conditions of self and others, SPSS 26.0 was used for descriptive statistics, and jamovi 2.2.3 was used for generalized linear mixed model analysis. Results:(1) The results of the between-group effects at the level of autistic traits indicated that the frequency of positive interpretations in the high autistic group was significantly lower than that in the low autistic group(54.5(11.8), 57(11.8) )( χ2=13.99, P<0.001). The results of the interaction between level of autistic traits and type of ambiguous situation indicated that in the positive ambiguous situation, the frequency of positive interpretations in the high autistic group was smaller than that in the low autistic group (33(4), 34(3)) ( P<0.001). There was no significant differences in the number of positive interpretations between high autistic group and low autistic group in negtive ambiguous situation( P>0.05). (2) The results of the main effects of the ambiguous situation types indicated that the frequency of positive interpretations in positive ambiguous situations was significantly higher than that in negative ambiguous situations(33(4), 23(9.25)) ( χ2=1 348.50, P<0.001). The results of the interaction between level of autistic traits and type of ambiguous situation indicated that the frequency of positive interpretations in positive ambiguous situations (33(4), 34(3)) in both high and low autistic groups was larger than that in negative ambiguous situations (22(10), 24(9)) ( P<0.001). (3) The main effects results for the self/other related conditions suggested that the frequency of positive interpretations of familiarity with others (19(4)) was significantly higher than that of self-related conditions (19(5)) and strangers (19(5)) ( χ2=9.51, P<0.01), and there was no significant difference between self-related conditions and strangers( P>0.05). The results of the interaction between ambiguous situation type and self/other related conditions suggested that in the positive ambiguous situation, the frequency of positive interpretations of familiarity with other people's conditions was greater than that of self-related conditions( P<0.01), and in the negative ambiguous situations, there was no significant difference in the frequency of positive interpretations related to different self/others( P>0.05). Conclusions:(1) High school students with high and low autistic traits are more inclined to show positive interpretations in the ambiguous situations, and it higher under the condition of positive ambiguous situations and acquaintances.(2) Compared with those with low autistic traits, individuals with high autistic traits tend to give less positive interpretations to ambiguous situations, but this difference is mainly manifested in positive ambiguous situations.(3) In the negative ambiguous situation, there is no significant difference in number of positive interpretations produced by senior high school students with high and low autistic traits, and they are stable across self and other related conditions.

Value of unenhanced CT-based 5-point predictive score combined with blood glucose detection for predicting short-term prognosis in patients with spontaneous intracerebral hemorrhage / 中国基层医药

Objective:To investigate the value of a 5-point predictive score based on unenhanced CT combined with blood glucose detection for predicting short-term prognosis in patients with spontaneous cerebral hemorrhage.Methods:A total of 102 patients with spontaneous intracerebral hemorrhage who received treatment in Zhejiang Provincial People's Hospital from March 2020 to March 2022 were included in this study and analyzed retrospectively. Blood glucose level was measured and BAT score was used to evaluate hematoma enlargement. After 30 days, Glasgow Outcome Scale was used to evaluate the prognosis of patients. The relationships between blood glucose and BAT score, and between blood glucose and BAT score and prognosis were analyzed. The value of blood glucose and BAT score for predicting short-term prognosis was analyzed.Results:The Glasgow Outcome Scale results showed that among the 102 patients, 24 patients (23.53%) had poor prognosis. The BAT score and blood glucose level in patients with poor prognosis were (3.13 ± 0.68) points and (11.58 ± 2.30) mmol/L, respectively, which were significantly higher than (2.40 ± 0.59) points and (8.88 ± 1.71) mmol/L in patients with good prognosis ( t = 5.10, 5.30, both P < 0.05). Pearson correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level was positively correlated with BAT score ( r = 0.43, P < 0.05). Spearman correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level and BAT level were positively correlated with prognosis ( r = 0.42, 0.47, both P < 0.05). The receiver operating characteristic curve showed that the area under the curve plotted for BAT score combined with blood glucose level for predicting short-term prognosis was 0.874, which was significantly greater than the area under the curve plotted for BAT score alone for predicting short-term prognosis ( Z = 2.54, P < 0.05). Conclusion:A large proportion of patients with spontaneous intracerebral hemorrhage have a poor prognosis. The patients with a poor prognosis have higher blood glucose levels and BAT scores than those with good prognosis. Blood glucose and BAT score have a high value for predicting the prognosis of patients with spontaneous intracerebral hemorrhage.

Assessment of renal function in chronic hepatitis C patients / Монголын Анагаах Ухаан

Background@#The association between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) still remains controversial. We aimed to investigate whether HCV really affects renal function, and to analyze the association between clinical effects of CHC and decreased kidney function (assessed by glomerular filtration rate (eGFR) level).@*Aim@#Study of renal dysfunction in chronic hepatitis C virus infection@*Materials and Methods@#An estimated 222 patients with HCV infection and 222 age- and sex-matched community-based control individuals without HCV were enrolled (1:1, case and control ratio) in this study between from June 2022 to March 2023. We used the modification of diet in renal diseases to calculate eGFR. This study was approved by the review board of the Ethics Subcommittee of Ach Medical University and followed the Declaration of Helsinki. All statistical analysis was performed with SPSS version 26.0 software (SPSS Inc., Chicago, IL, USA), and a P value < 0.05 was considered statistically significant. Continuous variebles were presented as mean ± standard deviation, while categorical data was represented as numbers and percentages. Independent t-tests were used to compare the differences in parametric variables. The Mann-Whitney U test was performed to compare the follow-up period. Pearson’s chi-squared and Fisher’s exact tests were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factors associated with recurrence. @*Results@#The median age of the respondents was 40 (range 21-70). In the case group, the speed of hanging judgment was 105.3±24.5, and in the control group, it was 118.7±18.5, which was a statistically significant difference (p<0.05, p<0.05). It was observed that the rate of filtration of the renal is below 90 or the loss of renal function increases with age (47.50±9.3 vs 40.21±11.1; p<0.01). In order to reduce the effect of age, when evaluating the renal function of participants over 45 years of age in the case-control group, the HCV was 99.69 in the case group and 111.05 in the control group, although there was an age effect on the decline in HCV in both groups, but it decreased more in the HCV-infected group. When comparing two groups (<3.25, >3.25) with liver fibrosis degree above and below 3.25, the higher degree of fibrosis affects the decrease in the rate of hepatic filtration (112.92±19.8 vs 105.23±27.1; p<0.01). The proportion of cryoglobulinemia was high when renal dysfunction was beginning or when the GFR was below 90 (<90). Logistic regression analysis showed that cryoglobulinemia had the greatest influence on the decrease in glomerular filtration rate (OR 4.22, 95% CI 1.97-9.00, p<0.05). The relationship between age and the decline in hanging judgment speed was statistically significant and directly moderate (r=0.95, p=0.009). On the other hand, there is a statistical relationship between gender and the decrease in the speed of hanging judgment, with a probable and weak correlation (r=0.07, p=0.01).@*Conclusion@#Our study found that the patients with HCV infection are associated with a low eGFR compared with non-HCV–infected patients. This association is consistent in age, gender, cryoglobulinemia and liver fibrosis patients.

Correlation between persistent high-risk human papillomavirus infection and vaginal microecology and cervical lesions / 中国热带医学

@#Abstract: Objective To investigate the correlation between persistent and non-persistent HPV infection and vaginal microecology and cervical lesions, and to provide the basis for HPV prevention and treatment. Methods In this prospective study, 229 female patients with high-risk type (HR-HPV) were selected for cervical cytology and vaginal microecological examination in the gynecological outpatient department of Baise Maternal and Child Health Hospital from January 2018 to June 2021. The patients were followed up for 1 year to detect persistent HR-HPV infection. The relationship between HR-HPV persistent infection and vaginal microecology and cervical lesions was analyzed using the HPV-negative group as a control. Results Among 229 patients with HR-HPV, there were 109 patients with persistent HR-HPV infection and 120 patients with non-persistent HR-HPV infection in 1-year follow-up, and the incidence of persistent HR-HPV infection was 47.6%. In the HR-HPV persistent and non-persistent infection and HPV-negative groups, the bacterial vaginal incidence was 20.2%, 15.0% and 8.6%, respectively; vulvovaginal candidiasis was 19.3%, 13.3% and 7.9%, respectively; trichomoniasis vaginitis was 12.8%, 9.2% and 4.5%, respectively; mixed infection was 10.1%, 6.7% and 2.7%; H2O2 detection rate was 24.8%, 18.3% and 12.0%,the positive rate of pH value was 52.3%, 40.8% and 36.4%, and microecological normal detection rate was 22.9%, 32.7% and 40.2%, respectively. There were significant differences among the three groups (χ2=10.634, 10.522, 9.010, 9.374, 10.054, 8.268, P<0.01). In the HR-HPV persistent and non-persistent infection groups, the rates of atypical squamous cell detection were 12.8% and 10.0%, and 8.3% and 4.2% for low-grade squamous cell lesions, and 4.6% and 1.7% for high-grade squamous cell carcinoma, 2.8% and 0 for squamous cell carcinoma, respectively. There was no significant difference in the composition of atypical squamous cells between the two groups (χ2=4.358, P>0.05), there were significant differences in the composition of low-grade, high-grade and squamous cell carcinoma (χ2=11.472, 12.685, 11.378, P<0.01). Spearman rank correlation analysis showed that the presence or extent of HPV infection was positively correlated with bacterial vaginosis, vulvovaginal candidiasis, trichomonal vaginitis and mixed infection (P<0.05), positively correlated with H2O2, sialdase, leucocyte esterase,pH positive and positive for all four items (P<0.05), negatively correlated with microecology (P<0.01), positively correlated with low grade, high grade and squamous cell carcinoma (P<0.01), and not significantly correlated with atypical squamous cell carcinoma (P>0.05). Conclusion Persistent cervical HPV infection is an important factor of dysregulation in vaginal microecology and aggravates the degree of dysregulation in vaginal microecology, which is related to the development of cervical lesions.

A study on the relationship between occupational fitness, moral dilemma and resilience of nurses in emergency department / 中国实用护理杂志

Objective:To explore the correlation between nurses′ workplace adaptability, moral dilemma and resilience after suffering workplace violence in emergency department, in order to provide reference about improving the workplace adaptability and formulating intervention.Methods:A cross-section survey was conducted, we selected 248 nurses who had suffered workplace violence in the emergency department of five tertiary hospitals in Qingdao from January 2022 to January 2023 by convenient sampling method, and used self-designed general information questionnaire, moral dilemma scale, resilience evaluation scale for medical staff and nurses′ workplace adaptability scale to conduct a questionnaire survey on nurses who had suffered workplace violence, and found out the factors affecting their workplace adaptability.Results:The score of workplace adaptability of 248 nurses who had suffered workplace violence was (39.37 ± 12.77) points. Univariate analysis showed that education, length of emergency service, department or social part-time job, professional title, number of night shifts and sleep condition were the influencing factors of workplace fitness for emergency nurses ( t/ F values were -12.72 to 132.15, all P<0.05). The correlation analysis showed that the nurses′ workplace adaptability after workplace violence was negatively correlated with the scores and total scores of all dimensions of moral dilemma ( r values were -0.725 to -0.194, P<0.05), and positively correlated with the scores and total scores of all dimensions of resilience ( r values were 0.135 to 0.732, P<0.05). Multi-factor results showed that education background, department/social part-time job, working years, professional title, sleep status, moral dilemma and resilience were the influencing factors of nurses′ workplace adaptability after workplace violence ( t values were -9.25 to 15.25, P<0.05). Conclusions:Nurses with specialized education, emergency service for 1-3 years, no department/social part-time job, primary professional title, sleep disorder, higher degree of moral dilemma and low level of resilience have low occupational adaptability. Nursing managers should focus on such nurses and improve their occupational adaptability.

Study on the status quo and correlation between body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine / 中国实用护理杂志

Objective:To investigate the current situation of body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine, and analyze the correlation between them.Methods:A cross-sectional study was conducted using convenience sampling method to investigate 150 patients with drug-resistant tuberculosis treated with Clofazimine in tuberculosis ward of Chengdu Public Health Clinical Medical Center from October 2020 to October 2021. The general questionnaire, Body Image Scale (BIS) and Tuberculosis Related Stigma Scale were used to conduct a questionnaire survey.Results:A total of 130 questionnaires were effectively collected. The body image score of 130 patients with drug-resistant tuberculosis treated with Clofazimine was (20.51 ± 6.80) points; the score of stigma was (17.78 ± 6.92) points. There was a positive correlation between the total score of disease shame and the total score of body image ( r=0.544, P<0.05). Conclusions:Patients with drug-resistant tuberculosis treated with Clofazimine have body image disorder and stigma, and the two are positively correlated. Caregivers should carry out psychological assessment and intervention at an early stage to improve the patient′s mental health level.

Relevancia curricular de la carrera de enfermería en la Universidad Técnica del Norte (Ecuador), 2023 / Curriculum relevance of the nursing degree curriculum at the Universidad Técnica del Norte Technical University of the North (Ecuador), 2023

INTRODUCCIÓN: El currículo en la educación de enfermería debe estar alineado con las necesidades sociales y las políticas de educación superior y salud, siendo necesaria la revisión permanente de sus elementos curriculares a fin de lograr una mayor pertinencia y adecuación con los procesos académicos sustantivos: investigación, docencia y vinculación con el medio. OBJETIVO: Analizar el nivel de pertinencia del currículo de la carrera de enfermería de la Universidad Técnica del Norte, 2023. METODOLOGÍA: Estudio con enfoque cuantitativo de tipo no experimental con diseño descriptivo, analítico y de corte transversal. RESULTADOS: Existe una participación predominante de estudiantes mujeres en un 68% y el 93% de docentes mujeres quienes tienen una alta preparación académica, la mayoría se auto identifican como mestizos y un 18% son de otras etnias. Para el 54,2% de los participantes, el currículo de la carrera tiene un nivel medio de pertinencia, un significativo porcentaje 23,2% lo califica con una puntuación alta. Se considera la articulación del currículo-vinculación como el medio con la mayor fortaleza de la carrera. Otros elementos son considerados apropiados como equipamiento, planta física y recursos didácticos y existe coherencia de los planes de estudio y contenidos micro curriculares con las exigencias de las políticas y dinámicas del mercado laboral en el ámbito sanitario. CONCLUSIONES: Los porcentajes elevados de las diferentes tablas y el análisis realizado concluye que se requiere innovación en los procesos de enseñanza-aprendizaje que permitan adaptarse a las necesidades actuales del campo laboral y se destaca, además la importancia de una gestión académica que promueva un currículo pertinente, apropiado y dinámico que analice y mejore las necesidades sociales y de salud.

INTRODUCTION: The nursing education curriculum must be aligned with the social needs and policies of higher education and health, and the permanent review of its elements are necessary to achieve greater relevance and adequacy with respect to academic processes, research, teaching, and association with the community. OBJECTIVE: To analyze the relevance of the curriculum that prepares students for the nursing career at the Universidad Técnica del Norte, 2023. METHODOLOGY: Study using a non-experimental quantitative approach with descriptive, analytical, and cross-sectional design. RESULTS: There is a predominant participation of female students (68%) and female teachers (93%) who have high academic qualifications; the majority self-identify as mestizos and 18% with other ethnicities. For 54,2% of participants, the nursing career curriculum has an average level of relevance; a significant 23,2% rate it with a high score. The articulation of the curriculum linkage is considered the greatest strength of the career path, and the curricula and microcurricular contents are coherent with the policies and dynamics of the labor market in the health field. Other elements considered appropriate include equipment, physical plant and teaching resources. CONCLUSIONS: The high percentages seen in the different tables and the subsequent analysis conclude that innovation is required in the teaching-learning process to facilitate adaptation to the current needs of the labor market. Academic management is also important to promote a dynamic and relevant curriculum that meets social and health needs.

Relevance of the Health Extension Program to the current Health Needs and Evolving Demands of Rural Ethiopia: A Mixed-Method Analysi

BACKGROUND: Ethiopia has been implementing a health extension program (HEP) to respond to the high maternal and child mortality in rural communities. HEP has brought tremendous contributions to improved access and coverage of primary healthcare in the last 15 years. Despite its attributions, attention to HEP has declined in recent years due to several reasons. This study is designed to explore HEP's relevance to the current healthcare needs of the rural communities. METHODS: This study is a nested cross-sectional mixed method to the overall HEP's evaluation between March and May 2019. Descriptive statistics were used on qualitative and quantitative assessment. A literature review supplemented the assessment. A representative quantitative sample of 11,746 women, men, and young girls; a qualitative sample of 268 key informants from Kebele administrators, HEWs, program people in the health system and focus groups from community leaders, men and women from 185 Kebeles in 62 woredas were selected. A thematic approach was used for qualitative analysis. RESULTS: Rural communities and program managers asserted that HEP's service packages with the existing service delivery modalities were relevant. Eighty-two percent of men and women and 77% of young girls confirmed this relevance. Besides the existing packages, additional curative services for adults and children were recommended with emphasis on the pastoralist community. HEP's service uptake has declined as over 86% of targeted rural communities bypassed HPs due to unavailability of services and capacity problems of HEWs. CONCLUSION: The current HEP packages with the existing service delivery modalities are still relevant to the rural communities' health needs. However, on-going changes to address the evolving demands of the targeted rural communities are crucial

Biochemical relationship between leiomyosarcoma and peroxiredoxin-6 expression level: Clinical implications

Uterine leiomyosarcomas are tumors with a heterogeneous genetic profiles that respond very poorly to cytotoxic chemotherapy with aggressive progression. We aimed to show the status of peroxiredoxin 6 as a biomarker in leiomyosarcoma progression.Study included 12 patients diagnosed with "leiomyosarcoma" and 13 patients diagnosed with "myoma" (as control) after histopathological examinations of clinical samples. Peroxiredoxin-6 gene expression and protein levels were evaluated on the tumor preparations (blocks) utilizing ELISA and PCR methods.Peroxiredoxin-6 protein was mainly localized in the cytoplasm of leiomyosarcoma cells, and the expression of peroxiredoxin-6 was significantly increased in cancerous tissues compared to normal myoma tissues (3.33±1.7 vs. 2.03±1.07fold change; P= 0.031). Peroxiredoxin-6 tissue protein levels were also significantly higher in leiomyosarcoma cases (100.54±66.86 vs. 183.72±64.54 pg/µg protein; P= 0.005). Our findings demonstrate that peroxiredoxin-6 plays a vital role in the emergence and development of leiomyosarcoma and that peroxiredoxin-6 level assessments can be used as a biomarker in guiding better prognosis andtreatment plans while managing leiomyosarcoma.

Exploring the Learner’s Perception about Embryology – Before and After Introduction of Competency Based Medical Curriculum (CBME)

Background: The perceived relevance of a subject/area will decide how much the student will study that. Competency based Medical Curriculum helps students to understand the subject relevance due to its structured format. The feedback from students about subject relevance is needed as they are the primary stakeholders for learning. In this era of involving molecular biology and genetics in medical field, it is very difficult to determine how much to teach a basic subject like embryology. This questionnaire study was done to know the viewpoints of 3rd semester & 5th semester medical students about the relevance and necessity of embryology in medical education. Method: An anonymous questionnaire was sent to 3rd semester, CBME batch & 5th semester students, traditional or regular batch of Sree Balaji Medical College, Chrompet. The pre validated questionnaire contained questions regarding the perceived relevance & importance of embryology. Results: Students reported the relevance of embryology knowledge for learning other medical subjects & they more often acknowledged embryology as being of great importance for their professional careers. This perception has increased especially after introduction of Competency based Medical Curriculum. Overall, study results suggest that medical students have a positive attitude toward embryology undergraduate course. Conclusion: This evidence could be used as an additional motive for the development embryology courses, with special emphasis on practical application of knowledge in clinically-oriented setting.

Associated factors to lower renal glomerular filtration rate in chronic hepatitis C patients / Монголын Анагаах Ухаан

Introduction@#Studies have shown that hepatitis C virus (HCV) infection not only causes hepatitis, but also pathological changes in other organ systems. Therefore, it is necessary to study the relationship between chronic HCV and chronic kidney disease.@*Objective @#To determine the factors influencing renal glomerular function in chronic hepatitis C patients@*Materials and methods@#Patients with chronic hepatitis C virus were referred to Third Central Hospital, Tegsh Huslen Medical Center, two regional 2020 from August to October. Data on morbidity of patients with chronic hepatitis C were analyzed. The results were processed using SPSS-23 software. Statistical probabilities were determined by checking whether there were statistically significant differences between the groups, using logistic regression analysis and chi-square methods.@*Results @#There were 54 (46.9%) individuals whose renal glomerular filtration rate was reduced to less than 90 ml/min. In a linear regression analysis, a decrease in renal glomerular filtration rate with age was a significant correlation. Renal glomerular filtration rate is decreased in 37% patients by age-related manner (r2 = 0.37). To determine other causes, no significant correlations were observed when grouped by diabetes, cirrhosis, BMI, and hepatic steatosis (p>0.005). The older age of the patient and the high blood pressure were at 6.4 times higher risk to decrease the glomerular filtration rate in patients with chronic hepatitis C (OR 6.4 (95% CI 1.3-31.4), p=0.021) than the patients who have young age and normal blood pressure by multiple logistic regression analysis.@*Conclusion@#The age of the patient and high blood pressure are contributing factors to the decline in the incidence of low glomerular filtration rate in patients with chronic hepatitis C.

Early life adversity and depression / 中华行为医学与脑科学杂志

The onset of depression is related to many factors such as biological, psychological and social environment, and more and more studies have shown that early life adversity is a risk factor for depression. Patients with depression who have early life adversity have different clinical characteristics, such as greater cognitive impairment and higher risk of suicide, which may be related to changes in cognitive patterns. In addition, early life adversity can cause endocrine, immune and nervous system specific changes in depressed patients. This article reviews the relationship and mechanism between various types of early life adverse and depression, explores the onset of depression and provides theory evidence for early intervention.

Generic Association Analysis on "Prescription-Formula-Dosage-Property" of Tibetan Medicine Based on Partial Order Structure and Property Theory / 中国实验方剂学杂志

Objective:In view of the complexity of the "Prescription-Formula-Dosage-Property" relationship of Tibetan medicine and the outstanding common relationship，it is difficult to reveal the hidden and specific rules of clinical medication of Tibetan medicine. Method:Based on the attribute partial order structure and the vector structure model of "Ro-Nus-Zhu-Rjes"（Taste，Post-Digestive Tastes and Potency），clustering analysis and other methods and software，this study analyzed the "Prescription-Formula-Dosage-Property" relationship of 184 commonly used prescriptions in the 1995 edition of the standards issued by the Ministry of Tibetan medicine（SIMTM）. Result:Among them，the analysis of the relationship between prescription and formula found that 11 prescriptions with the largest common attribute，such as Chebulae Fructus and Carthami Flos，were the key components of classification and compatibility，which could effectively classify the 8 kinds of prescriptions for the treatment of lung disease，tripa disease and blood fever. Among them，the san Yin and auxiliary viscera function prescriptions，such as Sanguotang powder and Liuwei Liangyao powder，had the strongest commonality. According to the analysis of relationship between formula and dosage ，the dosage of Chebulae Fructus，Carthami Flos，pomegranate seed，Phyllanthi Fructus was the highest，which suggested that these drugs were often used as primary drugs，while the Liuwei Liangyao powder，such as Amomi Fructus Rotundus and Tsaoko Fructus，had a higher frequency but a lower dose，which mainly played a role in regulating the overall drug property of the prescription and protecting the viscera. The Tibetan medicine-specific drugs including Moschus，Bovis Calculus，and Zhaxun，which were used in a high frequency but very low dose，had the effect of enhancing the drug property and guiding the affected part. According to the analysis of the relationship between dosage and property，there were many prescriptions belonging to cool nature，accounting for 75.6%. It was found that 67 prescriptions did not conform to the efficacy due to their different dosage. Conclusion:There are many common components and common usages in Tibetan medicine prescriptions. If these common associations are not treated，it will lead to the result that all diseases take these common associations as the core，but the hidden key factors cannot be solved. Therefore，it is necessary to pay attention to sensitivity and specificity at the multi-dimensional level of "prescription-formula-dosage-property"，so as to reveal the clinical medication thought of Tibetan medicine more effectively.

COVID-19 and Its Implications in Dental Care

COVID-19 was first reported in Wuhan, Hubei Province of China a few months ago (December 2019) and had since become a major challenging public health problem for not only China but also many countries around the world. It was on March 11, 2020, characterized by WHO as a pandemic. The pandemic so far has killed more than 526,465 people and infected more than 11,046,917 people around the world as of 05 July 2020. Nigeria currently has 28,167 confirmed COVID-19 cases with 11,462 (40%) discharged, 16,071 (57%) currently receiving treatment at designated facilities across the country and unfortunately 634 (3%) deaths as at the time of writing this manuscript. As far as the authors are aware, there are little or no work carried out on the implications of COVID-19 on dental practices in Nigeria. Recently, COVID-19 was identified in saliva of infected patients and so transmission via aerosols and splatter generated during dental procedures is sure. To limit exposure, there was a need to avoid scheduling patients except for emergency dental care during this outbreak. This limitation on activities of the dental sector has a very huge impact on the economy of the sector as it has already resulted in serious monetary implications for dental practices worldwide. While dental practices in the high-income countries are getting help from their respective Government, those in the middle and low-income countries like Nigeria have been left to wallow in bankruptcy without support. The authors highly recommend that the Government of these neglected countries, step up and support dental practices that are on the brink of closing down due to the low turnout of patients to their practice during this outbreak.

Relevance of Established Risk Factors for Carcinoma Breast in Indian Women.

Breast cancer is the most common cancer in women of India and across the globe. More than 2.1 million women were diagnosed to have breast cancer in 2018 worldwide. An incremental trend in incidence and mortality has been observed in South-Asian, low to middle income, developing countries. Age adjusted incidence in India is 25.8 per 100,000 women in India. The established risk factors for causation of carcinoma breast have been deduced primarily from Western studies and their applicability to Indian women remains varied. We wanted to evaluate the relevance of the established risk factors for carcinoma breast in patients presenting to our institute. METHODSThis case-control study included 65 patients with histologically confirmed diagnosis of carcinoma breast in the test group and 65 healthy women in the control group. All enrolled women were made to fill a questionnaire to assess for presence or absence of established risk factors in them. Results were obtained by calculating percentage of women with these risk factors in both arms. RESULTSAmong the established factors for carcinoma breast, 18.4% patients in the test group were obese compared to 12.3% women in the control group. This difference was found to be statistically significant with a p value of <0.02. However, there was no significant relevance between the two compared groups with respect to other risk factors studied. CONCLUSIONSWhile the established risk factors for carcinoma breast have been found to be relevant in multiple national and international studies, their applicability to specific populations such as those catered to by our institution varied. Out of all the established risk factors for carcinoma breast in the western population, the present study suggested significance only for obesity, with a BMI of ≥30 Kg/m2

Preferencias del usuario, categorización de consultas y documentos, tres variables importantes en el cálculo de relevancia / User preferences, query and document categorization, three important variables in relevance calculation

The quality of an information retrieval system depends largely on the satisfaction degree of users with the results obtained when executing a query, so it is essential to design processes that store the preferences patterns of each of them and vary the way in which the results are shown taking into account the specific characteristics of each user. The objective of this article was to present an algorithm for calculating the relevance of the documents provided to users, which used the variables: the user's search profile, the category of the documents and the category of the query as parameters, to customize the results provided by the search engine to the users. In addition, it used as impulse factors the degree of predominance of a search category in the user's profile and the categories to which the document belongs. To validate the algorithm, precision and recall metrics were applied to check that the results obtained are relevant to users(AU)

La calidad de un sistema de recuperación de información depende en gran medida del grado de satisfacción de los usuarios en cuanto a los resultados obtenidos al realizar una consulta. Para obtener resultados de búsquedas relevantes es esencial diseñar procesos que almacenen los patrones de preferencias de cada usuario. Este estudio tuvo como objetivo presentar un algoritmo para el cálculo de la relevancia de los documentos brindados. El algoritmo utilizó como parámetros las siguientes variables: perfil de búsqueda del usuario, categoría de los documentos y categoría de la consulta para personalizar los resultados brindados mediante el motor de búsqueda. Además, utilizó como factores de impulso el grado de predominio de una categoría de búsqueda en el perfil del usuario y en las categorías a las que pertenece el documento. Para la validación del modelo se aplicaron las métricas de precisión y exhaustividad que permitieron comprobar que los resultados obtenidos son relevantes para los consumidores de la información(AU)

A fenomenologia de Heidegger na crítica de Dreyfus à IA simbólica / Heidegger's Phenomenology in Dreyfus's Critique of Symbolic AI

Embora influente na recepção de Heidegger nos Estados Unidos da América, o trabalho de Dreyfus foi repetidas vezes criticado por desenvolver uma leitura distorcida e seletiva da fenomenologia de Heidegger. Nesse artigo, mostramos que, independentemente de seus desenvolvimentos posteriores em ciência cognitiva, sua crítica inicial à IA simbólica se apoia em duas teses que podem ser localizadas em Ser e Tempo, a saber, de que nosso senso de situação é (i) pragmático-holístico, e (ii) intrinsecamente relevante (i.e. definido por nossas interesses). Após uma introdução geral, reconstruímos, numa primeira seção, em linhas gerais o projeto da IA simbólica e o tom geral da crítica de Dreyfus; numa segunda seção, reconstruímos a crítica de Dreyfus a SAM, de R. Schank; na terceira seção, indicamos como as duas teses podem ser localizadas em Ser e Tempo; concluímos apontando questões pendentes.

While influential in Heidegger's reception in the United States of America, Dreyfus's work has been repeatedly criticized for developing a distorted and selective reading of Heidegger's phenomenology. In this paper, we show that, regardless of Dreyfus's later developments in cognitive science, his early critique of symbolic AI is supported by theses that can be located in Heidegger's Being and Time, namely, that our sense of situation is both (i) pragmatic-holistic and (ii) intrinsically relevant (i.e. defined by our interests). After a general introduction, we present in the first section the project of symbolic AI and the general tone of Dreyfus's criticism thereof; we then reconstruct Dreyfus's criticism of R. Schank's SAM; after that, we indicate how these theses are to be found in Heidegger's Being and Time; we finally conclude by pointing out pending issues.