Repercussions of the Emergency neurological life support on scientific literature: a bibliometric study / Repercussões do Emergency neurological life support na literatura científica: um estudo bibliométrico

Abstract Background In 2012, the Neurocritical Care Society launched a compilation of protocols regarding the core issues that should be addressed within the first hours of neurological emergencies - the Emergency neurological life support (ENLS). Objective We aim to evaluate this repercussion through a bibliometric analysis. Methods We searched Scopus on October 2022 for articles mentioning ENLS. The following variables were obtained: number of citations; number of citations per year; number of publications per year; year of publication; research type; research subtype; country of corresponding author and its income category and world region; journal of publication and its 5-year impact factor (IF); and section where ENLS appeared. Results After applying eligibility criteria, we retrieved 421 articles, published from 2012 to 2022. The mean number of citations per article was 17.46 (95% Confidence Interval (CI) = 8.20-26.72), while the mean number of citations per year per article was 4.05 (95% CI = 2.50-5.61). The mean destiny journal 5-year IF was 5.141 (95% CI = 4.189-6.093). The majority of articles were secondary research (57.48%; n= 242/421) of which most were narrative reviews (71.90%; n= 174/242). High-Income countries were the most prominent (80.05%; n= 337/421 articles). There were no papers from low-income countries. There were no trials or systematic reviews from middle-income countries. Conclusion Although still low, the number of publications mentioning ENLS is increasing. Articles were mainly published in journals of intensive care medicine, neurology, neurosurgery, and emergency medicine. Most articles were published by authors from high-income countries. The majority of papers were secondary research, with narrative review as the most frequent subtype.

Resumo Antecedentes Em 2012, a Neurocritical Care Society lançou uma compilação de protocolos sobre as questões centrais que devem ser abordadas nas primeiras horas de emergências neurológicas - Emergency neurological life support (ENLS). Objetivo Avaliar a repercussão do ENLS por meio de uma análise bibliométrica. Métodos A base de dados Scopus foi utilizada em outubro de 2022 para a busca por artigos mencionando o ENLS. As seguintes variáveis foram obtidas: número de citações; número de citações por ano; número de publicações por ano; ano de publicação; tipo de pesquisa; país do autor correspondente e sua categoria de renda; revista de publicação e seu fator de impacto de 5 anos (IF); e seção onde o ENLS apareceu. Resultados Os 421 artigos incluídos foram publicados de 2012 a 2022. A média de citações por artigo foi de 17.46 (intervalo de confiança (IC) 95% = 8.20-26.72), enquanto a de citações por ano por artigo foi de 4.05 (IC95% = 2.50-5.61). O IF médio por revista foi de 5.14 (IC95% = 4.19-6.09). A maioria dos artigos era de pesquisa secundária (57.48%; n= 242/421), dos quais a maioria eram revisões narrativas (71.90%; n= 174/242). Os países de alta renda foram os mais prolíficos (80.05%; n= 337/421 artigos). Não houve publicações de países de baixa ou média renda. Conclusão Embora ainda baixo, o número de publicações mencionando o ENLS vem aumentando recentemente. A maioria dos artigos foram publicados em revistas de medicina intensiva, neurologia, neurocirurgia e medicina de emergência. Artigos de pesquisa secundária foram os mais comuns, com revisões narrativas sendo o subtipo mais frequente.

Sistema de procedimientos para la formación interdisciplinar de la habilidad diagnosticar en residentes de dermatología / A System of Procedures for the Interdisciplinary Training of the Dill To Diagnose in Dermatology Residents

Introducción: En las prácticas de laboratorio se adquiere la habilidad que permite corroborar el diagnóstico de las enfermedades de la piel y anejos después de un diagnóstico presuntivo, con la utilización del método clínico. Esto se respalda en las exigencias establecidas en los documentos normativos de ese proceso formativo. Objetivo: Proponer un sistema de procedimientos para la formación interdisciplinar de la habilidad "diagnosticar enfermedades dermatológicas en los residentes de dermatología, a partir de insuficiencias detectadas en el programa de la especialidad. Métodos: La investigación fue cualitativa, con un estudio descriptivo en el Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, desde 2018 hasta 2022. Se trabajó con toda la población conformada por 16 residentes de primer año en dermatología. Se utilizaron métodos de nivel teórico, empírico y estadístico. Resultados: En el sistema de procedimientos propuesto, se concretan fortalezas y debilidades, objetivo general, orientaciones metodológicas, precisión de los objetivos específicos y sistema de acciones para cada procedimiento, y sistema de control y evaluación de la efectividad de las acciones realizadas. La demostración de la formación de la habilidad diagnosticar, a través de un caso clínico real, reveló como esencial la consecutividad lógica de las acciones del residente desde la atención médica del caso y la formulación del diagnóstico presuntivo hasta el establecimiento del diagnóstico corroborativo en los laboratorios de anatomía patológica, microbiología y parasitología médica. Conclusiones: Se aporta un sistema de procedimientos que posibilita la formación de la habilidad "diagnosticar enfermedades dermatológicas en los residentes, con carácter secuencial, interdisciplinar e investigativo(AU)

Introduction: Laboratory practices provide the ability that allows corroborating the diagnosis of skin and adnexal diseases after a presumptive diagnosis, with the use of the clinical method. This is supported by the requirements established in the standardization documents of this training process. Objective: To propose a system of procedures for the interdisciplinary training of the skill to diagnose dermatological diseases in Dermatology residents, based on insufficiencies detected in the specialty program. Methods: The research was qualitative and consisted in a descriptive study carried out in Hospital General Docente Dr. Antonio Luaces Iraola, of Ciego de Avila, from 2018 to 2022. The work was done with the entire population made up of 16 first-year residents in Dermatology. Theoretical, empirical and statistical methods were used. Results: In the proposed system of procedures, strengths and weaknesses are specified, together with general objective, methodological guidelines, precision of specific objectives and system of actions for each procedure, as well as system of control and evaluation of the effectiveness of the actions. Demonstrating the received formation for the diagnostic skill, through a real clinical case, revealed as essential the logical consecutivity of the resident's actions from the medical attention of the case and the formulation of the presumptive diagnosis to the establishment of the corroborative diagnosis in the laboratories of pathological anatomy, microbiology and medical parasitology. Conclusions: A system of procedures is provided that makes possible the formation of the skill to diagnose dermatological diseases in residents, with sequential, interdisciplinary and investigative character(AU)

Impact of accreditation on knowledge and awareness of laboratory technicians about the aspects of laboratory quality in a tertiary care public-sector teaching hospital

Background: Laboratory diagnosis in Indian health-care setup is usually the mainstay of screening and diagnosis of diseases. Accreditation is a process of approval by establishing adherence of pre-defined quality standards to the existing system which can bring about utmost quality in service delivery by increasing accuracy and reliability and minimizing errors. Need for accreditation is ever-increasing in public sector health-care centers. Aim and Objectives: To ascertain and to quantify the impact of accreditation via training and exposure in the cadre of laboratory technicians in tertiary care public sector hospital. Materials and Methods: It was an interventional study to check competency of laboratory technicians in various domains of NABL standards, before and after training and exposure to accreditation process. It was carried out amongst MLT students and employed laboratory technicians in the clinical biochemistry department of a public sector, tertiary care, teaching hospital and lasted for 2 months. Preformed questionnaire was used. Difference between pre- and post-test results was compared with appropriate statistical analysis. Results: Marked difference was seen in the performance of study subjects before (27.6 ± 9.9) and after (56.7 ± 6.2) exposure to training and accreditation process (Max. score of 80). Average gain was 37.5%. The difference was highly significant for each domain. Domains of pre-analytical, analytical, and post-analytical procedures saw the highest difference. There was a significant difference in competence gain between student lab. techs. and employed lab. techs. Conclusion: Benefits of accreditation are immense, yet it is a voluntary process in our country. Strict adherence to already laid out standards and protocols at national level can be achieved by continuous sensitization and capacity building. Public sector laboratories need to gear up and embrace this need. The same should also be incorporated effectively in the curriculum of laboratory technician students.

Responsabilidad profesional derivada del ejercicio de la odontología en Costa Rica: I Parte / Professional responsibility derived from the practice of dentistry in Costa Rica: Part I

El aumento a nivel mundial de las denuncias por responsabilidad profesional en Ciencias de la Salud hace imprescindible que quienes ejerzan esta profesión deban conocer las implicaciones de su labor, así como cumplir con los principios bioéticos y jurídicos para garantizar una sana relación odontólogo-paciente. Es importante comprender que el ejercicio de la odontología en Costa Rica está regulado por normas, códigos y leyes como cualquier otra actividad humana en un Estado de Derecho.

The number of complaints related to professional liability in health sciences has increased worldwide, it is essential for dental professionals to be aware of the implications of their labor, as well as to comply with bioethical and legal principles to ensure a healthy dentist-patient relationship. It is important to understand that the practice of dentistry in Costa Rica is regulated by norms, codes, and laws like any other human activity in a State governed by the rule of law.

Host cell protein quantification workflow using optimized standards combined with data-independent acquisition mass spectrometry / 药物分析学报

Monitoring of host cell proteins(HCPs)during the manufacturing of monoclonal antibodies(mAb)has become a critical requirement to provide effective and safe drug products.Enzyme-linked immunosor-bent assays are still the gold standard methods for the quantification of protein impurities.However,this technique has several limitations and does,among others,not enable the precise identification of pro-teins.In this context,mass spectrometry(MS)became an alternative and orthogonal method that de-livers qualitative and quantitative information on all identified HCPs.However,in order to be routinely implemented in biopharmaceutical companies,liquid chromatography-MS based methods still need to be standardized to provide highest sensitivity and robust and accurate quantification.Here,we present a promising MS-based analytical workflow coupling the use of an innovative quantification standard,the HCP Profiler solution,with a spectral library-based data-independent acquisition(DIA)method and strict data validation criteria.The performances of the HCP Profiler solution were compared to more con-ventional standard protein spikes and the DIA approach was benchmarked against a classical data-dependent acquisition on a series of samples produced at various stages of the manufacturing process.While we also explored spectral library-free DIA interpretation,the spectral library-based approach still showed highest accuracy and reproducibility(coefficients of variation＜10％)with a sensitivity down to the sub-ng/mg mAb level.Thus,this workflow is today mature to be used as a robust and straightforward method to support mAb manufacturing process developments and drug products quality control.

Development and application of data standards for real world studies of pancreatic diseases / 中华消化外科杂志

Pancreatic diseases is a kind of complex, high-risk gastrointestinal diseases. Pancreatic cancer is highly malignant and seriously endangers people′s health. Developing multi-center, large-scale real world research can better understand the incidence patterns and treatment outcomes of pancreatic diseases. Based on the multi-center and heterogeneous data, the authors for-mulate data standards for real world studies of pancreatic diseases, and build a database of pancreatic cancer, integrating and sharing data from multi-center sources, in order to fully explore the scientific research value of pancreatic cancer clinical information, and provide experience and reference for the construction of other real world research specific disease databases in the future.

Study on the efficacy evaluation criteria of randomized controlled trials of TCM in the treatment for edema / 国际中医中药杂志

Objective:To analyze the efficacy evaluation criteria of the existing TCM treatment for edema RCT research, and to provide reference for the construction of unified standards.Methods:The batabases CNKI, WanFang Data, VIP, CBM, Pubmed and Web of Science were retrieved. The randomized controlled trials for the treatment of edema of TCM research, from September 1, 1993 to July 31, 2022, were screened and included. The content of efficacy evaluation, performed statistics on evaluation standard, the curative effect evaluation indexes, as well as standard composition, usage were extracted. We analyzed the characteristics, application and problems of the existing efficacy evaluation criterion.Results:A total of 123 Chinese articles were included. The included literature involved nephrogenic edema, cardiogenic edema, idiopathic edema, apoplexy limb edema and other edema. In recent years, randomized controlled trials on the treatment of edema by TCM have mainly used four efficacy evaluation criteria. Of which the Guidelines for Clinical Research on New Chinese Medicines (Trial) in 2002 had the highest utilization rate of 29.27%. Secondly, the utilization rate of Standard for Diagnosis and Curative Effect of TCM Diseases and Syndromes was 21.14%. The rest of the criteria were used by less than 6%. While 39.02% of the literature did not use the standards or used self-designed standards. Among the composition of efficacy evaluation indices, the application rate of TCM syndrome or symptom efficacy index was the highest (91.87%), the utilization rate of the Minnesota Living with Heart Failure Questionnaire Indicators was only 4.88%; biochemical tests accounted for a large proportion of Western medical indicators, while the measurement of edema severity was rarely applied. Conclusions:At present, the evaluation criteria of edema curative effect are diversified and insufficiently popularized, which need to be further screened and improved. It is suggested to construct a TCM edema efficacy evaluation model based on the characteristics of edema syndrome, comprehensively evaluate the efficacy from multiple dimensions such as TCM syndromes, western medicine indicators, and quality of life, and improve the scientific indicators.

Reflections on nomenclature and expansion of surgical indications for endoscopic spinal surgery / 国际外科学杂志

In recent years, with the development and maturity of endoscopic technique, endoscopic spinal surgery represented by water media and optical rigid endoscope has been widely used in the treatment of many disorders in the cervical, thoracic and lumbar spine. Endoscopic spinal surgery shows similar clinical effects as traditional open surgery or other minimally invasive procedures, and is favored by spinal surgeons due to its advantages of less trauma and rapid recovery after surgery. However, the large-scale application of endoscopic technique brings problems such as non-standard nomenclature and unreasonable indications. Therefore, this article will summarize the surgical nomenclature and indications of endoscopic spinal surgery, in order to provide a reference for spinal surgeons to understand and apply endoscopic technology reasonably.

Application strategy of the Principles and Guidelines for Human Factors/Ergonomics (HFE) Design and Management of Work Systems in China / 中国职业医学

To provide in-depth information and guidance on ergonomics, the International Labour Organization (ILO) had issued a series of conventions, recommendations, and resolutions on human factors/ergonomics (HFE) and had published HFE guides and toolkits. In 2021, the ILO and the International Ergonomics Association released an international guideline on HFE entitled Principles and Guidelines for Human Factors/Ergonomics (HFE) Design and Management of Work Systems (hereinafter referred to as the HEF Guidelines), aiming to improve the occupational safety, health, and the well-being of workers from the perspective of work system sustainability. There are currently 112 national health standards in China related to HFE, of which 79 (accounting for 71%) are equivalent to relevant standards from the International Organization for Standardization. Most of the recommended standards do not meet the applicability requirements of HFE for the Chinese workforce, as they are different from the national occupational health standard system. At present, China's HFE capability cannot meet the needs of the workforce, and there is still a gap between occupational diseases related to HFE included in the Occupational Disease List of China and those compared to the ILO. In the future, China needs to pay attention to the application of the HEF Guidelines, further improve the technical services for occupational health, include diseases caused by poor ergonomics in the national occupational disease list, strengthen the HFE standard system in the national occupational health standard system, actively promote the application of action-oriented HFE tools, enhance “human-machine coordination” and “person-job matching”, and focus on physical and cognitive HFE design to promote equality in workplace and reduce the occurrence of occupational and work-related diseases.

Physical fitness evaluation results among students in Yunnan Province in 2019 / 中国学校卫生

Objective@#To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures.@*Methods@#The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t test, ANOVA, and χ 2 test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages.@*Results@#The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69）, with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09 %, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50 meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit ups ( 65.71 points) , 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage( F =293.53，452.85， χ 2/ χ 2 trend =466.65， 412.57 ； 1 553.22 ，1 045.36， P <0.01).@*Conclusion@#The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Study on quality standard of Gardenia jasminoides and its effective parts / 药学实践杂志

Objective To study the quality standard of Gardenia jasminoides and its effective parts. Methods TLC was used to identify Gardenia jasminoides and its effective parts. The heavy metals, harmful elements, and moisture in Gardenia jasminoides and its effective parts were examined. The content of Gardenia jasminoides and its effective parts was determined by high performance liquid chromatography. Results TLC method could be used to identify Gardenia jasminoides and its effective parts. The moisture content of Gardenia jasminoides and its effective parts were 8.4% and 3.2%, respectively. ICP-MS was used to determine the contents of five elements in Gardenia jasminoides and its effective parts simultaneously. There was a good linear relationship between arsenic, cadmium, copper, mercury, and lead in the range of 0~20, 0~10, 0~500, 0~5 and 0~20 ng/ml, respectively; The method detection limit of each metal element was 3.3×10−5~1.3×10−3 mg/kg. The relative standard deviation (RSD) of precision was 0.32%~0.82%. RSD values of each element content showed that the method had good repeatability. And the recoveries of arsenic, cadmium, copper, mercury, and lead were 103%~112%, 98%~99%, 98%~99%, 105%~106% and 100%~103%, respectively (n=3). The stability of each element was good within 8 h. The contents of the five elements were within the limits of the current edition of Chinese Pharmacopoeia. The standard curve equation of gardenia was Y=15860X+22543, r=0.9999, indicating that there was a good linear relationship of gardenia in the range of 20.16~322.6 μg/ml. The RSD of precision was 1.86%. RSD of the two samples were 2.38% and 2.60%, respectively, indicated that the method had good repeatability. The average recovery of Gardenia was 99.1% (n=6). The stability of the two solutions was good within 8 h. The contents of gardenia and its effective parts were 5.71% and 34.2%, respectively. Conclusion The research on the quality of Gardenia jasminoides effective parts was carried out based on the research on the quality of Gardenia jasminoides, and the results met the requirements. Therefore, the method established in this experiment could control the quality of Gardenia jasminoides and its effective parts simultaneously.

Characterization and Comparison Analysis of WHO Monographs on Selected Medicinal Plants and ISO Standards of Chinese Materia Medica / 中国结合医学杂志

Medicinal plants or Chinese materia medica (CMM) are now attracting worldwide attention as they have increasingly prominent advantages over chemical drugs in disease treatment and healthcare. Since the 1990s, World Health Organization (WHO) and International Organization for Standardization established the Technical Committee of Traditional Chinese Medicine (ISO/TC 249) have carried out the development of quality standards on medicinal plants or CMMs respectively, and a considerable number of monographs and international standards have been published. Since the two international organizations adhere to different principles, the standards they develop naturally have different emphasis. Driven by market demand and international trade, ISO mainly takes quality, efficacy and safety into consideration when developing standards, while WHO pays more attention to clinical practice, quality control and medication guidance. Up to now, there is a lack of comparative analysis on the records, background, principles, basic content, and main requirements of quality standards on medicinal plants or CMMs respectively published by WHO and ISO. Therefore, based on international standards of CMM developed by ISO/TC 249 platform and WHO Monographs on Selected Medicinal Plants, this paper systematically compares the purposes, selected principles, standard-developing process, basic content, and main quality requirements to summarize their similarities and differences, and find their merits, aiming to serve as a reference to the development of international standards for CMMs that helps them go global.

Progress of research on evaluation indicators and standards about high-speed train comfort / 中华劳动卫生职业病杂志

The rapid development of high-speed railway in China has proposed higher requests for the comfort level of high-speed trains. However, there is no internationally unified evaluation criterion for high-speed train comfort currently, which therefore substantially affects the comparability and standardization of research results for high-speed train comfort. This paper systematically reviews the research literature about evaluation indicators and standards related to high-speed train comfort, and finds that there is currently no unified definition, evaluation indicators, as well as evaluation criterion for high-speed train comfort. Most current evaluation criteria are based on a single indicator. Some indicators are simultaneously developed by different apartments and differ between each other, and there is no comprehensive indicator or criteria for high-speed train comfort, restricting the comparison of high-speed train comfort across regions. It is recommended that the administrative department of high-speed railroad in China should organize experts to establish a unified definition of high-speed train comfort, comprehensive evaluation indicators and relevant judgment criteria for high-speed train comfort, in face of the rapid development and globalization of high-speed trains.

Investigation and clarification of traditional measuring units of Tibetan medicine / 中国中药杂志

Quantity is the key factor to ensure the safety and effectiveness of medicines. It is very important to study and determine the traditional measuring units and their quantity values of Tibetan medicine. Based on the literature records of Tibetan medicine and combined with modern experimental verification and investigation research, this study determined the reference, name, and conversion rate of traditional measuring units of Tibetan medicine. Meanwhile, through large sample sampling and repeated quantification of refe-rence of basic units, its weight and volume were clarified. The modern SI volume and weight unit values corresponding to the traditional volume and weight units of Tibetan medicine were deduced, and the correctness, reliability, and practicability of these determination results were demonstrated. This study also put forward some specific suggestions and reference values for formulating the standards of measuring units of weight and volume of Tibetan medicine. It is of great significance in guiding the processing, production, and clinical treatment of Tibetan medicine, and promoting the standardization and standardized development of Tibetan medicine.

Estructuración y aplicación de la norma UNE 66177 para la integración de las normas ISO 9001 e ISO 45001 en estaciones de servicio de gasolina en Boyacá (Colombia) / Structuring and Application of the UNE 66177 standard for Integration of ISO 9001 and ISO 45001 in Boyacá - Colombia Gasoline Service Stations / Estruturação e aplicação da norma UNE 66177 para a integração das normas ISSO 9001 e ISSO 45001 em postos de gasolina em Boyacá (Colômbia)

Introducción: Las estaciones de servicio de gasolina actualmente tienen dificultad en certificar sus procesos de funcionamiento ante los entes correspondientes; por tal motivo, surgió el interés de cumplir con estándares inter-nacionales mediante la aplicación integral de dos normas técnicas colombianas, como lo son la ISO 9001:2015 y la ISO 45001:2018. Objetivo: Diseñar y aplicar un modelo integrado de gestión de la calidad y seguridad y salud en el trabajo bajo los requisitos de las normas técnicas colombianas ISO 9001 e ISO 45001 para las estaciones de servicio de gasolina de Boyacá, con aplicación en una empresa piloto. Metodología: Se desarrolló en tres fases. Inicialmente, se diagnosticaron las condiciones actuales de las estaciones de servicio de gasolina; posteriormente, se diseñó un modelo de integración bajo las normas objeto de estudio, y, por último, se aplicó dicho modelo a la empresa piloto. Resultados: Se obtuvo el diseño de un sistema de gestión integral basado en calidad, seguridad y salud en el trabajo mediante la aplicación de dos normas técnicas como lo son la ISO 9001:2015 e ISO 45001:2018, respec-tivamente. Conclusiones: Este sistema integrado de gestión es el primer paso para que las estaciones de servicio de gasolina puedan ofrecer calidad en la venta de combustible, alineado con las exigencias normativas expuestas en la Resolu-ción 0312 de 2019, y para cumplir los requisitos técnicos de la Resolución 40405 de 2020

Introduction: Gasoline service stations currently have difficulty certifying their operating processes by corresponding entities, for this reason there is an interest in complying these standards through the comprehensive application of two technical standards such as ISO 9001: 2015 and ISO 45001:2018. Objective: Design and apply an integrated model of quality management and occupational health and safety, under requirements of the Colombian technical standard ISO 9001 and ISO 45001 for ga-soline service stations in Boyacá, with a pilot company.Methodology: It was developed in three phases, initially it was discovered in the current conditions of gasoline service stations, later an integration model was started under the standards and finally the model was applied to the pilot Company. Results: The design of a comprehensive management system based on quality, safety and health at work was obtained through the application of two technical standards such as ISO 9001:2015 and ISO 45001:2018 respectively. Conclusions: An integrated management system based on ISO 9001:2015 and ISO 45001:2018 stan-dards was designed, which is the first step to gasoline service stations can offer quality in the sale of fuel aligned with the regulatory requirements in resolution 0312 of 2019 and to meet the technical requirements of resolution 40405 of 2020

Introdução: Atualmente, os postos de gasolina têm dificuldade para certificar seus processos ope-racionais perante as entidades correspondentes; por esse motivo, surgiu o interesse em cumprir as normas internacionais por meio da aplicação integral de duas normas técnicas colombianas, como a ISSO 9001:2015 e a ISSO 45001:2018. Objetivo: projetar e implementar um modelo integrado de gestão de qualidade e saúde e segurança ocupacional de acordo com os requisitos das normas técnicas colombianas ISO 9001 e ISO 45001 para postos de gasolina em Boyacá, com aplicação em uma empresa piloto. Metodologia: foi desenvolvida em três fases. Inicialmente, foram diagnosticadas as condições atuais dos postos de gasolina; em seguida, foi projetado um modelo de integração de acordo com os padrões em estudo e, por fim, o modelo foi aplicado à empresa piloto. Resultados: o projeto de um sistema de gestão integrado baseado em qualidade, segurança e saúde no trabalho foi obtido por meio da aplicação de duas normas técnicas, como a ISO 9001:2015 e a ISO 45001:2018, respectivamente. Conclusões: Esse sistema de gerenciamento integrado é o primeiro passo para que os postos de combustíveis ofereçam qualidade na venda de combustíveis, alinhados com os requisitos regulatórios estabelecidos na Resolução 0312 de 2019, e atendam aos requisitos técnicos da Resolução 40405 de 2020

Prosthetic maintenance assessment for implant fixed complete dentures and implant overdentures: a randomized clinical trial / Avaliação da manutenção protética para próteses totais fixas suportadas por implantes e Overdentures: um ensaio clínico randomizado

Objective: The rehabilitation choice for the edentulous patients usually lies between the fixed and removable prosthetic options. The treatment decisions are affected by many factors where complications and maintenance needs are both considered crucial factors, in addition to the cost effectiveness of the chosen treatment. Material and Methods: This study was applied on 44 edentulous patients, where 22 patient for each group were enrolled in the outpatient clinic of prosthodontics, Cairo University as per a set of eligibility criteria. Four inter-foraminal implants were installed for all eligible participants. Three months later, healing abutments were used for soft tissue preparation prior to the fabrication of the final prosthesis. A prosthetic treatment option was then randomly allocated to obtain two equal groups via computer generated randomization program; Group. A received telescopic implant overdentures, and Group. B received screw retained dentures. All Complications (Screw loosening or fracture, tooth or denture base fracture and mucositis) were reported after overdenture insertion along the follow up period (1, 6, 9 and 12 months respectively). Results: The frequency of the screw loosening for hybrid overdentures where (59.1%) compared to (27.3%) of telescopic prosthesis at 12 months follow up period (p=0.035), mucositis reporting at 6m interval had shown the highest frequency in both groups (Group A (54.5%), Group B (81.8%), (p=0.045), all other reported complications that lack statistical significance either within the same group or between both groups at different time intervals. Conclusion: Both treatment modalities; telescopic implant overdenture and hybrid fixed screw-retained are reliable for restoring the completely edentulous arches, the decision whether to make a fixed or removable implant denture shall be guided with the patient preference together with the dentist assessment in relation (AU)

Objetivo: A escolha da reabilitação para pacientes edêntulos geralmente recai entre próteses fixas e removíveis. As decisões de tratamento são afetadas por muitos fatores onde as complicações e as necessidades de manutenção são consideradas critérios cruciais, além do custo-efetividade do tratamento escolhido. Material e Métodos: Este estudo foi aplicado em 44 pacientes edêntulos, onde 22 pacientes para cada grupo foram matriculados no ambulatório de prótese dentária da Universidade do Cairo de acordo com um conjunto de critérios de elegibilidade. Quatro implantes interforaminais foram instalados para todos os participantes elegíveis. Três meses depois, pilares de cicatrização foram utilizados para preparação dos tecidos moles antes da fabricação da prótese final. Uma opção de tratamento protético foi então alocada aleatoriamente para obter dois grupos iguais por meio de andomização gerada através programa de computador. O Grupo A recebeu overdentures de implantes telescópicos e o Grupo B recebeu dentaduras fixas parafusadas sobre os implantes. Todas as complicações (afrouxamento ou fratura do parafuso, fratura da base do dente ou da prótese e mucosite) foram relatadas após a inserção da overdentures ao longo do período de acompanhamento (1, 6, 9 e 12 meses, respectivamente). Resultados: A frequência do afrouxamento do parafuso para Overdentures híbridas (59,1%) em comparação com (27,3%) da prótese telescópica no período de acompanhamento de 12 meses (p=0,035), o relato de mucosite no intervalo de 6 meses mostrou a maior frequência em ambos os grupos (Grupo A (54,5%), Grupo B (81,8%), p=0,045, todas as outras complicações relatadas foram sem significância estatística dentro do mesmo grupo ou entre os dois grupos em intervalos de tempo diferentes. Conclusão: Ambas as modalidades de tratamento; overdentures sobre implantes telescópicos e próteses híbridas fixas parafusadas são confiáveis para reabilitar as arcadas completamente edêntulas. A decisão de fazer uma prótese fixa ou removível sobre implantes deve ser guiada pela preferência do paciente juntamente com a avaliação do dentista em relação ao estado geral do paciente e sua saúde bucal. (AU)

Actualización en fibrosis quística estándares de atención para pacientes con diagnóstico de fibrosis quística con terapia moduladora: informe de la Sociedad Europea de Fibrosis Quística 2023 / Standards of care for patients with a diagnosis of cystic fibrosis who are on modulator therapy: report of the European Fibrosis Cystic Society 2023

La fibrosis quística ha entrado en la era de la terapia específica con los moduladores, útiles en variantes genéticas definidas por estudio molecular, con resultados clínicos exitosos. Este es un resumen de la publicación reciente de la Sociedad Respiratoria Europea que establece los estándares de cuidado para los pacientes que reciben este tratamiento.

Cystic fibrosis has entered the era of specific therapy called modulators, useful in genetic variants defined by molecular study, with successful clinical results. This is a summary of the recent publication of the European Respiratory Society that establishes the standards of care for patients receiving this treatment.

Estrategia intersectorial para el perfeccionamiento del programa de médico y enfermera de la familia

Introducción: La Medicina Familiar cubana se enfrenta hoy a nuevos retos para su perfeccionamiento, esto implica realizar un fortalecimiento del primer nivel de atención para garantizar mejoría en la calidad de los servicios para lo cual la intersectorialidad se ha consolidado como pilar fundamental. Objetivo: Diseñar y evaluar una estrategia de intervención intersectorial para perfeccionar el programa del médico y la enfermera de la familia. Métodos: Se realizó un estudio cuasi experimental de intervención a través de una estrategia intersectorial para perfeccionar el programa del médico y enfermera de la familia, en el período de diciembre de 2019 a diciembre de 2022 en la provincia Las Tunas. El universo estuvo conformado por 867 trabajadores del cual se seleccionó una muestra de 330. Se realizó en cuatro etapas: diagnóstica, de intervención, validación y de evaluación. Se empleó como medida de resumen para variables cualitativas el porcentaje, para la validación estadística de los cambios antes y después la prueba de Mc Nemar y para la validación teórica de la estrategia intersectorial se utilizó la matriz de Chanlat. Resultados: La aplicación de la estrategia mejoró el nivel de conocimientos en los equipos básicos de salud y en los actores sociales, se revitalizaron el 93,5 % de las acciones comunitarias e intersectoriales, se modificó el cuadro de salud en el 89,4 % y se elevó en un 94,1 % el nivel de satisfacción de la comunidad con los servicios prestados por el consultorio médico de la familia. Se demostró que es pertinente la aplicación de la estrategia en la práctica social mediante los resultados de la efectividad esperada. Conclusiones: La estrategia permitió perfeccionar el programa del médico y enfermera de la familia a través de la puesta en práctica de un programa intersectorial de forma integral, consciente, participativo y sistemático.

Introduction: Cuban Family Medicine faces today new challenges for its improvement; this implies strengthening the first level of care to guarantee improvement in the quality of services for which intersectorality has been consolidated as a fundamental pillar. Objective: To design and to evaluate an intersectoral intervention strategy to improve the program of the family doctor and nurse. Methods: A quasi-experimental intervention study was carried out through an intersectoral strategy to improve the family doctor and nurse program, from December 2019 to December 2022 in Las Tunas. The universe consisted of 867 workers from which a sample of 330 was selected. It was carried out in four stages: diagnostic, intervention, validation and evaluation. The percentage was used as a summary measure for qualitative variables, for the statistical validation of the changes before and after the Mc Nemar test and for the theoretical validation of the intersectoral strategy the Chanlat matrix was used. Results: With the application of the strategy, the level of knowledge in the basic health teams and in the social actors was improved, 93.5 % of the community and intersectoral actions were revitalized, modified the health picture in 89.4 % and the level of satisfaction of the community with the services provided by the CMF increased by 94.1 %. It was demonstrated that the application of the strategy in social practice through the results of the expected effectiveness of the strategy. Conclusions: The strategy made it possible to improve the family doctor and nurse program through the implementation of an intersectoral program in a comprehensive, conscious, participatory and systematic way.

Standards for psychosocial care in pediatric cancer: adapted proposal for Latin American and Caribbean countries / Normas para la atención psicosocial en el cáncer pediátrico: una propuesta adaptada para los países de América Latina y el Caribe / Padrões de atendimento psicossocial em câncer pediátrico: proposta adaptada para países da América Latina e do Caribe

ABSTRACT Objective. To highlight the objectives, achievements, challenges, and next steps for the World Health Organization's Global Initiative for Childhood Cancer (GICC) framework, a project designed to improve psychosocial care (PSC) in pediatric cancer centers across Latin America and the Caribbean (LAC). Methods. The project was launched in Peru, the first GICC focal country, in November 2020. The diagnosis phase included a survey and a semistructured interview with health professionals to assess PSC practices in institutions, and a needs assessment survey for caregivers. In the second phase, a strategic plan was developed to address the identified needs, including the adaptation of PSC standards, the establishment of multicenter working groups, the expansion of the proposal, and the development of materials. Results. The study found that PSC was not being adequately provided in accordance with international standards. Six adapted standards were proposed and validated, and more than 50 regional health professionals participated in online activities to support the project. The implementation process is currently ongoing, with the establishment of five multidisciplinary working groups, one regional committee, and the production of 16 technical outputs. Conclusion. This project represents a substantial step forward to improve PSC for pediatric patients with cancer and their families in LAC countries. The establishment of working groups and evidence-based interventions strengthen the proposal and its implementation. Development of health policies that include PSC according to standards is needed to achieve sustainable results in the quality of life of children with cancer and their families.

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RESUMO Objetivo. Destacar os objetivos, as conquistas, os desafios e as próximas etapas da Iniciativa Global para o Câncer Infantil (GICC), um projeto criado pela Organização Mundial da Saúde para melhorar a atenção psicossocial em centros de câncer pediátrico na América Latina e no Caribe. Métodos. O projeto foi lançado no Peru, o primeiro país focal da GICC, em novembro de 2020. A fase de diagnóstico incluiu uma pesquisa e uma entrevista semiestruturada com profissionais de saúde para avaliar as práticas de atenção psicossocial nas instituições, bem como uma pesquisa para avaliar as necessidades dos cuidadores. Na segunda fase, foi desenvolvido um plano estratégico para atender às necessidades identificadas, incluindo uma adaptação de padrões de atenção psicossocial, o estabelecimento de grupos de trabalho multicêntricos, a expansão da proposta e o desenvolvimento de materiais. Resultados. O estudo constatou que, de acordo com padrões internacionais, a atenção psicossocial não estava sendo adequadamente oferecida. Seis padrões adaptados foram propostos e validados, e mais de 50 profissionais de saúde da região participaram de atividades on-line para apoiar o projeto. O processo de implementação está em andamento, com a formação de cinco grupos de trabalho multidisciplinares e um comitê regional e a produção de 16 relatórios técnicos. Conclusão. Este projeto representa um avanço substancial para melhorar a atenção psicossocial para pacientes pediátricos com câncer e suas famílias nos países da América Latina e do Caribe. A criação de grupos de trabalho e intervenções baseadas em evidências fortalecem a proposta e sua implementação. É preciso desenvolver políticas de saúde que incluam atenção psicossocial segundo padrões estabelecidos para alcançar resultados sustentáveis na qualidade de vida das crianças com câncer e de suas famílias.

Discussion on Current National Standards for Traditional Chinese Medicine Dispensing Granules / 中国实验方剂学杂志

Strengthening the standard formulation and quality management of traditional Chinese medicine（TCM） dispensing granules is an important part of the strategic planning for the development of TCM in China. In order to examine the clinical application and overall quality control of the existing national standards for TCM dispensing granules， this study classified and summarized the varieties in the existing standards， analyzed their clinical applicability， and discussed the characteristics of the test methods for identification， content determination and specific chromatogram/fingerprint. It was found that the coverage of the existing standards was inadequate in terms of quantity， and it was even weaker in the aspects of therapeutic efficacy， herb family， processing method and preparation method of TCM dispensing granules. It was concluded that the characteristics of national standards in test methods were summarized as follows：guided by clinical application， based on the reference system， taking specific chromatogram as a breakthrough， so as to improve the overall quality control of TCM dispensing granules. It is suggested that the coverage of national standards should be subsequently expanded to meet the needs of market development. In order to enhance clinical applicability， the content of national quality standards should be increased， including increasing variety diversity to meet the needs of clinical application， raising the standard requirements to improve the clinical medication experience， and strengthening effectiveness research to highlight clinical efficacy. At the same time， the accessibility of regulatory inspection is enhanced， the rules for the management of varieties without national standards are promulgated to lay the foundation for the healthy and orderly development of TCM dispening granule industry.