Meta-analysis of the efficacy of invisible orthodontic appliances for maxillary molar distalization in adult patients / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of invisible orthodontic appliances without brackets for the distal movement of maxillary molars to improve the ability of orthodontists to predict treatment outcomes.@*Methods@#Web of Science, Cochrane Library, Embase, PubMed, Wanfang Database, CNKI Database, and VIP Database were searched for studies investigating the efficacy of invisible orthodontic appliances for distal movement of maxillary molars in adult patients and published from database inception to August 1, 2023. A total of three researchers screened the studies and evaluated their quality and conducted a meta-analysis of those that met quality standards.@*Results@#This study included 13 pre- and postcontrol trials with a total sample size of 281 patients. The meta-analysis revealed no significant differences in the sagittal or vertical parameters of the jawbone after treatment when compared with those before treatment (P>0.05). The displacement of the first molar was MD=-2.34, 95% CI (-2.83, -1.85); the displacement was MD=-0.95, 95% CI (-1.34, -0.56); and the inclination was MD=-2.51, 95% CI (-3.56, -1.46). There was a statistically significant difference in the change in sagittal, vertical, and axial tilt of the first molar before and after treatment. After treatment, the average adduction distance of the incisors was MD=-0.82, 95% CI (-1.54, -0.09), and the decrease in lip inclination was MD=-1.61, 95% CI (-2.86, -0.36); these values were significantly different from those before treatment (P<0.05).@*Conclusion@#Invisible orthodontic appliances can effectively move the upper molars in a distal direction and control the vertical position of the molars. When the molars move further away, there is some degree of compression and distal tilt movement, which is beneficial for patients with high angles. The sagittal movement of incisors is beneficial for improving the patient's profile.

Apego Adulto y Soltería: Validación de una Escala / Adult Attachment and Singleness: Validation of a Scale

Resumen El apego es un vínculo afectivo que caracteriza y moldea las relaciones interpersonales cercanas. Los estilos de apego son el conjunto de conocimientos, expectativas e inseguridades que se sostienen sobre el sí mismo y los demás. El objetivo de la presente investigación fue elaborar una escala que evalúe el apego adulto no solo en el contexto romántico, sino con otros significativos, lo que permitirá el estudio de las personas sin pareja. Se realizaron tres estudios: en el estudio uno se realizó un análisis factorial exploratorio (n=400); en el estudio dos un análisis factorial confirmatorio (n=700). Se obtuvo una escala compuesta por 16 reactivos distribuidos en cuatro factores: preocupado, temeroso, evitante y seguro. La varianza explicada fue del 38.09%, con un índice de fiabilidad con un rango de 0.46 a 0.82 en los distintos factores. En el estudio tres se analizó la validez concurrente (n=201). En los tres estudios se encontraron diferencias entre las personas con pareja y sin pareja, puntuando más alto en seguridad las primeras y más alto en apego ansioso aquellas sin pareja. Se obtuvo una escala válida, confiable, culturalmente relevante que evalúa el apego adulto no solo en el ámbito romántico, sino con otros significativos.

Abstract The attachment is an affective bond that characterizes and shapes close interpersonal relationships. Attachment styles are the set of knowledge, expectations and insecurities about oneself and others. The aim of this research was to develop a scale with adequate psychometric properties, that allows to assess adult attachment not only in a romantic context, but with significant others in general. It will allow the study of groups such as single people. To address that aim, three studies were conducted in which men and women form Mexico City participated voluntarily. In study one an exploratory factor analysis was performed (n=400), in study two a confirmatory factor analysis was performed (n=700). As a result of these studies, it was obtained a scale compounded by 16 items distributed in four factors: preoccupied, fearful, dismissing, and secure. The explained variance was 38.09%, with a reliability index of 0.46 to 0.82 in the different factors. In study three concurrent validity was analyzed (n=201). Differences between people with a partner and single were found in the three studies, scoring higher in security the first and single people scoring higher in preoccupied attachment. It was obtained a valid, reliable, and culturally relevant scale to assess adult attachment not only in the romantic ambit, but also in relation to significant others like family and friends.

ACADEMIC PROCRASTINATION AMONG UNIVERSITY STUDENTS: A SIGNIFICANT ISSUE FOR CONSIDERATION

In our daily lives, we have to perform multiple tasks in different areas. This leads people to two paths: carrying out the task as soon as possible or postponing it; the latter being part of the tendency to delay the start or completion of a task. This act also known as procrastination. procrastination is the characteristic or behavioural propensity to put off or delay completing a task or making decisions. Procrastination behavior is very common and a serious problem in the era we live in. Academic procrastination appears to be common in academic environments as students frequently put off their obligations without good reason and submit their work right up until the deadline. All levels of kids are impacted, and it may lead to major problems including declining grades and decreased wellbeing. The notion of academic procrastination, reasons why it occurs, negative effects of academic procrastination and several methods for dealing with it are all discussed in this article. It is suggested that some programs should be devised and executed to teach task-oriented coping strategies to students. For this one should reflect on the reasons why you procrastinate, your habits and thoughts that lead to procrastinating

Correlation between different retinal layers with visual acuity in diabetic retinopathy patients with clinically significant macular edema

Purpose: To study the corelation between outer retinal layer thickness (ORL), outer photoreceptor segment thickness (PROS), and central macular thickness (CMT) with best?corrected visual acuity (BCVA) in patients having clinically significant macular edema (CSME) and compare these parameters with normal patients. Methods: This was a prospective, nonrandomized, observational, comparative study done during the period of January to May 2019. The study included 60 eyes of 36 patients. The patient population was segregated into two Groups: Group ? (30 normal eyes of 15 normal patients) and Group ?? (30 eyes of 21 diabetic patients) with CSME. The comparison between ORL, PROS, and CMT was made between both the groups, and the correlation between ORL thickness, PROS thickness, and CMT with BCVA in Group ?? was studied. Results: The mean age in Group I was 52.6+10.66 years, and 53.42+8.15 years in Group II. The male/ female ratio was 1.1:1 in Group I and 4:3 in Group II. The mean CMT was greater in Group ?? (330.13 ± 37.01) than in Group ? (222.20 ± 12.30). The mean ORL thickness was greater in Group ? (97.73 ± 6.92) than in Group ?? (80.63 ± 9.03). The PROS thickness was statistically significant in Group ? (35.05 ± 3.4) than in Group ?? (28.57 ± 3.53). There was a strong correlation between BCVA and ORL thickness (r = ?0.580, P < 0.001) and more strong correlation between BCVA and PROS thickness in Group ?? (r = ?0.611, P < 0.000). There was a moderate correlation between BCVA and CMT (r = 0.410, P < 0.025), and all results were statistically significant. Conclusion: Both ORL and PROS thickness were greater in healthy normal eyes than in eyes with CSME. BCVA was strongly correlated with PROS and ORL thickness and moderately associated with CMT.

Establishment of a machine learning model for the diagnosis of clinically significant prostate cancer based on transrectal contrast-enhanced ultrasound parameters and clinical data / 中华超声影像学杂志

Objective:To establish a machine learning model for the diagnosis of clinically significant prostate cancer based on transrectal contrast-enhanced ultrasound parameters and clinically relevant data.Methods:A retrospective analysis was performed on 151 patients in Chongqing University Cancer Hospital who underwent transrectal contrast-enhanced ultrasonography and transrectal ultrasound-guided needle biopsy from November 2018 to September 2021. The time intensity curve was drawn using VueBox software and 12 parameters such as rise time, peak time, average transit time, peak intensity, and rising slope were quantitatively analyzed. Age, total prostate-specific antigen, free prostate-specific antigen, free prostate-specific antigen ratio, volume, prostate-specific antigen density, and transrectal contrast-enhanced ultrasonography parameters, a total of 18 characteristic parameters, were analyzed and screened through relevant attribute values and information gain attribute values. The screening features were trained and tested by the machine learning single algorithm and integrated algorithm, and then the model was evaluated by the F1 value and the area under the ROC curve(AUC).Results:Using the related attribute value and the information gain attribute value, 12 variables and 5 variables were screened out respectively to establish a machine learning model. The model established by the ensemble algorithm was better than the single algorithm. For the two variable selection methods, the AUC (0.810 vs 0.789) and F1 values (0.748 vs 0.742) of the Bagging ensemble algorithm model, which basic algorithm was decision tree, were the highest, followed by Logistic regression and support vector machine(SVM) in order of AUC and F1 values.Conclusions:Based on transrectal contrast-enhanced ultrasound parameters and clinical data, the Bagging ensemble model based on decision tree has the best performance in diagnosing clinically significant prostate cancer.

Risk factors and predictive effectiveness of PI-RADS after targeted combined system puncture for CsPCa patients with 3 points / 现代泌尿外科杂志

【Objective】 To investigate the risk factors and predictive effectiveness of prostate imaging reporting and data system (PI-RADS) score for patients with clinically significant prostate cancer (CsPCa) whose PI-RADS score was 3, so as to provide evidence for the diagnosis and treatment. 【Methods】 The clinical and multi-parameter magnetic resonance imaging (mpMRI) data of 153 CsPCa patients treated during Jan.2017 and Dec.2021 whose PI-RADS score was 3 were retrospectively analyzed. With PI-RADS score of 3 as the independent risk factor for CsPCa, the other relevant independent risk factors in predicting CsPCa were evaluated. 【Results】 Univariate and multivariate analyses showed that prostate-specific antigen (PSA) density and apparent dispersion coefficient (ADC) were independent risk factors for the diagnosis of CsPCa (P<0.05). Analysis of receiver operating characteristic (ROC) curve showed that combined PSA density and ADC were more effective than PSA density and ADC alone (P<0.05). 【Conclusion】 The combination of PSA density and ADC can guide clinicians to identify high-risk CsPCa patients from patients with PI-RADS score of 3 points.

Changes of intestinal wall barrier function and its correlation with susceptibility to infection in patients with cirrhotic portal hypertension / 中华肝脏病杂志

Objective: To investigate the changes of intestinal wall barrier function and its correlation with infection occurrence in patients with cirrhotic portal hypertension. Methods: 263 patients with cirrhotic portal hypertension were split into: the clinically evident portal hypertension (CEPH) combined with infection group (n = 74); CEPH group (n = 104); and Non-CEPH group (n = 85). Among them, 20 CEPH patients and 12 non-CEPH patients in non-infection status were subjected to sigmoidoscopy. Immunohistochemical staining was used to detect the expression of trigger receptor-1 (TREM-1), CD68, CD14, the inducible nitric oxide synthase molecule, and Escherichia coli (E.coli) in the medullary cells of the colon mucosa. An enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1), soluble leukocyte differentiation antigen-14 subtype (sCD14-ST) and intestinal wall permeability index enteric fatty acid binding protein (I-FABP). Fisher's exact probability method, one-way ANOVA, Kruskal-Wallis-H test, Bonferroni method, and Spearman correlation analysis were used for statistical analysis. Results: The serum sTREM-1 and I-FABP levels were higher in CEPH patients than those of non-CEPH patients in the non-infectious state (P < 0.05), but the difference in blood sCD14-ST levels was not statistically significant (P > 0.05). Serum levels of sTREM-1, sCD14-ST, and I-FABP in infected patients were higher than those in patients without a concurrent infection (P < 0.05). Serum sCD14-ST levels were positively correlated with serum sTREM-1, C-reactive protein (CRP), and procalcitonin (PCT), and sTREM-1 levels were also positively correlated with CRP and PCT (r > 0.5, P < 0.001). The rates of CD68, inducible nitric oxide synthase, CD14-positive cells, and E.coli-positive glands were higher in the intestinal mucosa of the CEPH group than those of the control group (P < 0.05). Spearman's correlation analysis showed that the rate of E.coli-positive glands in CEPH patients was positively correlated with the expression of molecular markers CD68 and CD14 in the lamina propria macrophages. Conclusion: Patients with cirrhotic portal hypertension have increased intestinal permeability and inflammatory cells, accompanied by bacterial translocation. Serum sCD14-ST and sTREM-1 can be used as indicators to predict and evaluate the occurrence of infection in patients with cirrhotic portal hypertension.

O Um e a função do sexo segundo a psicanálise / El Uno y la función del sexo según el psicoanálisis / The One and the function of sex according to psychoanalysis

RESUMO Segundo a ambiguidade constitutiva do Um que Lacan promove a partir da lógica e da matemática nos seminários O saber do psicanalista e ... ou pior, entre 1971 e 1972, o artigo busca fundamentar a teoria da sexuação desenvolvida nesse período e esclarecer que tal conceituação retoma a subversão freudiana do polimorfismo pulsional. Se a pulsão não tem qualquer determinação instintual quanto a seu objeto, constata-se que esse mesmo equívoco se deslinda como impossibilidade de proporção e relação sexual [rapport sexuel] para o ser falante, que se posiciona gramaticalmente na estrutura da linguagem a partir desse impasse. Nesse sentido, a bifididade do Um, entre conjunto e elemento, mesmidade e diferença, particularidade e universalidade, ex-sistência e relatividade, real e simbólico, reescreve a diferença (sexual) conforme a psicanálise. O sexo, portanto, é a própria ausência de qualquer referência que não seja a opacidade de princípio do significante, é a evasão fundamental do ser à verdade.

RESUMEN Basado en la ambigüedad constitutiva del Uno que Lacan promueve desde la lógica y de la matemática en los seminarios O saber do psicanalista e ...ou pior, entre 1971 y 1972, el artículo busca apoyar la teoría de la sexuación desarrollada en ese período y aclarar que tal conceptualización reanuda la subversión freudiana del polimorfismo de la pulsión. Si la pulsión no tiene ninguna determinación instintiva en cuanto a su objeto, parece que este mismo malentendido se revela como la imposibilidad de la proporción y la relación sexual [rapport sexuel] para el ser hablante, que se posiciona gramaticalmente en la estructura del lenguaje desde esta cuestión. Así, la bifidez del Uno, entre conjunto y elemento, igualdad y diferencia, particularidad y universalidad, ex-sistencia y relatividad, real y simbólico, reescribe la diferencia (sexual) según el psicoanálisis. El sexo, por lo tanto, es la ausencia misma de cualquier referencia que no sea la opacidad de principio del significante, es la evasión fundamental del ser de la verdad.

ABSTRACT Based on the constitutive ambiguity of the One that Lacan promotes from logic and mathematics in the seminaries O saber do psicanalista e ...ou pior, between 1971 and 1972, the article seeks to support the theory of sexuation developed in that period and clarify that such conceptualization resumes the Freudian subversion of the drive polymorphism. If the drive does not have any instinctual determination as to its object, it appears that this same misunderstanding is revealed as the impossibility of proportion and sexual relationship [rapport sexuel] for the speaking being, who grammatically positions themselves in the structure of language from this impasse. Thus, the bifidity of the One, between set and element, sameness and difference, particularity and universality, ex-sistence and relativity, real and symbolic, rewrites the (sexual) difference according to psychoanalysis. Sex, therefore, is the very absence of any reference other than the constitutive opacity of the signifier, it is the fundamental evasion of the being from the truth.

Ausencia de diferencias relacionadas con el sexo en los valores de los cambios mínimos significativos para composición corporal por DXA en sujetos adultos / Absence of sex-related differences in the values of minimum significant changes for body composition by DXA in adult subjects

Para la evaluación longitudinal de la composición corporal por DXA se deben calcular los cambios mínimos significativos (CMS). No está claro si hay diferencias de género para los CMS de adultos. Con consentimiento informado se realizaron 2 escaneos DXA de cuerpo completo consecutivos, con reposicionamiento entre ellos, en 40 varones y 40 mujeres (rango de edad de 22 a 85 años), con un equipo GE Lunar Prodigy Advance®, siguiendo las pautas de la International Society for Clinical Densitometry (ISCD). Todos los escaneos fueron obtenidos por la misma técnica experta. Los CMS se calcularon de acuerdo con el método propuesto por la ISCD. Los resultados se analizaron con GraphPad® para Windows 6.0, con una significancia fijada en p < 0,05. No hubo diferencias de género para la edad (p = 0,846) o el índice de masa corporal (p = 0,802). La altura, la masa corporal, la masa magra y el contenido mineral óseo (CMO) fueron mayores en los varones (todos p < 0,0001), mientras que la masa grasa fue mayor en las mujeres (p = 0,0036). No hubo diferencias significativas entre géneros para los coeficientes de variación de masa grasa (p = 0,0698), masa magra (p = 0,1483) o CMO (p = 0,5254). Los CMS (para IC de 95%) para la masa grasa fueron 1,780 kg (varones), 1,671 kg (mujeres) y 1,727 kg (ambos sexos); para masa magra, 1,658 kg (varones), 1,644 kg (mujeres) y 1,651 (ambos sexos); y para CMO, 112,2 g (varones), 109,4 (mujeres) y 110,8 g (ambos sexos). Los resultados sugieren que los CMS para la composición corporal de su-jetos adultos pueden calcularse a partir de una muestra de cualquier género o una que incluya sujetos de ambos sexos. (AU)

Lack of gender-related differences in least significant changes for DXA body composition analysis in adult subjectsFor longitudinal assessment of body composition by DXA, least significant changes (LSCs) should be calculated. It is unclear if there are gender differences for adult LSCs. With informed consent, 2 consecutive total-body DXA scans, with repositioning between them, were performed on 40 males and 40 females (age range 22 to 85 years) with a GE Lunar Prodigy Advance scanner, following the guidelines of the International Society for Clinical Densitometry (ISCD). All scans were obtained by the same skilled technologist. The LSCs were calculated according to the method proposed by the ISCD. Results were analyzed with GraphPad for Windows 6.0, with significance set at p < 0.05. There were no gender differences for age (p = 0.846) or body mass index (p = 0.802). Height, body mass, lean mass, and bone mineral content (BMC) were higher in males (all p < 0.0001), whereas fat mass was higher in females (p = 0.0036). There was no significant difference between genders for the coefficients of variation of fat mass (p = 0.0698), lean mass (p = 0.1483), or BMC (p = 0.5254). The LSCs (for a 95% CI) for fat mass were 1.780 kg (men), 1.671 kg (women), and 1.727 kg (both genders); for lean mass, 1.658 kg (men), 1.644 kg (women) and 1,651 (both genders); and for BMC, 112.2 g (men), 109.4 (women), and 110.8 g (both genders). These results suggest that LSCs for body composition of adult subjects can be calculated from either a sample of each gender or one that includes subjects of both genders. (AU)

Quality of life among geriatric population: A cross-sectional study to assess the quality of life among geriatric population covered under urban health training center of a tertiary care hospital in Kancheepuram, Tamilnadu

Introduction: To assess the quality of life among geriatric population covered under urban health training center of a tertiary care hospital in Kancheepuram and to find out if there are any associated factors affecting them. Methods: This cross-sectional study was conducted at Saveetha Medical College, Chennai, India. It comprised geriatric population of males and females aged above 60 and 58 respectively. A pre tested semi structured questionnaire was used for collecting socio demographic data, whereas a WHO standard questionnaire was used to assess the QOL. Analysis was done using SPSS software. Objectives: To assess the quality of life among the geriatric age group and to assess the factors affecting the quality of life among the geriatric population. Results: Out of the 228 geriatrics interviewed, females (68.66) were found to have a better QOL when compared to males (67.85). The p values obtained from the chi square tests were found to be significant for age (0.056), marital status (0.004), family type (0.002), co morbid factors (0.001), alcoholics (0.00). Conclusion: From the study we could infer that co morbidity, marital status, type of family have a significant association with QOL.

Perception and social attitude towards child adoption among doctors of a Medical College in Kancheepuram

Background: To assess the perception and social attitude among doctors towards child adoption and to find out if there are any associated factors affecting them. Methods: A cross sectional study was undertaken of sample of 258 volunteers .It comprised of doctors who volunteered for the research. A pre tested semi structured questionnaire was used for collecting socio demographic data and questions pertaining to attitude and perception toward child adoption. Analysis was done using SPSS software. Results: Out of the 258 volunteers interviewed, there was a positive association between age and perception and attitude toward child adoption (Chi square value -0.00). Sex and marital status were also analysed but no association was found (Chi square is 0.108 for sex and 0.916 for marital status). Conclusion: From the study we could infer that age has a significant association with perception and attitude toward child adoption among doctors

Secure Exchange of Medical Images Via Extended Visual Cryptography / Intercambio Seguro de Imágenes Médicas Mediante Criptografía Visual Extendida

ABSTRACT Medical image security is acquiring its importance to preserve the integrity and confidentiality of information (medical data) from malicious users given its importance in timely and successful diagnosis. In this context, several techniques have been developed to protect medical images, such as encryption, data hiding, image tagging, application of Hash algorithms, etc. This paper proposes a technique to cipher medical images by adding the metadata inside a cover image, based on extended visual cryptography as well as the inclusion of a Hash-like function to verify the integrity of the image and the metadata once they are recovered. The method proposed in this work is implemented using medical images with a grayscale resolution of [0,4095] that is a depth of 12 bits/pixel and color images with 24 bits/pixel depth. Experimental results prove the effectiveness of the proposed method in the task of secure exchange of medical images by allowing higher hiding capability, lower distortion in the visual quality of the image with the hidden medical data, as well as a means to verify the integrity of the sent data, compared to state-of-the-art.

RESUMEN La seguridad de imágenes médicas está incrementando su importancia para preservar la integridad y la confidencialidad de la información (datos médicos), frente a usuarios malintencionados dada su importancia en el diagnóstico oportuno y acertado. En este contexto, se han desarrollado varias técnicas para proteger las imágenes médicas, como el cifrado, la ocultación de datos, el etiquetado de imágenes, la aplicación de algoritmos Hash, etc. Este trabajo propone una técnica para cifrar imágenes médicas añadiendo los metadatos dentro de una imagen de cubierta, basada en la criptografía visual extendida, así como la inclusión de una función tipo Hash para comprobar la integridad de la imagen y los metadatos una vez estos sean recuperados. El método propuesto en este trabajo se implementa utilizando imágenes médicas con una resolución en escala de grises de [0,4095] es decir una profundidad de 12 bits/ píxel e imágenes en color con 24 bits/píxel de profundidad. Los resultados experimentales demuestran la eficacia del método propuesto en la tarea de transmisión segura de imágenes médicas permitiendo una mayor capacidad de ocultamiento, una menor distorsión en la calidad visual de la imagen con los datos médicos ocultos, así como un medio para comprobar la integridad de los datos enviados, en comparación con los artículos publicados.

Assessing Knowledge and Behaviour Towards HIV/AIDS among the school students: A cross sectional study

Background: Inadequate knowledge of advance, absence of exact health data, and the prohibitions associated with sex education at homes and schools, indulgence in risky behavior and a lack of access to adequate reproductive health services further lends the adolescents susceptible to AIDS. Aim & Objectives: In the present study, the knowledge and behavior towards HIV/AIDS among students in selected school have been assessed. Material & Methods: Primary data has been taken from selected school with the help of structured questionnaire tools; school is located at Bhaipur Brahman village in Jewar block of Gautam Budh Nagar district, India. Univariate and Bivariate tables as well as chi-square test have been applied to know the association between demographic variables of students and their response. Results: It was found that more than 65 % students were aware about HIV/AIDS. About 31% of students were reported that it cannot be transmit through sharing syringes where equal responses have been observed by male and female students. Conclusions: It was observed that they had inadequate knowledge towards HIV/AIDS especially among age group10-13 years. Most of them have good attitude towards HIV/AIDS infected person.

The application and research of using "creating significant learning experiences" in medical general education curriculum / 中华医学教育探索杂志

To improve the phenomenon of low participation and lack of innovation in education mode in general medical education elective courses, we have applied "creating significant learning experiences" to the design and implementation of medical general education curriculum, starting from six dimensions of learning including basic knowledge, application, synthesis, humanistic dimension, humanistic care, and learning to learn, setting learning goals, developing assessment tools and finally choosing teaching methods, thus forming a closed-loop teaching. And through the curriculum reform, collection of feedback and collation of data, the teaching activities designed according to this method fully meet and serve the teaching purposes, and assessment methods become more diverse and the content is more comprehensive, which reflects the multi-dimensional evaluation of the needs of general education.

Therapeutic effects of different dosage regimens of Conbercept on clinical significant diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the therapeutic effects of different dosage regimens of conbercept on clinical significant diabetic macular edema(CSME).<p>METHODS: Totally 65 patients with diabetes and CSME who were admitted to the Ophthalmology Department at Ganzhou People's Hospital between January 2019 and January 2020 were selected as the research subjects, and divided into observation group(<i>n</i>=33, conbercept 5+PRN regimen)and control group(<i>n</i>=32, conbercept 3+PRN regimen)using random number table method. Visual acuity test and optical coherence tomography(OCT)were carried out at 1, 2, 3, 6, 9, 12mo after treatment. Changes in the best corrected visual acuity(BCVA,LogMAR)and central macular thickness(CMT)were compared between the two groups. The mean injection times and complications in the two groups were recorded.<p>RESULTS: The BCVA was improved and CMT thinned in the two groups at 1, 2, 3, 6, 9, 12mo after treatment(<i>P</i><0.05). There was no statistically significant difference in BCVA and CMT between the two groups before treatment, and at 1, 2, 3, 6, 9, 12mo after treatment(<i>P</i>>0.05). The mean injection times in observation group was more than that in the control group \〖(5.81±0.54)times <i>vs </i>(4.19±0.41)times\〗(<i>P</i><0.05). In the early stage of postoperative follow-up, there were 30 times(23%)and 15 times(22%)of subconjunctival hemorrhage in observation group and control group, respectively(<i>P</i>>0.05). No other severe complications were observed in the two groups.<p>CONCLUSION:Both conbercept 3+PRN and conbercept 5+PRN are effective in the treatment of patients with diabetes and CSME. Both can significantly improve the patients' visual acuity and reduce CMT, with equivalent effect. The latter may increase the injection times but its adverse reactions are tolerable. In addition, it is safe and reliable.

Prevalence of Bacterial Urinary Tract Infection among patients With Type 2 Diabetes Mellitus on Sodium-Glucose Cotransporter-2 Inhibitors:A prospective real-world setting study / Journal of the ASEAN Federation of Endocrine Societies

Background@#Genitourinary tract infections, mycotic as well as bacterial, as defined by clinical symptoms, are one of the common adverse effects associated with the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2DM) patients in clinical trials. However, Indian data in terms of the prevalence of culture-proven bacterial type of urinary tract infection (UTI), and the causative organism is limited.@*Objective@#This study aimed to determine the prevalence and causative agents of bacterial UTI among patients with T2DM on SGLT2i.@*Methodology@#This was a prospective longitudinal study involving all patients with T2DM who were prescribed with SGLT2i, uncontrolled on other oral anti-diabetic medications, from June 2019 to February 2020. Prevalence of bacterial UTI was evaluated at baseline and 12 weeks after initiation of SGLT2i.@*Results@#A total of 80 patients were started on SGLT2i. One female patient on canagliflozin had significant asymptomatic bacteriuria and the causative agent was Acinetobacter baumannii. One male patient on dapagliflozin had symptomatic UTI with negative urine culture study. Four patients developed genital mycotic infection.@*Conclusion@#In this real-world study, SGLT2i as a class, was well tolerated with favorable safety profile, and risk of developing significant bacteriuria and/or symptomatic UTI was minimal.

Psicanálise e linguística: intersecções e cortes / Psychoanalysis and linguistics: intersections and cuts

Este trabalho faz parte do projeto de pesquisa "A pesquisa clínica em transferência". Neste artigo, revisitamos alguns conceitos linguísticos - linguagem, língua, discurso, signo linguístico, significante, entre outros - e suas articulações com o campo lacaniano no que diz respeito, principalmente, à lógica do significante. Serão analisadas referências da linguística em Saussure, Jakobson e Benveniste, além de textos de Lacan e leituras contemporâneas afins, com o objetivo de mostrar alguns pontos do caminho teórico percorrido por Lacan sob a influência da linguística, mas considerando também seu modo singular de apreender e utilizar esses conhecimentos. Apresentaremos, igualmente, alguns comentários sobre elementos discordantes entre essas duas disciplinas, o que, ao longo do seu ensino, levou Lacan a um afastamento conceitual da linguística. Tal distanciamento foi justificado pela ideia de que a psicanálise se ocupa do sujeito do inconsciente e do que fica fora da linguagem, diferentemente da linguística, que evidencia as funções de comunicação e expressão da linguagem no nível da consciência.(AU)

This work was created as part of the studies of a research entitled "The clinical research in transference". In this article, we reexamine some of linguistics concepts such as language, tongue, discourse, linguistic sign, significant, among others, and its articulations with de lacanian field in special the the significant logic. We will analyze linguistics references in Saussure, Jakobson and Benvenist's works, beyond Lacan'texts and contemporaneous readings about the issue aiming to show some matters from the lacanian trajectory since the linguistic influence, but also considering their unique way of apprehending and using such knowledge. We will also present some comments on discordant elements between these two disciplines, which, throughout his teaching, led Lacan to a conceptual separation from linguistics. Such distancing was justified by the idea that psychoanalysis deals with the subject of the unconscious and what lies outside of language, differently from the linguistic that demonstrates the communicative and expressive functions of the language in the conscious mind.(AU)

Este trabajo fue creado como parte de los estudios de una investigación titulada "La investigación clínica em la transferencia". En este artículo reexaminamos algunos conceptos lingüísticos como lenguaje, lengua, discurso, signo lingüístico, significante, entre otros, y sus articulaciones con el campo lacaniano en particular la lógica significante. Analizaremos los referentes lingüísticos em las obras de Saussure, Jakobson y Benveniste, más allá de los textos de Lacan y las lecturas contemporáneas sobre el tema, con el objetivo de mostrar algunas cuestiones de la trayectoria lacaniana desde la influencia linguística, pero también considerando su forma única de aprehender y utilizar dicho conocimiento. También presentaremos algunos comentarios sobre elementos discordantes entre estas dos disciplinas que, a lo largo de su enseñanza, llevaron a Lacan a una separación conceptual de la lingüística. Tal distanciamiento fue justificado por la idea de que el psicoanálisis trata el tema del inconsciente y lo que está fuera del lenguaje, a diferencia del lingüístico que demuestra las funciones comunicativas y expresivas del lenguaje em lamente consciente.(AU)

El reciclaje: Hecho significativo del valor ambiental desde el entorno educativo y su influencia en la salud / Recycling: a significant fact of environmental value from the educational environment and its influence on health

El reciclaje, la reutilización y la reducción en el consumo, es la demostración más concreta de una toma de conciencia en el ser y su papel protagonista en los procesos transformadores de nuestra realidad como especie. En este sentido, vemos que inculcar conocimientos en el área, desde las más jóvenes generaciones, hasta nuestros ancianos, puede lograr positivos cambios para la salud general, tanto del planeta, como del ser humano, siendo el propósito de la investigación conocer la importancia del reciclaje como un hecho significativo para exaltar el valor ambiental en los estudiantes. En cuanto al apartado epistemo­metodológico, se trabajó bajo el paradigma interpretativo, con un método fenomenológico­hermenéutico, usando la observación participante y la entrevista en profundidad, como técnicas de recolección de información, las cuales se aplicaron a un sujeto informante del aula de 4to año, siendo éste seleccionado por ser el más adecuado para el estudio. La técnica de análisis fue reducciones fenomenológicas a los extractos más importantes de la información, la cual fue proporcionada por el sujeto informante durante la entrevista, donde surgieron las categorías que se desglosaron en un cierre eidético que dio a conocer las ideas de la esencia verdadera del pensamiento del informante, así como también se hizo un giro hermenéutico, el cual logró proporcionar sentido a lo que se expresó en la investigación, como un aporte del investigador para dar visión a todo aquello en lo que se puede ir más allá del proceso investigativo(AU)

Recycling, reuse and reduction in consumption is the most concrete demonstration of an awareness of being and its leading role in the transforming processes of our reality as a species. In this sense, we see that instilling knowledge in the area, from the youngest generations, to our elders, can achieve positive changes for the general health, both of the planet and of the human being, the purpose of the research being to know the importance of recycling as a significant fact to exalt the environmental value in students. As for the epistemological-methodological section, we worked under the interpretive paradigm, with a phenomenological-hermeneutic method, using participant observation and in-depth interview, as information collection techniques, which were applied to an informant subject from the classroom of 4th year, this being selected for being the most suitable for the study. The analysis technique was phenomenological reductions to the most important extracts of the information, which was provided by the informant subject during the interview, where the categories emerged that were broken down into an eidetic closure that revealed the ideas of the true essence of the informant's thought, as well as a hermeneutical turn, which managed to provide meaning to what was expressed in the investigation, as a contribution of the researcher to give vision to everything in which one can go beyond the investigative process(AU)

Educação permanente na atenção secundária: elaboração de protocolo de atendimento de urgência / Permanent education in secondary care: elaboration of an emergency care protocol

Os centros de especialidades, não somente médicas, são apontados como fundamentais na retaguarda à Atenção Primária e desempenham importante papel em Redes Regionalizadas de Saúde, não só no Brasil, sendo representado pela Atenção Secundária. O processo de trabalho no SUS, para ser constituído de forma a permitir a melhor interação interprofissional, requer o exercício cotidiano da Educação Permanente em nossas Unidades de Saúde. Objetivo geral: Elaborar um procedimento operacional padrão para a organização do processo de trabalho comum grupo de funcionários que atua direta e indiretamente no ambulatório de cardiologia da atenção secundária de um município de médio porte da região serrana do estado do Rio de Janeiro. Objetivos especificos: 1.Identificar os entraves encontrados pelos trabalhadores do ambulatório de atenção secundária para o atendimento ao paciente com diminuição do nível de consciência. 2.Descrever as dificuldades no processo de trabalho quanto à necessidade da implementação da Educação Permanente 3.Propor estratégias que poderão ser vivenciadas e experimentadas através da Educação Permanente, para a solução ou enfrentamento desses entraves. Método: Trata-se de uma pesquisa qualitativa,tendo como referencial político-pedagógico a Política Nacional de Educação Permanente. O tipo de pesquisa é a análise intencional de pesquisa-ação de Thiollent (1997), referencial teórico, sendo utilizado como referencial filosófico, o educador Paulo Freire. A técnica e instrumento para coleta e análise de dados mediante grupo focal e/ou Questionário Semiestruturado, sob análise temática em Bardin e Turato (2011). O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense sob nº 4.428.883Resultados: Os resultados apontam para melhorias no processo de trabalho cotidiano, calcado em premissas da Educação Permanente como uma prática transformadora. Propõe uma reflexão sobre a prática individual do profissional e, mais do que sua interação multiprofissional no processo de trabalho, apresenta uma experiência positiva originada da atuação em processo de Educação Permanente na Atenção Secundária da região serrana do estado do Rio de Janeiro. Conclusão: Esse estudo trouxe contribuições significativas para a prática, mediante elaboração de um protocolo de atendimento a pacientes com nível de consciência reduzido, em Posto de Saúde da Atenção Secundária, adequado à realidade local, produto da demanda do grupo de trabalho.

Specialty centers, not only medical, are seen as fundamental in the rear of Primary Care, and play an important role in Regionalized Health Networks, not only in Brazil, being represented by Secondary Care. The work process in the SUS, to be constituted in a way that allows the best interprofessional interaction, requires the daily exercise of Continuing Education in our Health Units. General objective: To develop a standard operating procedure for the organization of the work process with a group of employees who work directly and indirectly in the secondary care cardiology outpatient clinic of a medium-sized city in the mountainous region of the state of Rio de Janeiro. Specific Objectives: 1. Identify the obstacles encountered by workers at the secondary care clinic for patient care with a decreased level of consciousness. 2.Describe the difficulties in the work process regarding the need to implement Continuing Education. 3.Propose strategies that can be experienced and tried out, through Continuing Education, for the solution or confrontation of these obstacles. Method: This is a qualitative research, using the National Policy for Continuing Education as a political-pedagogical framework. The type of research is the intentional analysis of action research by Thiollent (1997), theoretical framework, being used as a philosophical framework, the educator Paulo Freire. The technique and instrument for data collection and analysis through focus group and/or Semi-structured Questionnaire, under thematic analysis in Bardin and Turato (2011). The project was approved by the Research Ethics Committee of the Faculty of Medicine of Universidade Federal Fluminense under nº 4.428.883Results: The results point to improvements in the daily work process, based on premises of Continuing Education as a transforming practice. It proposes a reflection on the professional's individual practice, and more than its multidisciplinary interaction in the work process, it presents a positive experience originating from the performance in the Permanent Education process in Secondary Care in the mountainous region of the state of Rio de Janeiro. Conclusion: This study brought significant contributions to the practice, through the elaboration of a care protocol for patients with reduced level of consciousness, in a Secondary Care Health Center, adequate to the local reality, product of the demand of the work group.

Peer teaching, a didactic strategy for learning basic electrocardiography / La enseñanza por pares, una estrategia didáctica para el aprendizaje de la electrocardiografía básica

Abstract Teaching electrocardiography is a very important area in undergraduate student training. A constant concern of professors is for physicians in training to acquire competence in reading and interpreting electrocardiograms (EKGs). This study describes and explores how the didactic strat egy of peer teaching improves learning processes for second-year medical students. Evidence was found that peer teaching fosters significant learning of cardiac physiology and electrocardiograms, in particular, because it allows students to acquire abilities and skills in EKG reading, and improves the understanding and interpretation of this test. In addition, it promotes horizontal peer relationships which facilitate the development of autonomy, self-learning and teamwork. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1971).

Resumen La enseñanza de la electrocardiografía es un área de gran importancia en la formación de los estudiantes de pregrado, para los docentes es una preocupación constante que los médicos en for mación adquieran las competencias para la lectura e interpretación del electrocardiograma (ECG). El presente estudio describe e indaga sobre cómo la estrategia didáctica de la enseñanza por pares mejora los procesos de aprendizaje de los estudiantes de segundo año de formación médica. Se halló evidencia de que la enseñanza por pares favorece el aprendizaje significativo de la fisiología cardiaca y del electrocardiograma, en particular, porque permite la adquisición de habilidades y destrezas a los estudiantes en la lectura del ECG y mejora la comprensión e interpretación de dicho examen; además, propicia relaciones horizontales entre pares que facilitan el desarrollo de la autonomía, el autoaprendizaje y el trabajo en equipo. (Acta Med Colomb 2021; 46. DOI:doi.org/10.36104/amc.2021.1971).