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.

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.

Interpretation and reflection on the Measures for the Administration of Standards for Medicinal Products / 中国药房

In July 2023， the National Medical Products Administration issued the Measures for the Administration of Standards for Medicinal Products （hereinafter referred to as the Measures）. This article interprets the main content of the Measures， and analyzes its shortcomings as unclear definition of the drug standard code and the goals of drug standard information construction. It is recommended that the national drug regulatory department promptly apply to the standardization authority for the confirmation of the drug standard code “YB” letter， and the drug standard code and numbering rules would be included in the next round of amendments to the Measures. It is necessary to clarify the construction goals of the information system for drug standards at the same time， and build a national drug standard data-sharing platform based on the basic framework of user interface layer， computing processing layer， and data storage layer. Digital drug standards will be free， and access and download services for the public will be provided.

Interpretation and mirror of the National Health Education Standards in the United States / 中国学校卫生

Abstract@#In the context of frequent public health events, effective school health education is an important measure to improve students health literacy and public health system of China. The study examined the National Health Education Standards in the U.S., based on a literature review and comparative analysis, to provide guidance for China. Using the method of liberature riview paper interprets the curriculum of National Health Education Standards in the U.S. and provides a mirror for China. Health Education standards in the U.S. are characterized by their academic quality, standardized framework, assessment program, equity principles, and other components. A mirror for China includes promoting the construction of the standards based health education curriculum, developing the skills based health education curriculum system, and constructing a performancebased comprehensive evaluation system.

Performance of four simplified screening methods of elevated blood pressure among children and adolescents / 中国学校卫生

Objective@#To evaluate the performance of four simplified screening methods of elevated blood pressure commonly used among children and adolescents according to Chinese guidelines for prevention and treatment of hypertension (revised in 2018), so as to provide a reference for the early detection of the elevated blood pressure among children and adolescents.@*Methods@#Stratified cluster random sampling method was used to monitor the physical fitness of 5 211 children and adolescents in a city of Shanxi Province from October to November 2021. Chinese guidelines for prevention and treatment of hypertension was considered as gold standard, and sensitivity, specificity, area under the curve (AUC) and Kappa value were calculated to evaluate the screening effectiveness of formula method, height specific method, age group specific method, sex and age specific method for screening elevated blood pressure.@*Results@#The detection rates of elevated blood pressure among children and adolescents screened by gold standard, formula method, height specific method,age group specific method, sex and age specific method were 21.9%, 24.0%, 21.1%, 24.5% and 20.2%, respectively. There was no significant difference between prevalence of elevated blood pressure screened by formula method, sex and age specific method and gold standard( χ 2=1.21, 1.41, P >0.05), whereas height specific method and age group specific method had significant differences with gold standard ( χ 2=20.39, 67.09, P <0.05). AUC was the largest for height specific method [0.94(95% CI =0.93-0.95)], and the smallest for age group specific method [0.87(95% CI = 0.86 -0.88)]. The Kappa values of height specific method (0.89) and sex and age specific method (0.89) were both greater than 0.85 , which were more consistent with the screening effectiveness of gold standard. When comparing by sex, age and body mass index (BMI), the screening effectivenesses were consistent with the overall in boys, 6-11 years and normal body weight groups, while the screening effectivenesses were different in girls, 12-17 years, overweight and obese groups. The AUC (0.87), Kappa value (0.71) and sensitivity (82.33%) of age group specific method were the lowest and the screening effectiveness was the worst.@*Conclusion@#Height specific method is more effective and can be used for early identification and self detection of blood pressure abnormalities among children and adolescents.

Application of two different methods of visual acuity assessment for myopia screening among lower grade elementary school students / 中国学校卫生

Objective@#To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability.@*Methods@#From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated.@*Results@#The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2.@*Conclusions@#Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.

Development and implications of physical fitness assessment for children and adolescents in Japan / 中国学校卫生

Abstract@#To help children and adolescents grow up healthily, using literature, comparative analysis and other research methods, the historical development of Japan s physical fitness assessment system for children and adolescents are analyzed for the content structure of the latest version of its physical fitness assessment system (Sports adaptability assessment Ⅱ). On the basis of this analysis, some practical suggestions are proposed for improving the National Physical Fitness Standards for Students in China, such as adding a physical fitness assessment system for preschoolers, grouping the test subjects by age and setting common test indicators for males and females. Thus, the improved National Student Physical Fitness Standard is more aligned with the physical and mental growth patterns of Chinese children and adolescents.

Opinion on the development and research status of intelligent ophthalmology in China / 国际眼科杂志(Guoji Yanke Zazhi)

This paper provides a comprehensive analysis of the current state of intelligent ophthalmology in China, including technological advancements, academic exchange platforms, policy support, future challenges, and potential solutions. Technologically, remarkable progress have been made in various areas of intelligent ophthalmology in China, including diabetic retinopathy, fundus image analysis, and crucial aspects such as quality assessment of medical artificial intelligence products, clinical research methods, technological evaluation, and industrial standards. Researchers are constantly improving the safety and standardization of intelligent ophthalmology technology by formulating clinical application guidelines and standards. Academic exchange platforms have been established to provide extensive collaboration opportunities for professionals across diverse fields, and various academic journals serve as publication platforms for intelligent ophthalmology research. Regarding public policy, the Chinese government has not only established a supportive policy environment for the advancement of intelligent ophthalmology through various documents and regulations, but provided a legal basis and management framework. However, there are still challenges to overcome, such as technological innovation, data privacy and security, outdated regulations, and talent shortages. To tackle these issues, there is a requirement for increased technological research and development, the establishment of regulatory frameworks, talent cultivation, and greater awareness and acceptance of new technologies among patients. By comprehensively addressing these challenges, intelligent ophthalmology in China is expected to continue leading the industry's global development, bringing more innovation and convenience to the field of ophthalmic healthcare.

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.

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.

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

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.

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)

GMIA-Breast Oncoplastic and Reconstruction Society consensus on operative standards of breast cancer surgery / 南方医科大学学报

The Breast Cancer Surgery Operative Standards Consensus Conference aimed to establish industry technical standards and improve breast cancer surgery practices by addressing controversial and operative breast cancer surgery-related issues in clinical practice.The conference was led by the Breast Oncoplastic and Reconstruction Branch of Guangdong Medical Industry Association (GMIA) and involved 85 breast surgeons with expertise in breast cancer conserving, oncoplastic, and reconstructive surgery.Consensus was reached through 3 meetings.The first meeting brought up the topics of interest, and evidence summaries were presented for debate during the second meeting; the third meeting was held to reach consensus recommendation for selected topics.Pre-defined consensus criteria required that the consensus was reached only when more than 70% of the panelists agreed on the topic.Out of the 57 questions set for voting, 11 operative standards were recommended as Preferred, and one was recommended as Considered.Preferred operative standards included surgical details in breast conserving surgery, mastectomy, reconstructive surgery, surgical treatment of phyllodes tumor.Selected topics that did not reach consensus among the panelists were also discussed.These Preferred operative standards could help guide clinical surgical practice in routine patient care.

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.

4. Alignment of the 2022 Revision of the Model Core Curriculum for Medical Education in Japan with the‘Standards of the National Medical Practitioners Qualifying Examination' / 医学教育

In this revision, we have attempted to align the Model Core Curriculum for Medical Education competency, "problem-solving ability based on specialized knowledge," with the "Standards of National Examination for Medical Practitioners." The major diseases and syndromes in "Essential Fundamentals" correspond to the basic diseases in Table 1 of the Core Curriculum, symptoms, physical and laboratory examinations, and treatment in "General Medicine" correspond to the items in Table 2 of the Core Curriculum, and the diseases in "Medical Theory" correspond to the diseases in PS-02 of the Core Curriculum. The validity of the diseases in the Core Curriculum was verified using the evaluation results of the examination level classification of the "Research for Revision of National Examination Criteria." Approximately 690 diseases were conclusively selected. This revision mentions the number of diseases in the Core Curriculum for the first time. Hopefully, this will lead to a deeper examination of diseases that should be studied in medical schools in the future.