The syndemic framework proposed by the 2021–2030 World Health Organization (WHO) action plan for patient safety and the introduction of enabling technologies in health services involve a more effective interpretation of the data to understand causation. Based on the Systemic Theory, this communication proposes the “Systemic Clinical Risk Management” (SCRM) to improve the Quality of Care and Patient Safety. This is a new Clinical Risk Management model capable of developing the ability to observe and synthesize different elements in ways that lead to in-depth interventions to achieve solutions aligned with the sustainable development of health services. In order to avoid uncontrolled decision-making related to the use of enabling technologies, we devised an internal Learning Algorithm Risk Management (LARM) level based on a Bayesian approach. Moreover, according to the ethics of Job Well Done, the SCRM, instead of giving an opinion on events that have already occurred, proposes a bioethical co-working because it suggests the best way to act from a scientific point of view.

Spatial identity surpasses geographical boundaries of a certain space, and denotes not only physical characteristics of space, but its meaning to people that use it, as well as their intercommunication, which produces new social and spatial meaning. Unless there is an abrupt change in social structure or formal/functional transformation of (un)built environment, we perceive spatial identity as something almost permanent. However, it is in a constant state of change, existing in a present state that relies on our past experiences and contains projections of our future, maintained through constant background processes of disorganization and concomitant organization – in other words, identity is in the state of (perpetual) liminality. Liminality is the product, as well as the initiator of autopoietic processes within identity, which leads to the main premise of this article – (spatial) identity is an autopoietic system. This is analyzed through three chosen aspects of place attachment: ritual, memory and architecture.

Abstract The objective of the study was to assess the health risk related to the presence of heavy metals in street dust samples collected from Canton Sarajevo (CS). Street dust samples (42) were grouped in three categories: high density traffic roads, medical centers/parking and parks. The mean concentrations for Cd, Cr, Cu, Fe, Mn, Ni, Pb, V and Zn determined by flame atomic absorption spectrometry (FAAS) were 1.71, 30.99, 74.85, 674.4, 221.9, 33.16, 41.46, 22.97 and 53.92 μg/g, respectively. According to correlation matrix analysis very strong positive correlation was found between Zn and Fe. The Hazard index (HI) values for non-carcinogenic substances for adults and children were 2.46E-1 and 1.31E + 00, respectively. There is a possibility of occurring of non-carcinogenic effects of street dust on children, as opposed to adults. Exposure pathway that most impact the non-carcinogenic and carcinogenic risk, for both, children and adults, is the ingestion followed by the dermal and inhalation route. The carcinogenic risk caused by Cd, Cr and Pb in the street dust could be considered negligible.

Objetivo: sintetizar o conhecimento relacionado às estratégias para redução de erros de medicação durante a hospitalização de pacientes adultos. Método: revisão integrativa da literatura realizada em outubro de 2020 por meio da busca de publicações nas bases de dados eletrônicas: Web of Science, Pubmed, Cumulative Index of Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Google Scholar. Resultados: amostra composta por 12 estudos, cujas estratégias para a redução de erros de medicação foram apresentadas de acordo com as categorias: envolvimento do farmacêutico clínico nas atividades clínicas, implantação de tecnologiasda informação, estratégias educacionais mediadas por simulação e jogos, e redução da carga de trabalho. Conclusão: associado às tecnologias, o envolvimento do farmacêutico clínico com a equipe médica e de enfermagem resultará em melhorias na redução dos eventos adversos a medicamentos e na qualidade da assistência prestada ao paciente

In this paper we explore social responses, attitudes and social practices of everyday life in the midst of a complete social closure at an early stage of corona crisis, based on original empirical survey data collected via online questionnaire (N=352) during the lockdown and state of emergency in Bosnia and Herzegovina. Aiming to analyse social implications of the ongoing crisis and directions for future research we have particularly focused on several dimensions: work, free time and everyday activities, attitudes towards the new uncertainty and specific needs of different social groups in the context of crisis. Social responses to novel living circumstances have highlighted problems related to the status of vulnerable groups present from before in a society that is most commonly categorized as a country in transition marked by post-war challenges. Results show that established discrimination practices have resurfaced while vulnerable social groups’ living conditions have significantly aggravated even early at the times of pandemic emergence.

Fexofenadine hydrochloride (FFN), (±)-4-[1-hydroxy-4[4-(hydroxydiphenylmethyl)-1-piperidinyl]-butyl] α,α-dimethylbenzeneacetic acid hydrochloride, is a second-generation antihistamine that is used to treat allergies. The drug is highly hydrophobic and slightly soluble in water. Cyclodextrins are widely used to improve the physicochemical and pharmaceutical properties such as solubility, stability, and bioavailability of poorly soluble drug molecules.Cyclodextrins can molecularly encapsulate various drugs into their hydrophobic cavity without forming any covalent bonds. Cyclodextrin (CDs), especially ß-Cyclodextrin (ß-CD), are widely used in the pharmaceutical field due to its ability to stabilize drug molecules and taste masking purposes. The phase solubility study was performed according to the method of Higuchi and Connors by adding the fexofenadine hydrochloride in excess to different concentrations of cyclodextrin solutions. Phase solubility study records show that the stability constant and complex stoichiometry of FFN-CD complexes increases linearly with CD concentration. Also, an increase in the concentration of β-cyclodextrin leads to an increase in the aqueous solubility of FFN. Complexes were analyzed by UV-VIS spectroscopy using the calibration curve of FFN. Also, UV-VIS spectra indicate a bathochromic shift which proves that complex formation has occurred.Solid inclusion complexes of fexofenadine/β-cyclodextrin and its derivatives were prepared at the molar ratios of 1:1 by the physical mixing method. Characterization of the complexes was performed by using infrared spectroscopy. 

Due to COVID-19 pandemic, there is an increasing demand for mobile robots to substitute human in disinfection tasks. New generations of disinfection robots could be developed to navigate in high-risk, high-touch areas. Public spaces, such as airports, schools, malls, hospitals, workplaces and factories could benefit from robotic disinfection in terms of task accuracy, cost, and execution time. The aim of this work is to integrate and analyse the performance of Particle Swarm Optimization (PSO) algorithm, as global path planner, coupled with Dynamic Window Approach (DWA) for reactive collision avoidance using a ROS-based software prototyping tool. This paper introduces our solution – a SLAM (Simultaneous Localization and Mapping) and optimal path planning-based approach for performing autonomous indoor disinfection work. This ROS-based solution could be easily transferred to different hardware platforms to substitute human to conduct disinfection work in different real contaminated environments.

Introdução: A Candidíase é uma micose provocada pelo fungo do gênero Candida. A infecção pode ocorrer de forma aguda ou crônica, sendo possível apresentar uma fase invasiva sistêmica, correspondente à importante causa de morbimortalidade em neonatos prematuros e em crianças menores de cinco anos em situações graves. Objetivo: O presente estudo objetiva analisar a tendência temporal da taxa de mortalidade por Candidíase em crianças de 0 a 4 anos de idade no Brasil, entre 2010 a 2019. Metodologia: Trata-se de um estudo de séries temporais, de caráter observacional, analítico, longitudinal, retrospectivo e ecológico. Para tal, obtiveram-se as informações do Departamento de informática do Sistema Único de Saúde (DATASUS). Os dados utilizados correspondem ao número de nascidos vivos, disponíveis no Sistema de informações de Nascidos vivos (SINASC), e óbitos de crianças de 0 a 4 anos por Candidíase, disponível no Sistema de Informações sobre Mortalidade (SIM). O cálculo para obtenção da taxa de óbito correspondeu a: (óbitos de 0 a 4 anos ÷ nascidos vivos) x 100.000, para o país, no intervalo de 2010 a 2019. A análise de regressão temporal para a taxa de óbitos de crianças menores de 5 anos por Candidíase foi realizada no software Stata 14.0, utilizando a Regressão de Prais-Winten. Assim, obteve-se a taxa de incremento anual, de modo que a tendência só foi considerada significativa com p-valor < 0,05. Resultado: Após análise dos dados, observou-se no período entre 2010 e 2019 o total de 125 óbitos por Candidíase de crianças com idade inferior a 5 anos no Brasil. A maior taxa de óbitos foi expressa em 2019 (0,63/100.000), enquanto a menor referiu-se ao ano de 2017 (0,31/100.000). Os resultados apresentaram p-valor significante < 0,05 (0,031), com tendência crescente expressando uma taxa de variação média anual positiva de 5,3%, o que evidencia o agravamento do cenário da mortalidade por Candidíase no decorrer do período estudado. Conclusão: A partir desta apresentação, o estudo demonstrou o significativo aumento da taxa de mortalidade da Candidíase em crianças menores de 5 anos, a qual deve ser combatida através da conscientização da sociedade acerca do seu mecanismo de transmissão.

This article presents a comparison of the results obtained using the newly proposed Simple Weighted Sum Product method and some prominent multiple criteria decision-making methods. For comparison, several analyses were performed using the Python programming language and its NumPy library. The comparison was also made on a real decision-making problem taken from the literature. The obtained results confirm the high correlation of the results obtained using the Simple Weighted Sum Product method and selected multiple criteria decision-making methods such as TOPSIS, SAW, ARAS, WASPAS, and CoCoSo, which confirms the usability of the Simple Weighted Sum Product method for solving multiple criteria decision-making problems.

Introduction: Axial-loaded magnetic resonance imaging (MRI), which can simulate an upright position of the patient may cause a significant reduction of the dural sac cross-sectional area (DCSA) compared with standard MRI, thus providing valuable information in the assessment of the lumbar spinal canal. The purpose of this study was to investigate excessiveness of the change in DCSA and depth of lateral recesses (DLRs) before and after axial-loaded imaging in relation to body mass index (BMI) of the subjects.Methods: Twenty patients were scanned to evaluate DCSA and DLR at three consecutive lumbar spine intervertebral disc levels (L3/4, L4/5, and L5/S1) on conventional-recumbent MRI, and after axial loading were applied.Results: Axial-loaded MRI demonstrates a significant difference of DSCA in comparison to conventional MRI. Furthermore, results show a significant correlation between the DCSA and BMI on level L3/L4, both before and after axial loading MRI. With axial loading, there is a reduction of DSCA of 12.2%, 12.1%, and 2.1% at the levels L3/L4, L4/L5, and L5/S1, respectively. After axial loading has been applied, the depth of the neural foramen has been reduced by an average of 10.1%.Conclusion: Axial-loaded MRI reduces DCSA and DLRs in comparison to standard MRI. Information obtained in this way may be useful to explain the patient’s symptomatology and may provide an additional insight that can influence the treatment decision plan accordingly.

Aims: The aims of this study was to investigate the susceptibility of extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae clinical isolates to antibiotics and essential oils - Origanum compactum, Origanum majorana and Thymus serpyllum. Study Design: Study included 30 isolates of Klebsiella pneumoniae obtained from clinical material provided from the University Clinical Center Tuzla. Place and Duration of Study: Department of Biology, Faculty of Science, University of Tuzla, BiH, between September 2019 to September 2020. Methodology: Antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion method. The following commercially available antibiotic discs were used: amoxicillin (30µg), cefalexin (30 µg), gentamicin (10 µg), amikacin (30 µg), imipenem (10 µg), piperacillin (75µg), ampicilin (10 µg), meropenem (10 µg), ciprofloksacin (10 µg), ceftazidim (30 µg), cefotaksim (30 µg), ceftriaxone (30 µg), cefepime (30 µg) and aztreonam (30 µg). The antibacterial effect of the essential oils was tested for ESBL K. pneumoniae isolates using the diffusion method according to Clinical laboratory standards institute (CLSI) guidelines. Results: O. compactum and O. majorana essential oils showed the same antimicrobial activity with 80.0% effect on ESBL K. pneumoniae isolates, Thymus serpyllum EO showed antimicrobial activity of 60.0%. The lowest MIC value had the O. compactum essential oil (MIC 6 mg/ml-10.5 mg/ml), followed by the T. serpyllum (MIC 17.2 mg/ml-43 mg/ml), while the O. majorana essential oil showed MIC values in range from 11 mg/ml to 39 mg/ml. Conclusion: The results of the study showed the exceptional sensitivity of ESBL K. pneumoniae clinical isolates to the essential oils from Origanum and Thymus genera, which highly suggests their potential application in the struggle against these pathogens in the future.

ABSTRACT This article situates itself in the theoretical space between the field of genocide, and postcolonial studies, advocating for a closer relationship between the two, particularly in relation to the emerging field of postcolonial genocide. The Rwandan genocide is illustrative of this need, as a case which remains firmly rooted in identity categories that have been imposed on the native populations during the colonial era. The article traces the persistence of the colonial racial hierarchies in Rwanda and the role they played in the Rwandan genocide of 1994. It fosters a particularly significant focus on modernity as the symbolic line that divides the imagined racial categories in the colonial gaze, resulting in a crucial impact of nesting colonialisms in the genocidal rhetoric of the late twentieth century. The Rwandan genocidal project contains within it a desire to fulfil the promise of modernity by facilitating the emergence of an ethnically cleansed nation state, while simultaneously rejecting it as the heritage of violence ridden exploitation colonialism. This paradox of ambivalent modernity presents itself both as a crucial characteristic of the Rwandan genocide as well as a persistent rupture in the formation of contemporary Rwandan identities.