AboutOpen https://journals.aboutscience.eu/index.php/aboutopen <p>This open access journal publishes peer reviewed articles on clinical studies, real world evidence data, reviews, point of views, case series, and single clinical cases. The journal aim and scope encompasses clinical medicine, pharmacy, healthcare technology and other healthcare related disciplines with a focus on innovation in healthcare and policy. Articles may be in English, French, Italian and Spanish</p> Aboutscience Srl en-US AboutOpen 2465-2628 <p>Authors contributing to&nbsp;<em>AboutOpen</em>&nbsp;agree to publish their articles under the <a href="https://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener">Creative Commons NonCommercial 4.0 International License (CC BY-NC 4.0)</a>, which allows third parties to copy and redistribute the material providing appropriate credit and a link to the license but does not allow to use the material for commercial purposes and to use the material if it has been remixed, transformed or built upon.&nbsp;</p> Kidney Diseases: Challenges and Opportunities of the Third Millenium https://journals.aboutscience.eu/index.php/aboutopen/article/view/2029 Antonio Bellasi Biagio Di Iorio Luca Di Lullo ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-03-09 2020-03-09 7 1 1 3 10.33393/abtpn.2020.2029 A Budget impact analysis of pegfilgrastim biosimilar in the treatment of febrile neutropenia in Italy https://journals.aboutscience.eu/index.php/aboutopen/article/view/2030 <p class="abstract"><strong>Introduction:</strong> Granulocyte-colony stimulating factors (G-CSFs) can significantly reduce the risk of febrile neutropenia (FN) among certain patients receiving chemotherapy. FN is associated with significant clinical and nonclinical complications. At present, the patent protection of pegfilgrastim (Neulasta®) has expired, and a biosimilar (Ziextenzo®) has been approved. Since the biosimilar price is expected to be lower as compared with the originator’s, the present Drug Budget Impact analysis tries to evaluate whether and how much profitable the biosimilar availability will be for the Italian NHS, in terms of cost containment (savings).<br><strong>Methods and Results:</strong> The model time horizon extends to five years. The initial overall number of treatments with pegfilgrastim is estimated based on the number of pegfilgrastim packages (assuming a recommended dose of 6 mg is administered after each cytotoxic chemotherapy) and kept constant in time. The model assumes that, year by year, the number of treatments with the originator will partly switch to the biosimilar (according to an uptake rate assumed). The results show that the availability of the biosimilar would provide an €6.4 million cumulated savings to the NHS in the five years.<br><strong>Conclusions:</strong> According to the present analysis, the availability of the biosimilar would generate cumulated savings (in five years) as high as €6.4 million for the Italian NHS.&nbsp;</p> <p class="abstract">(HTA &amp; Market Access)</p> Roberto Ravasio Lorenzo Antonuzzo Marco Danova Paolo Pronzato ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-03-02 2020-03-02 7 1 4 8 10.33393/abtpn.2020.2030 Words for pharma: a quantitative and qualitative analysis on vision, mission and values of multinational pharma companies. https://journals.aboutscience.eu/index.php/aboutopen/article/view/2104 <p><strong>Introduction</strong>: Pharma companies deal with the same important challenges that humans face: to grow and stay healthy. The crucial role of pharma companies in preserving health would suggest that they might rank highly in the reputation indexes. However, this does not seem to be the case. Our aim was to collect, cluster and analyse the words used by pharma companies in their mission, vision and value statements as a base to identify areas of improvement in their corporate communication.</p> <p><strong>Methods</strong>: A total of 97 multinational pharma companies were selected based on their size and presence within major markets. Mission, vision and company values were captured from company websites and analysed. Word clouds were built to analyse the frequency of words in the statement. The influence of company size and location was also analysed.</p> <p><strong>Results</strong>: Most companies (90.7%) have a mission and 54.6% have a clearly stated vision statement, 71.4% mention values. “Life/lives” “patients”, “innovative”, “people/persons” are the most frequently used words. “Innovation” and “integrity” are by far the most common values, followed by “respect”, “ethics”, “responsibility” and “passion”. References to healthcare professionals, access to treatment and sustainability, open science, transparency and care for the environment are more scanty.</p> <p><strong>Conclusions</strong>: Most, but not all, pharma companies provide comprehensive statements focussing mostly on the innovation and its impact on patients. Topics such as role of health care professionals, economic sustainability and care for the environment are rarely listed. An in-depth analysis of their alignment with key needs and trending topics is warranted to further engage customers and build reputation and value.</p> Giulio Zuanetti Francesca Giorgia Colombo Carlotta Galeone ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-04-30 2020-04-30 7 1 9 15 10.33393/abtpn.2020.2104 A cost-minimization analysis of MD-Knee versus hyaluronic acid in patients with knee osteoarthritis https://journals.aboutscience.eu/index.php/aboutopen/article/view/2141 <p class="abstract"><strong>Introduction:</strong> The administration by injection of hyaluronic acid (HA) for 3-5 weeks is effective in the treatment of patients with knee osteoarthritis (OA). Other products for intra-articular use have been recently introduced for the treatment of OA. Among these, a medical device, MD-Knee, produced by Guna S.p.A.; this study aims to estimate the cost-minimization of MD-Knee versus HA in the treatment of knee osteoarthritis.</p> <p class="abstract"><strong>Methods and Results:</strong> We performed a cost-minimization analysis (CMA). The CMA was conducted from the perspective of the Italian National Health Service (iNHS). Only direct medical costs (MD-Knee and HA) were considered. We performed a sensitivity analysis to test the robustness of the results. The mean 6-months cost per patient was € 75,00 with MD-Knee and € 185,00 with HA.</p> <p class="abstract"><strong>Conclusion:</strong> From the Italian National Health Service’s perspective, MD-Knee appears to be the cost-saving therapeutic option compared with HA in the treatment of patients with knee osteoarthritis.</p> Alberto Migliore Roberto Ravasio ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-06-12 2020-06-12 7 1 16 20 10.33393/abtpn.2020.2141 Economic evaluation of low-dose SKA cytokines in patients with rheumatoid arthritis in maintaining low disease activity or remission https://journals.aboutscience.eu/index.php/aboutopen/article/view/2153 <p><strong>Introduction</strong>. The administration of low-dose SKA cytokines allows to maintain remission or low disease activity in patients with rheumatoid arthritis. This analysis aims to estimate the maintenance treatment cost of low-dose SKA cytokines versus DMARDs in patients with rheumatoid arthritis.</p> <p><strong>Methods and Results</strong>. Rather than evaluating the cost-effectiveness of individual therapeutic agents, it becomes recommendable for decision-makers to identify an optimal sequencing of such agents. A one-year cost consequence analysis (CCA) was conducted, comparing two alternative strategies to maintain remission or low disease activity in patients with rheumatoid arthritis: i) first line with low-dose SKA cytokines and second line with antitumor necrosis factor-α (TNF-α), ii) first line with DMARDs and second line with TNF-α. The CCA was conducted from the perspective of the Italian National Health Service (iNHS). Only direct medical costs (drugs cost) were considered. We performed a sensitivity analysis to test the robustness of the results. The sequence using cytokines in first line showed the lower mean annual cost of treatment: the mean annual cost per patient was €1,280.96 with cytokines and €1,987.21 with DMARDs. Sensitivity analyses confirmed the base case result.</p> <p><strong>Conclusion</strong>. From the iNHS’s perspective low-dose, SKA cytokines, as first line treatment appears a cost-saving strategy to maintain remission or low disease activity in patients with rheumatoid arthritis.</p> Roberto Ravasio Alberto Migliore ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-09-01 2020-09-01 7 1 67 73 10.33393/abtpn.2020.2153 Comedone switch and reverse nella patogenesi e nel trattamento dell’acne. Un ruolo per la silimarina? https://journals.aboutscience.eu/index.php/aboutopen/article/view/2175 <div class="article_abstract"> <p class="abstract">Recent developments in the understanding of pathophysiology of acne are creating new opportunities in the treatment of this disease. In this brief review, we illustrate the role of local inflammation, and LRIG1+ cells in the development of comedone switch, and the potential of silimarin to counteract this process and favour comedone reverse. Preliminary data using <em>Silybum marianum</em> in different studies have shown promising results. Further data from ongoing studies will clarify its role in the long-term treatment of patients with acne.</p> </div> <div class="keywords">&nbsp;</div> Stefano Veraldi Mauro Barbareschi ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-09-04 2020-09-04 7 1 74 75 10.33393/abtpn.2020.2175 Pronation Technique in ARDS Patients https://journals.aboutscience.eu/index.php/aboutopen/article/view/2159 <p class="abstract">In severe acute respiratory distress syndrome (ARDS), characterized by the ratio of arterial partial pressure of oxygen over fraction of inspired oxygen (P/F) less than 150 mm Hg, pronation cycles are the only intervention that showed improved survival, in combination with protective ventilation. The physiological advantages of performing pronation cycles, such as the improvement of oxygenation, better tidal volume distribution with increased involvement of dorsal regions, and easier drainage of secretions, overcome the possible complications, that is, endotracheal tube occlusion or misplacement, pressure ulcers, and brachial plexus injury. However, the incidence of complications is dramatically lower in intensive care units with expertise, adopting prone positioning in daily practice.</p> <p class="abstract">In this video we are proposing step by step an easy and ergonomic technique to perform pronation maneuvers in patients with severe ARDS. Recent literature suggests that a high percentage of these patients are treated without undergoing pronation cycles.</p> <p class="abstract">The main purpose of this video is to help increase the number of intensive care units worldwide commonly performing pronation cycles in patients that have indications to be pronated, in order to decrease healthcare burden and costs directly caused by ARDS.</p> <p class="abstract">Proper intensive care unit staff training is fundamental in minimizing the risks associated with the maneuver for both patients and operators; and diffusion of a safe technique encouraging the operators is the second main purpose of this video.</p> <p><a href="https://vimeo.com/aboutscience/20202159" target="_blank" rel="noopener"><img src="/public/site/images/lsteele/2159_f1_750.png"></a></p> <p><em>(This video was recorded before the COVID-19 outbreak)</em></p> Raffaele Di Fenza Hedwige Gay Martina Favarato Isabella Fontana Roberto Fumagalli ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-07-15 2020-07-15 7 1 21 23 10.33393/abtpn.2020.2159 From a patient-centered care model to an engagement ecosystem: the ASUGI model https://journals.aboutscience.eu/index.php/aboutopen/article/view/2142 Guendalina Graffigna Serena Barello Caterina Bosio Maria Giulia Olivari ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 24 26 10.33393/abtpn.2020.2142 Spreading the culture of Engagement: experiences and perspectives https://journals.aboutscience.eu/index.php/aboutopen/article/view/2116 <p>This article describes the fruitful collaboration between the Integrated Care Unit of the Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) and the EngageMinds HUB research Center of the Università Cattolica del Sacro Cuore in the area of patient Engagement. Since then, thanks to this partnership, many training activities have been carried out, allowing healthcare professionals belonging to ASUGI to get trained about patient Engagement measurement and promotion (with particular reference to the Patient Health Engagement Model developed by Graffigna et al., 2015) (the PHE-Model®) in various settings, territory continuity programmes, as well as in some local services. The assessment of the process carried out has allowed to identify and promote initiatives aimed at improving the implementation processes of the PHE-Model®.</p> Giuliana Pitacco Darinka Daneu Lorella Bucci Annamaria Kulla Monica Bonetti Bianca Lenardoni Raffaela Fonda Maria Cristina Vallon Barbara Ianderca ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 27 29 10.33393/abtpn.2020.2116 The city of Trieste as the center of the attention to the person: an historical and cultural framework of the enabling nursing, a fertile ground for the development of Engagement https://journals.aboutscience.eu/index.php/aboutopen/article/view/2117 <p>The Author of the article summarizes the core aspects and theoretical assumptions of the “Enabling Approach” that has characterized the clinical practice of the ASUGI for years. The model has proved to be effective in positively influencing the quality of life of individuals assisted and in reducing the number of hospitalisations. The model affirms the need to establish relations of a mainly symmetrical nature with the individuals assisted and their caregivers. On the contrary, according to this approach, proposing a “top-down” asymmetric relationship with the patient means responding to an unconscious health professional’s need of power over the patient rather than to the patient’s real needs. This aspect, in the perspective of the Author, lies at the basis of the active involvement (Engagement) of patients in their health care processes.</p> Maila Mislej ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 30 34 10.33393/abtpn.2020.2117 A co-constructed implementation path of active involvement practices in a context of integrated care: the experience of a participatory research with the ASUGI of Trieste https://journals.aboutscience.eu/index.php/aboutopen/article/view/2118 <p><strong>Introduction</strong>: In this article we can find the report of the main phases of the collaboration between ASUGI and the Università Cattolica del Sacro Cuore of Milan from 2015 to today.</p> <p><strong>Methods</strong>: During these years, a path of activation and implementation of engagement practices within ASUGI has been developed, from basic training on the tools for monitoring and supporting engagement to the selection of a group of operators involved in a participatory path as “trainers to trainers”, up to the grafting of engagement practices within the individual patient education paths in the different sectors of ASUGI.</p> <p><strong>Results and Conclusions</strong>: This contribution is an exemplifying scenario that can be useful for other health structures that want to undertake a similar path.</p> Julia Menichetti Guendalina Graffigna Giuliana Pitacco Darinka Daneu Lorella Bucci Marta Baldo ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 35 37 10.33393/abtpn.2020.2118 Assessing the engagement in a post-discharge phone Follow-Up project https://journals.aboutscience.eu/index.php/aboutopen/article/view/2119 <p><strong>Introduction</strong>: The article describes a post-discharge telephone Follow-Up pilot project that was activated in 2018 in the city of Trieste.</p> <p><strong>Methods</strong>: The pilot project, in addition to the interception of possible situations of discomfort to be reported to social services and to ensure informative support to guide people to an optimal use of services, aimed to investigate the conditions, 1 and 3 months after discharge, of people not followed by the community services, in particular: a) maintenance of functional capacity; b) self-assessment of the patient with respect to health conditions and level of engagement; c) state of the relationships network; d) use of public, private and/or third sector health or welfare resources.</p> <p><strong>Results and Conclusions</strong>: The Telephone Follow-Up has made it possible to experiment a “light” way of taking care of people discharged from a hospital or rehabilitation facility, to intercept situations of discomfort, reporting them to the Local District and social services and facilitating the appropriate use of local assistance services.</p> Giuliana Pitacco Ramiro Mendoza-Maldonado Sandro Centonze ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 38 42 10.33393/abtpn.2020.2119 The engagement in the complex structure of thoracic surgery of Trieste in a “Fast Track” surgery path (ERAS): how to promote the continuity of care after the discharge https://journals.aboutscience.eu/index.php/aboutopen/article/view/2120 <p><strong>Introduction</strong>: This article describes the use of the PHE-Scale® as an engagement measuring tool in the hospital practice.</p> <p><strong>Methods</strong>: The Thoracic Surgery Complex Structure in the Trieste hospital has been using the surgical “Fast Track” since 2009, and since January 2017 it uses the PHE-Scale® to measure the level of engagement of the assisted patient.</p> <p><strong>Results and Conclusions</strong>: The PHE-Scale®, administered in this context, helps the healthcare professional to understand how the state of illness is differently experienced from patient to patient in relation to the level of engagement, the psychological characteristics of the person, the caregivers around him/her and the information that the patient has received from the whole healthcare team.</p> Maurizio Cortale Michela Grassi Vanessa Stemberger ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 43 45 10.33393/abtpn.2020.2120 Engagement education: engagement training experiences in the nursing degree at the University of Trieste https://journals.aboutscience.eu/index.php/aboutopen/article/view/2123 <p><strong>Introduction</strong>: The article describes how in ASUGI nursing students are made aware, since their first year bachelor degree, about the importance of actively engaging the person in the health-care process and of measuring the level of engagement with validated instruments (with particular reference to the PHE-S®).</p> <p><strong>Methods</strong>: During the clinical internship, with the help of the internship tutors, students can experiment and use this tool. At the end of the third year, they try to systematize what they have learnt in the practical traineeship by connecting their practical experience with theoretical concepts learnt and critically analysing their clinical experiences.</p> <p><strong>Results and Discussion</strong>: This didactic experience has led to the preparation and defence of a good number of degree theses focused on the value of measuring and promoting the engagement of people along their healthcare</p> Adriana Fascì Barbara Ianderca Sara Maier Isabella Murano Giuliana Pitacco ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 46 48 10.33393/abtpn.2020.2123 CHE-S® as a tool to predict the Caregiver’s ability to actively manage disability of stroke patients admitted to the ward of the complex rehabilitation structure of ASUGI https://journals.aboutscience.eu/index.php/aboutopen/article/view/2124 <p><strong>Introduction</strong>: This article affirms that measuring the Caregiver’s emotional experience and engagement, especially as the condition of the person assisted changes, is useful for assessing the sustainability of the care plan.</p> <p><strong>Methods</strong>: With this pilot study, aimed at detecting the level of Caregiver engagement, by using the Caregiving Engagement Scale (CHE-S®), for people suffering from chronic and/or fragile pathologies, it was decided to verify the relationship between engagement levels and other variables such as: socio-demographic characteristics of the Caregiver; duration and frequency person; clinical characteristics of the assisted person.</p> <p><strong>Results and Conclusions</strong>: In the future, the results of this research will allow to define new working practices to support those who take on the responsibility and burden of caring for a sick, fragile, disabled family member.</p> Barbara Ianderca Darinka Daneu Lorella Bucci Annamaria Kulla Monica Bonetti Bianca Lenardoni Raffaela Fonda Maria Cristina Vallon Giuliana Pitacco ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 49 51 10.33393/abtpn.2020.2124 Engagement and health promotion: an integrated project between services, population and volunteering – the health path at local District 1 of Trieste https://journals.aboutscience.eu/index.php/aboutopen/article/view/2125 <p><strong>Introduction</strong>: The article describes the project “Health path: walking together against diabetes, overweight and obesity” that ASUGI proposed in 2016.</p> <p><strong>Methods</strong>: In this project the diabetologist, nurse and physiotherapist working in local health services collaborate together with patients’ associations to the realization of the project. The initiative is addressed at people living in the territory of the Local District no. 1 of Trieste, aged between 18 and 65 years affected by one or more of the following diseases: diabetes mellitus, overweight/obesity, chronic obstructive pulmonary disease. In the project, initial and final individual physiotherapeutic evaluations were carried out, including the evaluation of engagement with the PHE-S®.</p> <p><strong>Results and Conclusions</strong>: From 2016 to the present day, the project has aimed to sensitize people in the maintenance of healthy lifestyles and it was the occasion to make all the healthcare professionals involved co-responsible in encouraging therapeutic adherence and engagement thanks to training activities and the establishment of a cooperative relationship.</p> Martina Filipaz Martina Hmeljak Anna Barca ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-04 2020-08-04 7 1 52 54 10.33393/abtpn.2020.2125 The experience in bariatric surgery – ASUGI of Trieste https://journals.aboutscience.eu/index.php/aboutopen/article/view/2126 <p><strong>Introduction</strong>: This article illustrates the use of the PHE-S® engagement measurement instrument in bariatric surgery at ASUGI.</p> <p><strong>Methods</strong>: The assessment of the levels of engagement allowed healthcare professionals to differentiate the level of risk and to identify the target of patients with lower adherence to therapies.</p> <p><strong>Results and Conclusions</strong>: This also improved the identification of the best clinical-assistance program, the personalization of the treatment programs and the possibility to verify the effectiveness of the services provided. Knowing the level of engagement and its dynamic evolution over time is fundamental to adopt specific strategies and to allow people to reach or maintain positive life trajectories.</p> Annamaria Kulla ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-04 2020-08-04 7 1 55 57 10.33393/abtpn.2020.2126 The active involvement of the person being treated by the nursing clinic and with home-based care in the local context of local District n. 1, of the ASUGI of Trieste https://journals.aboutscience.eu/index.php/aboutopen/article/view/2127 <p><strong>Introduction</strong>: This contribution describes four different experiences of active engagement along the care pathway of people with chronic illness, performed at home and at the nursing clinic of the ASUGI Health District n. 1 in Trieste by a local care team.</p> <p><strong>Case description</strong>: The Home Nursing Service, named SID, of the Local Districts of Trieste is based on the principle of improving the quality of life of citizens by providing adequate home care in the logic of continuity of care, consistently with the needs of the person, after a multidimensional assessment and the construction of a personalized care plan, aimed at increasing engagement and participation. ù</p> <p><strong>Conclusions</strong>: This experience contributed to the cultural growth of professionals and to the systematic introduction of the PHE-S® evaluation tool in the home setting, improving also their relational skills.</p> Raffaela Fonda Daniela Ortolan ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 58 61 10.33393/abtpn.2020.2127 Engagement in the local context: the active involvement of the person suffering from long-term pathologies https://journals.aboutscience.eu/index.php/aboutopen/article/view/2128 <p><strong>Introduction</strong>: In 2017 the nursing staff of Health Local District no. 2 of Trieste followed 67 patients in charge at both the home and the outpatient services for long-term pathologies starting from the hospitalization.</p> <p><strong>Case description</strong>: The Service administered the PHE-S® scale to these 67 patients, in the light of a strategical consideration of the importance of monitoring the levels of patients’ engagement and of personalizing dedicated initiatives to promote the active involvement of the patients, also thanks to the improvement of the clinical relationship. The level of engagement was measured at zero, one and four months after hospitalization. In the four months after discharge, the nursing staff applied specific strategies to promote engagement.</p> <p><strong>Conclusions</strong>: This study shows that engagement of patients with long-term illnesses is strategically important to improve care and quality of life.</p> Bianca Lenardoni Ernesto Natale ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 62 63 10.33393/abtpn.2020.2128 Engagement in cardiological hospitalization: first steps with diabetic patients suffering from heart disease https://journals.aboutscience.eu/index.php/aboutopen/article/view/2129 <p><strong>Introduction</strong>: A lot has been done at the Trieste hospital to promote engagement among patients suffering from heart disease and diabetes mellitus. Among the different initiatives we can find the PHEinAction® protocol.</p> <p><strong>Case description</strong>: Patients recruited for the PHEinAction® protocol included: diabetic and cardiopathic patients, resident in Trieste, &lt;70 years old, having signed informed consent. Patients with cognitive impairment were excluded. The article reports the experience of two clinical cases in the cardiology department of the Trieste Hospital that took part in the PHEinAction® protocol. In one case there were clinical improvements, but the other developed a complication (TIA).</p> <p><strong>Conclusions</strong>: Despite the different results, both patients showed a good adherence to the proposed program, maintaining the PHE-S® scores and a high level of project approval.</p> Ana Karina Hinojosa Claudia Bamonte ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2020-08-03 2020-08-03 7 1 64 66 10.33393/abtpn.2020.2129