bluuebunny/crossref_metadata_2025 huggingface dataset:
Arterial Stiffness in the Heart Disease of CKD
Authors: Zanoli Luca , Lentini Paolo , Briet Marie , Castellino Pietro , House Andrew A. , London Gerard M. , Malatino Lorenzo , McCullough Peter A. , Mikhailidis Dimitri P. , Boutouyrie Pierre
Published: April 2019

CKD frequently leads to chronic cardiac dysfunction. This complex relationship has been termed as cardiorenal syndrome type 4 or cardio-renal link. Despite numerous studies and reviews focused on the pathophysiology and therapy of this syndrome, the role of arterial stiffness has been frequently overlooked. In this regard, several pathogenic factors, including uremic toxins (i.e., uric acid, phosphates, endothelin-1, advanced glycation end-products, and asymmetric dimethylarginine), can be involved. Their effect on the arterial wall, direct or mediated by chronic inflammation and oxidative stress, results in arterial stiffening and decreased vascular compliance. The increase in aortic stiffness results in increased cardiac workload and reduced coronary artery perfusion pressure that, in turn, may lead to microvascular cardiac ischemia. Conversely, reduced arterial stiffness has been associated with increased survival. Several approaches can be considered to reduce vascular stiffness and improve vascular function in patients with CKD. This review primarily discusses current understanding of the mechanisms concerning uremic toxins, arterial stiffening, and impaired cardiac function, and the therapeutic options to reduce arterial stiffness in patients with CKD.
Türkiye'de Turizme Yönelik Kamu Teşvik Politikaları Çerçevesinde İllerin Etkinlik Analizi
Authors: AYBARÇ Sibel , SELİM Sibel , AYVAZ KIZILGÖL Özlem
Published: April 2019

Turizm
sektörünün ülke ekonomisi açısından taşıdığı önem dolayısıyla devlet tarafından
gerek vergisel teşvikler, gerek yasal düzenlemeler, gerekse sağlanacak istisna
ve muafiyet uygulamaları ve sübvansiyonlarla desteklenmesi gerekmektedir. Bu
çalışmanın amacı, uygulanan kamu teşvik politikaları kapsamında 2005-2015
yılları arasında Veri Zarflama Analizi kullanılarak Türk turizminde illerin
teknik etkinliğini belirlemektir. Bu amaç doğrultusunda, çalışmada kullanılan
girdi değişkenleri, il bazında turizm sektörüne yapılan yatırım teşvik belgesi
sayısı, teşviklerle sağlanan sabit yatırımlar, istihdam, turizm amaçlı
kullanılan ihtiyaç kredileri, illerde kamu hizmetlerine yapılmış olan
harcamalar, turizm yatırım ve işletme belgeli tesis sayısı, oda sayısı, yatak
sayısı ve çıktı değişkenleri ise toplam tesise geliş sayısı ile geceleme sayısıdır.
Elde edilen bulgulara göre, Akdeniz ve Ege bölgesindeki illerin Doğu
bölgelerine göre turizm açısından daha etkin olduğu belirlenmiştir.
Die rol van die Hoogste Howe van die Verenigde State van Amerika, Suid-Afrika en die Europese Unie in buitelandse aangeleenthede
Authors: Eksteen R
Published: April 2019

In die Verenigde State van Amerika (VSA) beskik die President oor besondere wye magte ten opsigte van buitelandse aangeleenthede; so ook die Kongres, en die Senaat in besonder. Die regsgesag het geen grondwetlik geformuleerde rol met betrekking tot buitelandse aangeleenthede nie. Dit beteken egter nie dat die Hooggeregshof (HH) se uitsprake nie 'n wesentlike invloed op buitelandse beleidsmaatreëls het nie. Die beklemtoning van menseregte het in 1994 sterk na vore getree met Suid-Afrika (SA) se benadering tot buitelandse aangeleenthede. Algaande het hierdie benadering begin verflou. Die Konstitusionele Hof (KH) het nie teruggedeins om die uitvoerende gesag krities oor sy grondwetlike verpligtinge tereg te wys en van sy vergrype ongrondwetlik te verklaar nie. Die Europese Geregshof (EG) het ewe-eens oor dekades heen bepaalde beslissings gelewer wat die buitelandse beleidstandpunte van die Europese Unie (EU) in wese geraak het. Vir die Unie is sy Hof 'n kernpilaar om die hele stelsel standvastig te hou. Terwyl politieke gesagsinstellings buitelandse beleid die direkste raak, is die bydrae van die regsgesag nie minder betekenisvol nie. Dit bepaal die grense waarbinne politieke take verrig mag word. Die regsgesag het die onmiskenbare feit dat dit 'n rol in buitelandse aangeleenthede het beklemtoon.
Факторы роста ожидаемой продолжительности жизни: кластерный анализ по странам мира
Authors: Колосницына Марина Григорьевна , Коссова Татьяна Владимировна , Шелунцова Мария Александровна
Published: April 2019

Повышение ожидаемой продолжительности жизни до 80 лет к 2030 г. – одна из провозглашенных национальных целей развития страны. Для ее достижения важно понимать, какие факторы влияют на ожидаемую продолжительность жизни и могут быть, в свою очередь, объектами управляющего воздействия государства. В работе ставится цель выявить основные детерминанты продолжительности жизни населения в группах стран, различающихся уровнем продолжительности жизни, и показать место России в этом ряду. Для этого используются данные Всемирной организации здравоохранения и Всемирного банка по 82 странам мира, проводится дескриптивный, кластерный и корреляционный анализ. Проведенный анализ демонстрирует, что продолжительность жизни в России намного ниже, чем в странах с сопоставимым уровнем экономического развития и расходов на здравоохранение. Показано, что в зависимости от принадлежности стран к разным кластерам по уровню продолжительности жизни на здоровье населения влияют различные факторы и в неодинаковой мере: развитие экономики, в том числе здравоохранения, урбанизация, питание, нездоровый образ жизни. В заключение приводятся рекомендации для государственной политики.
How to create a new protocol v14
Authors: Broellochs Anita
Published: April 2019

This protocol describes how to create a new protocol on protocols.io.
Application of 5P Teaching Method in China’s Middle School English Teaching
Authors: Luo Rui
Published: April 2019

Directed by the traditional teaching methods, China’s middle school English teaching pays much attention to passing down linguistic knowledge, ignoring students’ learning motivation, which leads to students’ inadequate ability of English application. 5P Teaching Method aims to improve students’ self-learning ability and their language application ability, which requires teachers to change their roles and strengthen the interaction with students. Meanwhile, it can provide an active and lively environment for English teaching. This paper analyzes the application of 5P Teaching Method in middle school English teaching in China and proves its necessity and validity.
Determining the Factors that Affecting Confectionery Sunflower Yield: The Case of Erzurum Province
Authors: UZUNDUMLU Ahmet , ÖKSÜZ Muhammet Emre
Published: April 2019

Objectives of this study was to determine the factors affecting the
yield in confectionery sunflower production in Pasinler district of Erzurum
province. In the study, the number of questionnaires was determined by using
the simple random sampling method based on the main population ratios. Overall,
84 questionnaires were administered to the households of 13 villages with the highest
sunflower production in the district. In order to determine the factors
affecting the confectionery sunflower yield in the study, the socioeconomic and
demographic factors of the producers and factor analysis coefficients for the
problems encountered in confectionery sunflower production were analyzed by
using the ordinary least squares method (OLS). In conclusion, as the age of the
producers and the amount of chemical pesticides use increase, a yield increase
in confectionery sunflower is achieved, whereas the yield decreases as the
entrepreneurship problems of the family and the amount of agricultural supports
increase. In order to the farms to achieve a higher level of yield and make a
more conscious production, courses should be organized by universities and
agricultural research institutes in areas including input use, farming
techniques, and entrepreneurship. In addition, a small amount of premium
support should be given to the confectionery sunflower as applied to oil
sunflower.
Clinicobacteriological profile, antibiotic sensitivity patterns and mortality of neonatal sepsis in a tertiary care hospital in Kashmir, Jammu and Kashmir, India
Authors: Wani Gh Rasool , Ahmed Nazir , Irshad Mohd , Ashraf Mohd , Teli Bashir Ahmed
Published: April 2019

Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were males while as 49 were females. Sixty three (63) neonates had late onset of sepsis while as 37 had early onset sepsis. The positive  blood culture was more common in males, late onset sepsis, babies born in rural areas, home born, vaginal births, preterm and other  low birth weight neonates .The gram negative isolates were most common followed by positive ones .The best sensitivity of gram negative isolates was to ciprofloxacin followed by amikacin and cephalosporins while as gram positive isolates were sensitive to imipenum followed by vancomycin. Pseudomonas was most responsive to pipercillin +tazobactum combination. The neonatal mortality was 35% being higher in early onset sepsis and low birth weights.Conclusions: This study depicts a high rate of neonatal sepsis, mainly caused by gram negative organisms followed by gram positive organisms with rising drug resistance that could bear far reaching implications to the times to come, mandating the implementation of sepsis preventive measures and administration of specific antibiotics.
Study of respiratory complications and outcome in meconium stained deliveries
Authors: Shukla Omprakash S. , S. T. Swapna
Published: April 2019

Background: To study the development of respiratory complications in the form of meconium aspiration syndrome (MAS), persistent pulmonary hypertension of newborn (PPHN), pulmonary hemorrhage and pneumothorax in neonates born through meconium stained liquor.Methods: It was a prospective study conducted during the period of February to October 2018. All live babies associated with meconium stained liquor were included.Results: Total 606 neonates with meconium stained amniotic fluid (MSAF) were enrolled. Chance of meconium passage was more after 37wk of gestation, in birth weight >2.5 kg and in AGA babies. The rate of LSCS was higher in MSAF group. MAS developed in 28% cases, out of which 42.9% expired. PPHN developed in 6.9% cases, out of which 80% expired. 100% mortality was there in babies with pulmonary hemorrhage. Apgar scores <7 is significantly associated with the development of respiratory complications. 22.8% of vigorous babies and all non-vigorous babies developed respiratory complications showing statistical significance with P-value of <0.00001. Mortality in MSAF was 12%. All babies who expired had severe meconium aspiration syndrome. 83.9% of the patients stayed for <7 days in the hospital. All of the expiry except one occurred within 7 days of life due to development of respiratory complications.Conclusions: MSAF is associated with the development of respiratory complications and mortality in neonates. Non-vigorous babies and the babies with Apgar scores <7 at birth are more prone to developing respiratory complications. Most of the MSAF babies were discharged and mortality was more in patients with respiratory complications.
Clinical profile of neonates with acute renal injury in neonatal intensive care unit at GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India
Authors: Katariya Kajal Lakhubhai , Pandya Nimisha K.
Published: April 2019

Background: Acute kidney injury (AKI) is defined as an acute deterioration in ability of the kidneys to maintain homeostasis of body fluids and electrolytes leading to retention of wasted and toxic metabolic end products. It is fairly common in newborn population and is a major contributor of neonatal mortality and morbidity. The aim was to study the incidence of renal failure in high risk neonates and risk factors for renal failure.Methods: A prospective observational study was done to evaluate renal profile in high risk neonates admitted to neonatal intensive care unit, GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India over a 1-year period. nRifle criteria was used for classification of acute kidney injury.Results: The incidence of AKI in high risk newborns admitted in this study was 52 (37.14%). The male to female ratio in current study was 2.46:1. Majority of neonates with AKI were out born 44 (84.6%). The incidence of AKI was higher in term newborns. Mean weight in AKI group was 2048 grams. The highest incidence of AKI was found in AFD newborns (57.69%). nRifle criteria was used to diagnose AKI in this study. Out of 52 neonates who had AKI, 27 (51.9%) were in risk category, 21 (40.4%) were in injury group and 4 (7.7%) were in failure group. Mortality in these groups were 5 (18.51%), 7 (33.33%) and 3 (75%) respectively. Highest correlation of risk factors for AKI was found with birth asphyxia 18 (34.9%) followed by sepsis 12 (23.1%) and shock 15 (28.5%). 29 (55.76%) neonates had non oliguric AKI. 28 (53.8%) neonates with AKI developed dyselectrolytemia.Conclusions: Early recognition and management of risk factors can help in reducing the occurrence and improve outcomes in them.
Clinical and laboratory predictors to differentiate severe dengue from scrub typhus in children
Authors: Elangovan Bharathi , T. Rajesh N.
Published: April 2019

Background: Objective of study was to compare the clinical features and laboratory parameters at admission and differentiate severe dengue from scrub typhus in children.Methods: Retrospective analysis of case records and comparison of clinical and laboratory parameters at admission of all children with a diagnosis of severe dengue and scrub typhus was done.Results: A total of 72 children were included (severe dengue =40; scrub typhus =32) during the study period. The mean (SD) age of children with severe dengue and scrub typhus was 7.9(3.8) and 11.8(5.8) years, respectively. Majority of children with severe dengue presented with hypotension, 21(52.5%) vs 3(9.4%) in scrub typhus. Children with severe dengue had a relatively low ANC (2.6±1.97x103/mm3 vs 3.9±2.06x103/mm3), low platelet count (50.23±35.55x103/mm3 vs 140±95.0x103/mm3) and low mean ESR at 1hour (8.1±6.82mm vs 33.88±13.79mm) than scrub typhus.Conclusions: Compared to scrub typhus, severe dengue was significantly associated with hypotension, lower ANC, ESR and platelets.
Incidence and risk factors of retinopathy of prematurity in Goa, India: a report from tertiary care centre
Authors: Kossambe Sarvesh , Joglekar Shilpa , D'lima Annely , Silveira M. P.
Published: April 2019

Background: To report the incidence and risk factors leading to the development of retinopathy of prematurity (ROP) from a tertiary care center in the western Indian state of Goa, India.Methods: This was a prospective observational study carried out in a level II neonatal intensive care unit (NICU) for a period of 18 months. Babies born at < 34 weeks’ gestation and having a birth weight of <1500gm were screened for ROP and laser photocoagulation was done for those who developed threshold ROP. Group differences between any ROP and threshold ROP were analysed using the chi-square test.Results: Out of the 244 preterm neonates screened, 37 developed ROP (15.16%), and 14 out of them (5.73%) developed threshold ROP requiring laser photocoagulation. Very low birth weight, prematurity, apnea, anemia, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, blood transfusions, exchange transfusions and days taken to reach full enteral feeds and regain birth weight were significantly associated with the development of ROP.Conclusions: This is the first report of ROP from Goa where less than 1 in 5 babies developed ROP. This is similar to that reported across the rest of the country. Judicious oxygen use, ventilation strategies, transfusions guidelines, control of sepsis, early enteral feeds and adequate nutrition may help prevent the development of ROP in the future.
The evaluation of effectiveness of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital: a before and after study
Authors: A. Bhowmik , G. Gargi , M. Nandy
Published: April 2019

Background: Kangaroo mother care (KMC) is a standard of care for preterm and low birth weight babies. To implement KMC in institutional care it was often practiced inside intensive care unit and also in separate ward. In present study authors have tried to evaluate effect of separate kangaroo mother care ward on implementation of kangaroo mother care in tertiary care hospital.Methods: Uncontrolled study before and after establishment of separate kangaroo mother care ward comparing kangaroo mother care in sick new-born care unit versus kangaroo mother care in separate ward.Results: In separate ward, as compared to kangaroo mother care practice in sick newborn care unit, mean (SD) duration of kangaroo mother care increased from 5.3 (1.6) to 11.4 (7.4) hours/day (95%CI 5.0-7.1, p value <0.0001). Mean (SD) weight gain increased from 10.7 (7.0) g/day to 13.7 (11.1) g/day (95% CI 1.0-4.8, p value <0.0024). Incidence of sepsis diminished from 14.0% to 28.9% (95% CI 6.4-23, p value <0.0006). Exclusive breast-feeding rate at discharge (42.3% vs. 57.3%) (95% CI 4.8- 24.9, p value <0.0041) and follow up (49.4% vs. 65.0%) (95% CI 1-29.4, p value <0.0378) increased. Mortality also decreased in this group of patients (8.6% vs.2.3%) (95% CI-1.6-11.4, p value <0.0082).Conclusions: Kangaroo mother care ward is better place than sick new born care unit for providing kangaroo mother care in tertiary care hospital.
Study on the effect of maternal anemia on birth weight of term neonates among rural population India
Authors: Gnanasekaran Sruthy , V. Jakanattane , R. Rajendran R.
Published: April 2019

Background: Maternal anemia in pregnancy is common and has several deleterious effects on the health of the mother and the fetus. Maternal anemia is an important risk factor for LBW babies and preterm babies. There exists an insufficient information regarding the adverse effect of anemia during pregnancy especially among rural population. The aim of the study was to determine whether maternal anemia would affect the birth weight of the baby.Methods: The study was conducted in post-natal ward in Sri Venkateshwara Medical College Hospital and Research centre, Ariyur, Puducherry, India a tertiary care hospital in a rural area.Results: About 85% of low birth weight babies were born to mothers with severe maternal anemia with a p value of <0.001 which is statistically significant. None of the mothers who didn't have maternal anemia had low birth weight babies.Conclusions: Maternal anemia is directly proportional to fetal growth. Maternal anemia being an important risk factor for low birth weight should be prevented as early as possible thus helpful in de-creasing the incidence, mortality and morbidity of LBW babies.
Simplified bronchiolitis severity score for health care providers
Authors: Rudhan Rachel P. , Biswal Niranjan
Published: April 2019

Background: Bronchiolitis is a viral lower respiratory infection of young infants. It requires monitoring by outpatient health care providers and rarely needs hospitalization. Scoring of severity in community helps in early referral. A simplified bronchiolitis scoring for rural health care providers with no facility for measurement of oxygen saturation (SpO2) and chest X-ray (CXR) is a long-felt need. This study proposes a simplified score.Methods: The proposed bronchiolitis severity score (PSS) has to be validated against the standard bronchiolitis severity score (SSS). The PSS was administered by a physician, nurse and researcher. The reliability was measured by the comportment of internal consistency and inter-observer agreement.Results: The physicians rating of severity by SSS and PSS was similar in 97% of cases. The internal consistency of 0.72 and the kappa index of 0.86 were obtained. The inter-rater agreements between physician, nurse, researcher was 0.94, 0.94 and 0.93 respectively.Conclusions: The PSS is reliable, valid and can be administered by nurses in peripheral health care settings.
Glycemic status in exclusively breast fed low birth weight babies In first 72 hours of life in a teriary care hospital
Authors: Natta Vithal Rao S. , Pagali Deepthi , Dandugula Venkata Priyanka , Veera Sowjanya Bhanu
Published: April 2019

Background: Neonatal hypoglycaemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. It can lead to considerable mortality and morbidity with long term neurological sequelae. Adequate breast feeding play an important role in maintaining normal glucose levels. So, this study is done to assess the incidence of hypoglycaemia in exclusively breast fed low birth weight babies, both term and preterm neonates and evaluate the impact of early breast feeding on glycaemic status upto 72 hours of life.Methods: This study was conducted over 12 month period involving 236 AGA (Appropriate for gestational age), SGA (Small for gestational age) babies with birth weight between 1.6-2.49 kg. Blood glucose values were measured at birth, 3h, 6h, 12h, 24h, 48h and 72h of life after delivery which was independent of feeding time. Hypoglycaemia was assessed against age of onset, gestational age, sex of baby, mode of delivery and time of initiation of breast feeding.Results: Total 56 episodes of hypoglycaemia were recorded in 52 babies of which 46 (27%) were term SGA babies and 6(8%) were preterm AGA babies (p=0.00148). The incidence of hypoglycaemia was found to be 22%, highest during the first 24 hours of life (93%) and delayed breast feeding is the most commonly noted risk factor (p=0.00024).Conclusions: Low birth babies are more prone to develop hypoglycaemia especially in first 24 hours of life with delayed introduction of breast feeding being one of the common risk factors and asymptomatic hypoglycaemia can be managed with frequent breast feeding without any formula feeds.
Plasma zinc levels in normal and malnourished children with lower respiratory tract infection from 2 months to 5 years of age
Authors: E. Dinesk Kumar , Annamalai Thumjaa , M. Shafath Ahmed , S. Sundari
Published: April 2019

Background: Acute Lower Respiratory Tract Infection (ALRI) is an important cause of morbidity and mortality in the developing world. Pneumonia is a severe form of ALRI that cause over 2 million deaths annually among children younger than 5 years of age. About 19% of all deaths, pneumonia is the leading cause of child mortality. Malnutrition is known to be associated with greater intensity of lower respiratory tract infections, higher the frequency of complications, longer episodes of infections. This study is to assess the plasma zinc levels in normal and malnourished children with LRI aged 2 months to 5 years.Methods: This is a case control study, which was carried out in the Department of Paediatrics, Sree Balaji Medical College and Hospital, the study period is one year from July 2016 to July 2017. 100 children between 2 months to 5 years of age with LRI was included in the study and children less than 2 months and more than 5 years. 50 Children with normal nutrition were taken as controls and 50 children with moderate and severe malnutrition were taken as cases. Age and sex were matched among cases and controls. Blood samples were collected for zinc estimation in both the cases and controls. All children were investigated and treated as per the department protocol for the particular condition. All statistical procedures were performed using SPSS v 21.0.Results: In present study, 66% of children had normal zinc levels, 34% of children had low zinc levels. The mean zinc level in our cases was 54.84±18.31 and in controls was 76.84±15.2, which was statistically significant (p = 0.000). Mean plasma zinc levels with respect to age and sex were not significant.Conclusions: Total 34% of children with LRI had low plasma zinc levels. Plasma zinc level were significantly low in malnourished children than normally nourished children with LRI, which is one of the most important cause of high childhood mortality in developing countries.
Comparison of the inferior vena cava index and inferior vena cava collapsibility index obtained by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome
Authors: Gupta Deepesh , Devpura Kusum , Agrawal Kamlesh Kumar
Published: April 2019

Background: There is triad of hypoalbuminemia, edema, and hyperlipidemia in nephrotic syndrome patients. Management of nephrotic syndrome includes general measures like fluid restriction, emergency albumin transfusions and diuretics that provide symptomatic relief till steroids act. These measures require an assessment of body fluid volume to avoid circulatory failure which is very difficult in these patients because of edema. The objective of the study was to measure and compare the Inferior Vena Cava (IVC) Index and Inferior Vena Cava Collapsibility (IVCC) Index by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome.Methods: The present observational study was conducted in all children of age more than 1 year up to 18 year. There were two groups; group 1 was nephrotic syndrome patients-Initial episode or in relapse and group 2 (Control) was age and sex-matched non-nephrotic children. IVC index and IVCC index were measured and compared in both the groups.Results: Mean value of minimum diameter of IVC during inspiration in cases was 5.91±1.60 mm as compared to 4.53±0.94 mm in controls which was significantly higher in case group {P ˂0.0001}. Mean value of IVC index in cases was 0.88±0.20 cm/m2 as compared to 0.93±0.19 cm/m2 in controls which was non-significant. Mean value of IVCC index in cases (35.61±13.68) was significantly less as compared to controls (52.23±2.01) {P ˂0.0001}.Conclusions: The present study concluded that IVCC index is better indicator of body fluid volume status in nephrotic patients as compare to IVC index.
Experience with Holter monitoring for evaluation of infant arrhythmia
Authors: Baghel Anita , Kumar Manoj , Soni J. P. , Agarwal Mudit , Kumar Ravi
Published: April 2019

Background: Arrhythmia is defined as abnormal heart rates. Sometimes they are intermittent and difficult to diagnose on routine ECG. Neonatologist and Pediatrician needs to rapidly establish accurate diagnosis and management for infants suspected to have arrhythmia. Hence Holter monitoring of the infants presenting with symptoms suggestive of arrhythmia is necessary as it provides a continuous record of heart’s electrical activity. The aim of this paper is to find out the role of continuous ambulatory electrocardiographic monitoring in daily clinical practice of Pediatrics.Methods: All infants including neonates, either inborn or brought to the paediatric emergency with risk factors, between January 2016 to January 2018, were included in this prospectively study. Evaluation including chest X-ray, standard 12-lead electrocardiography, 24 hours continuous ECG monitoring using Mortara holter, echocardiography, biochemical and haematological analysis.Results: A total of 73 babies were enrolled in present study. In this study arrhythmia was found in 29 (39.72%) new-borns. The most common arrhythmia observed was supraventricular tachycardia (SVT) (41.3%). Other arrhythmia observed were ventricular tachycardia (VT), AV block (34.4%), atria premature beats (3.4%) and ventricular premature beats (6.89%), tachy-bradyarrhythmia (3.4%) and junctional rhythm (3.4%). Of 29 arrhythmia patients four were diagnosed solely by Holter monitoring. None of the babies had long QT syndrome on Holter monitoring.Conclusions: Cardiac arrhythmias are important causes of infant morbidity, and mortality if undiagnosed and untreated. It is important for the neonatologist and paediatrician to be aware of these of arrhythmias and the various diagnostic modalities available for them. A Holter electrocardiogram may be of value in identification of these transient arrhythmic events.
Social dilemma and vitamin D deficiency: a cross-sectional study of nutritional rickets in children ages 6 months to 24 months
Authors: S. Sajid , Khan Irfan , K. Khalid , A. Khalil , Marwat Zahid I. , N. Shah
Published: April 2019

Background: In developing countries, malnutrition's is one of the challenges that still need to be addressed. Undernutrition is usually a result of the unavailability of food and/or repeated infections in children. Countries with comparatively lower per-capita incomes as well as those with middle per-capita income have its increased prevalence in younger age. Social dilemma of mothers, like exclusively breastfeeding, heavy clothing’s and practice of keeping babies inside the doors, lead vitamin D deficiency and ultimately into nutritional rickets. The objective of this study was to determine the frequency of factors leading to nutritional rickets in children ages 6 months to 24 months.Methods: This cross-sectional study was conducted at Department of Pediatrics, Ayub Teaching Hospital, Abbottabad, Pakistan from March to December 2017. After inclusion/exclusion criteria, total 160 patients of rickets were observed. Detailed history followed by vitamin D level (<15 ng/ml) was measure. Data was analyzed by SPSS-22 and all documents were locked with principal author.Results: Present study showed that 62% children were in age ranged 6-12 months and 38% children were in age range 13-24 months. Mean age was 12 months with SD±2.16. Seventy nine percent children were male, and 21% children were females. More over 52% children had exclusive breast feeding, and 48% children did not have exclusive breast feeding. Similarly, 15% children had limited sun-light exposure and 85% children did not have limited sun-light exposure.Conclusions: Present study concluded that a lack of health education and sunlight exposure and exclusive breastfeeding were the significant risk factors contributed to nutritional rickets among children of Abbottabad, Pakistan.
Langerhans cell histiocytosis presenting as isolated central diabetes insipidus in a 2-year-old child: a rare manifestation of rare disease
Authors: R. Nirmal S. , Krishnakumar Revathi , Nair Gayathri G. , Chordia Sri Lakshmi , Arunagirinathan Arulkumaran
Published: April 2019

Central diabetes insipidus, though uncommon in children, has varied causes, the commonest ones being genetic mutations, infiltrative disorders, infections. Isolated central diabetes insipidus is not one of the often encountered conditions in the pediatric practice. Here we report a case of 2 ½ years old female child who presented to us following history of polyuria for 2 months, who was confirmed to have central diabetes insipidus which was later evaluated to be secondary to Langerhans cell histiocytosis. Magnetic resonance imaging (MRI) and histopathological studies further helped in confirmation of the diagnosis. Langerhans cell histiocytosis is a rare, multifarious, and underdiagnosed hematologic disease in which isolated diabetes insipidus can be the sole presenting feature before other manifestations. Hence, this diagnosis could strongly be considered in the work up of central diabetes insipidus in children.
Enfermedad, transgresión y subjetividad en el México contemporáneo Presentación
Authors: Sacristán Cristina , Chaoul María Eugenia
Published: April 2019

Presentación
Facing food security and climate change adaptation in semi-arid regions: lessons from the Brazilian Food Acquisition Program
Authors: Mesquita Patrícia , Milhorance Carolina
Published: April 2019

Family farmers of semi-arid regions are especially vulnerable to climate change, due to the reliance on rain-fed production systems and the limited capacity to cope and adapt to impacts. The Brazilian Food Acquisition Program (PAA), as an example of a food procurement program that also functions as a food-based safety net for vulnerable populations, is analysed in a context of extreme drought in the Cariri region (Ceará state, Brazil).  Limitations that prevent the full range of potential PAA benefits are examined as perceived by institutional actors involved with the program, while measures to foster the full potential positive impacts on beneficiaries are discussed. Findings indicate that more consideration of the importance of governance and institutional factors on functioning of food acquisition programs, as well as the importance of the role of climate change on this equation, are essential for program sustainability, especially in a scenario of climate change.
Air Embolism in Sitting Position during Neurosurgical Operations and It’s Prevention: A Narrative Review
Authors: Khan Zahid Hussain , Samadi Shahram , Zanjani Amir Poya , Hatemi Bassim Mohammed
Published: April 2019

Venous air embolism (VAE) is an entrapment of air or exogenously delivered gas from the operative field or the communicated environment into the venous system due to gradient pressure. VAE and paradoxical air embolism (PAE) are potentially serious neurosurgical complications and carry high neurologic, respiratory, and cardiovascular morbidity or even may be fatal. Some procedures are at risk of developing these conditions, but the sitting and semi-sitting positions represent a higher risk. It’s occurrence during anesthesia is challenging to the anesthesiologists in terms of early discovery and management. Anesthesiologist can play an important role in detection and urgent treatment of VAE in case of occurrence. If the sitting position is needed for a neurosurgical necessity it can be used with vigilant follow up throughout the procedure to detect any occurrence of VAE.
Derbi Futbol Maçlarında Açılan Pankartlarin Göstergebilimsel Analizi
Authors: BULUT Erol , DEVER Ayhan
Published: April 2019

Bu
çalışmanın amacı nitel bir araştırma yöntemi olan göstergebilim analiz
metodundan hareketle derbi maçlarda açılan pankartların analizini yapmaktır.
Çalışmada Roland Barthes’in göstergebilim anlayışı kullanılmış, gösteren –
gösterilen – gösterge tabloları oluşuturularak pankartlar açıklanmaya
çalışılmıştır.

Derbi
maçlar olarak nitelendirilen kökeni oldukça geçmişe dayanan ve onbinlerce
taraftarın izlediği futbol karşılaşmaları farklı duyguların yaşandığı
alanlardır. Bu farklı düşünceler doğrultusunda hazırlanan pankartlar da çok
daha farklı olabilmektedir. Bu nedenle özellikle etnik, sınıfsal farklılıklara
göre şekillenen Boca Juniors – River Plate, AS Roma – Lazio Roma, Celtic FC –
Rangers FC, Barcelona FC – Real Madrid FC maçlarına yönelinmiş ve taraftarların
bu iki farklılığı pankartlarda nasıl sunduğu ortaya koymaya çalışılmıştır.
Yapılan araştırma sonucunda taraftarların açtığı pankartların, görünenden
ziyade görünmeyene vurgu yaptığı ve içinde bulunulan ve taraftarlara
rahatsızlık verilen durumların pankartlara da yansıdığı ve pankartlarda karşı
tarafın aşağılandığı, tehdit edildiği ve milliyetçi duyguların daha yoğun bir
şekilde yer aldığı sonucuna ulaşılmıştır.
Durkheim’in Sosyolojisinde İntihar Olgusu ve İntiharla Mücadelede Sosyal Hizmetin İşlevi
Authors: ŞEKER Aziz
Published: April 2019

İntihar
bir sosyal sorun haline dönüşmeye başladığından itibaren sosyal bilimin
dikkatini çekmiştir. İntiharın nedenleri ve hangi etkenlerin ne tip intiharlara
kaynaklık ettiğine yönelik araştırmalar yapılmış, intihara yönelik mücadelede
çözüm yolları ve öneriler üzerinde durulmuştur. İntihar olguları ile ilgili ilk
alan çalışmaları sosyal bilimler çevresinde başlangıçta özellikle sosyoloji
etrafında şekillenmiştir. Zamanla bu alanla ilgili sağlık profesyonellerinin
katkılarının yanında sosyal psikolojinin ve sosyal hizmet mesleğinin
gelişimiyle intihar olgusuna bakışta yeni sosyal yaklaşımlar geliştirilmiştir. Bu
çalışmada günümüz toplumları açısından bir sosyal sorun haline gelmiş olan
intihar olgusu sosyolojik açıdan Durkheim’ın bu alanda yaptığı çalışmasından
yola çıkılarak analiz edilecek ve intihara yönelik çalışmalarda sosyal hizmet
uygulamasının işlevi genel olarak irdelenecektir.
Değerler Eğitimi ve On Kök Değer
Authors: TOPAL Yakup
Published: April 2019

Bir toplumu “muasır medeniyetler” seviyesini yakalayabilmesi;
en başta üstün vasıflarda donanmış ahlâkî değerlere sahip gençler
yetiştirmesiyle mümkün olabilir. Bir ülkenin geleceğinin güzel olması da hiç
şüphesiz buna bağlıdır. Bu gerekçelerden ötürü ülkemizde “Değerler Eğitimi”ne
önem verilmektedir. Bu konuyla ilgili olarak Millî Eğitim Bakanlığı 2017
yılında müfredatta bazı değişiklikler yapılmasıyla ilgili basın açıklamasında
“Değerler Eğitimi” konusuna da gündeme getirmiş ve MEB değerler eğitiminde esas
alınması gereken “on kök değer” tespit etmiştir. Bu makalede tespit edilen “on
kök değer”in değerler eğitimi açısından genel bir değerlendirilmesi yapılmaktır.
Ayrıca yarı yapılandırılmış 4’lü likert ölçek şeklinde hazırlanan bir anket
hazırlanmıştır. Bu anketle öğretmenlerin “On Kök Değer”e karşı görüşleri
değerlendirilmiş, bu değerlerin yeterli olup olmadığı, bu değerlerden başka
manevî ve dinî değerlere yer verilip verilmemesiyle ilgili öğretmen görüşleri
alınmıştır.
Moğollarda Kullanılan Beki/Begi Unvanı Üzerine Notlar
Authors: ERDOĞAN Coşkun
Published: April 2019

Cengiz
Han kurduğu devletin geleceğini belirleme adına onun kurumsal yapısını tesis
etmeye çalışarak, hayatı boyunca fayda iktiza ettiği her yapıyı bozkır geleneği
temelinde şekillendirmeye gayret etmiştir. Moğolların kullandığı unvanlarda bu
bağlamda değerlendirmeye tabi tutulması gereken bir mevzudur. Beki/begi unvanı
olarak Moğol siyasî, sosyal ve idarî hayatında görülen unvanın mevkii ve
etkinliği hakkında bu güne kadar çeşitli görüşler ortaya konulmuştur. Türk
idarî yapılanmasında beg/bey unvanı ile paralellikler gösteren bu unvan, Moğol
toplumsal yapısı içerisinde farklı anlam kümesine tekabül edecek şekilde
kullanılmıştır. Araştırmada unvanın mahiyeti, konumu ve mevkii incelenirken,
Moğol inanç dünyasının kutsalları arasındaki bağlantıları da tespit edilmeye
çalışılmıştır. Ayrıca unvan hakkında şimdiye kadar ortaya konulan görüşlerin
bir hülasası yapılmaya çalışılmakta ve Moğol Devleti’nde belli bir döneme kadar
aktif olarak kullanılan bu unvanın gelişim seyri takip edilmeye
çalışılmaktadır.
ПРИМЕНЕНИЕ МЕТОДОВ ЭЛЕКТРОРАЗВЕДКИ С КОНТРОЛИРУЕМЫМИ ИСТОЧНИКАМИ ДЛЯ ВЫЯВЛЕНИЯ ПРИЧИН РАЗВИТИЯ СУФФОЗИОННО-ПРОСАДОЧНЫХ ПРОЦЕССОВ
Authors: (Aleksandr E. Shalaginov) Шалагинов Александр Евгеньевич , (Nina N. Nevedrova) Неведрова Нина Николаевна , (Ilya O. Shaparenko) Шапаренко Илья Олегович , (Sergey M. Babushkin) Бабушкин Сергей Михайлович
Published: April 2019

Актуальность работы обусловлена недостаточностью знаний о причинах развития суффозионных процессов, выраженных в виде провалов земной поверхности, угрожающих инфраструктуре промышленного производства в Прикаспийской впадине. Цель: определение приповерхностного и глубинного геоэлектрического строения участка проявления суффозионно-просадочных образований для выяснения возможных причин их возникновения. Объектом исследования являются суффозионно-просадочные образования в виде воронкообразных провалов земной поверхности глубиной от 1 до 6 м в количестве 15 штук, расположенных в трёх практически параллельных зонах. Методы. Весь объем полевых данных получен тремя разноглубинными методами геоэлектрики: электротомография, вертикальное электрическое зондирование, нестационарное электромагнитное зондирование. Обработка, интерпретация, визуализация данных осуществлялась с помощью интерактивных программных комплексов моделирования и инверсии ЭРА, EMS, Zond, Res2D, ERTLab. Обоснование результатов проведено на основе анализа и сопоставления полученных данных геоэлектрики с априорными геологическими данными. Результаты. По результатам выполненных работ с максимальной глубинностью до 400–500 м построены разрезы и карты распределения удельного электрического сопротивления на разных глубинах, трехмерные геоэлектрические модели, как для приповерхностной, так и глубинной части участка. В результате геологической интерпретации данных выделены зоны (по параметру УЭС), к которым приурочены существующие воронки, определено направление выноса разрушенных (размытых) горных пород. Выявлены структуры, связанные с зонами развития суффозионно-просадочных процессов, и сформулированы возможные причины их формирования. Выводы. Показана высокая эффективность комплекса электромагнитных методов, использованных на участке с деструктивными явлениями. Сделан вывод, что основной механизм образования воронок связан с вымыванием известнякового и солевого «цемента» из неоген-четвертичных отложений, с дальнейшей разгрузной в более глубокие обводненные горизонты. Этот комплекс может быть рекомендован при решении аналогичных задач в других регионах, где имеются зоны проявления суффозионных процессов, а также для мониторинга их развития.
СОВЕРШЕНСТВОВАНИЕ ТЕХНОЛОГИИ ПЕРЕРАБОТКИ СУНГУЛИТ-ВЕРМИКУЛИТОВЫХ КОНГЛОМЕРАТОВ
Authors: (Anatoly I. Nizhegorodov) Нижегородов Анатолий Иванович , (Alexey N. Gavrilin) Гаврилин Алексей Николаевич , (Boris B. Moyzes) Мойзес Борис Борисович
Published: April 2019

Актуальность. Усовершенствованная энерго- и ресурсосберегающая технология, реализуемая в новых технологических комплексах с предварительным «холодным» дообогащением, позволяет вернуть в промышленный оборот ценные сырьевые ресурсы и получить вермикулитовые и сунгулитовые концентраты из горнопромышленных отходов, накопленных на Ковдорском флогопит-вермикулитовом месторождении. В связи с этим данная работа посвящена вопросам совершенствования технологии переработки сунгулит-вермикулитовых конгломератов. Цель: анализ возможности совершенствования технологии получения термоактивированного сунгулита и вспученного вермикулита из горно-промышленных отходов Ковдорского флогопит-вермикулитового месторождения и повышение ее энергоэффективности. Объект: технологическое оборудование по переработке сунгулит-вермикулитовых конгломератов, реализующее энерго- и ресурсосберегающую технологию получения активированного сунгулита и вермикулитового концентрата. Методы исследования базируются на экспериментальных данных и анализе процессов аэродинамического отделения вермикулита и сунгулита от оливин-пироксеновой породы и повышения доли сунгулита в сунгулит-вермикулитовом концентрате. Результаты подтверждают достижение цели исследования. На их основе можно создать усовершенствованную технологию получения вермикулита, в том числе вспученного и магнезиально-силикатного реагента (термоактивированный сунгулит) из горно-промышленных отходов с экономией энергии до 182 кДж/кг, что уменьшает энергоемкость их переработки на 28 % по сравнению с предшествующей технологией. Кроме того, дополнительные технологические операции позволяют получить 350 кг вермикулита-сырца, 68 кг чистого магнезиально-силикатного реагента с размерами зерен 2,4…3,5 мм и 158 кг сунгулитового концентрата в термоактивированном виде с зернами 1,3…2,4 мм при почти 86 процентной концентрации. В целом можно сделать вывод о перспективности продолжения работ в области развития и совершенствования технологий переработки сунгулит-вермикулитовых конгломератов.
ОПРЕДЕЛЕНИЕ ПАРАМЕТРОВ ЖИВУЧЕСТИ ЗАЩИЩЕННЫХ ОТВЕТСТВЕННЫХ СТРОИТЕЛЬНЫХ КОНСТРУКЦИЙ ПРИ УДАРНО-ВОЛНОВОМ НАГРУЖЕНИИ
Authors: (Georgy I. Odnokopylov) Однокопылов Георгий Иванович , (OlegG. Kumpyak) Кумпяк Олег Григорьевич , (Zaur R. Galyautdinov) Галяутдинов Заур Рашидович , (Daud R. Galyautdinov) Галяутдинов Дауд Рашидович
Published: April 2019

Актуальность работы связана с тенденцией возникновения чрезвычайных ситуаций аварийного характера на предприятиях нефтегазовой промышленности. В связи с чем необходимо проектировать железобетонные конструкций, на которые возможно воздействие интенсивных кратковременных динамических нагрузок аварийного типа, носящих ударно-волновой характер. Учет реакции распора при проектировании позволяет выявить скрытые запасы несущей способности в изгибаемых железобетонных конструкциях, а также снизить трещинообразование, за счет увеличения жесткости. Эффективным способом снижения величины динамического воздействия является применение податливых опор в виде сминаемых вставок кольцевого сечения. Таким образом, совместное применение податливых опор и учет реакции распора дает возможность предотвратить повреждения, полное или частичное разрушение конструкций. Кроме того, повреждения строительных конструкций ответственных зданий и сооружений нефтегазового комплекса приводят к остановке технологического процесса, что в ряде случаев не только экономически не выгодно, но и недопустимо, а также может привести к значительному материальному ущербу и гибели людей. Цель: разработать методику и алгоритм построения энергетической диаграммы, выполнить числовую оценку применения податливых опор на живучесть защищенных строительных конструкций при интенсивном нагружении Методы: экспериментальные исследования: реакция входного силового воздействия, реакция выходного силового воздействия, ускорения, перемещения методами тензометрии, численное интегрирование методом Симпсона. Результаты. Разработана методика и алгоритм построения усредненной энергетической диаграммы. Выполнена числовая оценка применения податливых опор на живучесть защищенных строительных конструкций сооружений нефтегазового комплекса при кратковременном динамическом нагружении.
ГЕОХИМИЯ УРАНА И ТОРИЯ В ДОННЫХ ОТЛОЖЕНИЯХ МАЛЫХ ИСКУССТВЕННЫХ ВОДОЕМОВ И ОЗЕР НА ТЕРРИТОРИИ ЮГА ТОМСКОЙ ОБЛАСТИ
Authors: (Andrey Y. Ivanov) Иванов Андрей Юрьевич , (Sergey I. Arbuzov) Арбузов Сергей Иванович
Published: April 2019

Актуальность. Радиоактивные элементы являются эффективными маркерами состояния донных отложений малых водоемов и озер. Актуальность проблемы определяется слабой изученностью радиоактивных элементов в донных осадках озер и искусственных водоемов на территории юга Томской области. Цель: изучение радиогеохимических особенностей донных осадков озер и искусственных водоемов на территории юга Томской области. Объектом исследования являются донные отложения малых водоемов и озер юга Томской области. Методы: детальное опробование донных отложений малых водоемов, многоэлементный инструментальный нейтронно-активационный анализ, обработка и интерпретация полученных данных методами прикладной статистики. Результаты. Проведены радиогеохимические исследования донных осадков озер и искусственных водоемов на территории юга Томской области. Сделаны оценки среднего содержания урана и тория в донных осадках озер и искусственных водоемов на территории юга Томской области. В процессе исследований установлено, что содержание как урана, так и тория зависит от минерального типа донных осадков. Наименьшие концентрации урана были установлены в торфянистом типе, а наиболее высокие концентрации – в терригенном типе донных осадков. Установлено две зоны с повышенным содержанием урана. Первая зона пространственно приурочена к Кожевниковскому и Шегарскому районам Томской области. В этом районе выделяется Осиновско-Бабарыкинская радиогеохимическии аномальная зона повышенного накопления урана, которая очень четко прослеживается в субмеридиональном направлении. В пределах Кожевниковского района она может быть связана с разгрузкой подземных вод в зоне Колыванского разлома. В Шегарском районе повышенные содержания урана пространственно приурочены к гранитоидам позднепалеозойского фундамента. Вторая зона накопления урана простирается вдоль южного обрамления Западно-Сибирской плиты в пределах Кузнецко-Алатаусского блока.