bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences With Internet Triaging of 9498 Outpatients Daily at the Largest Public Hospital in Taiwan During the COVID-19 Pandemic: Observational Study
Authors: Lu Ding-Heng , Hsu Chia-An , Yuan Eunice J , Fen Jun-Jeng , Lee Chung-Yuan , Ming Jin-Lain , Chen Tzeng-Ji , Lee Wui-Chiang , Chen Shih-Ann
Published: May 2021

Background

During pandemics, acquiring outpatients’ travel, occupation, contact, and cluster histories is one of the most important measures in assessing the disease risk among incoming patients. Previous means of acquiring this information in the examination room have been insufficient in preventing disease spread.

Objective

This study aimed to demonstrate the deployment of an automatic system to triage outpatients over the internet.

Methods

An automatic system was incorporated in the existing web-based appointment system of the hospital and deployed along with its on-site counterpart. Automatic queries to the virtual private network travel and contact history database with each patient’s national ID number were made for each attempt to acquire the patient’s travel and contact histories. Patients with relevant histories were denied registration or entry. Text messages were sent to patients without a relevant history for an expedited route of entry if applicable.

Results

A total of 127,857 visits were recorded. Among all visits, 91,195 were registered on the internet. In total, 71,816 of them generated text messages for an expedited route of entry. Furthermore, 65 patients had relevant histories, as revealed by the virtual private network database, and were denied registration or entry.

Conclusions

An automatic triage system to acquire outpatients’ relevant travel and contact histories was deployed rapidly in one of the largest academic medical centers in Taiwan. The updated system successfully denied patients with relevant travel or contact histories entry to the hospital, thus preventing long lines outside the hospital. Further efforts could be made to integrate the system with the electronic medical record system.
Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review
Authors: Pallavicini Federica , Pepe Alessandro , Mantovani Fabrizia
Published: May 2021

Background

Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games.

Objective

The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play).

Methods

A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [(“video game*”) OR (“computer game*”)] AND [(“stress”) OR (“anxiety”) OR (“relaxation”)] AND [(“study”) OR (“trial”) OR (“training”)].

Results

A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety.

Conclusions

Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety.

Trial Registration

International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081
Effect of Baduanjin on pulmonary rehablitation in patients with moderate chronic obstructive pulmonary disease: a multi-center randomized controlled trial (Preprint)
Authors: Chen Xuan , Fu Cuiping , Wang Xiongbiao , Sun Meng , Zhang Wei , Li Shanqun
Published: May 2021

BACKGROUND

Baduanjin has been applied in health and rehabilitation and gained a growing number of practitioners both in home and abroad.To explore the effect of home based and video guided PR training, our research determined to evaluate Baduanjin on moderate COPD patients and explore its synergy effect with IMT in inducing improvement in pulmonary function, exercise capacity and quality of life.

OBJECTIVE

We cooperated Baduanjin as a pulmonary rehabilitation intervention for patients with moderate COPD. We evaluated its efficiency on pulmonary function, exercise capacity, quality of life in moderate COPD patients.

METHODS

This was a multi-centered, prospective, randomized controlled trial. Moderate COPD patients were collected from ten hospitals in Shanghai. After a two-week run-in period, all eligible participants were randomly assigned into Baduanjin training group, Tri-Ball® Respiratory training group, Baduanjin combined with respiratory training group and control group. The outcome assessments were conducted at four time points, namely at the 4th week and 8th week during the intervention, after 12-week pulmonary rehabilitation program and 3-month follow up.

RESULTS

A total of 240 participants were recruited in this study. 217 moderate COPD patients were analyzed in this study. After 12-week PR intervention, improvement was noticed in pulmonary function (FEV1%), exercise capacity (6MWD) and quality of life (CAT, SGRQ and T.C.M score) in Baduanjin training group when compared to the control group (P<0.05). Combining Baduanjin with additional inspiratory muscle training exerted better result than Banduanjin or inrespiratory muscle training alone (P<0.05). Improved performances after 12-week PR intervention were maintained after 3-month follow up in this research. Compared with the control group, drastically more percentage of participants with mMRC≤2 in combination training group was observed (mMRC≤2, 55(100%) vs 44(83.02%); mMRC＞2, 0(0%) vs 9 (16.98%), P＜0.01).

CONCLUSIONS

The results of this trial suggested that, Baduanjin training, as a simple daily pulmonary rehabilitation maneuver, could prevent the deterioration of pulmonary function in COPD patients and associated with improvement in exercise capacity and quality of life.

CLINICALTRIAL

The study protocol has been registered with the Clinical Trial Registry (NCT03892629).
A Text Message Intervention for Adolescents With Depression and Their Parents or Caregivers to Overcome Cognitive Barriers to Mental Health Treatment Initiation: Focus Groups and Pilot Trial (Preprint)
Authors: Suffoletto Brian , Goldstein Tina , Brent David
Published: May 2021

BACKGROUND

Many adolescents with depression do not pursue mental health treatment following a health care provider referral. We developed a theory-based automated SMS text message intervention (Text to Connect [T2C]) that attempts to reduce cognitive barriers to the initiation of mental health care.

OBJECTIVE

In this two-phase study, we seek to first understand the potential of T2C and then test its engagement, usability, and potential efficacy among adolescents with depression and their parents or caregivers.

METHODS

In phase 1, we conducted focus groups with adolescents with depression (n=9) and their parents or caregivers (n=9) separately, and transcripts were examined to determine themes. In phase 2, we conducted an open trial of T2C comprising adolescents with depression referred to mental health care (n=43) and their parents or caregivers (n=28). We assessed usability by examining program engagement, usability ratings, and qualitative feedback at the 4-week follow-up. We also assessed potential effectiveness by examining changes in perceived barriers to treatment and mental health care initiation from baseline to 4 weeks.

RESULTS

In phase 1, we found that the themes supported the T2C approach. In phase 2, we observed high engagement with daily negative affect check-ins, high usability ratings, and decreased self-reported barriers to mental health treatment over time among adolescents. Overall, 52% (22/42) of the adolescents who completed follow-up reported that they had attended an appointment with a mental health care specialist. Of the 20 adolescents who had not attended a mental health care appointment, 5% (1/20) reported that it was scheduled for a future date, 10% (2/20) reported that the primary care site did not have the ability to help them schedule a mental health care appointment, and 15% (3/20) reported that they were no longer interested in receiving mental health care.

CONCLUSIONS

The findings from this study suggest that T2C is acceptable to adolescents with depression and most parents or caregivers; it is used at high rates; and it may be helpful to reduce cognitive barriers to mental health care initiation.
Using peer support to strengthen mental health during the COVID-19 pandemic: a review (Preprint)
Authors: Suresh Rahul , Alam Armaghan , Karkossa Zoe
Published: May 2021

BACKGROUND

The coronavirus (COVID-19) pandemic has had a significant impact on society’s overall mental health with a notable effect on healthcare providers. To manage this global crisis, governments have had to implement numerous measures such mandated lockdowns and physical distancing to minimize the risk of overloading healthcare systems. Altogether, these measures have contributed to higher levels of anxiety, depression, insomnia, post-traumatic stress disorder, and other metrics indicating worsening mental health. Unfortunately, the availability of crucial mental health resources and support remains scarce during this time as services attempt to transition to an effective online delivery model. Peer support, which is peer-to-peer provided social and emotional support, is an underutilized and effective mental health resource that is easily delivered/accessed in-person by members within a social distancing bubble, or virtually across different bubbles.

OBJECTIVE

This review aims to summarize the toll that this pandemic has had on society’s mental health as found in peer-reviewed literature from October 2019 to March 2021, as well as suggest the utility of peer support to address these needs. Lastly, we provide strategies to effectively deliver peer support so that members of the community can better support one another during these unprecedented times.

METHODS

References for this review were chosen through searches of PubMed, Web of Science, and Google Scholar for articles published between October 2019 and March 2021 that used the terms: “coronavirus”, “COVID-19”, “mental health”, “anxiety”, “depression”, “isolation”, “mental health resources”, “peer support”, “online mental health resources”, and “healthcare workers”. Articles resulting from these searches and relevant references cited in those articles were reviewed. Articles published in English, French and Italian were included.

RESULTS

As stated in peer-reviewed literature, this pandemic has ubiquitously worsened the mental health of populations across the world, which is further exacerbated by extended periods of lockdown. Peer support has been demonstrated to yield positive effects on the mental health of a wide variety of recipients, and it can be provided through numerous accessible mediums such as web/mobile applications, video-conferencing software, workshops, telephone services, and student programs.

CONCLUSIONS

The provision of peer support can be very beneficial for improving mental health during the COVID-19 pandemic and may be an effective tool should similar events arise in the
future.

CLINICALTRIAL

N/A
Effectiveness of Self-Guided Virtual Reality–Based Cognitive Behavioral Therapy for Panic Disorder: Randomized Controlled Trial (Preprint)
Authors: Shin Bokyoung , Oh Jooyoung , Kim Byung-Hoon , Kim Hesun Erin , Kim Hyunji , Kim Suji , Kim Jae-Jin
Published: May 2021

BACKGROUND

Virtual reality (VR) is as effective a technique as traditional cognitive behavioral therapy (CBT) and a promising tool for treating panic disorder symptoms because VR exposure can be safer and has better acceptability than in vivo exposure and is more immersive than exposure through imagination. CBT techniques can be delivered more effectively using VR as well. So far, VR has required high-quality devices, but the development of mobile VR technology has improved user availability. At the same time, a well-structured form of VR can be reproduced and used anywhere. This means that VR can be used to provide a self-guided form of treatment and address the high treatment costs of evidence-based therapy and the lack of professional therapists. This study aimed to investigate the potential of self-guided VR as an alternative to high-cost treatment.

OBJECTIVE

The main goal of this study was to offer data about the efficacy of a mobile app-based self-led VR CBT in the treatment of panic disorder.

METHODS

A total of 54 subjects with panic disorder were enrolled in this study and randomly assigned to either the VR treatment group or waitlist group. The VR treatment was designed to be total 12 sessions for 4 weeks. The VR treatment consists of 4 steps in which patients are gradually exposed to phobic stimuli while learning to cope with panic symptoms in each stage. The effectiveness of treatment was assessed through the Panic Disorder Severity Scale, Hamilton Rating Scale for Depression, Body Sensations Questionnaire, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, Hospital Anxiety and Depression Scale, Korean Inventory of Social Avoidance and Distress Scale, Korean Inventory of Depressive Symptomatology, and Perceived Stress Scale. In addition, physiological changes using heart rate variability were evaluated.

RESULTS

In within-group analyses, the VR treatment group exhibited improvements in panic disorder symptoms, anxiety, and depression after 4 weeks, while the waitlist group did not show any significant improvement. Compared to the waitlist group, the VR treatment group showed significantly greater improvements in the Panic Disorder Severity Scale in both completer analysis and intention-to-treat analysis. Heart rate variability in the VR treatment group showed improvement in normalized high frequency from baseline to postassessment with no significant differences in any outcome measure between groups.

CONCLUSIONS

The self-guided, mobile app-based VR intervention was effective in the treatment of panic symptoms and restoring the autonomic nervous system demonstrating the validity of the use of VR for self-guided treatment. VR treatment can be a cost-effective therapeutic approach.

CLINICALTRIAL

ClinicalTrials.gov NCT04985019; https://clinicaltrials.gov/ct2/show/NCT04985019
Comparison of Learning Environment in 3 Different Settings to Support Clinical Skills Acquisition in Undergraduate Medical Students
Authors: Mohan Kirubashni , Emilia Ova , Widyandana Widyandana
Published: May 2021

Background: Integration between preclinical basic science education, skills training program in the laboratory setting and real clinical setting is recommended. This study explores clinical setting which suitable for undergraduate skills training program. The purpose of this study is to compare 3 different clinical settings (Sardjito Hospital, Klaten Hospital, and Puskesmas), which is appropriate for undergraduate clinical skills training.Method: This was a descriptive quantitative study, using cross sectional method. Data collection used self administrated questionnaire comprised of clerkship students who pooled of Sardjito Hospital, Klaten Hospital and Puskesmas (Primary Health Centre). Data analysis was done using ANNOVA test.Results: The Puskesmas scored the highest mean compared to Sardjito Hospital and Klaten Hospital for an overall learning environment and also in the scales for autonomy, social support, and role clarity. Sardjito Hospital scored the highest mean for the scales of supervision, workload, emphasis on teaching and learning and variety. There is a positive correlation between the learning environment and skills practice opportunity.Conclusion: Puskesmas as primary health centers is a better overall clinical learning environment compared to Sardjito Hospital and Klaten Hospital, but scored low means in domains such as emphasis on teaching and learning and variety. There is a positive correlation between the learning environments and skills practice opportunity with different features for each setting. There is no correlation between skills practice opportunity and gender or marital status.
Faktor-faktor Yang Dianggap Sebagai Prediktor Terhadap Keefektifan Kelompok Tutorial Problem Based Learning (PBL)
Authors: Istadi Yani , Mardiwiyoto Harsono , Prabandari Yayi Suryo
Published: May 2021

Background: The tutorial plays a central role in problem-based learning (PBL). The effectiveness of small group tutorials is one of the key aspects to the students’ success in exam. This study aimed to identify factors perceived as the predictors for effectiveness of PBL tutorial group.Method: The subjects of the study were all of the students (year of 2008) of the Medical College of Sultan Agung Islamic University who were taking tropical disease module. The adapted version of the scales adopted in this study included the scale developed by Van den Bossche et al. for assessing team effectiveness, beliefs about the interpersonal context and group’s learning behavior dimension, scale developed by Dolmans & Ginns for assessing tutor’s performance, scale developed by Munshi et al. for assessing quality of case problem, scale developed by Lepper et al. for assessing learning motivation. Quantitative approach with correlation and double regression analysis was applied.Results: The 223 subject included in the study consisting of 84 (37.3%) male and 139 (62.3%) female students. There was a significant correlation between effectiveness of tutorial group and a tutor’s performance (r = 0.456, p < 0.01), quality of case problem (r = 0.366, p < 0.01), beliefs about the interpersonal context dimension (r = 0.631, p < 0.01), group’s learning behavior (r = 0.559, p<0.01) and motivation (r = 0.137, p<0.05). There was a correlation between the variables of tutor’s performance, beliefs about the interpersonal context dimension, and learning behavior and group effectiveness indicated by the regression coefficient of 0.739 (p < 0.05). These three variables contributed to the group effectiveness as much as 54% with F value 87.857. The quality of case problem and motivations were not the predictive factors for group effectiveness.Conclusion: Improving tutorial group effectiveness requires improving factors beliefs about the interpersonal context dimension, group’s learning behaviors dimension and tutor’s performance. A favorable learning atmosphere is needed to improved motivation and better quality of case problem.
Tingkat Pelaksanaan Problem-Based Learning di Fakultas Kedokteran Universitas Gadjah Mada Berdasarkan Pembelajaran Konstruktif, Mandiri, Kolaboratif, dan Kontekstual
Authors: Dibyasakti Banu Aji , Rahayu Gandes Retno , Suhoyo Yoyo
Published: May 2021

Background: Problem-based Learning (PBL) is a new strategy on a learning system. There are four basic theories regarding PBL such as constructive, self-directed, collaborative, and contextual learning. The success of the implementation of PBL in one institution can be measured by the implementation of its four basic theories. Faculty of Medicine UGM (FM UGM) has been implementing PBL as their curriculum since 2002, however there have not been any conducted research that measure the implementation of PBL in FM UGM towards its 4 (four) basic theories. The objectives of this study are to validate instrumen developed by Romauli et al8 that can measure the implementation level of PBL towards its 4 basic theories, to measure the implementation level of PBL in FM UGM towards its 4 basic theories, and to compare the implementation level of PBL based on students’ academic level and regular/international program.Method: This research used quantitative non-experimental research with cross-sectional design. 321 students from 2nd (2008) and 3rd (2007) students’batch regular and international program filled the questionnaire developed by Romauli et al (2009) which had been reliable (Alpha Cronbach) and validated (Pearson Moment Product) twice previously. The data were analyzed using mean analysis to measure the implementation level of PBL towards its four basic theories. This research also compared the implementation level of PBL based on students’ academic level and regular/international by using Independent Sample t-test.Results: Instrument developed by Romauli et al8 had high validity and reliability level (á=0,01 and r=0,931). The implementation level of PBL in FM UGM towards constructive, self-directed, collaborative, and contextual learning were in moderate level (1,72±0,28;min 0 & max 3). There were not any significant differences of the implementation level of PBL among 2007 & 2008 batch (p>0,05). There were any significant differences of the implementation level of PBL among regular & international students regarding constructive & contextual learning (p<0,05), however there were not any significant differences for self-directed & collaborative learning, (p>0,05).Conclusion: Instrument developed by Romauli et al (2009) had high validity and reliability. The implementation level of PBL were in moderate level. There were not any significant differences of the implementation level of PBL among two different students’ batch. There were any significant differences of the implementation level of PBL among reg
Intrument for Evaluating Didactical Performance of Clinical Skill Laboratory Teachers
Authors: Setiawan Ide Pustaka , Jan Van Dalen Jan Van Dalen , Jill Whittingham Jill Whittingham
Published: May 2021

Background: There are some studies about strategies for clinical skills teachers and criteria for effective teaching in a Skills lab. However, there isn’t an established instrument yet to evaluate clinical skills teacher’s didactical performance while facilitating skills learning. The aim of this study was to develop an appropriate instrument to evaluate clinical skills teachers’ didactical performance.Method: A preliminary instrument was developed based on recent available literatures. This instrument was applied by students, to quantitatively evaluate didactical performance of skills teachers who teach a certain skill. Then focus group discussions (FGD) were conducted. The results of both procedures were compared.Results: 255 first year medical students participated (response rate: 91%). There was significant difference between students’ judgments of clinical teacher’s (specialist) and Skills lab teacher’s (general practitioner) didactical performance (p<0.05). Cronbach’s alpha of the instrument turned out to be .95, indicating a high homogeneity. All items contributed to this measure of reliability. This quantitative finding was supported by qualitative resultsConclusion: The questionnaire developed is valid and reliable. It can be concluded that characteristics of a proper instrument for evaluating clinical skills teachers’ didactical performance encompass didactic skill, interpersonal & communication skills and condition/strategy of skills training.
Hubungan Persepsi Lingkungan Pembelajaran dengan Strategi Pembelajaran Mahasiswa Program Studi Pendidikan Dokter Universitas Jambi
Authors: Shafira Nyimas Natasha Ayu , Jusuf Anwar , Budiningsih Setyawati
Published: May 2021

Background: Students' perceptions toward learning environment may influence the use of students' learning strategies. In medical education, the students are expected to implement deep approach. Therefore, students' learning environment should be able to direct the students to learning by using deep approach. The purpose of the research was to investigate the relationship between students' perception about learning environment, students' learning strategies, among medical student in Jambi Medical School (UNJA)Method: This research employs cross sectional design from April to June 2012. The samples were 198 respondents who were students in semester 2, 4 and 6. The date of the perception about the learning environment and learning strategies was adopted from questionnaires from Dundee Ready Educational Environment Measure (DREEM) and The Revised two Factor study process Questionnaire (R-2F-SPQ).Results: The study showed that 80 percent of the students have positive perception regarding learning environment in UNJA. More than half of the students applied deep approach. There was significant relationship between students' perceptions about learning environment with learning strategies used by the students (p = 0,001). There was a tendency that better students' perception toward learning environment made students prefer deep approach.Conclusion: There is significant relationship between students' perceptions about learning environment with learningstrategies used by the medical students of PSPD Jambi.
Hubungan Motivasi dan Hasil Belajar Mahasiswa Kedokteran
Authors: Lisiswanti Rika , Sanusi Rossi , Prihatiningsih Titi Savitri
Published: May 2021

Background: Motivation is the force that drives a person to do something. Motivation can affect student learning achievement. The purpose of this study was to examine the relationship between motivation and student learning achievement. Method: This research method was a cross sectional survey. The study was conducted at the Medical Faculty of Lampung University. The study population was students that taking Medical Basic Science (MBS) blocks 3. Samples were from all population. The instrument used to assess motivation was Motivated Strategies of Learning Questionnaire (MSLQ). The questionnaire comprises 6 dimensions divided into 31 questions that intrinsic, extrinsic, task value, control of learning beliefs, self-efficacy and anxiety. Learning achievement were measured by the MCQ which. Questionnaire data were taken at the end of the block MBS3, which analyzed using Pearson Product Moment correlation. Results: The correlation between intrinsic motivation and student’s achievement obtained -0.020 with 0.805 significance (p> 0.05). Relationships intrinsic motivation and student’s achievement showed an inverse relationship. Extrinsic motivation and student’s achievement obtained 0.670 with 0.397 significance (P> 0.05). The correlation task value and student’s achievement  0.066 with 0.403 significance (p> 0.05). The correlation control of learning beliefs and student’s achievement of 0.054 with 0.339 significance (p> 0.05). The correlation of self-efficacy and student’s achievement of 0.054 with 0.496 significance (p> 0.05). The correlation test anxiety and student’s achievement -0.060 with 0.447 significance (p> 0.05). The correlation of total score of motivation and student’s achievement  0.034 with 0.670 significance (p> 0.05). All correlation dimension obtained motivation was weak and not significance.Conclusion: The results showed very weak positive correlation between the total score of motivation to learning achievement.
Corporate Social Responsibility and Justice in the Salary Structure: Practice or Symbolism?
Authors: Ibáñez María José , Huamán Joana
Published: May 2021

Socially responsible companies should provide fair wages and maintain reasonable internal wage gaps as part of a commitment to workers as primary stakeholders of the organization. Our research seeks to clarify the influence of the Corporate Social Responsibility (CSR) system on the salary level of unskilled workers and the magnitude of internal salary gaps between the highest and lowest levels of the organization. We used a sample of 815 companies that are representative of the Chilean business ecosystem and developed a linear regression model with endogenous treatment. Our results show that the declaration of a CSR program positively influences the wage level of unskilled workers but increases the magnitude of internal organizational wage gaps. These findings suggest a partial adherence of companies declaring CSR in terms of commitment to their employees.
Safeguarding Environment through Religion: A Study of Prophet Muhammad (PUBH) Sunnah
Authors: Ahmad Muneeb
Published: May 2021

Environmental degradation forms one of the main concerns of humanity world-wide. Environment receives high proportion of toxic waste in each possible form - solid, liquid, and gaseous, each passing day. All this should call upon the attention of human beings to think on the grave issue of environmental pollution. Every year June 5 is celebrated as the World Environment Day (WED) under the aegis of United Nations, intending to raise awareness about the environmental issues within the global society. Seminars, Symposia, and conferences are held world-wide to seek strategies and tools to minimize the harmful effects of environmental pollution. There is no denying of the fact that all such human endeavors bear fruits. However experts at such events fail to invoke the teachings of religious scriptures. As the post-modern man still believes in the inviolability of nature, which forms the trust of God in the hands of man, to call upon the religious teachings on the environmental preservation and protection will help a lot to build our healthy relationship with the environment. In the paper my venture is aimed to explore the Prophetic Sunnah of Muhammad where in the conservation and care for the environment is deeply cherished. The study could prove useful to both religious and ir-religious in drawing vital insights and handy conclusions for the preservation of the environment that we all are part of.
Business Communication Strategies: Analysis of Internal Communication Processes
Authors: Ali Bayad Jamal , Anwar Govand , Gardi Bayar , Othman Baban Jabbar , Aziz Hassan Mahmood , Ahmed Shahla Ali , Hamza Pshdar Abdalla , Ismael Nechirwan Burhan , Sorguli Sarhang , Sabir Bawan Yassin
Published: May 2021

The purpose of this research is to investigate the current situation of internal communication in the maintenance department in the cement industry. In most organizations, employees and managers have struggled with the thought of attempting to solve weak and bad communication between the two parties which mostly cause issues to an organization, whether in performance or cost wise. This research was carried out at the maintenance department in Cement Company. A quantitative method was used to gather relevant information regarding a study of internal communication in maintenance department in cement industry. The research findings were supported that current management at Cement industry implementing team meetings effectively. The current management at Cement industry is creating and using online- printed communications tools, organizing regular events. The research findings were supported that current management at Cement industry using online tools for internal communication. In terms of notice board communication, the researcher was not able to find any link between company’s’ standard as a fact of internal communication method and respondent’s perception as research findings. At this point the researcher was able to point out the gap between this study and the fact of internal communication at maintenance department in Cement industry. According to the findings the researcher was able to find out the gap between site visit communication between perception and the fact. Concerns of face-to-face communication method, also, was not found in the standard of internal communication at cement industry. Accordingly, the researcher was able to point out the gap between face-to-face communication method as a fact and respondents’ perception according to the research findings. The current management at Cement industry is establishing a regular, transparent communication with all employees covering the entire organization. The research findings were supported that current management at Cement industry implementing network communication effectively.
The Role of Shopping Malls on Kurdistan Regional Government’s Economy
Authors: Ali Bayad Jamal , Gardi Bayar , Othman Baban Jabbar , Sabir Bawan Yassin , Sorguli Sarhang , Ismael Nechirwan Burhan , Hamza Pshdar Abdalla , Aziz Hassan Mahmood , Ahmed Shahla Ali , Anwar Govand
Published: May 2021

This research covers the history of shopping malls in KRG and how the malls were a new shopping destination for the citizens of KRG. However, with the current economic crisis in KRG and the financial difficulties that people have been facing in the past two years. This research studies the impact of economy crisis on the spending's of individuals and the shopping centers that were used to be filled with people who would spend a huge amount of money on shopping. We distributed 240 questionnaires in three languages: Kurdish, Arabic and English in order to identify people’s shopping behavior and the factors that attract people to the shopping malls. The things that we managed to accomplish in this research was that people are pessimistic about the financial situation and future of the economy. People would rather save their cash than spending it on shopping. These achievements met the main objective of this study which was to find out people’s behavior to do their shopping and satisfy their needs and wants that are provided in the malls.
Características clínicas de anorexia nervosa extrema. Reporte de caso
Authors:   Universidad Nacional (UNAM). Médico pasante de servicio social . Ciudad de México, México, Morales Allende María Fernanda , Galván Sánchez Griselda ,   Secretaría de Salud (Ssa). Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Clínica de Trastornos de la Conducta Alimentaria. Ciudad de  México, México
Published: May 2021

Anorexia nervosa is currently considered a disease of great impact due to its association with malnutrition. It occurs mainly in women, adolescents and young adults. The severity is defined by BMI. It is a multifactorial disease, with great influence of the cultural environment, biological, family and personal aspects. No system in the body is spared from the adverse sequelae of these illnesses, especially as anorexia nervosa becomes more severe and chronic. We review the medical complications that are associated with extreme anorexia nervosa. It is also considered as a disease with a high morbidity and mortality rate, due to an increase of up to 6 times the risk of death and the multiple medical complications associated with the disease. Hence, it is essential to increase health resources, reinforce information in first-contact doctors to identify this condition, and increase factors of good prognosis such as early patient care. Keywords: Anorexia nervosa; medical complications; eating disorders
Enfermedad de Von Willebrand como factor de riesgo para hemorragia postparto. Reporte de caso
Authors:   Instituto Mexicano del Seguro Social. (IMSS). Hospital General de Zona No. 33. Bahía de Banderas, Nayarit, Chavira Anaya Cynthia Fabiola , Arriaga López Alberto ,   Instituto Mexicano del Seguro Social (IMSS). Hospital de Ginecología y Obstetricia No. 4 “Luis Castelazo Ayala”. Unidad Médica de Alta Especialidad.  Ciudad de México, México, Álvarez Torres Alfredo ,   Instituto Mexicano del Seguro Social (IMSS). Hospital de Ginecología y Obstetricia No. 4 “Luis Castelazo Ayala”. Unidad Médica de Alta Especialidad.  Ciudad de México, México
Published: May 2021

The Von Willebrand´s disease is the most common inherited bleeding disorder, with higher prevalence in women in fertile age. There are three principle types, that are caused by either a quantitative or qualitative defect in von Willebrand factor and in severe cases, the coagulation factor VIII is affected too. The incidence in pregnancy is relatively infrequent, however there are worldwide reports where it has been considered a risk factor for bleeding during the resolution of pregnancy. We present the case of a 20-year-old woman on her second pregnancy, with a previous abortion, who had a full-term pregnancy with a diagnosis of Von Willebrand disease since she was twelve years old, treated with nasal desmopression only in the presence of hemorrhagic events. Gestation was terminated via abdominal route due to failed induction, and in spite of preoperative hematologic and anesthetic prophylactic management, she presented postpartum hemorrhage, according to current definitions based on national and international guidelines, attributing the cause of the bleeding to the patient's coagulopathy. Keywords: Von Willebrand´s disease; pregnancy; postpartum hemorrhage.
Escisión transcervical de un adenoma paratiroideo mediastínico gigante
Authors:   Secretaría de Salud (Ssa). Hospital General “Dr. Manuel Gea González”, División de Otorrinolaringología y Cirugía de Cabeza y Cuello, Ciudad de México,  México, Barrientos López Isaías Adrián , Castillo Ventura Bertha Beatriz ,   Secretaría de Salud (Ssa). Hospital General “Dr. Manuel Gea González”, División de Otorrinolaringología y Cirugía de Cabeza y Cuello, Ciudad de México,  México
Published: May 2021

Primary hyperparathyroidism (HPTP) is the third most common neuroendocrine disorder, its main cause is parathyroid adenoma. Within the classification, those adenomas that weigh more than 3.5 g are classified as giant parathyroid adenomas (APG), and are associated with a worse evolution and malignancy. The purpose of this article is to present our diagnostic and therapeutic approach of a patient with HPTP ssociated with a mediastinal APG. A search in the international literature of the last 10 years revealed that only 8 other centers ha ve reported the extraction of an APG of similardimensions to ours and in a similar location. Case presentation: A 66-year-old woman with a history of multinodular goiter, thyroid profile and parathormone (PTH) measurement were requested, with a report of 350.60 pg/mL. A thyroid/parathyroid scintigraphy was performed with 99mTc sestaMIBI which reported persistence of a focal area of the concentration located in the topography of the lower pole of the right thyroid lobe. This study was complemented with SPECT-CT, which reported an image of hyperfunctioning right inferior parathyroid compatible with adenoma and the patient was diagnosed with PTH. Finally, resection was performed, obtaining a tumor measuring 7.0 × 4.5 × 2.0 cm, with a weight of 24.5 g. Conclusions: Our case highlights the use of imaging studies to facilitate localization and achieve diagnosis together with clinical presentation and biochemical profile. Selective treatment was achieved safely through a minimally invasive transcervical technique, combined with the measurement of PTH. Keywords: Parathyroid adenoma; neoplasia; hypercalcemia; primary hyperparathyroidism; case report.
On the sources of the night side ionosphere of Venus
Authors: Pérez De Tejada Héctor
Published: May 2021

Se presenta una descripción general de las características de la ionósfera nocturna en Venus y del medio magnético y plasmático en su estela. Se sugiere que el carácter variable de la ionósfera nocturna, es debido en parte, a condiciones de asimetría y variaciones temporales de la penetración viscosa del viento solar a la región de la umbra óptica atrás del terminador planetario. Además de Ios efectos de inducción, la presencia de flujos magnéticos asociados con el plasma solar debe contribuir a explicar la dependencia que ejerce el campo magnético interplanetario sobre la geometría magnética dentro de la umbra óptica.
Trace element geochemistry of a box-core from San-Pedro Basin, NE Pacific
Authors: Terrel David J. , Pal Surendra
Published: May 2021

Se midieron 16 elementos "trazas" y 3 elementos "mayores" en los sedimentos de una caja proveniente de la cuenca de San Pedro, situada en la zona costera de California, utilizando el método de análisis instrumental de activación por neutrones (AlAN). La precisión bastante buena de estas mediciones (cerca de ± 10%) permite la observación de variaciones significativas en las concentraciones de estos elementos aun en los 26 cm superiores de la caja.Los elementos 'tierras raras' presentan un patron tipo "lutita" para estos sedimentos. La razón de K/Cs indica que el cesio sigue al potasio en sedimentación fina. El valor promedio de K/Cs ﹶﹶ 1.2x 10³ junto con el valor de 12.4 ppm de Cs corresponden a sedimentos finos argiláceos no-carbonáceos. Las concentraciones de Th (-7.5 ppm) son parecidas a las de arcillas pelágicas. Estos sedimentos se caracterizan más por valores normales de Cr, Zr y Ta, concentraciones relativamente altas de Nay Sb, y bajos contenidos de Fey Sc, cuando se les compara con los reportados para sedimentos marinos de otras áreas.
Thermal and radiational aspects of the christmas eve 1977 air pollution episode in Mexico City
Authors: Galindo I. , Chávez A.
Published: May 2021

Durante la noche del 24 de diciembre de 1977, miles de llantas fueron quemadas en las calles de la Ciudad de México. La carga adicional en la troposfera de partículas y materia gaseosa aunada a condiciones meteorológicas de estabilidad atmosférica, generaron un episodio de contaminación severa del aire afectando el balance térmico. El día 25 de diciembre entre las 0700 y las 1400 horas TSV (tiempo solar verdadero), la visibilidad horizontal se redujo a menos de 1 km, alcanzando su mínimo de <0.1 km entre las 1200 y las 1400 horas TVS. La altura matutina de la capa de mezcla fue de 90 m con velocidad media del viento de 1 m seg-1. Los efectos térmicos de la capa atmosférica de aerosoles se manifestaron mediante un calentamiento nocturno de 2-3°C (efecto .de invernadero); durante el día, hubo por el contrario un enfriamiento de 1.5°C. La duración de insolación se redujo 1 hora. La turbiedad atmosférica alcanzo valores muy altos. La radiación total incidente en la superficie disminuyó en 26.8%.La razón radiación difusa/directa se invirtió, indicando que gran parte de la radiación entrante fue dispersada en la capa de aerosoles. La acción combinada de los procesos de absorción y retrodispersión en la capa adicional de aerosoles parece ser la responsable del enfriamiento diurno del aire en superficie. Se analizan por separado los efectos sobre el balance térmico de la absorción y la retrodispersión en la capa. La retrodispersión (reflexión) es similar a la producida por una capa de nubes. Utilizando el modelo de Yamamoto y Tanaka, se estima que el albedo global se pudo incrementar de 0.15 a 0.30. Los efectos radiativos descritos pueden ser los responsables del enfriamiento diurno observado.
A numerical method for simulation of convective plume field dispersion
Authors: Lal Murari
Published: May 2021

Al simular dispersión en situaciones complejas, la descripción simple de movimientos no resueltos en términos de una función espectral y distribución de velocidad, puede ser insuficiente debido a que se ignora la información sobre fases relativas de las diferentes componentes espectrales. Esta información de la fase se puede retener directamente generando explícitamente los vientos mediante un modelo de sistemas significativos pero no resueltos. Como ejemplo de un sistema tal, se considera aquí, el de plumas convectivas en una capa límite inestable. Los resultados muestran que algunos de los aspectos cualitativos de la dispersión encontrada mediante la simulación física de una capa límite inestable, que no pueden ser explicados por una aplicación racional de la aproximación de difusividad de "eddies", se explican empleando el método de Monte Carlo. Es necesario un entendimiento más completo de la naturaleza física del campo de una pluma convectiva, antes de esperar obtener un entendimiento cuantitativo del problema.
Oaxaca, México, earthquake of 29 November 1978: a preliminary report on spatio-temporal pattern oe preceding seismic activity and mainshock relocation
Authors: Ponce I. , Mcnally K. C. , Sumin De Portilla V. , González J. , Del Castillo A. , González L. , Chael E. , French M.
Published: May 2021

El análisis de la actividad sísmica (m>2.8) registrada por medio de una red local de 6 sismógrafos durante 3 semanas previas a la ocurrencia de un fuerte temblor (29 de noviembre de 1978, M8=7.8) en Oaxaca--, revela los siguientes aspectos: (I) Las distribuciones espacial y temporal de la actividad sísmica precedente sugieren que ella ocurre a lo largo de una dirección con rumbo N66°±6°W y probablemente a lo largo de otras dos direcciones con rumbo N39°±6°E que·cruzan los flancos occidental y oriental de la zona de réplicas (2). En una área de 3000 km² que rodea al temblor principal se presenta una calma sísmica para temblores de m>2.8 excepto durante dos periodos en que ocurren “temblores precursores" (a menos de 24 km del epicentro de! temblor principal): el primero, 2 semanas antes de la ruptura el segundo. 21 hrs. antes de la ruptura y luego la actividad declina durante 17 hrs. hasta la ocurrencia de! temblor principal. Este comportamiento de la actividad sísmica en el tiempo, observado inmediatamente antes de la ocurrencia del temblor principal, es similar a otros casos observados mundialmente. Mientras que los temblores precursores ocurren en la mil ad norte de un círculo de radio de 2,1 km centrado en el epicentro de! temblor principal de las 12 replicas mas fuertes (mb>4.0. 30 nov – 8 dic.) ocurren dentro de este pequeño círculo al sur de los temblores precursores. Además 8 de dichas replicas, los temblores precursores. el temblor principal y 2 de los mayores temblores precedentes (m = 3 .9 y 3.4) se encuentran alineados a lo largo de la dirección N -S. Se observa que existe una aceptable correlación entre los lineamientos definidos por la información sismológica y las fallas activas encontradas en base a estudios geomorfoestructurales. Un resultado importante de este estudio es la documentación de la actividad sísmica precedente a niveles de energía menores que los umbrales de -detección acostumbrados (mb≅1). La relocalizacion del temblor principal se encuentra aproximadamente a 50 km al sureste de! epicentro publicado por NEIS; las relocalizaciones de las replicas difieren entre 40 y 100 km de los epicentros publicados por NEIS.
Statistics of remanent magnetization intensities of some cenozoic extrusive igneous rocks from Jalisco state, Mexico
Authors: Urrutia Fucugauchi Jaime
Published: May 2021

El relevamiento de ocho unidades volcánicas de la Era Cenozoica del estado de Jalisco, México, ha demostrado que las intensidades de magnetización remanente de las rocas, tienen una distribución de función de densidad que se aproxima a la distribución logarítmica normal. Las intensidades medias calculadas en base a los distintos lazos parecen guardar relación con la polaridad. La intensidad logarítmica media de todos los lazos, se presenta en comparación con otros datos de la Era Cenozoica.