bluuebunny/crossref_metadata_2025 huggingface dataset:
Corona kontrovers III
Authors: Breusing Mia
Published: October 2022

Im Rahmen der SARS-CoV-2-Pandemie führten in Deutschland weitreichende Einschränkungen der Grundrechte zu einer Vielzahl kontrovers geführter Diskussionen über die Verhältnismäßigkeit von Maßnahmen und Reaktionen seitens Politik, Gesellschaft und Medien.
Die drei konsekutiv angeordneten Bände bieten einen Einblick in die zentralen Eckpunkte der Debatte und durchleuchten ihre schwerpunktmäßige Zuordnung im Spannungsfeld zwischen einem Top-Down- und einem Bottom-Up Krisenmanagement. Sie stellen nicht zuletzt umfangreiche Unterrichtsmaterialien bereit, welche es den
Schülerinnen und Schülern ermöglichen, ihre eigenen Vorstellungen von Demokratie weiter auszubilden.
Band 3 beleuchtet die getroffenen Maßnahmen in der Pandemie sowie ihre Folgen für Gesellschaft und Demokratie.
Reported knowledge and practices towards the proper use of patient information leaflet among university students
Authors: Al-Taie Anmar
Published: October 2022

Background: A patient information leaflet (PIL) is a valuable tool that can convey basic information about the disease conditions and the recommended medication enabling both the patients and the health care professional to get rapid, easy, and precise access to the treatment process.
Objective: To evaluate the level of knowledge and practices for appropriate and useful use of PIL among final-year medical and non-medical undergraduate university students in Baghdad, Iraq.
Method: A descriptive, cross-sectional study was conducted among final-year undergraduate university students with different academic disciplines, including medical (pharmacy, dentistry) and non-medical disciplines (law, media) in Baghdad, Iraq, using a structured questionnaire to evaluate the level of knowledge and practices towards the proper use of PIL.
Result: A total of 384 students enrolled in this study and the majority were medical students (59.1%). The proportion of non-medical students who read the PILs was lower than that of medical students (82.2% vs. 91.6%, p<0.0001). According to participants’ responses, 84.6% (p=0.03) of the medical students stated that reading PIL was useful for accurate medication use, while 60.5% of the non-medical students reported that the language of PIL was difficult to understand. Instructions for proper medication intake were significantly higher among the medical students (78%, p<0.0001).
Conclusion: An acceptable level of knowledge along with several different practices toward the proper use of PIL while taking medicines was reported among medical and non-medical undergraduate university students.
The impact of video lecture capture on student attainment and achievement of intended learning outcomes
Authors: Remião Fernando , Carmo Helena , Gomes Miguel , Silva Renata , Costa Vera Marisa , Carvalho Félix , Bastos Maria de Lourdes
Published: October 2022

Background: The multimedia capturing of live lectures has increased within higher education institutions, even in the pre-COVID-19 period. Despite student satisfaction, the video lecture capture (VLC) influence on students' attainment and achievement of intended learning outcomes is controversial.  
Methods: To explore the impact of VLC, a cross-sectional study across 2016/17 (n=209 students) and 2017/18 (n=206 students) was conducted in the course of Mechanistic Toxicology in Pharmaceutical Education.    
Results: The results showed that 73% and 90% of the assessed students viewed the videos of theoretical (550 minutes) and practical/laboratory classes (250 minutes), respectively. VLC impacted student attainment and the achievement of intended learning outcomes on the capacity to understand the subjects and apply knowledge.    
Conclusion: The effectiveness of VLC is to be considered under the framework of constructive alignment and the specificities of the course.
Exploring the undermined: Pharmacy students' perceptions of their role models’ core competencies
Authors: Khabaz Mafinejad Mahboobeh , Hadizadeh Nastaran , Doostkamel Donya , Sayarifard Azadeh , Rezaie Shirmard Leila
Published: October 2022

Background: As an integrated part of pharmacy education, role modelling is pivotal in fostering desirable professional attributes in students. This study aimed to explore top pharmacist role model competencies as perceived by pharmacy students of different years of the curriculum.  
Methods: A newly developed 14-item questionnaire (The Competencies of Role Models in Pharmacy (CRMP) questionnaire) was distributed among 207 pharmacy students and filled out anonymously, and the results obtained were analysed on SPSS 26 software. The Kolmogorov-Smirnov test was used to check data normality, and Kruskal-Wallis one-way analysis was utilised to assess the variations in CRMP scores based on the students’ academic year.   
Results: Teaching skills and professionalism were the most vital attributes selected by pharmacy students, followed by communication skills and laboratory skills. Interestingly, students perceived business and entrepreneurship skills as well as the career status of role models as the least essential competencies. Moreover, notable differences were observed in the overall opinions of students in different academic years, which may be indicative of the dynamic changes in student perspectives as they move forward in their pharmacy programme.    
Conclusion: The competencies of pharmacist role models were assessed and ranked according to their importance as perceived by pharmacy students across different academic years. This information helps gain insight into students’ prioritisation of role model competencies and sheds light on the path toward developing future role model training/assessment programmes to improve the quality of pharmacy education.
Pharmacy technician training in Mongolia: Past, present, and future
Authors: Sodnomtseren Purevsuren , Purevkhuu Mandakhnaran , Dovchinsuren Baigalmaa , Sanjkhuu Tugsbileg , Badarch Boditsetseg , Damdinsuren Ariunaa , Bayarkhuu Bolor , Batjargal Otgonbat , Badamtsetseg Myagmarsuren , Otgonbayar Khatanbold
Published: October 2022

The first official training of pharmacy technicians started in 1926 in Mongolia and pharmacy technicians were the only national pharmaceutical staff till the first national pharmacist graduated in 1954. Pharmacy technicians have played a valuable role in pharmaceutical care and service in Mongolia for the last century, which is still maintained nowadays. As of June 2022, one public university and one private medical institute implemented a pharmacy technician curriculum in Mongolia, and 512 pharmacy technicians had graduated in 2016-2020. Graduated pharmacy technicians are eligible to work in a community pharmacy, hospital, or pharmaceutical industry after being registered. They can also further their studies to get a B. Pharm. degree with an additional three years of training. As of 2020, a total of 2009 pharmacy technicians worked in Mongolia, 807 of them were employed in Ulaanbaatar and 1556 pharmacy technicians worked in the community pharmacies.
The Risk Factors for Ultrasound-diagnosed Non-alcoholic Fatty Liver Disease Among Adolescents
Authors: Fu Chen-Chung , Chen Ming-Chen , Li Yin-Ming , Liu Tso-Tsai , Wang Li-Yu
Published: October 2022

Introduction: Non-alcoholic fatty liver disease (NAFLD) is garnering increasing interest and acceptance as one of the most important causes of chronic liver disease. The aim of this study was to investigate the risk factors for NAFLD among selected adolescent students in Hualien City, Taiwan.

Materials and Methods: A stratified random sampling scheme was carried out among 1724 adolescent students aged 12 or 13 years old in Hualien City. In total, 220 students (normal: overweight: obese = 97:48:75) agreed to join the study. They underwent physical examination, laboratory tests and ultrasonography examination of the liver. Diagnosis of NAFLD in this study was based on sonographic evidence of a fatty liver and testing negative for serum HBsAg and anti- HCV antibody.

Results: Of the 220 participants, 4 were excluded because they tested positive for HBsAg or anti-HCV antibody. NAFLD was detected in 86 (39.8%) out of the 216 subjects. The rate of NAFLD in the adolescents increased progressively from 16.0% in the normal group to 50.5% in the overweight group, and 63.5% among the obese subjects. Compared to their normal counterparts, adolescents with NAFLD had a significantly higher weight, body mass index (BMI), waist circumference, levels of alanine aminotransferase (ALT), triglyceride and non- high-density-lipoprotein (non-HDL) cholesterol. However, among the participants with NAFLD, only 20 (23.3%) showed ALT abnormality but there was an increasing trend of ALT abnormality as the severity of fatty liver increased. In addition, the higher ALT, Homeostasis model assessment- insulin resistance (HOMA-IR), cholesterol, triglyceride, and non-HDL levels and lower HDL-C as the severity of fatty liver increased. In a stepwise logistic regression analysis, the most significant factor associated with the presence of NAFLD was weight category. When compared with their normal counterparts, overweight and obese adolescents had a 4.14 and 5.98 times the risk of having NAFLD, respectively. Elevated ALT was the second most important factor as adolescents with elevated ALT were more likely to have NAFLD (odds ratio = 3.32, 95% CI: 1.16 to 9.50). Non-HDL cholesterol level was the third most important factor associated with NAFLD with a 3.81-fold increase in risk incurred for every l n (1 mg/dL) increment.

Conclusions: Obesity, ALT abnormality and elevated non-HDL-cholesterol are risk factors for NAFLD in adolescents. However, only 23.3% of the adolescents with NAFLD showed an abnormality for ALT. Therefore, ALT alone is not a sufficient indicator; and it is recommended that ultrasonog- raphy of the liver should be part of the routine health examination of obese adolescents.

Key words: Adolescents, Non-alcoholic fatty liver disease, Obese, Risk factors
Medical Management of Obesity and its Complications
Authors: Caterson Ian D
Published: October 2022

Obesity is increasing and with this comes an increase in Metabolic Disease. Current therapies are effective. We need to establish groups that are experts in “lifestyle therapy” but make sure that they use the very effective adjunctive therapies when indicated. Whilst bariatric surgery is effective for those with Grade III obesity, it is important to realise that medical therapy is very effective for those who are overweight or with lesser degrees of adiposity. There needs to be a proper lifestyle programme and the use of adjunctive treatment when necessary. This approach can reduce weight, reduce cardiovascular risk, help control diabetes and prevent it. We MUST establish proper treatment programmes and follow-up systems.

Key words: Approach to treatment, Complications of obesity, Lifestyle management, Obesity pharmacotherapy
The Relevance of the Metabolic Syndrome
Authors: Taslim Siska , Tai E Shyong
Published: October 2022

Introduction: To review the definitions of the metabolic syndrome according to various expert groups and assess their relevance to clinical practice.

Materials and Methods: Medline searches were conducted to identify studies which addressed: (i) the utility of the metabolic syndrome compared to multivariable predictive functions for the identification of individuals at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), (ii) the importance and definition of obesity in the definition of the metabolic syndrome and (iii) the impact of lifestyle and pharmacological interventions designed to reduce the risk of cardiovascular disease in those with and without the metabolic syndrome.

Results: Although inferior to multivariable risk scores in predicting T2DM and CVD, the metabolic syndrome represents a simple clinical tool, particularly for the prediction of T2DM. Obesity is not a critical component of the metabolic syndrome for identifying those at increased risk of CVD but may be important for predicting T2DM. If anything, pharmacological therapy, especially lipid lowering is as, if not more, effective in those with the metabolic syndrome than in those without.

Conclusions: Although the metabolic syndrome appears to have limited utility for the identification of individuals at increased risk of T2DM or CVD, the diagnosis of the metabolic syndrome presents an opportunity to rationalise health services to deliver coordinated care to those with metabolic syndrome.

Key words: Cardiovascular disease, Diabetes mellitus, Insulin resistance, Obesity
Diagnostic Accuracy of Anthropometric Indices for Obesity Screening Among Asian Adolescents
Authors: Deurenberg-Yap Mabel , Niti Matthew , Foo Ling Li , Ng Swee Ai , Loke Kah Yin
Published: October 2022

Introduction: Weight-and-height-based anthropometric indices have long been used for obesity screening among adolescents.However, the ability of their age-and-sex-specific reference values in classifying adolescent as “obese” in different populations was not fully established. Our study aimed to validate the existing international (BMI-for-age charts from WHO, CDC, IOTF) and local cut-offs [percent weight for height (PWH)] for obesity against body fat percentage, as assessed by 4 skinfolds measurement.

Materials and Methods: A cross-sectional sample of 6991 adolescents aged 12 to 18 years was measured. All anthropometric measurements were compliant with the internationally accepted protocol. Obesity was defined as percentage body fat greater than or equal to 95 percentile, specific to age and sex. The validity of the existing classification criteria in detecting obesity was evaluated by comparing their respective diagnostic accuracy.

Results: Both prevalence of obesity and diagnostic accuracy indices varied by the classification criteria. While all criteria generated very high specificity rates with the lowest being 95%, their sensitivity rates were low ranging from 43% to 71%. Youden’s index suggested that CDC and WHO criteria had optimal sensitivity and specificity. ROC analysis showed that overall performance could be improved by refining the existing cut-offs.

Conclusions: Clinical validity of weight-and-height-based classification systems for obesity screening in Asian adolescents is poorer than expected, and this could be improved by refining the existing cut-offs.

Key words: BMI-for-age references, Percentage body fat, Singapore, Validity, Weight-for height
Cardiovascular Risks Associated With Obesity in Children and Adolescents
Authors: Ho Ting Fei
Published: October 2022

Introduction: The aim of this paper is to review the cardiovascular (CVS) risks associated with obesity in children and adolescents. Both short-term and long-term CVS consequences, the mechanisms of how these develop and the measures that can alter or reverse these CVS events are reviewed.

Materials and Methods:Selected publications include original articles and review papers that report on studies of CVS risks and consequences related to childhood obesity. Some papers that contain data from adults studies are also included if the contents help to explain some underlying mechanisms or illustrate the continuation of related CVS changes into adulthood.

Results: Obese children and adolescents have an increased risk for CVS complications that include elevation of blood pressure, clustering of CVS risk factors (Metabolic Syndrome), changes to arterial wall thickness, elasticity and endothelium, as well as changes in left ventricular structure and function. Some of these cardiovascular problems may be initiated or potentiated by obstructive sleep apnoea that can accompany obesity in children. Many of such changes have been noted to reverse or improve with weight reduction.

Conclusions:Early development of CVS risks in obese children and the possible continuation of CVS complications into adulthood have been observed. Obstructive sleep apnoea in obese children can further contribute to such CVS risks. These findings underscore the importance of prevention of childhood obesity as a priority over management of obesity in children.

The prevalence of obesity has risen by three-folds or more in many countries since 1980. In 2005, it was estimated that globally there are about 1.6 billion overweight adults and at least 400 million of them are obese. This increase in the prevalence of adults being overweight and obese comes with a heavy price. The cost of healthcare has significantly increased and is expected to increase even more because of the close association between obesity and various chronic diseases.

Key words: Endothelial function, Hypertension, Metabolic syndrome, Obstructive sleep apnoea
Review on Epidemic of Obesity
Authors: Low Serena , Chin Mien Chew , Deurenberg-Yap Mabel
Published: October 2022

There has been a growing concern about obesity worldwide. We performed a review on the prevalence and trends of obesity among adults and children. We reviewed the data on the prevalence of adult obesity and being overweight from the Global Database on Body Mass Index on the World Health Organisation (WHO) Website and prevalence of children being overweight from the International Obesity Task Force website. Various databases were also searched for relevant reviews and these include PubMed, EMBASE, NHS CRD databases and Cochrane. The prevalence of obesity is high in many parts of the world. Generally, there is an increasing trend of prevalence of adult obesity with age. The peak prevalence is reached at around 50 to 60 years old in most developed countries and earlier at around 40 to 50 years old in many developing countries. Obesity is a major health concern. Appropriate strategies need to be adopted to tackle obesity which itself brings about significant disability and premature deaths. Further observa- tion may be needed to see if the trend of prevalence abates or increases in the near future.

Key words: Epidemiology, Overweight, Prevalence
11th Yahya Cohen Memorial Lecture – An In vivo Comparative Study of the Ability of Derived Mesenchymal Stem Cells in the Treatment of Partial Growth Arrest
Authors: Hui James HP , Li Li , Ouyang Hong-Wei , Teo Yee-Hong , Lee Eng-Hin
Published: October 2022

Few in vivo studies had previously been attempted in reaffirming the in vitro data in current literature. This study evaluated the ability of mesenchymal stem cells (MSCs) isolated from bone marrow, periosteum and fat to treat partial growth arrest in immature New Zealand white (NZW) rabbits. A physeal arrest model in an immature rabbit was created. The bony bridge was excised 3 weeks later, and MSCs from various sources were transferred into the physeal defect of different rabbits. Group I consisted of bone marrow-derived MSCs, Group II: periosteum- derived MSCs, Group III: fat-derived MSCs. Contra-lateral tibiae, without undergoing opera- tion, served as self-control. The animals were subsequently sacrificed, with radiological and histological analyses performed. All MSCs demonstrated chondrogenic and osteogenic differen- tiation potentials in vitro. In correction of varus angulation groups I and II exhibited superior results when compared to group III (P <0.05). The length discrepancies between operated and normal tibiae in groups I, II and III were significantly corrected when compared to the control group (P <0.01). In conclusion, bone marrow and periosteum derived stem cells provided better correction of physeal arrest in rabbits. The source of MSCs itself could influence the success in the treatment of growth arrest.

Key words: Bone marrow, Fats, Periosteum
Development of Bariatric Surgery: The Effectiveness of a Multi-disciplinary Weight Management Programme in Hong Kong
Authors: Wong Simon KH , Mui Wilfred LM , Ng Enders KW
Published: October 2022

Introduction: In Hong Kong, obesity and its associated co-morbidities are increasingly becoming a health and societal burden. Conservative weight management therapy is ineffective in maintaining substantial weight loss in severely obese patients and more invasive interventions are required to achieve sustainable weight loss.

Materials and Methods: Invasive bariatric procedures were introduced to Hong Kong in 2002. Severely obese patients will be seen in a combined obesity clinic where multi-disciplinary assessment was carried out before interventional therapy. Patients will be allocated to various bariatric surgeries such as laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG) or laparoscopic gastric bypass (LGB) when operative criteria were met. For selected patients who were not suitable or refused surgical treatment, endoscopic placement of intragastric balloon (IGB) will be used as an alternative weight control option. Multi-disciplinary approach was also applied during perioperative period to accomplish different clinical needs for the individual patient.

Results: Over 500 patients were seen in our unit seeking advice on severe obesity. Two hundred and twenty-five patients received interventional therapy which included LAGB (n = 57), LSG (n = 71), LGB (n = 7) and IGB programme (n = 120). Thirty patients (25%) received second bariatric surgery after IGB removal. Adverse events occurred in 20 patients (7.8%) and there was no operative mortality. At 2 years, the mean percentage of excessive weight loss (%EWL) for LAGB, LSG and LGB are 34%, 51% and 61%, respectively. In those patients who received IGB alone, the mean %EWL at removal and 6 months after removal were 44% and 34%, respectively.

Conclusions: Through a multi-disciplinary weight management programme with different specialties and various bariatric procedures, favourable results can be achieved in patients with severe obesity.

Key words: Bariatric surgery, Laparoscopy, Obesity, Outcome
12th Yahya Cohen Memorial Lecture – The Cellular and Molecular Basis of Radiation-induced Sensori-neural Hearing Loss
Authors: Low Wong-Kein , Tan Michelle GK , Chua Alvin WC , Sun Li , Wang De-Yun
Published: October 2022

Introduction: Sensori-neural hearing loss (SNHL) is a frequent complication of conventional radiotherapy for head and neck tumours, especially nasopharyngeal carcinoma. To manage radiation-induced ototoxicity appropriately, an understanding of the cellular and molecular basis of this complication is necessary.

Materials and Methods: A medline search of relevant literature was done, focusing on the radiation-induced cellular and molecular processes that lead to hair cell death in the cochlea.

Results:Radiation-induced SNHL occurs in the cochlea, with the retro-cochlear pathways remaining functionally intact. By simulating radiotherapy regimes used clinically, radiation-induced cochlear cell degeneration in the absence of damage to the supporting structures and blood vessels has been demonstrated in animals. This could be due to apoptotic cochlear cell death, which has been shown to be associated with p53 upregulation and intra-cellular reactive oxygen species (ROS) generation. Oxidative stress may initiate the upstream processes that lead to apoptosis and other cell death mechanisms.

Conclusions: A model of radiation-induced SNHL based on a dose and ROS-dependant cochlear cell apoptosis, is proposed. This model supports the feasibility of cochlear implantation, should one be clinically indicated. It can explain clinical observations such as radiation-induced SNHL being dose-dependent and affects the high frequencies more than the lower frequencies. It also opens up the possibility of preventive strategies targeted at different stages of the apoptotic process. Antioxidants look promising as effective agents to prevent radiation-induced ototoxicity; they target upstream processes leading to different cell death mechanisms that may co-exist in the population of damaged cells.

Radiation-induced sensori-neural hearing loss (SNHL) has long been recognised as a complication of radiotherapy (RT) for head and neck tumours, if the auditory pathways had been included in the radiation fields. In Singapore, nasopharyngeal carcinoma (NPC) is common and the prevalence of SNHL after radiotherapy for NPC has been reported to be as high as 24%. Radiation-induced ototoxicity is therefore an important clinical problem in Singapore. To be able to manage radiation-induced ototoxicity appropriately, a good understanding of the cellular and molecular basis of this complication is necessary.

Key words: Apoptosis, Deafness, Hair cell, Ototoxicity, Radiotherapy
Epidemiology and Control of Hand, Foot and Mouth Disease in Singapore, 2001-2007
Authors: Ang Li Wei , Koh Benjamin KW , Chan Kwai Peng , Chua Lian Tee , James Lyn , Goh Kee Tai
Published: October 2022

Introduction: We reviewed the epidemiology of hand, foot and mouth disease (HFMD) in Singapore after the 2000 epidemic caused by Enterovirus 71 (EV71), with particular reference to the cyclical pattern, predominant circulating enteroviruses and impact of prevention and control measures in preschool centres.

Materials and Methods: We analysed the epidemiological data from all clinical cases and deaths of HFMD diagnosed by medical practitioners and notified to the Ministry of Health, as well as laboratory data on enteroviruses detected among HFMD patients maintained by the Department of Pathology, Singapore General Hospital, and the Microbiology Laboratory, KK Women’s and Children’s Hospital from 2001 to 2007.

Results: The incidence rate was highest in the 0 to 4 years old age group, with males being predominant. Three deaths were reported between January and February 2001. Nationwide epidemics occurred periodically; the predominating circulating virus was Coxsackievirus A16 (CA16) in the 2002, 2005 and 2007 epidemics, and EV71 in the 2006 epidemic. During the epidemic years between 2005 and 2007, 2 peaks were observed. The number of institutional outbreaks had increased 10-fold from 167 in 2001 to 1723 in 2007, although most of these outbreaks were rapidly brought under control with an attack rate of less than 10%.

Conclusion: HFMD remains an important public health problem in Singapore with the annual incidence rate per 100,000 population increasing from 125.5 in 2001 to 435.9 in 2007, despite stringent measures taken in preschool centres to prevent the transmission of infection. A high degree of vigilance should be maintained over the disease situation, in particular, surveillance of EV 71 which continues to cause severe complications and deaths in the region.

Key words: Coxsackievirus A16, Enterovirus 71, Epidemic, Preschools
Junior Doctors’ Attitudes Towards Older Adults and its Correlates in a Tertiary-care Public Hospital
Authors: Lui Nai Lee , Wong Chek Hooi
Published: October 2022

Introduction: The medical community in Singapore is faced with a rapidly ageing demo- graphic. This would result in an increase in the interaction between medical professionals and older adults. In anticipation of an increased exposure to elderly patients, we sought to determine the attitudes of our house officers (HO), medical officers (MO) and Registrars towards the elderly.

Materials and Methods: A descriptive pilot study of junior doctors from the Division of Medicine carried out during a luncheon in the largest tertiary-care public hospital in Singapore. A validated self-administered structured questionnaire using Kogan’s Old People (KOP) Scale was used to evaluate attitudes towards older adults and basic demographics and medical educational data were collected.

Results: Fifty-one questionnaires were completed. The mean KOP score was 114.4, suggesting an overall positive attitude towards older people in this sample. The prevalence of negative attitude was 7.8%. There was no significant difference in attitudes among doctors with different designation, age, marital status, medical school attended, nation- ality, years in medical practice and living arrangement. Doctors who had previous exposure with a posting in Geriatric Medicine had higher KOP scores but were just out of significance (P = 0.098). Respondents who found treating older people unrewarding had significantly lower KOP score (P <0.001).

Conclusion: In this sample of junior doctors, overall attitudes towards older people as measured by the KOP scale were moderately positive. Exposure to a Geriatric Medicine posting during residency may positively influence a doctor’s attitudes towards the older adults.

Key words: Ageing, Attitudes, Elderly, Geriatrics
Herpes Zoster as a Useful Clinical Marker of Underlying Cell-mediated Immune Disorders
Authors: Soyuncu Secgin , Berk Yeliz , Eken Cenker , Gulen Bedia , Oktay Cem
Published: October 2022

Introduction: The objective of this study was to determine the necessity of further evaluation of patients presented with herpes zoster (HZ) to the Emergency Department for the underlying decreased cell-mediated immunity.

Materials and Methods: The data of 132 adult patients presenting with HZ to the Emergency Department were collected from the computerised database of Akdeniz University Hospital. The following data were recorded: demographic data and underlying diseases during onset of HZ and laboratory results (white blood cell counts, blood glucose levels).

Results: There were 132 patients with HZ in the study period. The mean age of patients was 52.98 ± 18.91 years (range, 14 to 96) and 53% (70 patients) were male. Of the study patients, 70.5% (93 patients) were over 45 years old. Eight (6.1%) patients had been diagnosed to have a malignancy, 18 (13.6%) had diabetes mellitus and 3 (2.3%) patients had undergone organ transplantation during their admission. Malignancy, diabetes mellitus and organ trans- plantation prevalence in the HZ group was significantly higher than the whole Emergency Department population.

Conclusions: Our results indicate a relationship between the presence of HZ and increasing age and cell-mediated immunosuppressive disorders in Emergency Department patients over the age of 45 years. HZ should be considered as a clinical marker of cell- mediated immunosuppressive disorders, particularly in elderly patients.

Key words: Cell-mediated immunity, Emergency department, Immunosuppression
Deletions in the Survival Motor Neuron Gene in Iranian Patients with Spinal Muscular Atrophy
Authors: Hasanzad Mandana , Golkar Zahra , Kariminejad Roxana , Hadavi Valeh , Almadani Navid , Afroozan Fariba , Salahshurifar Iman , Shafeghati Yousef , Kahrizi Kimia , Najmabadi Hossein
Published: October 2022

Introduction: Spinal muscular atrophy (SMA) is a common neuromuscular disorder with progressive paralysis caused by the loss of -motor neurons in the spinal cord. The survival motor neuron (SMN) protein is encoded by 2 genes, SMN1 and SMN2. The most frequent mutation is the biallelic deletion of exon 7 of the SMN1 gene. In SMA, SMN2 cannot compensate for the loss of SMN1, due to the exclusion of exon 7. The aim of our study was to estimate the frequency of the common SMN1 exon 7 deletion in patients referred to our centre for carrier detection and prenatal diagnosis. Materials and Methods: We performed the detection of exon 7 deletion of the SMN1 gene for the affected patients and fetuses suspected to have SMA. Results: Of 243 families, 195 were classified as SMA type I, 30 as type II, and 18 as type III according to their family histories. The analysis of exon 7 deletion among living affected children showed that 94% of the patients with SMA type I, 95% with type II families and 100% with type III had homozygous deletions. Of the prenatal diagnoses, 21 (22.8%) of the 92 fetuses were found to be affected and these pregnancies were terminated. Conclusions: The homozygosity frequency for the deletion of SMN1 exon 7 for all 3 types was (94%), similar to those of Western Europe, China, Japan and Kuwait. Key words: Iranian patients, SMN1
Prevalence of Metabolic Syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions and their Association with Coronary Heart Disease in an Elderly Iranian Population
Authors: Hadaegh Farzad , Zabetian Azadeh , Tohidi Maryam , Ghasemi Asghar , Sheikholeslami Farhad , Azizi Fereidoun
Published: October 2022

Introduction: To determine the prevalence of the metabolic syndrome (MS) in an Iranian elderly population and show its association with coronary heart disease (CHD).

Materials and Methods: This is a cross-sectional study on 720 Iranian men and women aged 65 years who participated in the Tehran Lipid and Glucose Study (TLGS). Logistic regression analysis was used to estimate the odds ratio (OR) of developing CHD in model 1, an age-adjusted model; model 2, adjusted for age, smoking status, premature history of CHD and low-density lipoprotein (LDL) cholesterol; and model 3, adjusted for mentioned variables plus the MS components.

Results: The prevalence of MS was 50.8%, 41.8% and 41.9% based on the Adult Treatment Panel (ATPIII), the World Health Organisation (WHO), and the International Diabetes Federation (IDF) definitions, respectively. The IDF definition showed high agreement with the ATPIII definition. Age-adjusted OR (95% CI) of the MS for CHD was 1.6 (1.2 to 2.2) by both the ATPIII and WHO definitions and 1.4 (1.0 to 1.9) by the IDF definition. IDF-defined MS lost its association with CHD in model 2. In model 3, obesity (WHO definition) and high blood pressure (ATPIII and WHO definitions) were associated with CHD.

Conclusions: In an elderly Iranian population MS is highly prevalent. ATPIII and WHO definitions seem to be more pertinent than IDF for screening CHD risk. None of these definitions showed association with CHD when considering their components.

Key words: Ageing, Cardiovascular disease, Epidemiology, Insulin resistance
Interventional Management of Chronic Pain
Authors: Nocom Glenice , Ho Kok-Yuen , Perumal Muralitharan
Published: October 2022

Chronic non-cancer pain is a common clinical condition affecting a significant part of the population. This article aims to review the interventional options for non-cancer pain. Multiple searches using Medline were carried out and additional searches were made using reference lists of published papers and book chapters. The article discussed procedures ranging from selective nerve root or zygapophyseal (facet) joint block with local anaesthetics to irreversible neurodestruction with radiofrequency energy or neurolytic agents and neuromodulation with spinal cord stimulation. Other techniques include intraspinal delivery of analgesics. There is evidence that these interventional procedures are valuable both diagnostically and therapeutically.

Key words: Intrathecal drug delivery, Neuropathic, Spine
Cardiac Rupture due to Fall: A Case Study
Authors: Türkmen Nursel , Bilgen M Sadik , Eren Bülent , Fedakar Recep , Senel Berna
Published: October 2022

Studies have shown that cardiac ruptures due to blunt trauma are seen more often than expected. However, epicardial injuries and atrial ruptures are common findings in deaths due to falls. Our aim is to present a unique, isolated cardiac rupture in a 2 year-old child resulting from a fall from a bed, to evaluate autopsy findings among the literature from a medico-legal point of view.

Key words: Autopsy, Childhood, Fall
An Unusual Cause of Abdominal Pain
Authors: Khine Myo , Roslani April Camilla
Published: October 2022

A 36-year-old man presented with a 7-day history of intermittent right-sided abdominal pain. He also had a reducible right-sided inguinal hernia for the past 10 years. He was initially managed as acute hepatitis as there was right hypochondrial tenderness associated with elevated liver enzymes. Two days later, a mass was palpable in the right iliac fossa. A computed tomography (CT) scan of the abdomen was performed.
Trends in Long-term Cancer Survival in Singapore: 1968-2002
Authors: Lim Gek-Hsiang , Wong Chia-Siong , Chow Khuan-Yew , Bhalla Vineta , Chia Kee-Seng
Published: October 2022

Introduction: The life expectancy of cancer patients has increased in recent decades due to better diagnostic and screening tools as well as better treatment modalities. Hence, it becomes increasingly important to study trends in long-term cancer patient survival in order to document that medical progress has conveyed benefit at the population level. In this paper, we assessed the long-term survival experience of all incident cancer patients in Singapore.

Materials and Methods: The study population consisted of patients diagnosed with single primary invasive cancer from 1 January 1968 to 31 December 2002, and passively followed up to 31 December 2005. The data was derived from the Singapore Cancer Registry, which has been in existence since 1968. Relative survival via the period approach was used to provide a more up-to-date estimate by looking at recent cohorts of patients. Sex- and stage-specific survival was compared for each cancer.

Results: The overall age-standardised 10-year relative survival ratios for the calendar years of 1998 to 2002 were 30.5% in males and 44.2% in females. A steady improvement in overall long-term cancer survival was observed over the study period. This upward trend in survival was observed in localised tumours and cancers with a favourable prognosis such as breast, cervical and colorectal cancers. In contrast, survival of cancers with poor prognosis such as lung, liver and pancreas remained low.

Conclusions: Although factors such as changes in diagnostic criteria could influence the trend in survival, we believed that the improvement in survival predominantly reflected real progress in cancer control in Singapore.

Key words: Carcinoma, Period analysis, Population-based, Public Health, Relative survival
Perceptions of the Senior High School Students on the Use of Classroom Response System in Learning Mathematics
Authors:   1Senior High School Department, Tairan National High School, Ministry of Basic, Higher, and Technical Education-Basilan, BARMM, Philippines,7301, Alviar Jayson V. , Gamorez Anabel E. ,   Department of Mathematics and Statistics, College of Science and Mathematics, Western Mindanao State University, Zamboanga City, Philippines,7000.
Published: October 2022

Classroom Response System (CRS) is one of the educational tools teachers can use to promote active learning and improve student learning. Despite the promising benefits of the CRS, there is less account of its impact in secondary mathematics classrooms as compared to higher education. In this study, a descriptive survey design was used to describe the perception of Senior High School students on the use of the CRS in learning mathematics. Students were exposed to Blicker, a classroom response system tool that uses Bluetooth Low Energy to interact with the teacher. Survey shows that CRS increase students’ engagement, interactivity, and students perceived CRS to be beneficial for their learning. Moreover, students favored the CRS’ anonymity feature and enjoyed the affordability of the CRS to promote student-teacher interaction through the question-feedback process. The interview shared common themes on the CRS benefits and validated students’ claims that CRS attributed to an increase in engagement, interactivity, and learning in mathematics. Overall, the student’s perceptions of the use of CRS are overwhelmingly positive and students strongly recommend the use of CRS in other learning areas.
The So-called Corpus in Big Data
Authors:   Far East University,South Korea, Kang Namkil
Published: October 2022

The main goal of this article is to analyze 688 KCI (Korea Citation Index) articles in terms of the Biblio data collector and the software package NetMiner. A point to note is that there was a publication of 33 KCI articles in December in 2020, which have the highest frequency (33 articles) and the highest proportion (0.048). A further point to note is that the word study was the most frequently used keyword, followed by the word Corpus, and the word verb, in that order. It is interesting to note that topic 6 that is constituted by the words learner, English, study, verb, and student occurred in 125 articles (the highest). It is noteworthy that topic 6 was the most preferred by authors, followed by topic 5, topic1, and topic 8. With respect to degree (the frequency of documents), it is worthwhile noting that the word study was the most preferred by authors, followed by the word Corpus, the word result, the word analysis, and the word corpus. Finally, this article provides the visualization of which words are linked to the word corpus. To be more specific, the words language, student, translation and the Korean word malmwungchi ‘corpus’ are directly linked to the word corpus.
Legal Protection of Traditional Knowledge (Comparative Study of Bangladesh, Australia and Indonesia)
Authors:   2Master of Law, Universitas Diponegoro,Street Imam Bardjo No. 1, Pleburan, South Semarang, Central Java, 5024, Tri Wibowo Andi Tyas , Setiyono Joko ,   2Master of Law, Universitas Diponegoro,Street Imam Bardjo No. 1, Pleburan, South Semarang, Central Java, 5024
Published: October 2022

One field that is loaded with IPRs is Traditional Knowledge. Traditional knowledge (traditional knowlegde) is included in the scope of intellectual work originating from ideas, ideas, or discoveries of community groups of a country. As time goes on, it is important that Traditional Knowledge be protected. Especially the protection of IPR laws against traditional knowledge itself. Legal protection This traditional knowledge is in fact not only done in developing countries but also in developed countries. In this paper, the authors are interested in discussing the comparison of traditional knowledge legal protection in several countries, such as Bangladesh, Australia and Indonesia. The research method used in this paper uses normative juridical. The discussion in this paper will be divided into two, namely the concept of understanding traditional knowledge as intellectual property and a comparison of legal protection for traditional knowledge in Bangladesh, Australia, and Indonesia.
Corporate Criminal Liability for the Crime of Money Laundering with a Follow-The-Money Approach
Authors:   Universitas Pembangunan Negeri Veteran Jakarta,Jl. Rs. Fatmawati, Pondok Labu, Jakarta. 12450, Herwanda Langgeng Sukma
Published: October 2022

Based on Law Number 40 of 2007 concerning Limited Liability Companies Jo. Law Number 8 of 2010 Concerning the Prevention and Eradication of Money Laundering Jo. Regulation of the Indonesian Republic of Indonesia Court of Justice Number 13 of 2016 concerning Procedures for Handling Criminal Cases by Corporations provides space for criminalizing corporations as subjects that are held liable for criminal acts of money laundering. However, law enforcement officers rarely place corporations as subjects for criminal responsibility in money laundering cases, even though corporations play an essential role in the occurrence of money laundering crimes. This was proven by handling the money laundering case taken by the Corruption Eradication Commission, which for the first time, made PT Putra Ramadhan a corporation that was asked to be held responsible for criminal acts of money laundering.
Professional identity of language teacher trainees during practicum: A metaphor analysis
Authors: TURHAN Burcu
Published: October 2022

Teachers may face dilemmas when they realize certain discrepancies between theory and practice throughout their career. Especially for teacher trainees, such dilemmatic spaces may be beneficial in uncovering multiple identities developing and being shaped especially during practicum. More specifically, the most frequent discrepancy could be between the desire to explore one’s own teacher identity and to please mentors and supervisors. Therefore, teacher training programs should provide spaces for teacher trainees to reflect and analyze those dilemmas so that they could develop their teacher professional identity (TPI) in an unproblematic and smooth manner. To this end, this study involved twelve senior English teacher trainees into a five-week process when they expressed their growing professional identities through metaphorical discourse within the scope of Teaching Practice I course. The thematic analyses of the elicited metaphors revealed vital hints about the TPI of language teacher trainees. Besides, the place and importance of metaphors for understanding TPI were discussed in the context of teacher education.
Intrauterine Spontaneous Subdural Hematoma with Hydrocephalus
Authors: Jabbar Mohammed Nooruldeen , Alhurmuzi Fidan Nadmi Nadim
Published: October 2022

Abstract

Subdural hematoma in newborn baby is associated with history of maternal trauma, complicated vaginal delivery, instrumental delivery, foetal / maternal thrombocytopenia, coagulopathy, hepatic disease, infection or using drugs during the pregnancy; but in the absence of the above, intrauterine subdural hematoma is a rare event.
We present a newborn delivered to a healthy mother at 38 weeks by elective caesarean section after he had been diagnosed with macrocephaly by routine obstetric growth scan ultrasound at 35 weeks of gestational age. The baby’s APGAR score was 4 at 1 minute, he was pale, his fontanel was tense and his Occipitofrontal circumference (OFC) was 46 cm, therefore, he was intubated immediately and transferred to Neonatal Intensive Care Unit (NICU). Brain Computed tomography (CT –scan) revealed huge right sided subacute subdural hematoma that was almost occupying the entire right hemicranial space and severely compressing the underlying brain tissue. In addition, there was marked dilatation of the left lateral ventricle with blood clots at the occipital horn.
Subdural hematoma was evacuated by two burr holes surgery, followed by repeated subdural tap. Intraventricular haemorrhage treated by repeated ventricular tap until Cerebrospinal Fluid (CSF) became clear, then ventriculoperitoneal shunt surgery was done for him.

Keywords: Subdural hematoma, Newborn, Hydrocephalus, Burr hole, Shunt surgery.
A Goodness-of-Identifiability Criterion for Parametric Statistical Models
Authors: Pacini David
Published: October 2022

Abstract

This note sets out a goodness-of-identifiability criterion. This criterion quantifies the identifying strength of a parametric statistical model. Unlike the qualitative criterion for identifiability based only on the Fisher matrix, it applies to both regular and irregular points of the Fisher matrix. Unlike the qualitative criterion based only on the Hellinger distance, it quantifies set-identification.

JEL classification numbers: C10, C50.
Keywords: Parametric statistical model, Identifiability, Fisher matrix, Hellinger distance.
Panel Vector Auto-Regressive Model For COVID-19 Infected Cases and Deaths
Authors: Rajarathinam A. , Anju J.B
Published: October 2022

Abstract
This study aims to model the dynamic relationships between the number of COVID-19 infected cases and deaths in all the districts of Kerala state, India, from January 2021 to December 2021 based on the panel vector auto-regressive model. The random effect panel vector auto-regressive model of order two was found suitable to model dynamic relationships. This model explains 62 % variations in the endogenous variable, deaths (number of deaths). The exogenous variable deaths (-1) are highly significant, whereas the exogenous variable cases (-1) are significant at a 5% level. Both of these exogenous variables positively influence the endogenous variable. The other exogenous variables, viz., deaths (-2) and cases (-2), are non-significant. The Durbin-Watson test statistic value confirms the independence of the residuals, and the Wald test confirms the validity of the significance of the estimated regression coefficients.

JEL classification numbers: E18, HO, I1, J64, J88.
Keywords: Fixed and Random Effect Models, Panel VAR model, Cointegration test, Levin-Lin-Chu unit root test, Granger causality test, Hausan test, Wald test.