bluuebunny/crossref_metadata_2025 huggingface dataset:
LGBTQIA + HEALTH
Authors: Evelly da Silva Olanda Débora , Fernandes Filgueiras Mateus , De Oliveira Souza Eclésia , Thallyta Alexandre de Pontes Arunna , Carolina Salustino dos Santos Maria , Claudino do Nascimento Nathalia , Allyson Gomes Ferreira Jefferson
Published: August 2022

The health of the LBTQIA+ public deserves care and respect in a multiprofessional way, therefore, this study brought a reflection on the theme, in an integral and systematic way, from the reading of several theoretical materials. Health education seeks to improve its professionals regarding the LGBTQIA+ population, thus ensuring access to health in a humanized way, where it aims to guarantee priorities such as the eradication of discrimination in health services and improve the quality of care and services provided.
HEALTH CARE IN PEDIATRIC EMERGENCIES
Authors: da Silva Santos Samara , Dayanna Alves Resende Tamires , Kelly da Silva Nathalia , Da Silva Carvalho Denise , Gomes De Souza Silva Lúcia , Carolina Salustino dos Santos Maria , Claudino do Nascimento Nathalia
Published: August 2022

In pediatric emergencies, care is defined according to the priority of the cases, analyzed from a triage in order to filter this priority, as an urgency or emergency, based on the complaints and the clinical scenario of the patients. Study of reflective origin, built in 2022, through a combination of readings. Thus, there are numerous factors that place the child in risk situations. The main causes of emergency care in pediatric care units include respiratory diseases, convulsive states, poisoning, accidents and trauma.
WOMEN’S HEALTH IN PRIMARY CARE
Authors: Dayanna Alves Resende Tamires , Da Silva Santos Samara , Cristina Cavalcante Lucena Cybelle , Clara Ribeiro Costa Maria , Medeiros Borburema Myllena , Carolina Salustino dos Santos Maria , Claudino do Nascimento Nathalia
Published: August 2022

In the sphere of women’s health, practices are based on the National Policy for Integral Attention to Women’s Health, which will guide actions aimed at cervical and breast cancer, reproductive health, prenatal care, childbirth and the puerperium. Qualitative, descriptive and reflective research, built in the year 2022. However, the health team and the public power play a fundamental role in this assistance, as they are able to develop strategies that meet this female population, taking into account their particularities and needs , with the objective of promoting and preventing care.
ELDERLY AND ACTIVE AGING AND HEALTH
Authors: Da Silva Santos Samara , Kelly da Silva Nathalia , Cristina Cavalcante Lucena Cybelle , Medeiros Borburema Myllena , Gomes De Souza Silva Lúcia , Carolina Salustino dos Santos Maria , Claudino do Nascimento Nathalia
Published: August 2022

Aging is part of the natural process of life, this aging relates some aspects of health indicators to the gradual aging of the population, there are more specific variables such as the degree of wealth in each country, thus concentrating a greater or lesser amount of elderly people. Reflection study, which brought together thematic content, in the year 2022, sharing knowledge and the main results about the elderly and their active aging process.
The Role of Plant Foods in the Evolution and Dispersal of Early Humans: A Perspec- tive from Across the Wallace Line
Authors: Florin S. Anna
Published: August 2022

In recent years, new evidence for the early use of plant foods has challenged the stereotype of the meat-eating Paleolithic. Whilst often making up the smaller component of the diet, plant foods are key to hominin diets, carbohydrates especially providing an efficient energy resource. This paper reviews the current evidence for the role of plant foods in the evolution and dispersal of early modern humans and our closest ancestors, with a focus on new evidence for early diet from Island Southeast Asia, Australia and New Guinea. It demonstrates the importance of plant foods and their processing, to the dietary flexibility and adaptive capacity of our species.
The Cultural and Chronostratigraphic Context of a New Leaf Point from Hohle Fels Cave in the Ach Valley of Southwestern Germany
Authors:   University of Tübingen, Conard Nicholas J. , Janas Alexander , Marcazzan Diana , Miller Christopher E. , Richard Maïlys , Schürch Benjamin , Tribbolo Chantal
Published: August 2022

During the summer of 2020 the excavation team at Hohle Fels Cave in the Ach Valley of southwestern Germany recovered a leaf point (in German Blattspitze) made from gray Jurassic chert. The find is well-preserved and remarkable for a number of reasons. First this is the only leaf point recovered by a modern excavation in the Swabian Jura, and is the first leaf point discovered in situ since 1936, when Gustav Riek’s crew recovered two well-preserved leaf points at the excavation of Haldenstein Cave in the Lone Valley. The leaf point and associated finds originate from archaeological horizon (AH) X, 120 cm below the base of the rich Aurignacian deposits at the site that dates with radiocarbon to ca. 42 ka cal BP. Four ESR dates made on the teeth of large mammals from AH IX overlying the new leaf point yielded an average age of 62.5 ± 4 ka BP. This date represents a minimum age for the new horizons, which based on convention would be placed in the cultural taxonomic unit of the Blattspitzengruppe. Since the Blattspitzengruppe is typically interpreted as the last Middle Paleolithic cultural unit, we were intrigued to find an assemblage containing a Blattspitze in such an early chronostratigraphic context. While in Germany the Blattspitzengruppe is usually associated with the end of the Middle Paleolithic, many researchers across Europe have described these leaf point assemblages as being transitional industries at the interface between the Middle and Upper Paleolithic. Historically, some authors have even suggested a degree of cultural continuity between leaf point assemblages of the Middle and Upper Paleolithic. Here we present the stratigraphic and chronological context of the AH X and provide a preliminary description of the material cultural record from this horizon. Keeping in mind that we so far have only excavated parts of 6 m2 of the new find horizon and the underlying find horizon AH XI, the paper provides initial observations that will need revision as the excavation proceeds. These findings suggest that leaf points represent a feature in the technological repertoire of the Late Pleistocene Neanderthals of southwestern Germany rather than a reliable cultural stratigraphic marker for the last phase of the Middle Paleolithic.
Dental Wear Evidence for Browsing and Grazing Dietary Traits in the Giant Deer from the Late Pleistocene of Central Europe
Authors: Rivals Florent , Drucker Dorothée G. , Starkovich Britt M. , Russo Gabriele , Leder Dirk , Conard Nicholas J.
Published: August 2022

The paleoecology of the giant deer (Megaloceros giganteus), including its dietary preferences, is poorly known, mainly because reconstructions based on morphological characteristics have produced contradictory results. In this study, we propose to reconstruct the diet of the giant deer from five archaeological sites located in Southern Germany and the Harz Mountains using microwear and mesowear analyses. We also include the results of a review of tooth wear data published during the past decade for ten localities in Europe. The objective is to provide a largescale vision of the diet of the giant deer and to analyse the spatial and temporal diversity of its dietary habits. According to our results, the dietary traits of the giant deer were found to range from leaf browsing to grass-dominated mixed feeding, depending on the vegetation available regionally and seasonally. The combination of the two proxies, mesowear and microwear, allowed us to characterize the dietary flexibility of the giant deer. Finally, we discuss the causes of its extirpation and conclude that its extinction was not likely driven by a narrow dietary niche.
Der abenteuerliche Weg der Vogelherd-figurinen – von ihrer auffindung bis heute
Authors: Wolf Sibylle , Schürch Benjamin , Frick Jens A. , Seifert Michael
Published: August 2022

Die Vogelherd-Figuren wurden unter Leitung des Urgeschichtlers Gustav Riek 1931 in der Vo- gelherd-Höhle bei Niederstotzingen ausgegraben. Riek hatte offensichtlich eine starke Bindung zu den Figurinen. Sie zählen zu den ältesten figürlichen Kunstwerken der Welt. Ihre Auffindung wird hier diskutiert. Die Aufbewahrung der Figuren seit 1931 bis heute hat eine wechselvolle Geschichte, die hier erstmalig mittels Einsichtnahme in die Akten des Archivs der Universität Tübingen nachvollzogen wurde. Heute sind die Figuren im Museum für Alte Kulturen im Schloss Hohentübingen ausgestellt.
Zur rekonstruktion der mammutelfenbeinflöte aus dem geißen- klösterle. ein erfahrungsbericht
Authors: Hein Wulf
Published: August 2022

Seit der Entdeckung der Flöten aus den Aurignacien-Schichten der Höhlen auf der Schwäbi- schen Alb beschäftigt sich der Autor mit der Rekonstruktion dieser bislang ältesten Musikinstru- mente der Welt. Der folgende Bericht beschreibt die Erfahrungen, die bei der Arbeit gesammelt werden konnten, am Beispiel des jüngsten Nachbaus der Mammutelfenbeinflöte aus dem Geißenklösterle.
Trauma and Memory
Authors: Jovic Vladimir , Varvin Sverre
Published: August 2022

A theory of traumatic memory was developed by Breuer and Freud in “Studies on Hysteria” based on Charcot’s theory on the traumatic origin of mental disorders. This was again developed in DSM-III in 1980 with the introduction of posttraumatic stress disorder (PTSD), where traumatic memory was conceptualized as a core of the syndrome and set in causal relationship with its manifestations. This implied that “trauma” tended to be seen as something static and reified, like a “thing” in the mind. It is shown that this conceptualisation diverts attention from the dynamic and reorganizing processes in the traumatized person’s mind, body and relations to others. The psychoanalytic conceptualization includes a wider spectre of the manifestations in posttraumatic conditions and it differs in the understanding of underlying processes. What is common for both childhood and adult trauma and their posttraumatic manifestations are deficiencies in symbolization processes related to the traumatic experiences. The signal anxiety function fails and the ego is overwhelmed by automatic or annihilation anxiety. The ability to distinguish between real danger and neutral stimuli which function as triggers fails. As anxiety related to trauma cannot be mentalized, fragments of the self are split off and evacuated. These experiences remain as fragmented bits and pieces that can express themselves in bodily pain, dissociated states of mind, nightmares and relational disturbances. Thus, the consequences of psychological trauma may be conceptualised as processes characterised by splitting off of not mentalized inner objects/introjects and parts of the mental apparatus. These processes are illustrated with a short clinical vignette.
En las Fronteras de Cronos
Authors: Acosta Silvia Raquel
Published: August 2022

Se presenta en este articulo un recorrido conceptual sobre las diferentes formas de pensar la temporalidad y lo traumático donde es posible percibir que la capacidad de encontrar evidencias de la ligadura indisoluble sujeto-trauma-tiempo es claramente un emergente central de la identidad y el quehacer psicoanalíticos. En ese sentido, la consideración de una temporalidad singular representa uno de sus actos más persistentes de rebeldía frente a la voracidad de Cronos. A partir de la conceptualización de los procesos inconscientes, Freud desmonta la certeza de la causalidad y la explicación asestando una marca indeleble a esta pretensión. La potencialidad de nuevas representaciones y condiciones de inscripción de vivencias -y, por lo tanto, nuevos trayectos subjetivos-, donde el analista actúa creando un pasado/futuro para un sujeto que aún no existe, implica afirmar no solo que el tiempo subjetivo no se puede mensurar, sino que se puede re-crear en análisis, en la transferencia.
Le Négatif du Trauma: pour une Métapsychologie de l’Irreprésentable
Authors: De Vincenzo Mario
Published: August 2022

L’auteur se propose de problématiser les conceptions psychanalytiques du trauma à partir de la prise en compte des conditions cliniques marquées par le vide psychique que l’on retrouve chez les pathologies limites caractérisées par des traumatismes précoces non représentés. À travers une analyse théorique et métapsychologique des différentes conceptions freudiennes et post-freudiennes des traumas primaires, l’auteur propose de concevoir les restrictions du moi et les difficultés d’accès à la représentation comme des issues subjectives liées au négatif du trauma. Ce dernier sera compris comme la trace en creux et non représentée d’expériences fondamentales, comme l’absence de mirroring, qui n’ont pas eu lieu dans la préhistoire du sujet et que de ce fait se révèlent traumatiques en entravant ainsi la construction d’un appareil pour penser les pensées.
Trauma Cumulativo: Quando a estória sobrevive entre a repetição relacional do trauma e o corpo
Authors: Ferrajão Paulo , Esteves António , Stumpf Mairi
Published: August 2022

As formulações dominantes na literatura descrevem a perturbação pós-traumática como uma perturbação da memória. No âmbito de extensa investigação extra clínica e prática clínica, apresentamos um modelo das consequências pós-traumáticas como uma perturbação da identidade, especificamente uma dissociação estrutural da personalidade. Descrevemos a dissociação estrutural terciária associada ao trauma cumulativo precoce ocorrido num contexto relacional. Apresentamos a expressão da narrativa psíquica na dissociação estrutural terciária em duas modalidades: 1) enactment de sistemas relacionados dissociados na qual a divisão de múltiplas representações do self e dos objetos instauram a oscilação entre múltiplos sistemas relacionais: vítima, perseguidor e salvador; 2) preocupações ou sintomas somáticos com predomínio de um pensamento concreto que origina que o corpo seja o continente dos afetos não-elaborados e dessimbolizados expressos como memórias corporificadas. Propomos que a repetição relacional do trauma no triângulo do drama e/ou as preocupações ou sintomas somáticos deverão ser analisadas na relação transferência-contratransferência destes pacientes como procedimento de explicitação no aqui-e-agora dos sistemas relacionais implícitos. Este processo auxilia na estruturação e integração progressiva das partes dissociadas no self que promovem a mudança estrutural do psiquismo.
Controversies on Psychoanalytic Psychotherapies
Authors: Becker Joana Proença , Paixão Rui , Quartilho Manuel João
Published: August 2022

Psychoanalysis is indispensable when writing and discussing traumatic stress, but in the treatment of these conditions it is ultimately disregarded. Since they are considered long-term treatments, therapies derived from psychoanalysis, such as Psychodynamic Psychotherapy (PDT), are not the first choice in health centers and clinics, which may be also a reflection of a scarcity of publications on its effectiveness.  Through a literature review, focused on the effect size of PDT in the treatment of Posttraumatic Stress Disorder (PTSD), we have confirmed this scarcity. However, in the few studies conducted on this topic, findings have shown similarities between PDT and other therapies in reducing PTSD symptoms, both in post-therapy and follow-up assessments. The time of psychoanalytic psychotherapies is often pointed out as an obstacle, although studies have indicated that patients treated through these techniques present a continuous state of improvement.
Intervenção Clínica no Trauma: Implicações Terapêuticas
Authors: Aragão Oliveira Rui
Published: August 2022

O tratamento psicanalítico é habitualmente referido como indicação terapêutica para situações de trauma com perturbações graves do processo de pensamento. Neste artigo procuramos sintetizar o conhecimento da expressão clínica de acontecimentos traumáticos, realçando as principais implicações terapêuticas na atualidade, à luz da psicanálise, e apresentar as principais linhas de carácter clínico no âmbito da escola psicanalítica associadas às problemáticas do trauma psíquico.
Rebeldía y Obediencia: Una Dualidad Necesaria
Authors: Sierra Moreno Olmo Jesús
Published: August 2022

Este artículo reflexiona sobre la paradoja en la que se encuentra la rebeldía y la obediencia desde los planteamientos del marxismo y los relaciona con ideas fundamentales del psicoanálisis. A partir de ahí realiza una crítica al modelo político y económico, evidenciando la paradoja actual en la que se halla el sujeto con su goce. Solo la verdad le brinda al sujeto librarse de las imposiciones del capitalismo, le posibilita la rebeldía. El artículo finaliza con una crítica a los movimientos contrahegemónicos.
Eros e Tanatos
Authors: Salgueiro Emílio
Published: August 2022

O psicanalista Vamik Volkan hipotetiza a necessidade absoluta, reequilibradora, de ter amigos e inimigos, tanto a título pessoal, como grupal, como, até, nacional. São assim criados objectos externos e internos, depressivos ou desamparados e persecutórios, e chega-se, por esta via, à criação das áreas mentais de Eros e de Tanatos, instrumentos fundamentais na classificação da realidade. “Bodes-persecutórios e desesperados”, e “bodes animadores e exaltantes”, são assim criados e usados.  São feitas reflexões sobre a pedofilia ou a corrupção, como males sociais prevalentes, e o medo de as entender, é relembrado o diálogo entre Einstein e Freud sobre a violência e a agressão e a sua inevitabilidade. Freud admite que só educação poderá minorá-las, mas não fazê-las desaparecer. O episódio bíblico de Sansão e Dalila ajuda a entender estes conceitos e, finalmente, acrescentam-se algumas considerações sobre as crises contemporâneas.
Distance learning syndrome and its overcoming
Authors: Татаринцева Р.И.
Published: August 2022

Текст статьи представляет частный взгляд на одну из обозначившихся проблем дистанционного обучения – так называемого дистанта. Уверенно, перспективно и оптимистично моделировавшийся исследователями в предшествовавшие три десятилетия, в тотальной практике дистанционного обучения последних двух лет, одномоментно и жёстко навязанной противостоянием пандемии коронавируса, дистант предстал новыми реалиями, существенно скорректировавшими его возможности на текущем и ближайшем этапах соответствующих технических и образовательных возможностей. В настоящее время в проблематике дистанта уже вполне обозначился и сформировался некий «синдром», пока не медицинский, но психолого-педагогический вопрос. Поэтому рассматриваемые условия позволяют сегодня говорить лишь о прикладном, вспомогательном значении дистанционного обучения в ближайшей перспективе, как и о преждевременности масштабных национальных проектов реализации дистанта на всех уровнях российской системы образования. Это отражается во взглядах автора статьи, сформулировавшего «концепцию ограниченного оптимизма».

The text of the article presents a private view on one of the identified problems of distance learning - the so-called "distant work". Confidently, promisingly and optimistically modeled by researchers in the previous three decades, in the total practice of distance learning of the last two years, immediately and rigidly imposed by the confrontation with the coronavirus pandemic, distance learning appeared as new realities that significantly corrected its capabilities at the current and near stages of the corresponding technical and educational opportunities. At present period, in the problematics of "remote distance" a certain syndrome has already been fully identified and formed, not yet a medical, but a psychological issue. Therefore, the conditions under consideration nowadays allow us to speak only about the applied, auxiliary value of distance learning in the short term, as well as about the prematureness of large-scale national projects for the implementation of "distance learning" at all levels of the Russian education system. This is reflected in the views of the author of the article, who formulated the "conception of limited optimism".
Understanding mathematics as forming a mathematical worldview
Authors: Туктамышов Н.К.
Published: August 2022

Актуальность данного исследования обусловлена тем, что проблема качества образования, глубоко связанная с вопросами понимания учащимися учебного материала, несмотря на множество дискуссий, не имеет однозначного решения. Здесь сформулирован альтернативный подход к этой проблеме. Целью статьи является анализ феномена понимания в математике. В работе вводятся понятия математической картины мира (МКМ) и индивидуальной математической картины мира (ИМКМ). Отличительной особенностью работы является то, что в ней понимание в математике трактуется как процесс формирования ИМКМ. Выделен базовый элемент ИМКМ. В рамках ИМКМ представлена структура категории понимания, имеющая образ, значение, личностный смысл своими компонентами, которые связаны в единое целое через наименование понятия. Автором предложена схема, дающая возможность формировать математические понятия у обучающихся. Статья предназначена для педагогов-исследователей, аспирантов и будет полезна для преподавателей математики.

The relevance of this study stems from the fact that the problem of quality of education, deeply related to the issues of students' understanding of learning material, despite many discussions, does not have an unambiguous solution. Here we formulate an alternative approach to this problem. The purpose of this paper is to analyze the phenomenon of understanding in mathematics. The concepts of the mathematical worldview (MWV) and the individual mathematical worldview (IMWV) are introduced. The distinctive feature of the work is that understanding in mathematics is interpreted as a process of IMWV formation. The basic element of IMWV is distinguished. The structure of category of understanding within the limits of an individual mathematical worldview, having components (an image, value, the personal sense), connected in a uniform whole through the name of concept is presented. The author suggests the scheme which gives the possibility to form mathematical notions of students. The article is designed for teacher-researchers, post-graduate students and will be useful for teachers of mathematics.
Features of the use of interactive teaching methods in the context of digitalization of education in US universities
Authors: Ирхина И.В. , Литовченко М.В.
Published: August 2022

Актуальность статьи обусловлена необходимостью изучения зарубежного опыта разработки и использования эффективных способов организации учебного процесса в современном вузе. Цель статьи заключается в раскрытии особенностей применения интерактивных методов обучения в условиях цифровизации в высших учебных заведениях США. Представлена классификация используемых методов в зарубежных высших учебных учреждениях, рассматриваются основные принципы организации эффективного занятия, определены способы взаимодействия студентов с преподавателем во время учебного процесса. В статье с позиции американских ученых отображены практические примеры интеграции интерактивных методов в аудиторные занятие с помощью цифровых технологий. На основе анализа научной литературы были выделены основные трудности, с которыми сталкиваются американские преподаватели, а также представлены рекомендации по решению выявленных проблем.

The relevance of the article is due to the need to study foreign experience in the development and implementation of effective ways of organizing the educational process in a modern university. The purpose of the article is to reveal the features of the use of interactive teaching methods in the conditions of digitalization in higher educational institutions of the USA. The classification of the methods used in foreign higher educational institutions is presented, the basic principles of the organization of effective classes are considered, the ways of interaction of students with the teacher during the educational process are determined. The article shows practical examples of the integration of interactive methods into classroom classes using digital technologies from the stand point of American scientists. Based on the analysis of scientific literature, the main difficulties faced by American teachers were identified, as well as recommendations for solving the identified problems were presented.
Impact of Belt Road Initiative on Indonesia‘s Oil and Gas Trade
Authors: Rachmadi Rafi , Puspitawati Eka
Published: August 2022

The development of international trade is important to boost an economy. Economic integration is used by Indonesia to increase trade values. Belt Road Initiative (BRI) is a new integration that is usefull for Indonesia. Under BRI, the most frequently traded commdities are oil and gas. However, Indonesia should consider impacts of the integration on the trade of oil and gas. This study using a gravity model aims to analyse impact of BRI on Indonesia’s oil and gas trade and determinant factors in the trade. The result of this study shows that Indonesia get a trade diversion from BRI. Determinant factors influencing on Indonesia’s trade are GDP, distance, price and consumption. Indonesia should take more benefits of energy sectors particularly oil and gas from BRI.
Outcome after single dose of ChAdOx1 vaccine against SARS-CoV-2 infection at 16 weeks post-vaccination among healthy adults in Saudi Arabia
Authors: Alghamdi Ahlam , Alsanea Nasser , Alraey Mohammed , Joseph Mercy , Aboud Mohammed , Almangour Thamer , Alharbi Wasaef , Alhumidan Hind , Alanizi Abdalrhman , Al-jedai Ahmed
Published: August 2022

BACKGROUND:

The rate of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination among young and healthy participants remains unclear in Saudi Arabia.

OBJECTIVES:

Assess the rate of subsequent infection and immunogenicity of a single dose of ChAdOx1 vaccine at 16 weeks post-vaccination in a sample of healthy and young participants.

DESIGN:

Cross-sectional study

SETTING:

Academic teaching hospital in Riyadh, Saudi Arabia

SUBJECTS AND METHODS:

Healthy participants 18–50 years of age, who received one dose of ChAdOx1 vaccine and had no history of SARS CoV-2 infection were recruited, and blood samples were obtained 16 weeks after vaccination to assess immunogenicity using a commercially available kit.

MAIN OUTCOME MEASURES:

The rate of SARS-CoV-2 infection within 16 weeks post-vaccination.

SAMPLE SIZE:

385 participants with median (IQR) age of 34 (29-38) years.

RESULTS:

Eleven (2.8%) participants acquired polymerase chain reaction (PCR)-confirmed infection within 16 weeks after a single dose of ChAdOx1 vaccine (mean [SD] 42.5 [28] days post-vaccination). No hospital or intensive care unit admissions occurred among the subjects in this sample. Females were significantly over-represented in PCR-confirmed cases of SARS-CoV-2 infection, with 10 of 11 infections occurring in females (
P
=.006). Antibody response against anti-spike IgG were detectable in 92.7% of subjects at 16 weeks’ post-vaccination. The median anti-spike IgG level after vaccination was 273.1 (IQR 107-1052 AU/mL). However, the anti-nucleocapsid IgG antibody demonstrated a sensitivity of only 20%.

CONCLUSION:

A single dose of ChAdOx1 vaccine in healthy and young individuals was associated with a low, single-digit rate of PCR-confirmed infection, most of which were mild.

LIMITATIONS:

Small sample size and single-center.

CONFLICT OF INTEREST:

None.
Prevalence of anti-SARS-CoV-2 antibody in hemodialysis facilities: a cross-sectional multicenter study from Madinah
Authors: Housawi Abdulrahman A. , Qazi Shazada Junaid S. , Jan Abdulhalem A. , Osman Rashid A. , Alshamrani Mashil M. , AlFaadhel Talal A. , AlHejaili Fayez F. , Al-Tawfiq Jaffar A. , Wafa Ahmed A. , Hamza Abdulmageed E. , Hassan Moustafa A. , Alharbi Suliman A. , Albasheer Hamza , Almohmmdi Majed M. , Alsisi Salem A. , Mankowski Michal , Van de Klundert Joris , Alhelal Amal M. , Sala Fatima H. , Kheyami Ali , Alhomayeed Bader A.
Published: August 2022

BACKGROUND:

Since the occurrence of coronavirus disease in 2019 (COVID-19), the global community has witnessed its exponential spread with devastating outcomes within the general population and specifically within hemodialysis patients.

OBJECTIVES:

Compare the state of immunity to SARS-CoV-2 among hemodialysis patients and staff.

DESIGN:

Cross-sectional study with a prospective follow-up period.

SETTING:

Hemodialysis centers in Madinah region.

PATIENTS AND METHODS:

We prospectively tested for SARS-CoV-2 antibodies in dialysis patients using dialysis centers staff as controls. The participants were tested on four occasions when feasible for the presence of anti-SARS-CoV-2 antibodies. We also analyzed factors that might be associated with seropositivity.

MAIN OUTCOME MEASURES:

SARS-CoV-2 positivity using immunoglobulin G (IgG) levels

SAMPLE SIZE:

830 participants, 677 patients and 153 dialysis centers staff as controls.

RESULTS:

Of the total participants, 325 (257 patients and 68 staff) were positive for SARS-CoV-2 IgG antibodies, for a prevalence of 38.0% and 44.4% among patients and staff, respectively (
P
=.1379). Participants with a history of COVID-19 or related symptoms were more likely to have positive IgG (
P
<.0001). Surprisingly, positivity was also center-dependent. In a multivariable logistic regression, a history of infection and related symptoms contributed significantly to developing immunity.

CONCLUSION:

The high prevalence of SARS-CoV-2 antibody among hemodialysis patients and previously asymptomatic staff suggested past asymptomatic infection. Some centers showed more immunity effects than others.

LIMITATIONS:

Unable to collect four samples for each participant; limited to one urban center.

CONFLICT OF INTEREST:

None.
Comparison of nutritional risk status assessment tools in predicting 30-day survival in critically ill COVID-19 pneumonia patients
Authors: Kasapoglu Umut Sabri , Gok Abdullah , Delen Leman Acun , Ozer Ayse Belin
Published: August 2022

BACKGROUND:

Few clinical studies have addressed nutritional risk assessment in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU).

OBJECTIVES:

Assess the nutritional risk status of the critically ill COVID-19 pneumonia patients admitted to the ICU, and compare the nutritional risk screening tools.

DESIGN:

Medical record review

SETTING:

Tertiary critical care unit

PATIENTS AND METHODS:

We included adult (age >18 years) PCR-confirmed critically ill COVID-19 pneumonia cases admitted to the ICU between August 2020 and September 2021. Scoring systems were used to assess COVID-19 severity and nutritional status (mNUTRIC: modified Nutrition Risk in Critically Ill, NRS2002: Nutritional Risk Screening 2002). The 30-day mortality prediction performance of nutritional scores and survival comparisons between clinical and demographic factors were assessed.

MAIN OUTCOME MEASURES:

Compare the nutrition risk tools

SAMPLE SIZE:

281 patients with a mean (SD) age of 64.3 (13.3) years; 143 (50.8%) were 65 years and older.

RESULTS:

The mean mNUTRIC score of the cases was 3.81 (1.66) and the mean NRS-2002 score was 3.21 (0.84.), and 101 (35.9%) were at high risk of malnutrition according to the mNUTRIC score and 229 (81.4%) according to the NRS 2002 score. In cases at high risk of malnutrition by the mNUTRIC score there was a greater need for invasive mechanical ventilation, vasopressors, and renal replacement therapy (
P
<.001 for all comparisons). The mNUTRIC score was superior to the NRS-2002 score in estimating 30-day mortality. In patients who died within 30 days, the mNUTRIC score and NRS-2002 score on the day of hospitalization were significantly higher (
P
<.001), and the proportion of patients with NRS-2002 score ≥3 and mNUTRIC score ≥5 was significantly higher in the non-surviving group (
P
<.001). In addition, patients with a high risk of malnutrition had a shorter survival time. The mNUTRIC score was an independent and important prognostic factor for 30-day mortality, and patients with an mNUTRIC score ≥5 had a 6.26-fold risk for 30-day mortality in the multivariate Cox regression.

CONCLUSION:

One third of critical COVID-19 pneumonia cases hospitalized in the ICU due to acute respiratory failure have a high risk of malnutrition, and a high mNUTRIC score is associated with increased mortality.

LIMITATIONS:

Single center retrospective study.

CONFLICT OF INTEREST:

None.
Features and diagnostic accuracy of fine needle aspiration cytology of thyroid nodules: retrospective study from Oman
Authors: Alhassan Rafie , Al Busaidi Noor , Al Rawahi Abdul Hakeem , Al Musalhi Hilal , Al Muqbali Ali , Shanmugam Prakash , Ramadhan Fatma Ali
Published: August 2022

BACKGROUND:

Fine needle aspiration cytology (FNAC) of the thyroid has been a reliable and cost-effective method for diagnosing thyroid disorders. Since FNAC results are usually operator dependent, there is a compelling need to explore FNAC accuracy among Omanis.

OBJECTIVE:

Describe cytological features of FNAC and assess FNAC accuracy compared to the postsurgical histopathology report.

DESIGN:

Retrospective diagnostic accuracy study

SETTING:

Tertiary care center.

PATIENTS AND METHODS:

Our study included adult Omani adult patients with thyroid nodules who underwent FNAC from 2014 to 2017 and had final pathology results for patients who underwent thyroid surgery. The results were classified according to the UK Royal college of Pathologists ‘Thy’ categories. Accuracy of FNAC was calculated by determining false and true positive and negative results based on histopathology findings.

MAIN OUTCOME MEASURES:

FNAC accuracy (sensitivity and specificity) compared to the postsurgical histopathology.

SAMPLE SIZE:

867 patients with 1359 ultrasound guided FNACs of thyroid nodule; 137 underwent surgery.

RESULTS:

The mean age of the 867 patients was 43.7 (13.3) years, with a median of 42 years, and 87.8% were females. Out of 1359 FNACs, 1001 (73.7%) were benign (Thy2), 119 (8.8%) were atypia of undetermined significance or follicular lesion of undetermined significance (Thy3a), 31 (2.3%) were follicular neoplasm or suspicious for a follicular neoplasm (Thy3f), 52 (3.8%) were suspicious for malignancy (Thy4), 55 (4%) were malignant (Thy5), 101 (7.4%) as Unsatisfactory (Thy1). Only 137 patients underwent thyroid surgery, and the FNAC reports were compared with their final histopathology reports. The sensitivity, specificity and total accuracy of FNAC were 80.2%, 98.9% and 89.9%, respectively. The positive and negative predictive values of FNAC were 98.6% and 84.3%, respectively.

CONCLUSION:

Our study findings confirmed that FNAC of the thyroid is a sensitive, specific, and accurate initial tool for the diagnosis of thyroid lesions. Most of the FNACs were benign with a very low malignancy rate. Due to the minimal chance of false negative results and the slow-growing nature of thyroid malignancy, it is important that patients with benign FNAC should have periodic clinical and radiological follow-up.

LIMITATIONS:

Retrospective design and single-center study, and thyroid nodule size unavailable.

CONFLICT OF INTEREST:

None.
Trends in colorectal cancer in Iraq over two decades: incidence, mortality, topography and morphology
Authors: Ibrahem Salih , Ahmed Hussien , Zangana Suhair
Published: August 2022

BACKGROUND:

Colorectal cancer (CRC) is mainly a disease of the elderly in the Western world, but its characteristics are changing globally. Iraq does not have a well established CRC screening program. Understanding trends of CRC incidence, fatality and the clinical features of CRC patients is vital to the design of effective public health measures; public awareness, screening, diagnosis and treatment strategies to meet the future demands.

OBJECTIVES:

Determine trends in demography, incidence proportion, mortality, topography (primary tumor site) and morphology (histology) over two decades.

DESIGN:

Registry-based study

SETTING:

Iraqi National Cancer Registry (INCR) database

PATIENTS AND METHODS:

We collected and analyzed data from CRC patients obtained from the INCR to calculate incidence and mortality proportion per 100 000 population for the period from 2000 to 2019. In addition to estimation, data were examined by anatomic location and morphological type.

MAIN OUTCOME MEASURES:

Change in the incidence and mortality proportion, topography and morphology of CRC over 20 years.

SAMPLE SIZE:

20 880 CRC patients ranging in age from 14-80 years.

RESULTS:

The overall (males and females) CRC incidence proportion (CIP) increased from 2.28 to 6.18 per 100 000 population in 2000 and 2019, respectively, with an annual percentage change (APC) of 5.11%. The incidence proportion (IP) of CRC in patients from 20 to <50 years rose from 1.46 in 2000 to 4.36 per 100 000 population in 2019, which is an APC of 5.6%. The IP in patients older than 50 years rose from 12.7 to 40.59 per 100 000 population in 2000 and 2019, respectively, with an APC of 5.98%. The percentage of all CRC cases to all total malignancies in Iraq grew from 3.69% in 2000 to 6.5% in 2019. The CRC mortality proportion increased from 1.25 to 1.77 per 100 000 populations in 2010 and 2019, respectively, reflecting an APC of 3.54%. Anatomically, colon (C18) tumor represented 59.2% and 65.7% in 2000 and 2019, respectively. Rectal (C20) tumors were 37.2% in 2000 down to 31.4% in 2019, while rectosigmoid junction tumor (C19) were 3.6% in 2000 dropping to 2% in 2019.

CONCLUSIONS:

CRC in Iraq is still a disease of the elderly and is rising in incidence and mortality in all age groups. This necessitates reconsidering health policy regarding CRC; public awareness, screening and management strategies to accommodate for these alarming changes.

LIMITATIONS:

Data about stages, grades and molecular characterisations are not available in the INCR.

CONFLICT OF INTEREST:

None.
Association between serum vitamin D levels and age in patients with epilepsy: a retrospective study from an epilepsy center in Saudi Arabia
Authors: Alhaidari Hussam Mohammed , Babtain Fawzi , Alqadi Khalid , Bouges Abdulrahman , Baeesa Saleh , Al-Said Youssef A.
Published: August 2022

BACKGROUND:

Vitamin D deficiency has been linked to various medical conditions such as bone loss, decreased mineralization, endocrine disorders, and central nervous system disorders, including epilepsy. Vitamin D deficiency is prevalent among patients with epilepsy (PWE). However, the specific association between vitamin D levels and age in PWE is unclear.

OBJECTIVES:

Identify the relation between vitamin D level and age in PWE and evaluate factors that may play a role in seizure control.

DESIGN:

Retrospective analytical medical record review

SETTING:

Outpatient epilepsy research clinic in Saudi Arabia

PATIENTS AND METHODS:

Between November 2016 and April 2020, we selected eligible PWE aged older than 14 years whose vita-min D levels were recorded at least once after reviewing 1550 patient electronic files. We analyzed data on serum vitamin D level by age and other factors, vitamin D supplement use, seizure classification, and conducted a multivariate logistic regression to assess associations with seizure control.

MAIN OUTCOME MEASURES:

Relationships between vitamin D levels and age and factors that might affect seizure control.

SAMPLE SIZE:

524 patients

RESULTS:

The prevalence of low serum vitamin D levels was high (86.8%). The median vitamin D level in all patients was low (38 nmol/L), and was lower in young PWE than in adult PWE (P<.01). Only 146 patients received vitamin D supplements. High vitamin D levels were associated with a 40% seizure reduction.

CONCLUSION:

Vitamin D deficiency is underestimated in PWE in Saudi Arabia, and is more prevalent among young adults and patients on polytherapy than in other PWE. Patients with high vitamin D levels had good seizure control compared with those with low levels. The effect of vitamin D supplements on seizure control should be further investigated in randomized control trials.

LIMITATIONS:

Retrospective study and no categorization by presence of supplementation.

CONFLICT OF INTEREST:

None.
Health outcomes after acute ischemic stroke:retrospective and survival analysis from Oman
Authors: Al Alawi Abdullah M. , Al Busaidi Ikhlas , Al Shibli Emaad , Al-Senaidi Al-Reem , Al Manwari Shahd , Al Busaidi Ibtisam , Muhanna Fatema , Al Qassabi Ahmed
Published: August 2022

BACKGROUND:

Stroke mortality and related functional disability have been declining over the last two decades, but stroke continues to represent the second leading cause of cardiovascular death worldwide and the number one cause for acquired long-term disability.

OBJECTIVES:

Assess short- and long-term health outcomes after acute ischemic stroke and analyze factors associated with poor survival and functional outcomes.

DESIGN:

Retrospective and survival analysis

SETTING:

Inpatient unit at a tertiary care referral hospital.

PATIENTS AND METHODS:

All patients admitted with acute ischemic stroke from 1 January 2017 to 31 August 2018 were included in the study. Functional status was assessed using the modified Rankin Scale (mRS). Other demographic and clinical variables were obtained from medical records. Data were analyzed by multivariable logistic regression, Cox proportional hazards, and the Kaplan-Meier method. Long-term follow-up data, including mortality and mRS was collected by follow-up phone call.

MAIN OUTCOME MEASURES:

Functional dependency and factors associated with mortality.

SAMPLE SIZE AND CHARACTERISTICS:

110 with mean age of 67.0 (14.7) years; 59 patients (53.6%) were males.

RESULTS:

Hypertension (75.5%), diabetes mellitus (54.6%), and dyslipidemia (29.1%) were common. Sixty-five patients (59.1%) had mRS >2 upon discharge including 18 patients (16.4%) who died during the hospital stay. The cumulative mortality rate was 25.4% (28/110) at 12 months and 30.0% (33/110) at 24 months. Twenty-nine stroke survivors (29/70, 41.4%) remained physically dependent (mRS >2) at the end of follow-up. Old age, atrial fibrillation, history of prior stroke, chronic kidney disease, and peripheral arterial disease were associated with increased mortality and functional dependence.

CONCLUSIONS:

Patients in Oman with acute ischemic stroke tend to have a high comorbidity burden, and their functional dependency and mortality are higher compared to patients from developed countries. Therefore, evidence-based measures such as establishing stroke units are essential to improve the health outcomes of patients with acute ischemic stroke.

LIMITATIONS:

Retrospective at single center.

CONFLICT OF INTEREST:

None.
Ortaokul Öğrencilerinin Görüşlerine Göre Veli Eşliğinde Gerçekleştirilen İnceleme Gezilerinin Etkililiği
Authors: DEMİR Yılmaz
Published: August 2022

Bu çalışmanın amacı ortaokul beşinci sınıf öğrencilerinin görüşleri doğrultusunda Sosyal Bilgiler dersi kapsamında veli eşliğinde gerçekleştirilen inceleme gezilerinin etkililiğini incelemektir. Araştırmada veli ve öğretmen eşliğinde olmak üzere iki farklı şekilde gerçekleştirilen inceleme gezilerine katılan ve inceleme gezilerine katılmayan bir grup öğrencinin inceleme gezilerine yönelik görüşleri alınmıştır. Dolayısıyla araştırmada nitel araştırma yöntemlerinden biri olan görüşme tekniği kullanılmıştır. MAXQDA-12 programı kullanılarak verilerin içerik analizi yapılmıştır. Araştırmanın örneklem grubunu 2019-2020 eğitim öğretim yılı güz döneminde Kilis ili merkez ilçede öğrenim gören 113 beşinci sınıf öğrencisi oluşturmaktadır. Araştırma bulgularına göre veli eşliğinde inceleme gezilerine katılan öğrenciler (DG1) inceleme gezilerinin ağırlıkta “öğrenmeyi kolaylaştırma” yönüne; öğretmen eşliğinde inceleme gezilerine katılan öğrenciler (DG2) “bilgi edinme/öğrenme” ve “eğlenceli olma” yönüne; inceleme gezilerine katılmayan öğrenciler (KG) ise “öğrenmede kalıcılığı sağlama” yönüne daha çok dikkat çekmektedir. Ayrıca DG1 öğrencilerinin, inceleme gezisinin yürütücüsü olarak daha çok veliyi, DG2 ve KG öğrencilerinin ise öğretmeni tercih ettiği sonucuna ulaşılmıştır. Dahası inceleme gezilerine yönelik birbiriyle hemen hemen paralel görüşlere sahip olan DG1 ve DG2 öğrencileri; gerçekleştirilen gezilerle “akademik başarılarının arttığını, kültürel mirasa yönelik farkındalık sağlandığını, inceleme gezilerine yönelik tutumlarının olumlu yönde etkilendiğini ve derse yönelik motivasyon ile tutumlarını da olumlu yönde artırdığını belirtmişlerdir. Dolayısıyla veli eşliğinde inceleme gezileri gerçekleştirilerek öğrenciler için öğrenme çeşitliliği sağlanabilir.
Technical Efficiency of Tea Farms: Case Study in Thainguyen Province of Vietnam
Authors: Thi Vu Hien , Thi Duong Thao , Nguyen Huy Quoc
Published: August 2022

Tea production plays a vital role in rural development and poverty reduction in the North region of Vietnam, specializing in Thainguyen, a northeastern province of Vietnam. This study aims to analyze the technical efficiency of tea farms in Thainguyen province and subsequently to identify the key factors affecting their technical efficiency. The data envelopment analysis (DEA) method was first used to compute the technical efficiency levels. Tobit model was then used to determine factors affecting the inefficiency level of tea farms in the study area. The data of 50 farmers were collected by interview technique. The findings investigated that the average technical efficiency of tea farms was 0.73, implying that tea farms could increase their efficiency level by using inputs more efficient. The results of the Tobit regression model in the second stage revealed that factors related to age, education, and experiences had a significant positive influence on the technical efficiency of tea farms, therefore, to improve the efficiency of tea farms, the government should address policies to encourage tea farms to attain more education through extension system and training and technological transfers activities to help tea farms in adopting high technology in production to improve their efficiency level.
Relevance of Stunting and Economic Studies (Supported With Stunting Mapping Using K-means Clustering Method in Indonesia)
Authors: Septiani Reni Eka , Mulyanto
Published: August 2022

This study aims to determine the relationship between stunting and economic studies and to map stunting-prone areas to find out which areas require priority for stunting management in Indonesia. This research is a quantitative descriptive study with literature review and clustering methods using k-means clustering which is visualized through a map using ArcGIS software. Secondary data collection was obtained from previous journals and stunting prevalence data for 34 provinces in Indonesia was obtained from the Nutrition Status Monitoring 2017 book, Basic Health Research 2018, Study on Nutritional Status of Indonesian Toddlers 2019. The results of the study show that children who experience stunting in the future will lose their potential income due to their low production performance and ultimately increase poverty rates, economic inequality, and state economic losses. The results of the stunting clustering were divided into 4 clusters. Cluster I shows that the provinces with the highest average stunting prevalence are Aceh, East Nusa Tenggara, West Nusa Tenggara, Central Kalimantan, and West Sulawesi. Cluster II consists of the provinces of North Sumatra, West Kalimantan, South Kalimantan, Central Sulawesi, South Sulawesi, Southeast Sulawesi, Gorontalo, Maluku, and Papua. Cluster III consists of the provinces of West Sumatra, Riau, Jambi, South Sumatra, Bengkulu, Lampung, West Java, Central Java, East Java, Banten, East Kalimantan, North Kalimantan, North Sulawesi, North Maluku, and West Papua. Cluster IV consist of the provinces of the Bangka Belitung Islands, Riau Islands, Jakarta, Yogyakarta, and Bali.