bluuebunny/crossref_metadata_2025 huggingface dataset:
Reporte de caso: diabetes mellitus tipo 1 inducida por pembrolizumab en un paciente con adenocarcinoma de pulmón
Authors: Bedoya-Trujillo L. N. , Bedoya-Trujillo P. N.
Published: August 2021

Presentamos el caso de una paciente sin comorbilidades metabólicas con diagnóstico de adenocarcinoma de pulmón en manejo con pembrolizumab, quien, posterior al tercer ciclo de tratamiento, debuta con cetoacidosis diabética, requiere manejo para crisis hiperglucémica e insulina. Se realizó diagnóstico de diabetes mellitus tipo 1 y se reintrodujo el tratamiento de pembrolizumab a 200 mg cada tres semanas además del manejo con insulina. En la actualidad la paciente permanece con una respuesta parcial posterior a 1 año del diagnóstico y sigue en manejo con insulinoterapia. En vista que en la actualidad no se cuenta con protocolos y guías de manejo para esta entidad, se realiza revisión del manejo y de la literatura debido a que solo se encuentran 6 casos reportados, siendo este el primer caso reportado en Colombia.
Incidentaloma suprarrenal: ¿cuándo mantener la sospecha, aunque haya un buen lavado?
Authors: Duque-Ramírez J. , Castro-Pinzón A. , Díaz-Tribaldos D.
Published: August 2021

Se presenta a un hombre de 58 años, con hallazgo de masa incidental en la glándula suprarrenal izquierda. La tomografía computarizada de abdomen con protocolo para suprarrenales calculó un lavado absoluto del contraste de 72 %. La imagen de resonancia magnética de abdomen mostró intensidad de señal intermedia en T2 y baja en T1, sin presencia de grasa microscópica en secuencias eco gradiente fuera de fase. La bioquímica inicial fue normal, excepto por niveles de cortisol post dexametasona mayores de 1,8 ?g/dL y una 17-hidroxiprogesterona elevada. Se discute el enfoque diagnóstico y el abordaje de las lesiones suprarrenales.
Historia de los corticoides
Authors: Pizarro Francisco
Published: August 2021

Introducción-Fragmento

La historia de los corticoides comienza con la descripción que Thomas Addison (1793-1860) realizó sobre la melanodermia, más tarde conocida como enfermedad de Addison (Figura 1): “Un estado general de languidez y debilidad, desfallecimiento en la acción del corazón, irritabilidad en el estómago y cambio peculiar de coloración en la piel”. Estos pacientes evolucionaban indefectiblemente a la muerte. Las autopsias confirmaban las alteraciones en las glándulas suprarrenales, lo cual hizo pensar a Addison que existía alguna sustancia producida por esta glándula que sería responsable de esta condición mórbida. La glándula fue descrita en 1564 por Bartolomeo Eustachi y durante los siglos XVII y XVIII muchos investigadores no lograron demostrar la importancia funcional de las glándulas suprarrenales hasta la descripción que realizó Addison en 1855, en su libro “On the constitutional and local effects of the supra-renal capsules” (Figura 2). Los estudios de Addison le valieron cierto prestigio internacional. Fue invitado a París para participar del tratamiento de un paciente. Mientras estaba en la ciudad, recibió un homenaje de parte de sus anfitriones: Auguste Nelaton y Arman Trousseau. Fue este último quien propuso el nombre de enfermedad de Addison para describir la insuficiencia suprarrenal. A pesar de los descubrimientos, las revistas científicas de la época no le dieron importancia, lo cual, sumado a la personalidad depresiva de Addison, determinó que atentara contra su vida en más de una oportunidad. Se suicidó el 29 de junio de 1860, a la edad de 72 años.
Gastroparesia diabética: revisión corta con viñeta clínica ilustrativa. Actualización y puntos más relevantes para la práctica clínica
Authors: Costa Barney V. , Jaramillo Parra P. , Luna Meza Á.
Published: August 2021

La gastroparesia diabética es una entidad conocida, aunque en oportunidades se torna difícil su manejo con tratamiento médico, por lo que se deben contemplar otras opciones terapéuticas avanzadas. Es una enfermedad que amerita el tratamiento en conjunto entre gastroenterólogo, endocrinólogo y nutricionista.
Efectividad y seguridad de tocilizumab en 2 casos de orbitopatía tiroidea grave refractaria a corticosteroides. Hospital San José, Bogotá
Authors: Sierra Osorio A. , Manosalva Holguín S. , Coy A. , Benavides J. , Vargas JJ.
Published: August 2021

La orbitopatía tiroidea es la manifestación extratiroidea más frecuente del hipertiroidismo autoinmune; más del 90 % de los casos se asocian con enfermedad de Graves (EG). Es un trastorno complejo que puede provocar deformidad orbitaria, visión doble e incluso pérdida visual permanente, con gran impacto en la calidad de vida. Aproximadamente, el 2 % de los pacientes que desarrollan orbitopatía de Graves desarrolla enfermedad moderada a grave. Existe una creciente conciencia de la necesidad de un diagnóstico precoz y un manejo oportuno para disminuir las secuelas irreversibles. Su manejo inicial es con glucocorticoides; sin embargo, la recurrencia ocurre con frecuencia una vez que se retiran. En más del 60 % de los casos, la anatomía orbitaria normal no se restaura y se requiere cirugía de rehabilitación. En casos de refractariedad, las terapias biológicas son una alternativa, las cuales han demostrado ser efectivas. Dentro de estas están el teprotumumab, que reduce la proptosis, recientemente aprobado por la Food and Drug Administration (FDA); el rituximab, que reduce la inflamación; y el tocilizumab, que potencialmente beneficia ambos parámetros. A continuación, se describe el efecto del tocilizumab en 2 pacientes con orbitopatía tiroidea en el Hospital San José, en Bogotá.
Self-directed learning with a modified team-based strategy: A quasi-experimental study
Authors: Hwang Huei-Lih , Tu Chin-Tang , Kuo Tian-Yuan
Published: August 2021

Background and objective: Physical assessment skills are not effectively put into practice for nursing students, requiring an improvement in pre-registration programs and planning more tailored training courses for them. More flexibility in teaching methods can thus contribute to self-directed learning. The purpose of this study is to identify the effects of team-based learning when combined with an online teaching platform on self-directed learning compared to inquiry-based learning for junior college nursing students.Methods: In this quasi-experimental study, 103 students completely participated in the Self-directed Learning Instrument test before and after the course. Collected data were analysed using independent t-test and ANCOVA with the statistical package SPSS 21.0 for Windows. Qualitative focus group interviews were conducted after the survey with 14 participants.Results: Compared to the control group, the adjusted mean post-test score for self-directed learning ability was significantly higher in the intervention group. Students also reported that they were quite engaged in completing assignments and team learning activities in classroom, specifically for the group test.Conclusions: The modified team-based learning strategy was useful at engaging students to improve self-directed learning and to satisfy them. Educators are encouraged to integrate online response system technology into their classroom activities.
De ‘boodschappenaffaire’: een beoogd resultaat van de Participatiewet?
Authors: van Gijssel Anna
Published: August 2021

De ‘boodschappenaffaire’: een beoogd resultaat van de Participatiewet? Rb. Midden-Nederland,14 oktober 2019, ECLI:NL:RBMNE:2019:4746 (terugvordering bijstand)

Rechtbank Midden-Nederland heeft in de uitspraak van 14 oktober 2019 het beroep tegen een terugvordering van bijstand wegens het niet-naleven van de inlichtingenplicht ongegrond verklaard. Belanghebbende heeft circa drie jaar wekelijks boodschappen ontvangen van haar moeder. Omdat zij dit niet heeft gemeld aan het college van burgemeester en wethouders van de gemeente Wijdemeren, vordert het college de totaalwaarde van de ontvangen boodschappen terug ter hoogte van circa € 7.000. Deze uitspraak geeft aanleiding om in te gaan op de terugvorderingsplicht in de Participatiewet. Had de regering destijds de verstrekkende gevolgen van terugvordering in gevallen zoals de onderhavige zaak voor ogen?
Social Change and The Greek Welfare State Crisis (2010-2020)
Authors: Kourachanis Nikos
Published: August 2021

This article attempts to utilize the concept of social change for the study of transformations in the Greek welfare state during the period of the multiple crises it is currently experiencing (2010–2020). This will be done through an analysis of the changes taking place in the Greek social security system, the backbone of social policy in Greece. The main argument is that, although there are fundamental differences in the development of the Greek welfare state compared to the welfare model of Western European countries, in the last decade there has been a convergence towards a neoliberal model of social policy. The elaboration of this claim will examine those theories of social change that attempt to explain the transition from the Keynesian to the neoliberal welfare state both in the period after 1970 and in the period after the Great Recession of 2008. The development of the Greek social security system over time is then examined, with a particular focus on the decade from 2010–2020. This will show that, despite the different context for the development of the social security system in Greece, the reforms imposed by austerity policies in the last decade have led to a convergence with the model of the neoliberal welfare state. The trend towards residualization and privatization of the social security system with a focus solely on the management of extreme poverty can be observed as one of the mechanisms of social change that are being adopted.
Climate-Induced Relocation and Social Change in Keta, Ghana
Authors: Salifu Abdul-Moomin A
Published: August 2021

In this article, I analyze the resettlement of three communities in the Keta municipality of Ghana as a result of rising sea levels that threatened life and property. Although a few studies have documented the effects of relocation because of slow-onset climate-induced environmental change, little is known about how such resettlements have contributed to positive social change in the affected communities. I used critical theory to determine whether Keta’s relocation process contributed to positive social change. Transcriptions of interviews with a purposeful sample of 35 household members were coded and categorized into themes for essence description. Improved educational infrastructure for personal development, improved housing facilities, saved lives and protected culture, and improved healthcare facilities and general well-being were among the positive outcomes. Hence, through this study, I provide evidence to consider the need to prioritize the positive social change such resettlements will make in the lives of the affected populations in climate-induced resettlement and adaptation in Ghana and other parts of the world. Keywords: Climate change, relocation, resettlement, social change, sea level rise, improved livelihoods
Is ICD effective in primary prevention od Sudden Cardiac Death in patients with heart failure of nonischemic etiology?
Authors: Mitkowski Przemysław
Published: August 2021

In DANISH trial, published in 2016, beneficial effect of implantation of cardioverter-defibrillator on mortality in population of patients with heart failure of nonischemic etiology was not demonstrated. It should be pointed out that up to 58% of patients in both arms received cardiac resynchronization therapy, so there were not two but four arms of the trial: optimal medical therapy, ICD, CRTP, CRTD with respective mortality: 27; 25; 20 and 19% (p=0,08). In the trial 50% relative risk reduction of arrhythmic death was observed and beneficial effect on mortality was demonstrated in population under 59 years treated with ICD. Twenty four patients in non-ICD group were implanted during the trial because of arrhythmia. If composite end point would be defined as total mortality and necessity to implant ICD because of arrhythmia the difference between groups would reach statistical significance (p=0,0181). In metaanalysis of AMIOVIRT, CAT COMPANION, DEFINITE SCD-HeFT and DANISH 24% reduction in total mortality was demonstrated. Even if COMPANION will be removed from the analysis still 20% beneficial effect of ICD will be present. In large analysis of 45 trials on risk factors of arrhythmic events in the population of dilated cardiomyopathy the following had impact on this risk: LVEDD, LVEF, EPS results, presence of nsVT, QRS prolongation, LBBB, results of SAECG, fragmented QRS, QRS-T angle and TWA. DANISH trial, despite its importance, does not justify discontinuing ICD therapy in patients with nonischemic heart failure.
Can pacemaker protect against ischemic stroke?
Authors: Lubiński Andrzej
Published: August 2021

While the benefit of oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation (AF) is well established, it is not known whether oral anticoagulation is indicated in patients with atrial high-rate episodes (AHRE) recorded on a cardiac implantable electronic device, sometimes also called subclinical AF, and lasting for at least 6 min in the absence of clinically diagnosed AF. Clinical evidence has shown that short episodes of rapid atrial tachyarrhythmias are often detected in patients presenting with stroke and transient ischaemic attack. Patients with AHRE have a higher likelihood of suffering from subsequent strokes, but their stroke rate seems lower than in patients with diagnosed AF, and not all AHRE episodes correspond to AF. The prognostic and pathological significance of AHRE is not yet fully understood. Clinical trials of OAC therapy are being conducted to determine whether therapeutic intervention would be beneficial to patients experiencing AHRE in terms of reducing the risk of stroke.
Medtronic Micra leadless pacemaker implantation to patient with artificial tricuspid valve
Authors: Kowalska Wiktoria , Jędrzejczyk-Patej Ewa , Konieczny Aleksandra , Kozielski Jonasz , Bugajski Maciej , Woźniak Aleksandra , Kowalski Oskar , Średniawa Beata
Published: August 2021

In case of the need of pacemaker implantation, patients with artificial tricuspid valve are a special group of subjects,
because of high risk of dysfunction of the prosthesis. In case of mechanical prosthesis of tricuspid valve
the leads of pacemaker are usually located in coronary sinus. In case of biological prosthesis of tricuspid valve
despite of the risk of prosthesis damage the electrodes are implanted endocardially. The leadless pacemakers
seems to be promising alternative in patients with artificial tricuspid valve because of minor risk of valve damage.
The case report concerns to the patient with tachycardia-bradycardia syndrome and biological prosthesis
of tricuspid valve in whom the leadless pacemaker Micra was implanted.
Common ostium of the left pulmonary veins – to freeze or not to freeze – that was the question?
Authors: Orczykowski Michał
Published: August 2021

Second-generation cryoballoon (CB2) - based pulmonary vein isolation (PVI) has demonstrated encouraging
clinical results in the treatment of paroxysmal (PAF) and persistent atrial fibrillation (PersAF).
Nevertheless, the acute efficacy, safety, and long-term clinical results of CB2-based PVI in patients with a left
common pulmonary vein (LCPV) are still a matter of debate.
Commented paper by Heeger ChH, et al. analyzes this issue with some practical conclusions.
THE SOCIAL ECONOMY SECTOR AS AN INSTRUMENT FOR THE INCLUSION OF MARGINALIZED AND SOCIALLY EXCLUDED – A LOCAL PERSPECTIVE
Authors: Janowska Zdzisława
Published: August 2021

The aim of this study is to emphasize the importance of the social economy sector for local development. The social economy sector is bringing together various entities and is activating socially and professionally marginalized and excluded groups. Its proper functioning is an example of social inclusion, which is the slogan of the Europe 2020 Strategy. The guarantee of success is the local government applying a strategy for active social policy. The government should be the initiator and ally of changes aimed at strengthening social inclusion at the local level. Therefore, it should create favorable conditions for the emergence and functioning of social economy entities. It can act as their founder, but also as the ordering party of services (socially responsible procurement). In this way, the government becomes an advocate of the interests of socially excluded groups. Finally, it can be the initiator of establishing cooperation with business. Unfortunately, the research conducted in Poland on this issue, as well as my own experience managing a social cooperative, highlight serious discrepancies between the ideal state and reality. The spending of European funds for many years for the purpose of social inclusion are disproportionate to the achieved results. This study will present the barriers which inhibit the development of the social economy at the local level as well as at the national level and will indicate ways to overcome them.
EMPLOYMENT AND REMUNERATION OF PHYSICIANS COMPARED TO THE HEALTH INSURANCE SYSTEM IN THE USA
Authors: Karaszewska Hanna
Published: August 2021

The last decade has brought a sharp rise in healthcare costs in the US. This was not accompanied by an improvement in the indicators of the quality of healthcare. The health care system in the US, based in the same amount on private insurance as public funding, proved to be ineffective. This fact is mainly attributed to the growing costs of administering the complex system and high prices of medicines. And although the share of labor costs, including the remuneration of doctors in general health care expenditures, is relatively small (20%), there is an urgent need to look for pro-efficiency solutions also in this area. However, they must be accompanied by fuses that ensure adequate quality of health services and their availability. The article presents the mechanisms of employing doctors and their remuneration as an important element of systemic solutions in health care in the USA. It also features some characteristics of the pay relation. The article uses mainly secondary sources, including OECD statistical data. The results of reports published in American literature by various bodies and institutions, including Medscape and Doximity – the most popular American portals associating doctors, were also used. The information collected during unstructured interviews with participants of the health care system (doctors, hospital directors) during their stay in the USA was used as auxiliary.
On Minimal Second-order IIR Bandpass Filters with Constrained Poles and Zeros
Authors: Joelianto Endra
Published: August 2021

In this paper, several forms of infinite impulse response (IIR) bandpass filters with constrained poles and zeros are presented and compared. The comparison includes the filter structure, the frequency ranges and a number of controlled parameters that affect computational efforts. Using the relationship between bandpass and notch filters, the two presented filters were originally developed for notch filters. This paper also proposes a second-order IIR bandpass filter structure that constrains poles and zeros and can be used as a  minimal parameter adaptive digital second-order filter. The proposed filter has a wider frequency range and more flexibility in the range values of the adaptation parameters.
COVID-19 Prevention: Role of Activated Carbon
Authors: Reza Md Sumon , Hasan ABM Kamrul , Ahmed Abu Saleh , Afroze Shammya , Bakar Muhammad Saifullah Abu , Islam Shafi Noor , Azad Abul Kalam
Published: August 2021

Recently, Coronavirus Disease 2019 (COVID-19) has brought the whole world into a pandemic condition, where the number of infected cases and deaths is exponentially high. A number of vaccines are available for this novel virus, but these are in the preliminary stage and are also not available to everyone. As the virus is very contagious, protection and prevention are the best way to survive and get rid of this disease. The virus affects the human body by entering through the nose, mouth, and eyes, so face protection with an appropriate mask is highly advisable. Combined masks made with activated carbon (AC) can effectively adsorb the virus because of its high surface area and broad functional groups. Such combined masks can also control coronavirus transmission by capturing harmful gases and smoke as they help in decreasing the spread of the virus
Effect of Local Injection of Bupivacaine for Pain Management After Tonsillectomy: A Randomized Clinical Trial
Authors: Javaherforooshzadeh Fatemeh , Gousheh Mohamadreza , Akhondzadeh Reza , Olapour Alireza , Derakhshandeh Vita , Atigh Fahimeh
Published: August 2021

Background: Pain is one of the main side effects of tonsillectomy, especially in the pediatric population. Objectives: This study aimed to examine the effects of a local injection of bupivacaine on pain and postoperative nausea and vomiting after tonsillectomy. Methods: In this double-blind clinical trial, we enrolled 96 patients who were referred for elective tonsillectomy to the ear, nose, and throat (ENT) Clinic of Imam Khomeini Hospital in Ahvaz, Iran, from December 2016 to January 2018. The patients were selected by the simple random sampling method on a 1:1 ratio. To analyze the data, Student's t‐test or chi‐squared test were used. Results: Visual analog score measured in the recovery period at 0, 1, 2, 4, 8, 12, and 24 h after surgery was significantly lower in the bupivacaine group than in the placebo group (P < 0.001). Nausea was significantly different between the groups at all time, but for vomiting, significant differences between the groups were noted at 0, 1, 2, 4, and 8 h but not at 12 and 24 h after surgery. Conclusions: Preoperative local injection of 0.5% bupivacaine for tonsillectomy was effective in reducing postoperative pain, and it significantly reduces postoperative nausea and vomiting in children.
Serum Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) Can Predict Mild or Significant Liver Fibrosis in Non-alcoholic Fatty Liver Disease
Authors: Cheng Yu-Ming , Wang Chia-Chi
Published: August 2021

Background: The serum levels of M2BPGi increase with liver fibrosis progression in patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. However, the diagnostic performance of M2BPGi in non-alcoholic fatty liver disease (NAFLD) patients remains unclear. Objectives: To assess the severity of liver fibrosis in NAFLD patients and healthy controls by M2BPGi using acoustic radiation force impulse (ARFI) as the standard reference. Methods: Those suffering from NAFLD and healthy controls were recruited. NAFLD diagnosis was confirmed using fatty liver in imaging after excluding HCV, HBV, alcohol, drug, or other known causes of chronic liver disease. ARFI was used as the standard reference to determine the stage of liver fibrosis. Results: A total of 226 subjects were recruited, including 130 (57.5%) NAFLD patients who were divided into three groups according to the stage of liver fibrosis: F0, F1, and F ≥ 2. The serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST to platelet ratio index (APRI), M2BPGi, and the fatty liver grade were significantly different between the three groups. The levels of M2BPGi were correlated with median ARFI value (P < 0.001), APRI (P = 0.011), and fibrosis 4 index (FIB-4) (P < 0.001). The area under the curve (AUC) of M2BPGi test was 0.58 for F ≥ 1 and 0.68 for F ≥ 2, respectively (P = 0.039 and P = 0.024). Conclusions: The M2BPGi levels were correlated with ARFI, APRI, and FIB-4 scores in this study population. The level of M2BPGi could predict mild (F ≥ 1) and significant liver fibrosis (F ≥ 2) in NAFLD patients, suggesting a surrogate marker to differentiate between normal, mild, and significant fibrosis.
Anthropometric Indices and Age at Natural Menopause: A 15-Year Follow-up Population-Based Study
Authors: Farahmand Maryam , Ramezani Tehrani Fahimeh , Rahmati Maryam , Azizi Fereidoun
Published: August 2021

Background: Following menopause, the risk of many diseases is increased, and this situation may be due to changes in anthropometric indices (AI), while the association between adiposity and age at natural menopause (ANM) is not clear yet. Objectives: This longitudinal study was conducted to investigate the ability of AI in predicting ANM. Methods: For this purpose, a total of 3,876 women aged > 20 years old from participants of the Tehran lipid and glucose study (TLGS) met our eligibility criteria. The association between ANM and various AIs was assessed using the Accelerated Failure Time (AFT) model, and time ratio (TR) with 95% confidence intervals was reported in this longitudinal study. Results: The median [interquartile range (IQR) 25 - 75] of the survival time was 12.5 (7.9 - 15.8) years. At the end of the follow-up, 1,479 (38.2%) of the participants reached menopause. The median time to natural menopause was decreased by about 2% with one standard deviation (SD) increase of both a body shape index (ABSI) (time ratio (TR): 0.98, 95% CI: 0.97, 0.99) and lipid accumulation product (LAP) (TR: 0.98, 95% CI: 0.98, 0.99) z-scores; and this time was increased by about 1% (TR: 1.01, 95% CI: 1.00, 1.02) with one SD increase in body mass index (BMI) z-score. Conclusions: The ABSI, LAP, and BMI were the most useful AIs for identification of the time to menopause onset, and ABSI and LAP were inversely associated with the ANM. Also, the BMI was directly associated with the ANM.
Relationship Between the Use of Pornography and Marital Sexual Satisfaction with Attitudes Towards Marital Infidelity in Married Women in Zahedan City
Authors: Nikmanesh Zahra , Ganjali Samane
Published: August 2021

Background: The spread of the Internet and the improvement of audio and video media have led to the emergence of an industry called pornography. Objectives: The purpose of this study was to investigate the relationship between the use of pornography and marital sexual satisfaction and attitudes toward marital infidelity in married women in Zahedan. Materials and Methods: This was a descriptive correlational study. The statistical population consisted of all working married women and housewives in Zahedan during 2017. Among them, a sample of 190 people (95 housewives and 95 employed women) was selected through a convenience sampling method. To collect data, the problematic pornography use scale, the Sexual Satisfaction Questionnaire (women's form), and Whatley's attitudes toward marital infidelity scale were used. Data analysis was performed using Pearson correlation coefficient and stepwise regression. Results: According to the results, there was a significant reverse relationship between the use of pornography and its components and marital sexual satisfaction, and the use of pornography to escape or avoid negative emotions was a negative predictor of marital sexual satisfaction. There was a significant direct relationship between the use of pornography and its components and the attitude towards marital infidelity, and the psychological and social problems of using pornography were a positive predictor of attitude towards marital infidelity. Conclusions: It is necessary to consider appropriate strategies to reduce the use of pornography to promote marital sexual satisfaction and reduce the attitude towards marital infidelity in married women.
Systemic Medical and Procedural Therapies for Mucosal Lichen Planus: Update and Review of Challenges and Successes
Authors: Pincelli Thais , Tolaymat Leila , Sluzevich Jason , Bruce Alison
Published: August 2021

Context: Mucosal lichen planus is a chronic inflammatory debilitating condition that commonly affects the oral mucosa, but other sites such as the genital and ocular mucosae, esophagus and ear canal may also be involved, with risk of scarring and functional compromise. Spontaneous remission is rare and the condition tends to be recalcitrant to therapy, which makes management challenging. Topical therapies are often ineffective in severe cases and official treatment guidelines including systemic agents and procedural interventions are currently not available. Methods: We performed a literature review on current systemic therapies for mucosal lichen planus using PubMed, MEDLINE and Cochrane databases, with 74 publications identified including retrospective and prospective studies, case reports, and clinical trials. Therapies reviewed included biologics, immunosuppressive therapies, immunomodulating and anti-inflammatory drugs, vitamin A derivatives, devices and interventional therapies, and non-prescription drugs. Results: Reported treatments were classified into the following categories: biologics, anti-metabolic immunosuppressives, direct anti-T cell agents, other immunodulatory agents, antibiotics, retinoids, and procedure based interventions. Most studies on mucosal lichen planus are descriptive in nature and demonstrate low levels of evidence. Randomized controlled trials are lacking, which makes it difficult to directly compare different grading scales and outcome. Conclusions: The authors suggest clinical criteria for initiation of therapy in mucosal lichen planus, such as severe disease, lack of response to topical therapy, mucous membranes involvement and involvement of organs at risk of non-function. The authors also propose a stepwise treatment algorithm based on data from this review and their personal experience in an academic tertiary referral center.
Mathesis Universalis
Authors: de la Fuente Lora Gerardo ,   Society for Phenomenology and Media
Published: August 2021

One of the most surprising elements, within the already unprecedented situation created by the COVID-19 pandemic, is the space suddenly occupied by mathematics in the world, in terms of processing public policy decisions, as well as in forms of daily communication about the disease. This essay explores ten theses about how mathematics is, and will be perceived, in a world altered by the pandemic. The different human groups facing the COVID-19 pandemic and the proliferation of messages, figures, concepts, and quantitative debates that it entails, reveals an aesthetic rather than mathematical use of the numerical. Moreover, the presence of mathematics in public debate is an indicator of the very high capacity for formal and deductive reasoning and abstraction that humanity as a whole currently possesses. However, as governments mistrusted their populations’ ability to understand, on one hand, they resolved to establish media communication about the disease in mathematical terms, and on the other, they promoted intense campaigns of fear to make people accept the unprecedented confinement due to the pandemic. Nonetheless, in the future, mathematics will increasingly become the language of politics.
Opening through Silence
Authors: Powell Tracy ,   Society for Phenomenology and Media
Published: August 2021

Silence, an intangible something, through silencing creates, reveals, and transforms. It provides a space to examine psychological well-being as it removes the anchor tethering us to the temporal existence of our logical mind. From silence comes sound, and from sound silence. Neither mutually exclusive, sound and silence co-create one another, inextricably bound together through intentional force. The artistic expression of silence, as both ephemeral and ambiguous, allows for a personal transformative experience of opening to an authentic self. Music holds the power to envelop us within its sensorial embrace, enabling emotions to swell to the surface thereby creating a pause where self-revealment becomes possible. Existentialist ideology suggests the innate terror of nihilism clouds the human psyche, giving credence to our fear of non-existence. However, failure to leave the external noise and enter the silence between the notes resorts in a disillusionment of being, where the false self will ultimately crumble under the pressure to maintain its façade. Between the notes fosters introspection, allows an opening to well-being. It is here, in that silent space, that the authentic self can be discovered.
Grand Guignol and new French extremity: horror, history and cultural context
Authors:   , Hicks Oliver
Published: August 2021

This thesis will investigate and examine the French theatre The Grand-Guignol (1897-1962) and the film movement New French Extremity (1990s-roughly 2008). The theatre and the film movement will be examined in terms of their origins, evolutions and eventual declines. These will be related to French society and culture at the times as well as their historical contexts, for instance the long history of violence on French soil and the rise of the far-right in the 1980s/90s leading to the rise of New French Extremity. There will be an interrogation of the theatre and film movement’s use of ‘othering’, examining how they both alternately exploit the trope and subvert it, allying themselves with the so-called ‘other’. There will also be an examination of the term ‘Grand-Guignol violence’, often used colloquially to describe gruesome violence in entertainment. The term will be examined in relation to the stage violence inflicted during Grand-Guignol plays on stars like Paula Maxa and compared with the violence inflicted upon women in the mainly-female-led New French Extremity films. The escapist, entertaining violence of the theatre will also be contrasted with the nihilistic violence of New French Extremity, which often seeks to reinforce social commentary from the creative teams. The theatre and the film movement are both positioned as key moments in French horror history. This thesis will examine the ways that they are similar and the ways that they fundamentally differ, beyond their obvious stage/film barriers.
Differences of Polycystic Ovary Syndrome (PCOS) Effects among Asian and Caucasian Women
Authors: Choi Wooyoung , Park Jae Suk , Oluwatobiloba Adegoke , Morebise Olugbenga
Published: August 2021

PCOS, Polycystic ovary syndrome, is the most common endocrine disorder occurring in women with normal reproductive age. General symptoms of PCOS include irregular menstrual cycles, polycystic ovaries, hirsutism, and hyperandrogenism. Also, Insulin resistance that is associated with obesity, skin conditions such as acne, and even psychiatric conditions have been reported. Comparison of prevalence of PCOS is not an easy task due to the fact that there are too many variables to consider. The biggest one is that each research uses different diagnostic criteria. Also, some studies use small sample sizes, and some studies are too specific in location to represent the whole country. This study reviewed articles to determine how geographical and ethnic differences among Asians and Caucasians would affect the prevalence of polycystic ovary syndrome.
Farmers’ Preferences for Farming Enclaves in Forest Reserves of South-West, Nigeria: A Discrete Choice Experiment
Authors: Otekunrin Oluwaseun A. , Ademigbuji Alice T. , Otekunrin Olutosin A. , Kehinde Mojisola O.
Published: August 2021

Aims: Acquiring suitable land for agricultural purposes is a challenge for most prospective farmers in South-West, Nigeria. This makes them acquire lands in government-owned forest reserves with special contractual agreements. Therefore, we evaluate farmers’ preferences for selected attributes of farming enclaves in four hypothetical forest reserves in South-West, Nigeria.

Study Design:  An orthogonal main effects design was used to construct the choice sets used for preference elicitation.

Place and Duration of Study: The study was conducted in December, 2017 in randomly selected communities of Oluyole Local government area of Oyo State, South-West, Nigeria. 

Methodology: Focus group discussions and relevant literature search were conducted to identify the relevant attributes. Four hypothetical forest reserves were considered and the selected attributes were size of the farmland, type of cropping system and land rent fee per hectare. Multistage sampling techniques were used to select 100 farmers and data were collected via face-to- interview. Multinomial logit model was used to analyse the data and willingness to pay for each of the selected attributes was also calculated.

Results and Conclusion: We find that farmers value intercropping system the most. The coefficient of land rent fee (per hectare) is negative and significant implying that farmers obtain higher utility from very low land rent fees. They are willing to pay an extra 12.50 US Dollars land rent fees (per hectare) to have intercropping on a particular farming enclave while avoiding other enclaves with other cropping systems. Farm size and taungya do not contribute significantly to the farmers’ choice of farming enclave. These results will help forest reserve managers in formulating policies that will benefit farmers without jeopardising efficient management of forest resources.
A Review on Brown Planthopper (Nilaparvata lugens Stål), a Major Pest of Rice in Asia and Pacific
Authors: Iamba Kari , Dono Danar
Published: August 2021

Rice (Oryza sativa L.) is the most important staple food in the world including Asia and Pacific. Millions of people around the world depend on rice due to the high calories and economic returns it provides. More than 100 species of insects including 20 economic pests are capable of causing notable damage to rice plants. Insect pests continue to pose threat to rice farming since rice plants serve as their host plants. Pests are major constraints to rice production and coexist with rice growth. Information on pest economic importance, description, biology, distribution, economic threshold level, population dynamics, monitoring and forecasting is a prerequisite. This review is focused on brown planthopper (Nilaparvata lugens Stål) which is an important economic rice pest that are prevalent in tropical rice growing regions. Brown planthopper (BPH) is a serious pest of rice and has tremendous impact especially in Asia-Pacific region. Understanding the biology and ecology of this pest will enhance the designing, formulation and utilization of effective control measures. The control strategies as stipulated by integrated pest management (IPM) should be eco-friendly with minimum use of synthetic pesticides while boosting the activities of natural enemies and other biological control agents. The control measures discussed in this paper are oriented towards the cultural and biological aspects of managing the pest.
Vegetative Growth and Ion Relations in Soybean with Potassium Sulphate Application under Saline Environment
Authors: Zaman Badar-uz- , Gul Zaryab , Suhaib Muhammad , Ishaq Muhammad , Khurshid Haris
Published: August 2021

Aims: To evaluate the effect of K2SO42- application on growth of soybean cultivars besides chemical parameters under salt stress.

Study Design: Laid out the experiment in Complete Randomized Design in triplicates.  Analyzed the data statistically by using the statistical software Statistix 8.1.

Place and Duration of Study: The study was conducted in Soil Salinity and Bio-saline Research

green house and in the laboratory of Land Resources Research Institute at National Agricultural Research Centre, Islamabad (under PARC), Pakistan for three months.

Methodology: To study germination parameters under salt stress, NaCl was used @ 0, 100, 120 and 140 mmol L-1. At seedling stage, interactive effect among salt stress (0 and 4.5 dSm-1), potassium sulphate (KS) application @ 10 mmol L-1 and soybean (Cvs. NIBGE-301 and NIGBE-158) was recorded for growth and ion relations. 

Results: Germination, biomass, bio vigor, mass vigor and sap vigor of the seedlings and ion relations were affected highly significantly (p≤ 0.01).  Under interactive effect of KS and salt stress at vegetative stage, Na+/K+ in the plants declined with KS application. Sulphur and phosphorus concentration in the plants changed under the same conditions.

Conclusion: Induced salt stress revealed germination, seed bio vigor, seeding mass vigor, and seedling sap vigor seedling and other vegetative parameters of soybean cultivars. Potassium sulphate application revealed genotypes differential response to ion relations and growth under salt stress. NIBGE-301 was more tolerant to salt stress and more responsive to potassium sulphate application than NIGBE-158.
The Exergy Analysis for the Air Gasification in a Hybrid Fixed Bed Gasifier
Authors: Moshi Robert Eliraison , Kivevele Thomas Thomas , Jande Yusufu Abeid Chande
Published: August 2021

Municipal solid waste (MSW) is becoming a concern as population in urban area is increasing. Several disposal methods (landfill and biochemical) have been used. However, waste to energy (WTE) particularly gasification technology is a potential technology for energy recovery. The system is used to convert biodegradable material into syngas under limited gasifying media. This study presents numerical analysis of producer gas for the two air paths in the hybrid fixed bed gasifier (HFBG). It was revealed that the optimum operating condition was achieved when the air ratio at the first air flow path (AIR1) was 0.3. Furthermore, the exergy efficiency of about 81.51% was   achieved.
Effectiveness of Behaviour Change Communication for Mothers on Complementary Feeding Practices and Infants’ Nutritional Status in Nigeria
Authors: Afolabi Kolade Afolayan , Afolabi Adebukunola Olajumoke
Published: August 2021

Introduction: The quality of feeding in early childhood depends on nutritional knowledge of mothers. Improving maternal nutrition knowledge is therefore pivotal towards promoting effective infants’ feeding behaviour.

Objective: Study assessed mothers’ knowledge about complementary feeding and complementary feeding practices. Study also assessed effectiveness of Behaviour Change Communication on mothers’ knowledge and complementary feeding practices, compared the nutritional status of infants whose mothers received intervention to infants of mothers in the control group.

Materials and Methods: A quasi-experimental study conducted among 204 mothers in rural and urban local government areas, South-west Nigeria between March and September, 2019. Sample size was estimated using formula for comparison of two proportions, eligible mothers were selected through multistage sampling technique. Study was conducted in three phases: pre-intervention phase, intervention and post intervention phases.

Intervention: Selected mothers were randomly assigned into intervention and control groups. Mothers in the intervention group received Behavior Change Communication on complementary feeding and were followed up for six months.

Data Analysis: Data was analyzed using SPSS software version 25, Chi-square and repeated analysis of variance evaluated effectiveness of intervention, level of significance was < 0.05.

Results: BCC improved mothers’ knowledge about complementary feeding by 31.9% (χ2 = 21.62; p = 0.001), meal frequency by 16% (χ2 = 5.88, p = 0.01), dietary diversity by 19.6% (χ2 = 7.44, p = 0.01), minimum acceptable diet by 20.6% (χ2 = 13.09; p =0.01). Intervention also reduced under-weight by 14% (χ2 = 0.69, p = 0.01; (F(1,191) =275.34; p = 0.04) among intervention group.

Conclusion: Effective nutritional intervention for mothers towards improving nutritional status of children should incorporate appropriate behaviour change approach. This approach is capable of improving nutritional status of infants and children and consequently reduce malnutrition and related complications in early childhood.
Measuring Anger in Medical, Dental and Paramedical Post-graduate Students of Sumandeep Vidyapeeth, Vadodara, Gujarat, India: A Cross-Sectional Study
Authors: Chhasatia Anupsinh H. , Kataria Lakhan R.
Published: August 2021

Background: Medical, dental and paramedical post-graduate students are an essential part of multi-specialty teaching institutes where resident doctors are the ones who come in the first contact with the patients. In this study emotion of residents was measured through their anger. Anger has negative impacts on daily life, doctor-patient relationships. Throughout the post-graduation program, students experience stress and burn out.

Aim: The study was conducted with an aim to measure the level of anger amongst the post-graduate medical, dental and paramedical students at Sumandeep Vidyapeeth University, Vadodara, Gujarat, India.

Materials and Methods: After obtaining informed and written consent, 349 subjects were assessed through a semi-structured proforma and clinical anger scale to assess the level of anger. It was a cross-sectional single interview study. Enrolment of participants done for the tenure of 1 year from 2013 to 2014 and results assessed. At the end of the study, all CAS (clinical anger scale) parameters compared medical, dental and paramedical groups. Data analyzed through the SPSS v16 software package; One way ANOVA and independent t-test was applied.

Results: The overall anger was higher among post-graduate students. Post-graduate medical students had higher anger compared to paramedical post-graduate students. Female participants scored significantly lower on clinical anger compared to male participants. Post-graduates doing MD/MS were having significantly higher anger than post-graduates of MDS (p=0.002), MPT (0.000). Married participants scored lower on clinical anger compared to unmarried participants.

Conclusion: Overall anger is high in medical post-graduate students which have negative implications on doctor-patient relationships and patient care can get compromised so it is necessary to find the ways through which we can lower the anger.
Comparative Study between Stair-step Protocol of Clomiphene Citrate and Combined Clomiphene and Gonadotropins for Induction of Ovulation in Women with Polycystic Ovary Syndrome
Authors: Sallam Sabah E. , El-shwaikh Shereef L. , Hodeib Hossam A. , El-kholy Dina G.
Published: August 2021

Background: Polycystic ovary syndrome affects 7 to 8% of women and may be the most common cause of female infertility. Anovulation, early pregnancy loss has all been implicated in the low fecundity. The aim of this study was to compare between the use of clomiphene citrate by stair-step protocol and use of combined clomiphene citrate and gonadotropins in patients with polycystic ovary syndrome.

Methods: This randomized non blinded controlled clinical study was carried out on 60 Patients who was selected from outpatient clinic of Tanta university hospitals from September 2019 to September 2020. Selected patients were allocated into two groups with 1:1 ratio. Group (A): was subjected to clomiphene citrate stair-step stimulation protocol. Group (B): was subjected to combined clomiphene and gonadotropins stimulation protocol.

Results: Mann-Whitney U test was used to compare quantitative data because it is not normally distributed (Age, BMI and duration of infertility). Significance defined by p < 0.05. Chi-square analysis was used for the categorical variable (number of MGF). Mann-Whitney U test was used to compare quantitative data because it is not normally distributed (Size of larger follicle and Endometrial thickness), Chi-square analysis was used for the categorical variables (Ovulation rate and Pregnancy rate). Mann-Whitney U test was used to compare quantitative data which are not normally distributed (FSH and LH). Student t test was used for the quantitative data which are normally distributed (Prolactin and TSH).

Conclusions: In conclusion, the CC stair‐step protocol is a safe, simple option for the management of PCOS patients, having a larger number of mature Grafian follicle, lower endometrial thickness and higher ovulation rate compared to combined clomophine and gonadotrophin protocol.