bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignancy rates and risk factors in Bethesda category IV thyroid nodules: Is lobectomy enough in an endemic region?
Authors: ÖZDEMİR Ali , UYAN Mikail , KALCAN Süleyman , ÇOLAKOĞLU Muhammed Kadri , PERGEL Ahmet
Published: October 2022

In this paper, we determined the rates of Bethesda IV thyroid nodules and calculated the malignancy rates of these nodules in a university hospital located in an endemic area for thyroid diseases. We aimed to define the predictive factors for malignancy to select patients who need surgery. We included in the study 221 patients who had a preoperative biopsy for follicular neoplasm or because of suspicion for follicular neoplasm and underwent thyroidectomy between January 2012 and December 2018. We evaluated the data about patient characteristics, preoperative ultrasound results, indications for operation and postoperative pathological valuation results and calculated ratio of Bethesda Category IV nodules and incidental malignancy rates. The malignancy rate of Bethesda Category IV nodules was 48.9 %, while the incidental malignancy rate was 30.7 %. There was no statistical difference between patients with benign and malignant pathology results in terms of gender, age, preoperative diagnosis, size of the index nodule, number and results of biopsies and the thyroidectomy performed. The most important risk factor among all parameters was hypoechogenicity of the nodule. The solid structure increases this risk. Ultrasonographic hypoechogenicity is the most important risk factor for preoperative malignancy risk assessment for Bethesda Category IV thyroid nodules. Centers should determine their malignancy rates with particular risk factors and surgical approaches in endemic regions.
The effects of intermittent fasting on nighttime blood pressure levels
Authors: YILMAZ YÜCE Aslı Hilal , ADAR Adem , KORKUT Burcu , KALEM Pınar , İNCİ Habibe , ADAHAN Didem
Published: October 2022

Hypertension, a preventable disease with a high prevalence, is frequently seen in obese patients with cardiovascular risk factors. Our study aimed to investigate the effect of an intermittent fasting regimen on nighttime blood pressure levels. Patients who applied to Karabuk University Faculty of Medicine Training and Research Hospital Cardiology and Family Medicine Polyclinic between January and March 2021 and were followed up for 24 hours on an outpatient basis were included in this self-controlled interventional study. Patients underwent a second 24-hour Holter blood pressure follow-up after one month of diet, and the results were compared. The study was conducted with 30 subjects who adhered to a one-month intermittent fasting regimen. 63.3% of the patients were male, and the mean age was 54.60 ± 9.71 years. One month later, 13 patients whose nighttime blood pressure improved were assigned to Group 1 and 17 patients to Group 2. There was no important variance between the groups in terms of gender, age, height, waist circumference and BMI (p=0.609, p=0.105 and p=0.087, in order of). Mean VA and BSA were considerably lower in Group 2 (p=0.027 and p=0.045, in order of). HT duration was longer in Group 1 (p=0.001). There was no important variance between the groups in terms of smoking, alcohol use, average daily sleep time, salt intake awareness and exercise habits. The rate of snacking habits in Group 2 was statistically considerably higher (p=0.033). Intermittent fasting may be beneficial in preventing nocturnal hypertension.
How does visual praxis based occupational therapy program effect motor skills in children with hyperactivity and attention disorder? Single blind randomized study design
Authors: KÖSE Barkın , TEMİZKAN Ege , KARA KAYA Özgün , KARA Koray , ŞAHİN Sedef
Published: October 2022

Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized with problems such as; atypical attention skills increased impulsive behaviors at least two of the child’s areas of daily living. In studies investigating developmental aspect of the said problems of children with ADHD, it was stated that the children usually do not demonstrate normal development regarding the motor proficiency and may fall behind their peers in exhibiting normal motor performance. These problems in motor skills are said to cause a hindered development in complex skills which may result in; distorted body image, increased anxiety and poor social communication skills. This study’s aim was to investigate effects of a Visual-Praxis-based Occupational Therapy program (VPOT) on motor proficiency of children with ADHD. The 58 children who were included to the study were assigned numbers from 1 to 58 and randomized into two groups (the intervention group and the control group). Both groups were subjected to the Bruninks-Oserestry Test of Motor Proficiency 2–Brief Form (BOT2-BF). After the initial assessment, the participants in the intervention group were admitted into the VPOT program for a duration of 8 weeks with twice-weekly sessions of 45 minutes. End of the program, BOT2-BF was applied once more. The participants mean age was 8.44±1.39 years. There were no differences between the intervention and the control group in terms of age. When the BOT2-BF results for the intervention group were analyzed, it was found that there were significant differences between pre- and post-intervention scores of all sub-scores and the total score. Due to approaching the motor development aspect of ADHD within the context of motor proficiency and visual perception, this study can be considered to be one of the innovative and pioneer studies in the field and is positively unique regarding the usage of the intervention approach that was used.
The consequences of cesarean section and vaginal delivery on ovarian reserve in infertile women
Authors: BAKİ ERİN Kübra , KULAKSIZ Deniz
Published: October 2022

According to the data of the World Health Organization (WHO), although the rate of cesarean section is increasing worldwide, one out of every five births is performed by cesarean section. Cesarean section is life saving for both mother and baby depending on the situation. However, it also brings some complications. Its effect on fertility also raises concerns. The aim of the present study was to investigate the consequences of cesarean section on ovarian reserve. Anti-Mullerian hormone, Follicle-Stimulating Hormone, Luteinizing Hormone, Estradiol, antral follicle count, ovarian volume, and ovarian elastography results of 120 patients under the age of 30 who were not obese and were compatible with the criteria for unexplained infertility of the American Society for Reproductive Medicine were analyzed in both pre-pregnancy and postpartum period. There were 57 patients with vaginal delivery and 63 patients with cesarean section. Differences between the groups according to the mode of delivery and between the pre-pregnancy and postpartum groups were investigated. There was no statistically significant difference for the vaginal birth group in terms of AFC, AMH, FSH, LH, E2, SWE and ovarian volumes between pre-pregnancy and postpartum. In the cesarean section group, AFC, AMH and ovarian volumes were found to be significantly lower in the postpartum period than before pregnancy. As a result, cesarean delivery may have negative consequences for ovarian reserve tests.
Evaluation of the effect of vacuum assisted closure in the surgical management of Fournier's gangrene: A single center experience
Authors: UYAN Mikail , ACEHAN Türker
Published: October 2022

Fournier's gangrene is a surgical emergency arising in the perineum and genital area and is characterized as necrotizing fasciitis of the perineum and genital area. It quickly spreads between the fascial planes and causes soft tissue necrosis. Diabetes mellitus is the most prevalent predisposing factor. Early diagnosis and management are critical in the progression of the disease. Surgical debridement and wide-spectrum antibiotic therapy are the first steps in treatment. Despite advancements in diagnosis and treatment procedures and changes in critical care techniques, the disease has a death rate of 16-40%. This research compares patients operated on for Fournier's gangrene between January 2016 and January 2022, including those treated with vacuum-assisted closure technique, vs those who were not. We acquired and analyzed the data on the patients' demographic and clinical features from hospital records. The study involved 16 patients, six (38%) in Group 1 and 10 (62%) in Group 2, 11 men (68 %) and five women (32%). Swelling in the wound region was the most prevalent complaint. The most common gangrene site was the perianal region, and diabetes was the most common predisposing condition. Group 2 had a significantly shorter hospital stay (p=0.02). There was no statistically significant difference in mortality or other parameters between the groups. The main advantages of VAC therapy are that it requires fewer dressings, causes less pain, and reduces the risk of contamination. The advantages of the traditional wet dressing include its ease of use and low cost and the fact that VAC therapy promotes faster wound healing and shorter hospital stays.
Evaluation of biostatistics knowledge and skills of medical faculty students
Authors: TOMAK Leman , CİVANBAY Hasan
Published: October 2022

Successful implementation of a scientific study and correct analysis of data obtained is possible with advanced biostatistics knowledge. The aim of this study is to find out efficacy of basic biostatistics program given to medical faculty students and to evaluate students’ biostatistics knowledge, attitude and behaviour levels. Medical Faculty students in a Turkish university participated in this study. 123 of the respondents (52.6%) were male and 111 (47.4%) were female, with an average age of 20.2 ± 1.7 years. The survey used included items questioning demographic information, biostatistics knowledge, attitude and behaviours of students and 10 multiple choice questions including the subjects learned during the program. The students filled in this survey before and after training and data obtained were evaluated. Students’ positive responses to having biostatistics basic knowledge were 68.0% before training and 95.7% after training. The frequency of knowing the purpose of biostatistics was 81.5% before training and 96.6% after training. While the rate of positive response was 60.9% for population and sample, 63.2% for basic principles in summarizing data, 54.7% for central tendency-location measurements, 51.5% for variability measurements before training, they were found as 95% and higher after training. Positive responses of 70.8% for hypothesis and error types, 48.7% for statistical assumptions, 36.5% for parametric hypothesis tests, 33.0% for nonparametric hypothesis tests and 27.4% for statistical package programs before training were 93.6% and higher after training. Total score obtained from responses to multiple choice questions was 2.5±1.4 before training and 7.5±2.1 after training, which was statistically significant (p<0.001). In this study, biostatistics knowledge, attitudes and behaviours of medical faculty students were evaluated. Biostatistics training needs changes due to latest developments in information technology. Many medical faculties currently teach basic biostatistics concepts and carry out biostatistics training studies to allow critical evaluation during the process.
The effects of ATP sensitive potassium channel (KATP) opener and blockers on Bcl-2, Bax, and Cyt-c gene expression levels in epileptic rats
Authors: KILIÇ Ümit , SOYTÜRK Hayriye
Published: October 2022

In this study, it was aimed to investigate the gene expression levels of Bcl-2, Bax, and cytochrome c (Cyt-c), in the cortex region of pinacidil as a KATP channel opener and glibenclamide as a blocker on penicillin model epilepsy. Male Wistar-Albino rats were used. A total of 4 main groups were formed: Control, Epilepsy, Epilepsy-opener, and Epilepsy-blocker groups, then three-time points were formed subgroups (1st day, 4th, and 8th). 48 rats were used in total. The epileptic focus was created by intracortical administration of penicillin at a dose of 500 IU/2 μl. Cortex is removed from all animals and cyt c, Bcl-2, and Bax gene expression levels were determined by qPCR. The SPSS 21 program was used for statistics. Bcl-2 and Bax gene expression levels were increased in the cortex regions of rats with epilepsy (p<0.05). Bcl-2, Bax gene expression levels, which increased due to epilepsy with the effect of KATP channels opened with pinacidil, returned to normal levels in the epilepsy opener group (p<0.05). Bcl-2 gene expression level, which was increased as a result of epilepsy due to the effect of KATP channels closed with glibenclamide, was higher than in the control and epilepsy-opener groups (p<0.05). Bcl-2 and Bax gene expression levels are increased in the cortex region due to epilepsy indicates that the apoptotic pathway could be activated. This study also It has been shown that the apoptotic pathway activated by epilepsy can be inactivated by pinacidil.
Factors affecting women's access to antenatal care services
Authors: TÜRKER ARAS Ülkü Ayşe , KIRAT Samet , KORKMAZER Engin
Published: October 2022

The aim of this study was to quantitatively investigate the antenatal care provided by healthcare physicians in a rural area of North East Anatolia, Turkey, and the effective factors. Patients who applied to a Second-tier health institution for delivery were asked how many times they went for a check-up during their pregnancy. In addition, the sociodemographic characteristics of the responding patients were recorded. In this study, the rate of pregnant women who received inadequate antenatal care was 41.0%. Examining the risk factors for inadequate antenatal care in pregnant women who attended fewer than four antenatal care visits revealed that the risk was 2,115 (confidence interval [CI] = 1.328–3.368) times higher for those receiving spousal education for <5. Longer years than those with ≥6 years of partner training. Pregnant women who received inadequate antenatal care in the North East Anatolia region preferred to visit Secondary and Tertiary healthcare institutions instead of visiting primary care physicians. In conclusion, it is necessary to establish a referral chain through health plans and expand Primary antenatal care services to reduce both maternal and neonatal mortality and morbidity.
Investigation of the effects of pinacidil and glibenclamide administration on HCN1, KCNT1, Kir 6.1, SUR1 gene expressions in hippocampus and cortex regions in epileptic rats
Authors: KILIÇ Ümit , SOYTÜRK Hayriye
Published: October 2022

The purpose of this study was to look into the effects of pinacidil and glibenclamide on HCN1, KCNT1, Kir 6.1, and SUR1 gene expression in epileptic rats hippocampus and cortex. Male Wistar-Albino rats were used in this study. The drugs pinacidil and glibenclamide were utilized. Control, Epilepsy, Epilepsy-O, and Epilepsy-B were the five groups formed. The epileptic focus was created by intracortical administration of penicillin at a dose of 500 IU/2 μl. Hippocampus and Cortex are removed from all animals and Kir 6.1, SUR1, HCN1, and KCNT1 gene expression levels were determined by qPCR. The SPSS 21 program was used for statistics. HCN1 gene expression level is equal in the hippocampus and cortex (p<0.05). KCNT1, SUR1, and KIR6.1 are more expressed in the hippocampus than in the cortex (p<0.05). In epilepsy groups, HCN1 gene expression level was found to be higher than KCNT1, SUR1, and KIR6.1 gene expression levels (p<0.05). KIR6.1, SUR1, gene expression levels decreased with the application of pinacidil and glibenclamide (p<0.05). SUR1 and KIR6.1 gene expression levels were considerably lower in the epilepsy pinacidil group compared to the other groups. The gene expression levels in the hippocampus were found to be considerably higher than in the cortex group, according to this study. The fact that HCN1 gene expression levels are significantly greater in both the brain and the hippocampus 24 hours following the commencement of epileptic convulsions suggests that preventive medication may be possible.
COVID-19 infection may trigger SLE disease: A case report
Authors: ATALAR Ebru , MARAŞ Yüksel , SÜNGÜ Nuran , KÖKSAL CEVHER Şimal , KELEŞ Meryem , POLAT Bünyamin
Published: October 2022

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various body organs, especially the skin, joints, hematopoietic system, kidneys and central nervous system. The signs and symptoms occur depending on the inflammation in the affected tissues. Although many factors are responsible for its aetiology, it is known that some viruses such as Epstein Bar virus may also cause this disease by triggering autoimmunity. Recent studies have revealed that the immune system could be activated due to coronavirus infections and that some autoantibodies could be observed in the blood. A small number of SLE cases activated by COVID infection have been reported in the literature. The present study presented and discussed with the information in the literature a 20-year-old patient with COVID infection, diagnosed with SLE with renal involvement according to EULAR/ACR 2019 criteria by considering histopathological and immunofluorescence findings.
Large cervical myoma originating from the uterine corpus
Authors: KAYACIK GÜNDAY Özlem
Published: October 2022

This case report aimed to present a case of large cervical myoma that obliterated the ureterovesical area and filled the entire cervix. A 33-year-old patient had a tumoral lesion of approximately 80x60 mm, compatible with myoma, that filled the cervical cavity. On vaginal examination, a barrel- shaped, immobile and large cervix was palpated. A preoperative bilateral double J catheter was applied to the patient. While the uterine cervix was barrel-shaped due to myoma and was palpable from Douglas, it was firmly fixed anteriorly to the bladder and corpus. During bladder dissection, approximately 4 cm defect was formed in the isthmus, and the uterine cavity was entered. A myoma with a diameter of approximately 9 cm, which filled the entire cervix from the uterine isthmus and had a stem attached to the fundus, was observed in the cavity, and the myoma was pulled out from the defect with a tenaculum and removed. Since the anterior cervix could not be reached and bladder dissection could not be achieved, a subtotal hysterectomy was performed. Although they are mainly treated surgically, there is no standard treatment for cervical myomas. Due to its proximity to vital organs, care should be taken against the risk of organ injury.
PENGARUH KEPEMIMPINAN, KOMUNIKASI DAN REWARD TERHADAP KINERJA KARYAWAN KOPERASI SIMPAN PINJAM SRI ARPA SIDHI DENPASAR BALI
Authors: Putri Putu Ratna Windusara
Published: October 2022

Penelitian ini bertujuan untuk mengetahui Pengaruh Gaya Kepemimpinan dan Perlaku Pemimpin Terhadap Kinerja Karyawan Hotel Prime Plaza Suites Sanur baik secara parsial dan simultan. Unit analisis dalam penelitian ini adalah para karyawan Hotel Prime Plaza Suites Sanur yang berjumlah 49 orang. Mengingat jumlah populasi dalam penelitian ini hanya terdiri atas 49 orang, maka yang menjadi sampel adalah semua karyawan Hotel Prime Plaza Suites Sanur. Metode pengumpulan data dengan kuesioner dengan menggunakan skala likert sebagai alat ukurnya. Data dianalisis dengan menggunakan Regresi linier berganda dengan bantuan SPSS.

Hasil analisis data menunjukkan bahwa Berdasarkan hasil analisis dengan menggunakan Uji F, secara simultan gaya kepemimpinan dan perilaku pemimpin secara bersama-sama berpengaruh signifikan terhadap kinerja karyawan Hotel Prime Plaza Suites Sanur. Koefisien determinasi menunjukkan bahwa kinerja karyawan 47.6% disebabkan oleh gaya kepemimpinan dan perilaku pemimpin. Secara parsial gaya kepemimpinan dan perilaku pemimpin berpengaruh signifikan terhadap kinerja karyawan. Selain itu gaya kepemimpinan mempunyai pengaruh dominan terhadap kinerja karyawan Hotel Prime Plaza Suites Sanur.
Peran Koperasi Simpan Pinjam dan Pembiayaan Syariah (KSPPS) Dalam Pemberdayaan Usaha Mikro Kecil Dan Menengah (UMKM) Pada KSPPS Mandiri Artha Sejahtera
Authors: Syuhada' Syuhada' , Lailaturrohmah Lailaturrohmah
Published: October 2022

Tujuan penelitian ini untuk mengetahui peran KSPPS Mandiri Artha Sejahtera dalam pemberdayaan UMKM. Penelitian ini berlokasi di KSPPS Mandiri Artha Sejahtera Jln. Raya  Sumberrejo-Bojonegoro (depan pasar sumberrejo) No. 247. Jenis penelitian ini adalah penelitian lapangan (field research) yang bersifat kualitatif yaitu dengan menggunakan teknik observasi dan wawancara. Observasi dan wawancara yang dilakukan peneliti yang terlibat langsung dengan KSPPS Mandiri Artha Sejahtera dan nasabah usaha mikro kecil.

Hasil penelitian ini menunjukkan bahwa peran KSPPS Mandiri Artha Sejahtera dalam pemberdayaan UMKM di Sumberrejo sudah maksimal, hal ini dibuktikan dengan dibukanya lapangan pekerjaan di berbagai sektor untuk menyerap tenaga kerja dan meningkatkan kesejahteraan masyarakat khususnya masyarakat kecil atau kurang mampu. Namun ada problematika yang harus dihadapi oleh KSPPS Mandiri Artha Sejahtera di antaranya dari pihak eksternal dan pihak internal. Meskipun demikian, KSPPS Mandiri Artha Sejahtera tetap memiliki strategi-strategi khusus dalam menghadapi problematika tersebut. Dengan memberikan pelatihan-pelatihan dan mempermudah pelayanan pembiayaan di KSPPS Mandiri Artha Sejahtera maka UMKM dapat dikembangkan.
A practical example of strengthening governance in Japanese College Tennis Clubs
Authors: Hotta Shion , Yamamoto Mamoru
Published: October 2022

In 2019, the Japan Sports Agency formulated the Sports Organizations Governance Code, a code not directly applicable to college sports clubs. However, as seen in the scandal of the American football club of Nihon University, it is necessary to strengthen the governance of all college sports clubs, including tennis. Therefore, we conducted a governance survey at 268 Japanese college tennis clubs in 2021. The representatives of each college were asked to report their demographics and respond to the assessment measures regarding the governance of college tennis clubs. A simple tabulation and cross-analysis were conducted, and the Chi-square test or Fisher’s exact test were used at a significance level of five percent. Based on the results of the survey, we developed a “Governance Self-Assessment Sheet” for college tennis clubs. In this study, we introduce the outline of the results of the survey by comparing the governance of sports organizations in different countries. Moreover, a practical case study of Keio University in Japan, which is the world’s first university to use the Sheet, will be discussed based on the results of a new survey conducted in 2022.
The governance of tennis clubs: Relevant issues
Authors: Valiño Alejandro
Published: October 2022

Sports clubs are an expression of the universally recognised fundamental right of free association without any limitation other than the pursuit of lawful purposes. These organisations play a prominent role in the environment in which tennis takes place. This article shares some relevant aspects concerning the governance of tennis clubs. These include the legal nature of sports clubs, the management of tennis clubs in their sporting and economic aspects, the integration and management of training, competition and education programmes, certain cross-cutting aspects, and the internal organisation and liability regime of the volunteers and managers of tennis clubs. Finally, a brief note on the management of sports service companies is included.
Efektivitas Penggunaan Multimedia Berbasis Web sebagai Tolak Ukur dalam Peningkatan Aspek Kognitif Taruna Calon Perwira Kapal
Authors: Andromeda Vega F. , Mustain Iing , Herlina Yeyen
Published: October 2022

Pembelajaran berbasis web telah dikembangkan untuk memfasilitasi para taruna calon perwira kapal dalam mempersiapkan praktek laut. Pembelajaran materi tematik persiapan praktek laut dilakukan dengan menggunakan media pembelajaran multimedia berbasis web pada portal stemparala.or.id. Tujuan penelitian ini adalah untuk mengetahui pencapaian aspek kognitif taruna, peningkatan aspek kognitif taruna, dan efektivitas pembelajaran multimedia berbasis web pada portal stemprala.or.id. Penelitian menggunakan pendekatan kuantitatif dan metode kuasi eskperimen dengan desain penelitian Randomized sample Pretest- Posttest Design dengan sampel yang dipilih adalah cadet berjumlah 41 orang dari 120 cadet yang siap praktek laut. Data kuantitatif yang diperoleh dari tes awal dan tes akhir dan teknik pengambilan sampel dalam penelitian ini dilakukan dengan teknik random sampling. Hasil penelitian diperoleh capaian pengetahuan cadet pada aspek kognitif diperoleh peningkatan dan terdapat perbedaan yang signifikan capaian pretest dan capaian posttest. Pencapaian aspek kognitif taruna rata-rata capaian posttest kognitif taruna lebih besar secara signifikan dari rata-rata capaian pretest taruna. Peningkatan aspek kognitif taruna pada penggunaan multimedia berbasis web pada portal stemprala.or.id untuk aspek kognitif taruna diperoleh skor 0,11 atau (11%) dengan kategori rendah. Efektivitas berdasarkan uji Cohen’s sebesar 0.22, pada kategori kecil. Hasil ini memberikan gambaran perlu diberikan teknik penggunaan multimedia tematik yang lebih interaktif dan memberikan pembelajaran yang lebih bermakna dan autentik.
Kesiapan SDM dan Sarpras untuk Meningkatkan Efektivitas Pelayanan di Perusahaan Keagenan Kapal Berbasis Inaportnet di Wilayah Pelabuhan Indonesia (Pelindo) II dan III
Authors: Anggoro Retno , Susanti Susanti
Published: October 2022

Kementerian perhubungan laut dalam upaya mengintegrasikan sistem pelayanan kapal dan barang meluncurkan sebuah aplikasi berbasis national single windows bernama inaportnet. Metodologi yang digunakan dalam penelitian ini  menggunakan metode kuantitatif untuk menguji hipotesis pengaruh kesiapan SDM dan sarpras dalam memningkatakan efektifitas pelayanan perusahaan keagenan kapal berbasis inaportnet. Kualitas sumber daya manusia akan diperoleh secara maksimal tidak lepas dari beberapa faktor antara lain: tingkat pendidikan, pengalaman, dan pelatihan/ training. Selain sumber daya manusia satu hal yang menunjang efektifitas penerapan inaportnet adalah fasilitas atau sarana dan prasarana yang menunjang pengoperasian aplikasi inaportnet tersebut. Penelitian ini akan menguji korelasi antara faktor kesiapan SDM, sarana dan prasarana terhadap efektifitas pelayanan perusahaan keagenan kapal berbasis inaportnet dengan alat uji berupa aplikasi SPSS. Hasil perhitungan pengujian normalitas didapatkan hasil taraf signifikan kualtias SDM (X1) sebesar 1.128 dengan n=40. Hal tersebut dapat diartikan 1.128>0.05, dapat ditarik kesimpulan bahwa populasi data kesiapan SDM (X1) didistribusi noral. Demikian pula uji kenormalan variabel sarana dan prasarana (X2) didapatkan nilai signifikansi pengaruh sarana dan prasaraan sebesar 0.666 dengan jumlah n =40, artinya 0.666 >0.05, dengan demikian dapat ditarik kesimpulan bahwa populasi data sarana dan prasarana (X2) didistribusi normal. Sedangkan untuk uji normalitas variabel Y didapatkan taraf signifikansi efektifitas pelayanan perusahaan keagenan berbasis inaportnet (Y) sebesar 0.737 dengan n = 40. Hal ini berarti 0.737 >0.05, sehingga dapat ditarik kesimpulan bahwa populasi data efektifitas pelayanan perusahaan keagenan berbasis inaportnet didistribusi normal.
Анализ использования принципов циркулярной экономики в индустрии теплоизоляционных материалов (на примере компании Rockwool)
Authors: Сомина Ирина Владимировна , Кондаков Максим Викторович
Published: October 2022

Предпосылки исследования. Строительная отрасль производит треть глобальных отходов, большая часть которых попадает на свалку. За период с 2000 по 2020 год объем строительных работ вырос более чем в 12 раз. Обратной стороной процесса является пропорциональный рост отходов. В отрасли следует создать индустрию рециклинга отходов строительства и сноса. Для ускорения работы важно опираться на опыт передовых компаний, где индустрия рециклинга действует уже 20 лет. Предмет исследования. Процессы бережливого производства и экономики замкнутого цикла, внедрённые в компании Rockwool. Результаты исследования и их значение. В ходе исследования были проанализированы лучшие практики компании, которые при их применении другими игроками рынка помогут им включиться в общемировой тренд энергоэффективности и заботы о природе, а также могут улучшить ситуацию в строительной отрасли. Экологичные производства – часть новой модели развития мира, которая основана на циклической экономике, сохранении природного капитала и выпуске положительно влияющей на общество продукции.
Comparison between the chemical behaviors of different complex compounds formed by divalent transition metal ions with a heterocyclic ligand, leading to different structures
Authors:   University of Craiova, Faculty of Sciences, Department of Chemistry, Calea București 107i, Craiova, Romania, Sbîrnă Liana Simona , Moldovan Clementina ,   University of Petroșani, Faculty of Mining, Department of Management, Environmental Engineering and Geology, Strada Universității, 20, Petroșani, Romania
Published: October 2022

The main purpose of the present paper is to identify the structures for the complexes formed by six divalent transitional metal ions (namely Ni(II), Pd(II), Pt(II), Zn(II), Cd(II) and Hg(II)) with the same heterocyclic ligand, that is able to change the coordination manner, consequently affecting the structure of the respective complex compound.
Nutritional quality and antioxidant activity of currant fruits (Ribes spp.)
Authors:   University of Craiova, Babeanu Cristina
Published: October 2022

The purpose of this study was to comparatively evaluate the content of bioactive compounds and the antioxidant activity in four currant cultivars (white, two red and one black). The contents of sugar, glucose, total phenolic compounds and flavonoids were determined by colorimetric methods, ascorbic acid by iodometric method and the antioxidant activity was evaluated by DPPH and ABTS radical scavenging assay. The results showed that the studied chemical indices varied depending on the analyzed cultivar. Currants fruits are a rich source of phytochemicals with an important role in human health, especially compounds with considerable antioxidant activity. Blackcurrant fruits have the highest content of phenolic compounds, flavonoids and ascorbic acid and the highest antioxidant activity, demonstrating their health potential.
Tác động của đại dịch COVID-19 đến sức khỏe tâm thần của cán bộ Y tế Việt Nam năm 2021
Authors: Quỳnh Nguyễn Thị , Xuân Lê Thị Thanh , Thảo Nguyễn Thanh , Anh Nguyễn Ngọc , Quân Phạm Thị , Hương Phan Thị Mai , Doanh Nguyễn Quốc , Nhung Tạ Thị Kim , Anh Lương Mai , Huyền Nguyễn Thị Thu , Hương Nguyễn Thị Liên
Published: October 2022

Nghiên cứu mô tả cắt ngang được thực hiện nhằm mô tả tác động của đại dịch COVID-19 đến sức khỏe tâm thần của cán bộ y tế một số tỉnh thành Việt Nam năm 2021. Số liệu được thu thập bằng phỏng vấn theo bộ câu hỏi trên 1603 cán bộ y tế tại Hà Nội, Thái Bình, Đà Nẵng và Quảng Nam. Kết quả cho thấy hầu hết đối tượng nghiên cứu phơi nhiễm với COVID-19 hàng ngày (83,5%) và đã được đào tạo về COVID-19 trong năm 2021 (95,8%). 27,3% đối tượng nghiên cứu có rối loạn về sức khỏe tâm thần, trong đó cao nhất là Đà Nẵng (34,9%), tiếp đến là Hà Nội (28,9%), Quảng Nam (22,6%) và Thái Bình (22,2%). Giới nữ, độ tuổi từ 40 đến 49 và phơi nhiễm với COVID-19 hàng ngày là những yếu tố làm tăng tỷ lệ rối loạn sức khỏe tâm thần ở nhân viên y tế.
Một số yếu tố liên quan đến sức khoẻ tâm thần của cán bộ Y tế trong đại dịch COVID-19
Authors: Xuân Lê Thị Thanh , Thảo Nguyễn Thanh , Anh Nguyễn Ngọc , Quân Phạm Thị , Hương Phan Thị Mai , Doanh Nguyễn Quốc , Nhung Tạ Thị Kim , Anh Lương Mai , Huyền Nguyễn Thị Thu , Hương Nguyễn Thị Liên , Quỳnh Nguyễn Thị
Published: October 2022

Nghiên cứu mô tả cắt ngang được thực hiện nhằm phân tích một số yếu tố liên quan đến rối loạn sức khỏe tâm thần do đại dịch COVID-19 của cán bộ y tế năm 2021. Nghiên cứu được tiến hành trên 1603 nhân viên y tế tại Hà Nội, Thái Bình, Đà Nẵng và Quảng Nam. Phân tích nhân tố được áp dụng để xác định 3 lĩnh vực: sự ám ảnh, lảng tránh và phản ứng thái quá. Kết quả nghiên cứu cho thấy tổng điểm về sức khỏe tâm thần là 23,1 ± 16,05. Điểm trung bình của sự ám ảnh, sự lảng tránh và phản ứng thái quá lần lượt là 10,2 ± 6,39; 7,03 ± 5,88 và 5,9 ± 4,97. Có sự khác biệt có ý nghĩa thống kê về tổng điểm và điểm về sự lảng tránh giữa các tỉnh nghiên cứu trong đó cao nhất ở Hà Nội, rồi đến Đà Nẵng, Quảng Nam và thấp nhất ở Thái Bình (p < 0,05). Một số yếu tố như giới tính, tuổi đời, có sống một mình không và nguy cơ phơi nhiễm với COVID-19 có liên quan đến sức khỏe tâm thần của nhân viên y tế trong đại dịch COVID-19.
Vai trò tiên lượng của điểm Child-Pugh trên bệnh nhân ung thư biểu mô tế bào gan điều trị bằng Sorafenib
Authors: Hường Nguyễn Thị Thu , Quảng Lê Văn
Published: October 2022

Sorafenib được chấp thuận trong điều trị ung thư biểu mô tế bào gan giai đoạn bệnh tiến triển từ năm 2009, tuy nhiên không nhiều các nghiên cứu đánh giá chi tiết vai trò tiên lượng của các yếu tố tới kết quả điều trị, trong đó có tình trạng xơ gan dựa trên điểm Child-Pugh. Chúng tôi thực hiện nghiên cứu mô tả trên 110 bệnh nhân ung thư biểu mô tế bào gan điều trị tại Bệnh viện K và Bệnh viện Đại học Y Hà Nội từ 1/2010 đến 12/2018 nhằm đánh giá vai trò tiên lượng của điểm Child-Pugh đến kết quả điều trị của thuốc Sorafenib. Kết quả cho thấy Child-Pugh A (90,1%), Child-Pugh B (9,9%). Kết quả điều trị giữa 2 nhóm CP A so với CP B tương ứng: tỷ lệ kiểm soát bệnh 60,6% vs 45,5% (p = 0,352); PFS trung vị 4,7 tháng vs 2,9 tháng (p = 0,097); OS trung vị 8,7 tháng vs 2,7 tháng (p < 0,001). Kết quả OS trung vị ở CP 5 điểm, 6 điểm, 7 điểm, ≥ 8 điểm tương ứng là 10,6 tháng, 3,4 tháng, 5,9 tháng, 1,8 tháng (p < 0,001). Phân tích đa biến thấy bệnh nhân CP A có thời gian sống toàn bộ gấp 2,805 lần so với CP B (HR = 2,805, 95%CI: 1,250 - 6,290, p = 0,012). Điểm Child-Pugh là yếu tố tiên lượng độc lập tới kết quả thời gian sống toàn bộ.
Tiếp cận chẩn đoán và điều trị hội chứng QT dài bẩm sinh: Báo cáo một ca bệnh
Authors: Hương Trương Thanh , Hiệp Nguyễn Hoàng , Giang Trần Song , Lợi Đỗ Doãn , Phượng Đoàn Thị Kim , Thanh Kim Ngọc , An Lê Hồng
Published: October 2022

Hội chứng QT dài (Long QT Syndrome, LQTS) bẩm sinh là bệnh lý rối loạn kênh ion di truyền, đặc trưng là kéo dài thời gian tái khử cực thất và đột tử. Chúng tôi báo cáo 1 trẻ nam 5 tháng tuổi, tiền sử gia đình có anh trai và chị gái đột tử, có triệu chứng mệt thỉu và có khoảng QT hiệu chỉnh (corrected QT, QTc) 548ms trên điện tâm đồ. Xét nghiệm gen phát hiện đột biến gen SCN5A kiểu dị hợp tử (NM_000335.4: c.1231G>A, NP_000326.2: p.Val411Met). Bệnh nhi được chẩn đoán LQTS loại 3 và được xếp vào nhóm nguy cơ cao. Bệnh nhi được điều trị bằng propranolol với liều khởi đầu 1 mg/kg/24 giờ, sau đó tăng lên 1,5 mg/kg/24 giờ, kết hợp tránh sử dụng thuốc và thức ăn làm kéo dài khoảng QTc. Sau 7 tháng điều trị, trẻ dung nạp tốt, không có triệu chứng với khoảng QTc giảm còn 474ms. Thành công bước đầu này gợi ý hiệu quả của chiến lược chẩn đoán và điều trị LQTS dựa trên phân tầng nguy cơ, sử dụng thông tin lâm sàng, điện tâm đồ và xét nghiệm gen.
Tình trạng dinh dưỡng và đặc điểm nuôi dưỡng qua ống thông dạ dày ở người bệnh hồi sức tích cực tại Bệnh viện Điều trị người bệnh COVID-19
Authors: Linh Nguyễn Thùy , Hằng Hoàng Thị , Yến Ma Ngọc , Nam Nguyễn Thuý , Nga Tạ Thanh , Vi Bùi Thị Trà , Chinh Phạm Thị Tuyết , Dũng Lê Đức
Published: October 2022

Tình trạng dị hoá và viêm hệ thống khi mắc COVID-19 khiến người bệnh tăng tiêu hao năng lượng và protein, đặc biệt tình trạng này trở nên trầm trọng hơn với người bệnh hồi sức tích cực (ICU) và thường kèm theo tình trạng nuôi dưỡng kém. Nghiên cứu hồi cứu đánh giá tình trạng dinh dưỡng và đặc điểm nuôi dưỡng qua ống thông dạ dày của 60 người bệnh COVID-19 nặng điều trị tại ICU của Bệnh viện Điều trị Người bệnh COVID-19 trực thuộc Bệnh viện Đại học Y Hà Nội từ tháng 12/2021 đến 01/2022 cho kết quả: Tỷ lệ suy dinh dưỡng (SDD) theo tiêu chuẩn của sáng kiến lãnh đạo toàn cầu về suy dinh dưỡng (GLIM) là 65% với 13,3% SDD mức độ nặng và 51,7% SDD mức độ vừa. Mức giảm khối cơ và bề dày lớp mỡ dưới da từ nhẹ đến trung bình trở lên là 31,7% và mức nặng là 13,3%. Về đặc điểm nuôi dưỡng qua ống thông: 81,7% được nuôi dưỡng nhỏ giọt ngắt quãng; 5,0% nhỏ giọt liên tục; 13,3% được bơm bolus. Số bữa ăn qua ống thông trung bình là 4,5 bữa/ngày, mức năng lượng đạt 90,5% đến 100% nhu cầu khuyến nghị (NCKN), protein đạt 74,5 - 81,6% NCKN. Các vitamin và khoáng chất đạt NCKN từ 50 - 100%. Tỷ lệ người bệnh có triệu chứng kém dung nạp là 11,7%, gặp chủ yếu ở người bệnh được nuôi dưỡng bằng phương pháp bơm bolus. Tỷ lệ suy dinh dưỡng cao và nhu cầu một số chất dinh dưỡng còn chưa đạt NCKN, do đó, đánh giá tình trạng dinh dưỡng và can thiệp dinh dưỡng tích cực cho người bệnh COVID-19 tại ICU cần được thực hiện từ khi nhập viện và theo dõi trong suốt quá trình điều trị.
Loạn dưỡng não - thượng thận ở trẻ em: Báo cáo 2 ca bệnh
Authors: Hương Ngô Thị Thu , Mai Đinh Thị Ngọc , Hương Lương Thị Thu , Dung Nguyễn Thị Kim , Thành Đinh Trung
Published: October 2022

Bệnh loạn dưỡng não - thượng thận là một bệnh hiếm gặp, bệnh di truyền do đột biến gene ABCD1 trên nhiễm sắc thể Xq28.1, bệnh xuất hiện chủ yếu ở trẻ trai. Bệnh gây tổn thương nhiều cơ quan với 3 thể lâm sàng: thể não, thể adison và thể thần kinh tủy thượng thận. Bệnh có biểu hiện hay gặp ở trẻ nhỏ với thể não: tổn thương não kèm theo suy thượng thận. Nghiên cứu với mục tiêu mô tả đặc điểm lâm sàng, tiền sử, bệnh sử, thăm khám lâm sàng, cận lâm sàng, điều trị. Đột biến trên gen ABCD1 được phát hiện bằng kỹ thuật giải trình tự gen. Phát hiện sớm, điều trị sớm giúp cho trẻ kéo dài được thời gian sống và tư vấn di truyền cho gia đình để tránh sinh ra trẻ bị bệnh. Kết quả nghiên cứu là cơ sở di truyền để chẩn đoán sớm, chẩn đoán trước sinh, cho các trẻ được sinh ra tiếp theo của mỗi gia đình này.
Tác dụng chống viêm của TD0015 trên động vật thực nghiệm
Authors: Hà Nguyễn Thị Thanh , Trang Trần Quỳnh , Vân Anh Phạm Thị , Liên Nguyễn Thị Hương
Published: October 2022

TD0015 là chế phẩm gồm nhiều dược liệu, theo kinh nghiệm dân gian có tác dụng chống viêm và giảm đau, hướng đến mục đích điều trị giảm triệu chứng trong các bệnh lý về xương khớp. Nghiên cứu được thực hiện trên động vật thực nghiệm nhằm đánh giá tác dụng chống viêm cấp và chống viêm mạn của TD0015. Các thuốc nghiên cứu gồm có: aspirin đường uống liều 200 mg/kg và TD0015 đường uống liều 1,2 g/kg và 3,6 g/kg trong thử nghiệm chống viêm cấp với mô hình gây viêm màng bụng và mô hình gây phù chân chuột trên chuột cống trắng chủng Wistar. Trong thử nghiệm chống viêm mạn, methylprednisolon đường uống liều 10 mg/kg, TD0015 đường uống liều 2,4 g/kg và 7,2 g/kg được dùng trên chuột nhắt trắng chủng Swiss với mô hình gây viêm mạn bằng u hạt amiant. Kết thúc nghiên cứu, TD0015 liều 1,2 g/kg và 3,6 g/kg có tác dụng chống viêm cấp trên cả hai mô hình thông qua làm giảm phù chân chuột, làm giảm thể tích dịch rỉ viêm, số lượng bạch cầu và protein. TD0015 liều 2,4 g/kg và 7,2 g/kg có tác dụng chống viêm mạn thông qua giảm trọng lượng u hạt, giảm xơ hóa và giảm số lượng tế bào viêm.
Robust Model-Based Clustering
Authors: Gonzalez Juan Domingo , Maronna Ricardo , Yohai Victor , Zamar Ruben
Published: October 2022

We propose a class of Fisher-consistent robust estimators for mixture models. These estimators are then used to build a robust model-based clustering procedure. We study in detail the case of multivariate Gaussian mixtures and propose an algorithm, similar to the EM algorithm, to compute the proposed estimators and build the robust clusters. An extensive Monte Carlo simulation study shows that our proposal outperforms other robust and non robust, state of the art, model-based clustering procedures. We apply our proposal to a real data set and show that again it outperforms alternative procedures.
Spectrum Administration for Mobile Services in India: Need for a Regime Change
Authors: Mitra Anuradha , Sridhar V. , Sarangi Gopal K.
Published: October 2022

India’s spectrum management policies have transitioned from administrative allocation of spectrum to market-based assignment methods through auction, technological neutrality of licenses, and stronger ownership rights. Yet, the mobile service market in India has experienced financial distress, exit of operators, and growing concentration. 5G technologies will require wider access to spectrum resources, capital investment, and business innovation. This article examines how regulatory policies for availability and pricing of spectrum have impacted India’s mobile markets. Based on a comparative analysis of international spectrum policy trends, it concludes that India’s spectrum regime would require essential policy changes to meet the requirements of 5G.
Dis/Appearance for Appeal: On Marianne Moore’s “Performing” Archive
Authors: Liu Wei
Published: October 2022

This essay discusses Marianne Moore’s archival practices through the lens of live speech and performance. While it is common to view Moore’s poetic archive—both her eclectic composition and her collage form—as embodying the tension between knowledge and reality, her borrowing from live speech also draws attention to the tension between written documents and speech acts, between text and performance. Invoking Diana Taylor’s idea that the liveness of performance necessarily disappears in archival documents, the author argues that Moore’s archival practices enact a drama of dis/appearance by creating appearances of speech that measure themselves against states of disappearance. The dis/appearance of speech in Moore’s poetry evinces her obsession with liveness and her discernable concern to hold the audience’s attention; it illuminates how Moore wants her poetry to “appeal” to the reader. Through elaborating on her incorporation of live speech and its affinities with her performances, I seek to take an appeal as a fulcrum for interpreting Moore’s poetry and amplify the critical vocabulary for describing her readers’ engrossment and infatuation. Moore’s poetry often animates a quest for knowledge, but it also aims at the very effect of engaging us in the “here and now.” Her “performing” archive, by letting live speech dis/appear, ultimately challenges us to envision a modernist poetics that has appeal as its major theme and ethos.
Percepção de pacientes e cirurgiões quanto à autodemarcação do sítio cirúrgico para cirurgia eletiva: um estudo piloto
Authors: Gutierres Larissa de Siqueira , Raduenz Shara Bianca De Pin , Poveda Vanessa de Brito , Lemos Cassiane de Santana , Brasil Cassia , Pereira Gabriela Duarte
Published: October 2022

Objetivo: Mensurar a taxa de precisão na autodemarcação da lateralidade realizada pelo paciente cirúrgico eletivo no período pré-operatório imediato e analisar a percepção do paciente e do médico-cirurgião diante dessa prática. Método: Estudo transversal desenvolvido de junho a dezembro de 2018, em um hospital privado do Sul do Brasil. A amostra foi composta por 105 pacientes submetidos a procedimentos cirúrgicos eletivos de órgãos ambíguos, que responderam a um questionário sobre a demarcação do sítio cirúrgico. Os dados foram avaliados por meio de análise descritiva. Resultados: Foram analisados 105 questionários, dos quais três foram excluídos por estar incompletos, dessa forma, a amostra foi composta por 102 documentos. Todos os pacientes realizaram a autodemarcação no local correto. Dentre os participantes, 93% dos pacientes e 99% dos cirurgiões relataram sentirem-se seguros quanto à autodemarcação. Conclusão: A autodemarcação pode constituir uma complementação na prática assistencial, consistindo em mais uma barreira de segurança e promovendo a participação do paciente como agente de cuidado, porém não substitui a confirmação pelo cirurgião no período pré-operatório.
Litigation Financing - Untangling the Gordian Knot - The Future of Law Reform
Authors: Millhouse David G
Published: October 2022

Litigation funding is used to increase access to justice for those otherwise unable to prosecute a claim to uncover and remedy incompetence, reckless or egregious behaviour. Litigation can also be misused, perhaps as a strategic tool, and in the formulation of legal tactics in class action litigation. The financing of shareholder and other class actions has created substantial media interest. Media reporting can have a negative feedback loop acquiring influential global momentum of its own (for instance in director’s insurance) whereas legal scholarship, even when reported, does not. Legal scholarship is not replete with empirical analysis so in the present debate, published empirical analysis by this and other authors should be heeded. Reforms to date illustrate how the confluence of class action law, other litigation funding law, and managed investment scheme (MIS) law is problematic and unresolved ― a Gordian Knot which in the absence of exemptions can only be untied by significant reform of the legal architecture. There are three constituent elements of litigation financing ― (a) promotion of the MIS (or alternative litigation financing which may constitute a MIS) to general members, being mostly ‘retail’ financial consumers; (b) The class action, being a registered MIS with a ‘wholesale’ representative plaintiff; and (c) the litigation financing and associated stakeholders. Some proposed reforms are politically contested. Australian present and proposed practice deviates from preferred practices in other jurisdictions emulating divergences seen in comparative fiduciary and best interest law which generate additional director risk where there are cross-border investments. Law reform options to better provide for the interests of general member plaintiffs are proffered for debate.
Diagnostic Accuracy of Ultrasound in Detection of Spina Bifida in the First and Second Trimester Using Post-Natal MRI as Gold Standard
Authors: Hukamdeen Sajida , Arsalan Muhammad , Seyal Sidra , , Nasrullah Zahra , Ali Sidra , Ashraf Humna
Published: October 2022

Introduction: Antenatal ultrasound has been reported to be an effective tool for detecting neural tube defects including spina bifida. Moreover, major structural abnormalities can be detected by ultrasound examination, depending on the time of ultrasound scan. Objectives: To determine the diagnostic accuracy of ultrasound in detection of spina bifida in the first and second trimester using post-natal MRI as gold standard. Study Design: Descriptive, Cross-sectional study Study duration: 11th February 2019 to 10th August 2019 Settings: Department of Radiology, Jinnah Hospital, Lahore. Materials & Methods: A total of 125 pregnant patients/Gravida presenting in first trimester (11 to 13 weeks) & second trimester (14 to 22 weeks) assessed on dating scan, at risk for spina bifida were included. Women with pre-eclempsia and eclempsia determined on systolic BP > 140 and protein urea and history of congenital heart defects were excluded. A standard ultrasound scan was performed by the same Radiologist on the same ultrasound machine and any findings associated with the spina bifida would be noted & recorded on a predesigned Performa (Attached). Patients were followed till delivery and post-natal MRI was done to evaluate spina bifida. Presence of absence of spina bifida on USG & MRI was noted. Results: All the patients were subjected to first ultrasonography and then MRI. USG supported the diagnosis of spina bifida in 62 patients. MRI confirmed spina bifida in 63 cases. In USG positive cases, 58 were true positive and 04 were false positive. While in USG negative patients, 58 were true negative and 05 were false negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound in detection of spina bifida in the first and second trimester using post-natal MRI as gold standard is 92.06%, 93.55%, 93.55%, 92.06% and 92.80% respectively. Conclusion: This study concludes that ultrasonography is a highly sensitive and accurate modality for diagnosing spina bifida, and has not only dramatically improved our ability of diagnosing spina bifida but also be a simple, economical and readily available alternative to MRI. Keywords: Spina Bifida, Ultrasonography, Sensitivity