bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing metacognitive reinforcement learning using reward structures and feedback
Authors: Krueger Paul , Lieder Falk , Griffiths Tom
Published: October 2021

One of the most remarkable aspects of the human mind is its ability to improve itself based on experience. Such learning occurs in a range of domains, from simple stimulus-response mappings, motor skills, and perceptual abilities, to problem-solving, cognitive control, and learning itself. Demonstrations of cognitive and brain plasticity have inspired cognitive training programs. The success of cognitive training has been mixed and the underlying learning mechanisms are not well understood. Feedback is an important component of many effective cognitive training programs, but it remains unclear what makes some feedback structures more effective than others. To address these problems, we model cognitive plasticity as metacognitive reinforcement learning. Here, we develop a metacognitive reinforcement learning model of how people learn how many steps to plan ahead in sequential decision problems, and test its predictions experimentally.The results of our first experiment suggested that our model can discern which reward structures are more conducive to metacognitive learning. This suggests that our model could be used to design feedback structures that make existing environments more conducive to cognitive growth. A follow-up experiment confirmed that feedback structures designed according to our model can indeed accelerate learning to plan. These results suggest that modeling metacognitive learning is a promising step towards building a theoretical foundation for promoting cognitive growth through cognitive training and other interventions.
Not Just a Hijack: Imaginary Worlds Can Enhance Individual and Group-Level Fitness
Authors: Wilbanks Danica , Moon Jordan W , Stewart Brent Alan , Gray Kurt , Varnum Michael E. W.
Published: October 2021

Why has fiction been so successful over time? We make the case that fiction may have properties that enhance both individual and group level fitness by (a) allowing risk-free simulation of important scenarios, (b) effectively transmitting solutions to common problems, and (c) enhancing group cohesion through shared consumption of fictive worlds.
How do people plan to negotiate?
Authors: Le Dai , Jang Daisung
Published: October 2021

Planning is critical for negotiation success as it facilitates obtaining superior outcomes. However, little empirically is known about what people do to plan. We offer an initial exploration of the topic, with the aim of inspiring greater research attention to the topic. We approach the question from an individual differences perspective, since planning phase places greater emphasis on individual action. We explored how the Big Five personality factors and gender predict preference and search for information that facilitates efforts to claim value, create value, and manage relationships. In Study 1, we used a survey method to elicit preferences. Extraversion and conscientiousness predicted preference for information that would help to claim value, and agreeableness predicted preference for information that would help to manage relationships. Women preferred value creating information. In Studies 2, 3, and 4, we examined search behavior using the Mouselab paradigm (Johnson, Payne, Bettman, & Schkade, 1989). A different pattern of relationships emerged. When the search task was complex, agreeableness predicted how extensively people searched for information. When tasks were more constrained, we detected fewer relationships between individual differences and search behavior.
‘A Large and Longstanding Body’: Historical Authority in the Science of Sex
Authors: Lockhart Jeffrey W
Published: October 2021

This chapter draws on the literature reviews of 387 books and articles about sex differences to argue that the scientific authority of the sex binary is often rhetorically established through misleading, revisionist histories of the field.
How Ultrasonographic Guided Thoracentesis Scores over Blind Procedures?
Authors: Sharma Bharat Bhushan , Garg Sagar , Bhutani Abhivind , Aziz Mir Rizwan , Sarin Monu , Chauhan Gagan , Lathwal Surbhi , Kaur Manpreet
Published: October 2021

Thoracentesis is tapping of pleural fluid from the pleural cavity for either diagnostic or therapeutic purposes. These are the frequently encountered procedures in the medical practices. Many conditions warrant sending the cases of pleural effusion cases for intervention. Most of the cases had been tried blindly first in their respective departments but failed because of various reasons. It had been documented regarding the advantages and disadvantages of blind and ultrasonography (USG) guided procedures. The aim of the study was to highlight the advantages and benefits of USG guided thoracentesis. We carried out USG guided thoracentesis of fifty cases in our radiology section who were referred to us by various departments. There were 19 female (38%) and 31 male (62%) patients. All these candidates had failed in blind procedures, when tried first. All these cases underwent USG guided thoracentesis with almost negligible complications. These were found to be having pleural fluid collection due to different underlying pathologies. There was no major complication in any of the cases who underwent thoracentesis. We reiterate by this study that USG guided procedures in thoracentesis should be the first choice in the tapping of pleural fluid. This is a quick, affordable, and without any discomfort to the patient.
Antibiogram Profile of Bacteria Colonizing the Endotracheal Tubes (ETTs) of Patients Admitted to Intensive Care Units (ICUs) in a Tertiary Care Hospital of Nepal
Authors: Shrestha Rajani , Nayak Niranjan , Bhatta Dharm Raj , Hamal Deependra , Gokhale Shishir , Parajuli Sulochana
Published: October 2021

Hospital acquired infection (HAI) in intensive care units (ICU) are responsible for high morbidities and mortalities worldwide due to emergence of resistant bacteria. In developing countries, due to lack of knowledge of proper surveillance, proper resources and proper guidance this burden was somewhat underestimated. Thus, the aim of this study was to look for the spectrum of bacteria colonizing the ETTs and to determine proper empirical antibiotic therapy. We collected endotracheal tube aspirates from 188 patients of admitted in ICU of Manipal Teaching Hospital, Pokhara. All bacteria were identified by conventional techniques. Antimicrobial sensitivity testing was performed on Mueller-Hinton agar plates with commercially available antibiotic discs using Kirby-Bauer disc diffusion techniques and interpreted as per the guidelines of CLSI. The antibiotic discs (conc.) used were: piperacillin/tazobactam (100/10mcg), ciprofloxacin (5mcg), amikacin (30mcg), imipenem (10mcg), gentamicin (10mcg), cefaperazone sulbactum(75/10mcg), for Gram negative bacteria and erythromycin (15mcg), amikacin (30mcg), gentamicin (10mcg), ciprofloxacin (5mcg), and clindamycin (2mcg) for Gram positive bacteria. A total of 188 ETTs investigated, 128(68.08%) yielded positive culture. Single type of organisms was found in 119 (63.29%) and 9 (4.7%) cases yielded mixed type of growth. Acinetobacter spp. were the most predominant organism among all gram-negative organisms, which was found to be in 71 (51.82%) cases, followed by Klebsiella pneumoniae in 27 (19.7%), Pseudomonas aeruginosa in 23 (16.78%), Escherichia coli in 5 (3.64%), Enterobacter in 2 (1.46%). Whereas, Staphylococcus aureus (4.37%) was the commonest among all gram-positive organism followed by coagulase negative Staphylococcus in 2 (1.46%) and Enterococcus in 1 (0.73%). Most of Acinetobacter spp. showed resistance to ciprofloxacin (84.5%), while 74.6% were resistant to amikacin, 73.2% to gentamicin, 71.83% to piperacillin-tazobactam and 42.2% towards imipenem. Out of the 6 strains of S. aureus, 5 (83.3%) were methicillin resistant. Due to the increasing incidence of organisms in ICUs, an early and correct diagnosis of ETT associated infections is a challenge for optimal antibiotic therapy. Therefore, the best approach to manage the respiratory infections following ETT application will be appropriate use of antibiotics with adaptation of proper infection control measures, which could help to prevent further spread of infection.
A Simple Method to Type the Urinary Stones
Authors: Sivagnanam Sivarangini , Arasaratnam Vasanthy , Gunatilake Mangala
Published: October 2021

The main aim of this study was to find an alternative method to type the urinary stones, which do not comply with the available method. For this study 100 stones were selected and were analysed by wet chemical method. The compositions of randomly selected 10 stones each among the stones typed based on the available and the new method were crosschecked by Fourier Transform infrared Spectroscopy (FTIR) method. Among the 100 stones, 46 stones were of Category I [21 stones Uric acid/Urate, 13 stones Oxalate, 12 stones Phosphate] while five were of Category II stones. Rest 49 stones, which cannot be typed by the available method, were typed by considering the ratios between the characterizing and indicating anions. To type the Oxalate stones, Oxalate to Urate ratio between 16.8:1 and 67.7:1; Urate stones, Urate to Oxalate ratio between 0.7:1 and 101.7:1 and Non- infection Phosphate stones, Phosphate to Oxalate ratio between 0.4:1 and 24.4:1 were considered. Based on the newly proposed method majority of the stones were of Oxalate type (n=41). Based on both the methods of stone typing, of the total 100 stones, 54 stones were Oxalate type, 25 stones were Uric acid/Urate type, 16 stones were Non-infectious Phosphate stones and 05 were Infectious stones. The compositions of the randomly selected ten stones of each typed from the available and the newly proposed method were similar to the results obtained by FTIR method. This study indicated that, the new method could be used as an alternative method to type the stones.
A Comparative Study of Tramadol and Ketorolac for Pain Management in Post-Operative Patients with Appendectomy
Authors: Tuladhar Lujaw Ratna , Acharya Nikhil , Maharjan Shailesh
Published: October 2021

Appendectomy is one of the most common emergency surgical procedures performed in the world. The inflammation of the appendix triggers severe pain in the right lower quadrant of the abdomen. Additionally, the post-operative incision site pain may be distressing to the patients. Analgesic drugs like tramadol (opioid analgesics) and ketorolac (nonsteroidal anti-inflammatory drug - NSAID) are used to manage post-operative pain. The objective was to compare tramadol and ketorolac for pain management by observing the pain-free interval in post-operative patients with appendectomy. A descriptive cross-sectional study was conducted in the department of surgery from November 2019 to May 2020 to observe the duration of pain-free intervals between tramadol and ketorolac. The total number of appendectomy patients selected was 100. Fifty patients received tramadol and the next 50 patients received ketorolac. The data was entered in SPSS and an independent sample t-test was applied to determine the difference in duration of the pain-free interval between ketorolac and tramadol. The average duration of pain-free for the tramadol group was 4.95±1.19 hours (4 hours 57 minutes) while for the ketorolac group was 5.24±1.36 hours (5 hours 14 minutes). The difference was statistically insignificant. We also observed that the tramadol group (88%) received more anti-emetic drugs than the ketorolac group (24%). Therefore, post-operative pain management with ketorolac was found to be as effective as tramadol with comparable duration of the pain free interval.
Comparision of Coblation and Cold Dissection Techniques outcome among Tonsillectomy patients at Birat Medical College and Teaching Hospital
Authors: Koirala Bipin , Shah R.K. , Shrestha K. , Sapkota S.
Published: October 2021

Tonsillectomy is the most commonly performed surgery. Cold dissection tonsillectomy remains as the gold standard for tonsil removal, although it may increase risk for complication. Coblation tonsillectomy is a new technique .There are studies comparing these two method of surgery and have shown coblation technique to cause less postoperative pain, less intra operative time along with less intra and postoperative blood loss. In contrary few studies have shown it to be ineffective in reducing postoperative bleeding. Hence more studies are still required. Thus the objective of the present study was to compare coblation and cold dissection techniques outcome among tonsillectomy patients at Birat Medical College and Teaching Hospital. The study intended to determine and compare the intraoperative time, intra operative blood loss and postoperative pain in coblation and cold dissection tonsillectomy. This is a hospital based cross sectional comparative study. Eighty six patients underwent tonsillectomy during the study period of one year (15th Feb 2020 to 14th Feb 2021) in the department of ENT HNS, Birat Medical College and Teaching Hospital. Among 86 patients, 43 underwent cold dissection and 43 coblation tonsillectomy. Method of surgery was based on odd and even serial number of the patients during presentation. This study showed that intra operative time, intraoperative blood loss and post operative pain score was 16.77±2.7mins, 36.51±128ml and 6.28 respectively in coblation method and 37.84±3.1 mins, 101.4±12.7ml and 7.88 respectively in cold dissection method. Hence coblation method is a safer and effective method of tonsillectomy compared to cold dissection which ultimately leads to less post operative analgesics demands and early recovery.
Incidence of Symptomatic Internal Hernia following Minimal Invasive colorectal surgery: A Single Center Experience
Authors: Nakarmi Rajiv , Yu-Feng Tian , Ong Khaa-Hoo , Shrestha Muza , Maharjan Sundar , Chhetri Suman Bikram Adhikari
Published: October 2021

Laparoscopy has been adopted in the surgical specialties and colorectal surgery for treatment of benign and malignant diseases. Recent reviews suggest that the incidence of symptomatic internal hernias after laparoscopic colorectal resection is from 0.39 to 0.65%. Unlike in open surgery, laparoscopic closure of a mesenteric defect is inherently challenging as inadvertent injury to the marginal vessels may compromise blood supply to the anastomosis. For these reasons, many surgeons leave the defect open during laparoscopic surgery. But this may lead to development of post-operative internal hernia through the defect. This is a retrospective study where we included 149 patients who underwent laparoscopic/ robotic colorectal surgeries from March 2019 to March 2020. Data pertaining for following variables were collected which included age, sex, indication for surgery, location of the pathology, splenic flexure mobilization. The incidence of internal hernia among these patients were calculated and assessed using SPSS 20. Incidence of internal hernia was found to be 0.67% which was diagnosed and treated on the 18th post-operative day of initial surgery. Internal hernia is a rare but important complication of laparoscopic/robotic colorectal surgery with a high mortality rate if not diagnosed early. Defect closure is still controversial during the initial surgery and probably not indicated for all patients and depends on surgeon’s preference.
Management of Pain with Morphine in cancer patients in a Tertiary Care Centre of Nepal
Authors: Mahaseth Rita Kumari , Pun Rashmey , Shrestha Kriti
Published: October 2021

Pain is one of the most afflicting symptoms reported by cancer patients, mainly those with metastatic disease. The prevalence of cancer has increased, with an estimated projection of 17 million new cases in 2020. This means that there will be an increase in individuals with pain caused by the disease and by treatment. Morphine has been used to relieve pain in cancer patients for centuries. WHO, created a global health policy document for management of cancer pain entitled “Cancer Pain Relive,1 in which morphine was central. In a retrospective study of 1229 patients with cancer pain, the author reported that the analgesic ladder was effective in 71%. Many patients do not get adequate pain relief. Rationale of this study was to assess cancer related pain by using visual analogue pain scale and to prescribe optimal dose of morphine through dose titration to relieve pain and to improve quality of life. An interventional hospital-based study was done in fifty-two different types of cancer patients from 1st Jan, 2020 to 31st Dec, 2020 at Department of Oncology, Nepal Medical college and Teaching Hospital (NMCTH), Kathmandu. Among them 31 were male and 21 were female with mean age 63.87 and 58.19 respectively and SD +/- 12.10 in male and 16.07 in female with p value 0.152 significant. These patients were assessed for severity of pain through visual pain analogue. Improvement in daily activities after administration of morphine according to ECOG performance scale was done. Constipation was the most common complication induced by morphine 38.5%, sedation 32.7% and nausea in 25%. By understanding the context and social meaning surrounding the use of morphine to treat cancer pain, health care professionals can begin to anticipate, acknowledge and address some of the barrier to its use, thereby enhancing the pain control.
The Cost of Treating Neonates in Intensive Care Unit in a Tertiary Level Teaching Hospital
Authors: Basnet Sahisnuta , Adhikari Suraj , Timilsina Mukunda
Published: October 2021

Neonatal intensive care is associated with high costs world-wide and remains a matter of financial stress for families. This is an issue of great importance in a developing country like ours as financial burden may have a negative impact in the overall outcome of a newborn. The objective of this study was to evaluate the direct cost of treating newborns by family members in a neonatal intensive care unit (NICU). This was a prospective cross sectional study carried out in the NICU of Manipal Teaching Hospital, Pokhara, Nepal. There were 96 neonates included in this study over a period of 3 months from September to November 2020. The average cost per neonate per day was NRs. 5858 (USD 50). The highest health expenditure was incurred in neonates of gestational age of 32 to less than 37 weeks, and it was also significantly higher in neonates having birth weights less than 1.5kg. Preterms with hyaline membrane disease, followed by newborns with meconium aspiration syndrome resulted in maximum health costs. Maximum expenditure of the total bill was due to the cost of the bed charges. The median length of stay in the study was 5 days and the length of stay was directly and significantly related to the treatment costs.
Normal coronary diameters in coronary angiogram at Patan Hospital, Nepal
Authors: Adhikari Ashok , Shaha Kunal Bikram
Published: October 2021

This study aims to assess the normal coronary diameters of patient who underwent coronary angiogram in Patan Hospital. Angiographic and demographic data of a total of 307 patients (155 males, 152 females; mean age 62.09±11.06 years) who underwent elective coronary angiography in Patan Hospital due to suspicion of coronary artery disease between 2017 and 2020 and in whom coronary angiography documented normal coronary arteries without any intra-luminal irregularity were analyzed retrospectively. Proximal diameters of the main epicardial coronary arteries were measured quantitatively using automated software analysis (Allura, Philips). The mean diameter of unadjusted/adjusted left main coronary artery, proximal left anterior descending artery, proximal left circumflex artery, proximal right coronary artery were 4.87±0.85mm/2.8±0.54, 3.8±0.7/2.19±0.439, 3.4±0.7/1.98±0.44, 3.6±0.85/2.07±0.53 respectively. Our study findings contradict the traditional belief that females have narrower coronary arteries than males. Our study showed the females have statistically significant larger unadjusted Right Coronary Artery diameter and adjusted Left Main Coronary Artery diameter. We believe that our findings may contribute to the global data pool of normal coronary diameters and can be utilized in future studies as a database.
Cardiovascular Risk Assessment in Hemodialysis Patients
Authors: Pokhrel Asmita , Pokhrel Buddhi Raj , Gyawali Prajwal , Regmi Deepak , Khanal Madhav , Bhattarai Ashim , Poudel Prakash , KC Anil
Published: October 2021

Cardiovascular diseases are the leading cause of death in hemodialysis patients. We aimed to evaluate non-traditional cardiovascular risk factors: homocysteine, high sensitive C-reactive protein, oxidized LDL antibodies, phosphate, and red cell distribution width in chronic kidney disease patients under maintenance hemodialysis along with traditional cardiovascular risk factors like age, hypertension, diabetes mellitus, among others. A total of 78 diagnosed chronic kidney disease patients under maintenance hemodialysis visiting a tertiary care center were included in the study, of which 59% were male. Hyperhomocysteinemia was present in 79.5% of the participants, with the median homocysteine level being 28.43 μmol/L. The median hsCRP level was 4.74 mg/L, and 59% and 24.4% of the total participants were at high and moderate cardiovascular risk respectively. The median oxidized LDL antibody level was 4235 U/mL, which is within the reference range. The median red cell distribution width was 14.05%, which is within the normal range. Left ventricular hypertrophy, a common cardiovascular disease in such patients, was found in 55.13% of the participants. Serum homocysteine level was significantly higher in patients with left ventricular hypertrophy, whereas serum C- reactive protein level was significantly lower in patients with left ventricular hypertrophy. The mean serum phosphate was 6.23 mg/dL (i.e. higher than normal) and hyperphosphatemia was seen among 76.9% of the patients. The mean age of the patients was 47.5 years, which is distinctly lower when compared to the hemodialysis patients in the Western population. The prevalence of hypertension, diabetes mellitus, and anemia were 95%, 18.25%, and 92.3%, respectively.
Unilateral Pyosalpinx in an Adult Female presenting with Features of Acute Abdomen: A Case Report
Authors: Poudel Shankar , Sangroula U. , Rajak A.
Published: October 2021

Pyosalpinx is defined as collection of pus in the fallopian tube and is a late manifestation of pelvic inflammatory disease. Pelvic inflammatory disease refers to a spectrum of inflammatory changes of the female genital tract. It comprises of endometritis, salpingitis, cervicitis, pyosalpinx, tubo-ovarian abscess and peritonitis. Pyosalpinx may progress to tubo-ovarian abscess which may rupture leading to peritonitis. In addition, pelvic inflammatory disease commonly affects both side of the tube. Thus, early diagnosis and proper intervention plays a great role in the management of pyosalpinx. We report a case of unilateral left sided pyosalpinx which presented with features of acute abdomen.
Peningkatkan Kemampuan Menulis melalui Media Gambar Berseri dalam Pembelajaran Bahasa Inggris pada Siswa Kelas VIII SMPN Kelapa 2 Kabupaten Tangerang
Authors: Rismayanti Netty
Published: October 2021

Penelitian tindakan kelas ini bertujuan untuk meningkatkan kemampuan menulis melalui media gambar berseri dalam pembelajaran bahasa Inggris  pada siswa kelas VIII SMPN Kelapa 2 Kabupaten Tangerang. Penelitian ini dilaksanakan pada siswa kelas VIII yang berjumlah 35 siswa yang terdiri dari 15 siswa laki-laki dan 20 siswa perempuan. Metode penelitian yang digunakan pada penelitian ini adalah penelitian tindakan kelas dengan menggunakan model spiral dari Kemmis dan Mc Taggart. Adapun tahap-tahap penelitian tindakan kelas menurut Kemmis dan Mc Taggart yaitu perencanaan, tindakan, pengamatan, dan refleksi. Peningkatan nilai tes menulis dari kondisi awal ke siklus I hingga siklus III yaitu nilai rata-rata pada kondisi awal 59,67 dengan presentase ketuntasan 43,33% (18 orang), pada siklus I meningkat menjadi 65,33 dengan persentase ketuntasan 60% (23 orang), pada siklus II meningkat menjadi 72 dengan presentase ketuntasan 73,33% (27 orang), dan pada siklus III meningkat menjadi 75,66 dengan persentase ketuntasan 86,66% (31 orang). Hasil yang diperoleh dari penelitian tindakan kelas terhadap 35 siswa yaitu dengan meningkatnya nilai rata-rata dari kondisi awal sebesar 59,67 meningkat menjadi 65,33 pada siklus I, pada siklus II meningkat menjadi 72 dan pada siklus III meningkat menjadi 75,66. Hal ini dapat disimpulkan bahwa media gambar berseri pada pembelajaran bahasa Inggris dapat meningkatkan kemampuan menulis  siswa kelas VIII SMPN Kelapa 2 Kabupaten Tangerang. Para guru bahasa Inggris diharapkan menggunakan dan menerapkan media gambar berseri dalam pelaksanaan pembelajaran Bahasa Inggris  pada materi menulis di kelas. Guru bahasa Inggris dapat menggunakan media gambar berseri sebagai media pembelajaran yang dapat meningkatkan kemampuan menulis siswa, agar siswa dapat dengan mudah mengembangkan ide atau pikirannya dalam menulis.
Improvement of the Process of Mechanical Dehydration of Five-Layer Wet Leather Semi-finished Products
Authors:   Department of Mechanical Engineering, Sun Moon University, Asan, 31460, Korea, T. Amanov Auezhan , A. Bahadirov Gayrat ,   Institute of Mechanics and Seismic Stability of Structures of the Academy of Sciences of the Republic of Uzbekistan, Tashkent, 100125, Uzbekistan, N. Tsoy Gerasim ,   Institute of Mechanics and Seismic Stability of Structures of the Academy of Sciences of the Republic of Uzbekistan, Tashkent, 100125, Uzbekistan, M. Nabiev Ayder ,   Institute of Mechanics and Seismic Stability of Structures of the Academy of Sciences of the Republic of Uzbekistan, Tashkent, 100125, Uzbekistan
Published: October 2021

To improve the process of mechanical dehydration of semi-finished wet leather products, a multilayer dehydration using felt materials – monshons was experimentally investigated. The process is conducted by vertical feed of semi-finished wet leather products on a base plate between rotating squeezing rollers. The D-optimal method of mathematical planning of the experiment and the Kano design matrix were used for conducting experiments. The multi-layer package consists of five layers of semi-finished wet leather products and two layers of moistureremoving materials between each layer, folded over the base plate. The studies were carried out in laboratory conditions on an experimental bench, taking into account the production parameters of processing. As a result of the study, mathematical dependences of the amount of removed moisture for each of five layers of semifinished wet leather product on the feed speed and the pressure of the squeezing rollers were derived. The analysis of the results showed that, with the existing parameters of mechanical dehydration, it was possible to simultaneously squeeze out moisture from five layers of the semi-finished leather product with a minimum pressure of the squeezing rollers and an average feed speed. The productivity of the technological process was more than five times higher in comparison with the productivity of similar roller machines. In the near future, this research methodology will be used to determine the technological factors affecting the extraction of excess moisture from a package consisting of ten semi-finished wet leather products and moisture-removing materials.
Improving diagnostics of the cylinder-piston group by pneumatic testing
Authors: Grunin K. E.
Published: October 2021

The task of authors research was to determine the emerging leaks when compressed air is supplied to the above-piston space under pressure of 4, 5 and 6 kgf / cm2, respectively.

To obtain more reliable results, measurements of the leakage of the above-piston space by pneumatic testing should be performed three times. The deterioration of this tribo-coupling should be assessed by the average values of the obtained values. In order to identify the analytical relationships between the readings of the pneumotester and various types of cylinder malfunctions, it is necessary, to simulate during the experiment the malfunctions most often encountered during ordinary engine operation that affect the tightness of the combustion chamber.

The planned experimental studies were carried out in strict accordance with the tasks and included three stages.

The first stage included the collection and analysis of statistical data on the dependence of engine pneumatic testing indications on various types of cylinder-piston group (CPG) malfunctions during ordinary operation, as well as pneumatic testing of engine cylinders undergoing major repairs and their CPG micrometer size. At the second stage, an experiment to simulate malfunctions on an experimental setup and on a working engine, as well as to determine the influence on the readings of the pneumatic tester of the ratio of leaks in the piston ring sleeve interface was carried out. The third stage included the processing of statistical data, processing of the data obtained directly during the experiment with the introduced CPG malfunctions and the processing of the data obtained when determining the influence of the leakage ratio in the piston ring sleeve interface on the readings of the pneumatic tester.
Results of experimental studies of a tractor equipped with an elastic-damping mechanism when aggregated with a seeder
Authors: Sen'kevich S. E. , Il'chenko YE. N. , Alekseyev I. S.
Published: October 2021

One of the significant factors influencing the operation of the tractor is the unsteady load that occurs when starting off, during the initial period of acceleration and deceleration. The elastic-damping mechanisms are used to reduce the negative consequences of such loads. Scientists still develop and study their application.

In this article, the analysis of the cross correlation function and the analysis of the mutual spectral density of two processes were carried out. The analyzed processes were the engine crankshaft speed and the drive wheel speed. This analysis shows the change in the speed of the passing load frequencies along the shaft line of the traction class 1,4 wheeled tractor power transmission, where an elastic-damping mechanism is installed. The studies were carried out for the operating conditions of a tractor with a seeder. The purpose of the study was to determine the effect of the elastic-damping mechanism installed in the power transmission of a tractor on its operation with a trailed seeder.

In the general case, the object of research is the functioning of a tractor of traction class 1,4 process, which is located in a unit with a seeder. Analysis of the mutual correlation function of the two processes showed a change in the speed of the passing load frequencies along the shaft line. The ratio of the propagation time of the disturbance signal in the experimental tractor in relation to the production version along the shaft line when aggregating the tractor with the seeder decreases by 40,1 %. The analysis of the mutual spectral density shows a shift in the frequency of disturbing influences in relation to the serial version and a decrease in their value when the tractor is aggregated with a seeder by 33,3 %. The value of the mutual spectral density is lower in the experimental version of the tractor, which may mean that the elastic-damping mechanism, as an element of the power transmission, absorbs part of the load fluctuations and reduces their propagation speed along the shaft line.
Justification of the form and parameters of the new sorting device for grain materials
Authors: Isgandarzada E. B. , Abbasov B. A. , Ahmadli SH. V. , Islamova U. R.
Published: October 2021

The article is devoted to the substantiation of the shape and parameters of a new sorting device for granular materials. The materials of the article substantiate the relevance of the proposed new device, which has a great place in mechanical engineering and agricultural production.

The shape, design parameters and modes of operation of various elements with different: sorting assortment and efficiency indicators were substantiated taking into account the relevance of the device. For this purpose, a new auger sorting device was developed. It was equipped with various automation devices to increase productivity. The satisfactory results were obtained. This sorting device, equipped with an automatic regulator, received a patent from the Copyright Agency of Azerbaijan Republic.

The proposed device does not create conditions for pollution of the production area, it has competitive advantages and high rates of technical and economic efficiency.
An Analysis of Out-of-Pocket Expenditure Due to Non-Availability of Computed Tomography Scan in Public Sector: A Case Study of Hira Medical Center Sukkur Pakistan
Authors: Iftikhar Shahbaz , Naseer Baloch Hammal Khan , Riaz Sonia , Iqbal Sami
Published: October 2021

Background: Out of pocket (OOP) spending on health contributes significantly to levels of poverty in developing countries such as Pakistan. In poor countries there is reduced or limited access to health services, the issue of affordability and availability which all lead to impaired health status and increased morbidity and mortality rates in developing countries. Catastrophic health expenditure is not always synonymous with high health care costs; even small Out of pocket expenses may cause catastrophic condition for poor people.
Methods: This is a cross sectional study that determined the out of pocket cost of computed tomography scan test (CT scan). The study was conducted from April to June 2015. The study population was those patients who came for CT scan at Hira medical center in district Sukkur Sindh Pakistan. The study sample was one hundred and seventy patients. (n=150).  From the perspective of consumer the methodology was adopted, various recurrent costs were determined under different levels of input and cost canters. The data was entered and analyses using SPSS 20 to provide the results as percentages and averages for the different variables in this study.
Results: Through this research we found that out of pocket payments are way too high while putting alot of burden on lower socioeconomic groups. Health expenditure Average cost per patient calculated were Rs. 11000 which means people spend more than 40% of  their monthly income on health. There should be a government health facility in the city to compensate the huge cost which people pay for health especially low monthly income people.
Conclusion: Government should introduce a health coverage insurance system in Pakistan in order to cover all health care needs of the people irrespective of their socioeconomic status. Keeping in view high out of pocket spending on health, the Government should subsidize the prices of diagnostic test to give relief to its Population. Community participation is also essential for sustainable solutions.
Cardiovascular Disease Risk Factors’ Awareness and Prevalence among College Students in Karachi City
Authors: Jilani Uzma Aamir , Iqbal Mehveen , Jilani Syed Aamir
Published: October 2021

Background: The aim of the study was to determine the health beliefs and prevalence of cardiovascular disease (CVD) risk factors among the college students of Karachi city.
Methods: A survey among students of the United Medical and Dental College and non-medical students was performed from the period of October 2019 to January 2020. A validated questionnaire was used to identify the health beliefs of the subjects, related to CVD and its determinants, along with a brief medical history to determine the prevalence of risk factors. The data was analysed by using SPSS version 23.
Results: Among total subjects of 140, 53 (37.8%) males and 87 (62.1%) females participated in the study. The analysis presented an adequate knowledge of CVD and its determinants among 133 (95%) of the respondents. 112 (80%) of the participants demonstrated a significantly positive attitude and supported the primary prevention of CVD. However, the practices were found optimum in 80 (60%) of the respondents only, the rest were not up to the mark. It was identified that 69% of the respondents had at least one of the risk factors leading to CVD, which is a significant proportion.
Conclusion: The majority of the participants of this study were aware of the CVD and its determinants, however, the practices observed for the primary prevention of CVDs were not up to the standard. Risk factors were significantly pervasive among the participants. The findings of this survey support the need for modification of lifestyle to promote primary prevention of CVD from an early age.
Assessment of COVID-19 Management at Saidu Group of Teaching Hospital Swat: Analytical Cross-Sectional Study
Authors: Khan Akhtar Ali , Ali Anwar , Zeb Hussan , Rahman Bakht , Arif Ijaz , Muneem Abdul , Khan Misal , Awan Muhammad Naeem
Published: October 2021

Background: This research aimed to assess the current care management processes for COVID-19 and determine patient outcomes.
Methods: An analytical cross-sectional study was conducted at Saidu group of teaching hospital, a tertiary care hospital with more than a thousand-bed capacity. The target population was all patients admitted to the corona isolation ward and the hospital's critical unit. All the patients admitted through the emergency and inpatient department with Positive PCR, and respiratory symptoms were included in the study.
Results: In total, data of 151 patients were collected. Of these, 90 (59.6%) were male and 61 (40.4%) were female with a mean age of 59.17±13.79. The most common presenting symptoms were difficulty in breathing (n=147, 97.4%) and dry cough (n=104, 68.9%), followed by aches and pain (n=71, 47%) and fever (n=60, 39.7%). Most of the patients had an underlying health condition (n=96, 63.6%). The most common underlying conditions were hypertension (n=65, 43%) and diabetes (n=56, 37.1%). The mean time for the hospital stay was 11.68±15.31. About 64% of the patients recovered with the treatment and care protocols (n=97, 64.2%), while the remaining (n=54, 35.8%) died.
Conclusion: This study provides an overview of the clinical presentation and treatment protocol for COVID-19. Most of the patients received supportive treatment comprising of antivirals, steroids, and oxygen therapy. However, the mortality rate was low compared to other hospitals across the country.
Burnout among Adolescent Population during Covid-19 Lockdown in Sialkot Pakistan
Authors: Asif Roha , Amin Ijaz , Perveen Wajida , Ali Misbah Amanat , Ilyas Umer , Bashir Khizra
Published: October 2021

Background: To analyze the change in behavioral patterns, its impact, and peer pressure caused by COVID-19 lockdown among the adolescent population.
Methods: It was an observational study with sample size of 443 participants. The study was conducted after ethical approval. Data were collected from different academic institutions in Sialkot, Pakistan using Burnout rating scale. The target population was adolescents of age 13-19 years. Regression analysis was done to find predictor factors mobile use and lockdown on the dependent variable Burnout score. The correlation was applied among mobile phone use, lockdown, and burnout score. IBM software SPSS version 21 was used to analyze data.
Results: Among 443 participants, 305 were female and 138 were male making 68.8% and 31.2% respectively. 57.1% of participants were doing well, 24.8% became candidates for burnout. In 13.3% of candidates, the burnout made changes, and for only 4.7% action should be taken for their health. The correlation coefficient among burnout and using mobile was 0.194 that is highly significant showing a direct positive association between these two variables. The correlation coefficient (R) has a value of -0.222 between burnout and lockdown also showing significance.
Conclusion: Behavioral changes in adolescents concerning burnout due to COVID-19 lockdown was more exaggerated than the actual burnout rate. Behavioral outcome due to COVID-19 lockdown was not that much destructive for adolescent mental health, but only if combined with the other negative traits of the individual.
The protocol of the study was registered on ClinicalTrials.gov wide Identifier: NCT04697030
Hesitancy towards COVID-19 Vaccination and Neutralization of False Perceptions among the Communities
Authors: Weerawarna P.S.H. , Habib Murad , Abbas Muhammad
Published: October 2021

Coronavirus disease 2019 (Covid-19), which has invaded every continent very rapidly, has already been a pandemic. The best solution only seems to be the vaccination rather than simple preventive measures such as wearing masks, frequent hand washing, and social distancing.
In this article, we analyze the factors affecting hesitancy, delay, and refusal of Covid-19 vaccines and suggest how to take steps to overcome the vaccine hesitancy, thus increasing acceptance and eliminating the pandemic as soon as possible.
A comprehensive literature search was performed using Medline/PubMed, Web of Science, and Google Scholar to identify empirical literature published in English until April 2021. 
Several countries and pharmaceutical companies have come up with different vaccines for SARS-CoV-2 coronavirus. Since several strains are emerging, more new vaccines will come to the market. The cost, facilities available, and convenience need to be considered in choosing an option for vaccination. Although the world is looking at the positives of vaccines and getting out of this threat, some more factors might slow down that effort. Vaccine hesitancy, delay, or refusal should be discussed extensively as that influences the vaccination process remarkably.
The demographic features of several communities, educational background, socio-economic status, and trust in healthcare services are factors leading to vaccine hesitancy or acceptance. The governments, experts, and healthcare professionals should have an excellent understanding of the factors influencing hesitancy and acceptance and should take necessary steps to encourage the population's vaccination.
Relationship between quality of work-life, resilience and burnout among nursing professionals during COVID-19 pandemic in Iran: A cross-sectional study
Authors: Zahednezhad Hosein , Zareiyan Armin , Zargar Balaye Jame Sanaz
Published: October 2021

Background: The COVID-19 pandemic and the increased workload and stress associated with the disease prevalence have posed a high risk of burnout to nurses. The effects of the workplace and environmental factors on resilience and burnout among nursing professionals have not been investigated in Iran.
Objective: Present study aimed to assess a model linking quality of work-life to the resilience and various dimensions of burnout among Iranian nursing professionals based on the health service workplace environmental resilience model.
Methods: This was a cross-sectional study performed on 202 Iranian nurses employed in three educational hospitals. Maslach burnout inventory, Brooks’ quality of nursing work-life survey, and an abbreviated version of the Connor-Davidson resilience scale were used to collect data. The correlation between the study variables was assessed by conducting path analysis in AMOS 22.
Results: The final model demonstrated adequate fit. The quality of working life indirectly affected burnout via a direct impact on nursing professionals’ resilience (p <0.001, β = 0.39). In addition, resilience had negative, significant effects on all the dimensions of job burnout. The quality of work-life also had negative and significant effects on emotional exhaustion (p <0.001, β = -0.38) and reduced personal accomplishment (p <0.001, β = - 0.38).
Conclusion: Resilience and quality of work-life are protective variables against burnout in nursing professionals. Nursing managers can increase resilience and decrease burnout among nursing professionals by adopting policies that can improve the quality of work life.
What’s next for the New Zealand dairy feed-base? Learnings from climate analogues
Authors: Garcia Sergio Carlos , Kemp Stuart , Clark Cameron , Ota Noboru , Islam Md , Kriticos Darren
Published: October 2021

• The reviewed literature suggests that the likely main impact of climate change on New Zealand dairy systems will be a reduction in total annual rainfall and increased inter- and intra-season rainfall and associated soil moisture variability.• Future climate analogues for New Zealand’s current dairying regions are provided from both within New Zealand and Australia.• Future climate scenarios for New Zealand dairy systems can be found within New Zealand with the exception of Northland whose most similar climate analogue is in Australia.• A conceptual framework to increase the boundaries of the ‘zone of system control’ (ZSC) by the farmer is provided here for the first time. The ZSC is defined as the optimal range for a critical input (rainfall or soil moisture in this case) where productive and profitable farming can occur.• Risk of failure increases as the frequency inputs fall above (excess) or below (deficit) the ZSC. Options to reduce the risk of system failure (outside of this zone) are provided with emphasis on soil moisture.• This framework could be used to focus future research and development investment to make the New Zealand and Australian dairy industries more resilient to climate change.
“Noema” and “Noesis” by Information after Husserl’s Phenomenology Interpreted Formally
Authors: Penchev Vasil
Published: October 2021

Husserl’s “noema” and “noesis” are main concepts in phenomenology able to represent its originality. Following the trace of a recent paper, its formal and philosophical approach is extended to both correlative notions, in the present article. They are able to reveal the genesis of the world from consciousness in a transcendental method relevant to Husserl, but furthermore described formally as a process of how subjective temporality appears being isomorphic to objective temporality of the “world by itself” (an abstraction meaning it out of consciousness or transcendental consciousness): thus, it shares the same mathematical structure, which is embodied in the physical process of decoherence by the physical quantity of quantum information. The temporal world is able to appear naturally . The same process translated by formal and mathematical tools as interpreted in terms of “noema”, “noesis”, or transcendental consciousness is isomorphic to how “Self” appears in virtue of transcendental consciousness.
Çerçeve Tipi Betonarme Binalarda Zemin Kat Yüksekliği Etkileri ve Maliyet Analizi
Authors: Garip Zehra Şule
Published: October 2021

Bu çalışmada, farklı iki deprem tasarım sınıfı dikkate alınarak yeterli dayanımda tasarlanan deprem etkisindeki betonarme bina modellerinde zemin kat yüksekliğinin yapı davranışına ve kaba yapı maliyetine etkileri araştırılmıştır. Bu amaçla, betonarme bina modellerinde kat sayıları ve farklı zemin kat yükseklikleri parametre olarak dikkate alınmıştır. Çerçeve tipi betonarme bina modellerin dinamik analizleri Sta4Cad bilgisayar paket programında gerçekleştirilmiştir. Dinamik analizlerden elde edilen sonuçlar TS500-2000 ve TBDY2018’e göre değerlendirilmiştir. Betonarme bina modellerinin göreli kat ötelemeleri, ikinci mertebe etkileri ve maliyet hesabı değerleri tablo ve şekillerle sunulmuştur. Zemin kat yüksekliğinin artması göreli kat ötelemeleri arttırırken, kat sayısının da göreli kat ötelemelerinde etkili olduğu görülmüştür.