bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy Consumption for Uniform Movement of the Upper Parts of Plants between the Upper Conveyor Belt and the Deck
Authors: Николаев В.А. , Гумённый В.В. , Генералов В.А.
Published: August 2021

Комбайн, который производил бы выделение зёрен из колосьев методом вытирания, имеет два варианта исполнения устройства для извлечения зёрен из колосьев: с декой, совершающей колебания, и с неподвижной декой. Рассмотрено выделение зёрен из колосьев при неподвижной деке. Перемещение верхних частей растений между лентой верхнего транспортёра и декой включает два этапа. На первом этапе происходит ускорение колосьев, на втором – их равномерное движение. Рассмотрена схема воздействия на колос ленты верхнего транспортёра и деки в начале её равномерного перемещения на прямолинейном участке деки. Определены силы воздействия зерновки на деку и реакции деки. Проанализированы эпюры напряжений, возникающих в колосе от воздействия на колос ленты верхнего транспортёра и деки. Установлено, что напряжения, возникающие в связи зерновок с основанием колоса достаточны для извлечения зерновок из колоса. Выявлено общее максимальное усилие воздействия деки на все колосья, исходя из которого можно произвести расчёт на прочность элементов деки. Вычислено давление рабочей жидкости в гидроцилиндрах поддержки жёлоба, обеспечиваемое гидропневмоаккумулятором. В результате расчётов определены затраты энергии на равномерное перемещение верхних частей растений в промежутке между лентой верхнего транспортёра и декой.

The combine, which would extract grains from the ears by grinding method, has two versions of the device for extracting grains from the ears: with a deck making vibrations and with a fixed deck. Grain extraction from ears at fixed deck is considered. The movement of the upper parts of plants between the belt of the upper conveyor and the deck includes two stages. At the first stage the ears accelerate, at the second – their uniform movement takes place. The scheme of influence on the ear of the upper conveyor belt and the deck at the beginning of its uniform movement on the linear part of the deck was considered. The forces of bruchid weevil effect on the deck and reaction of the deck were determined. Stress diagrams arising in the ear from the impact on the ear of the upper conveyor belt and deck were analyzed. It has been found that the stresses arising in connection of the bruchid weevils with the base of the ear are sufficient to extract the bruchid weevils from the ear. The total maximum impact force of the deck on all ears was revealed, based on which it is possible to calculate the strength of the deck elements. Working fluid pressure in gutter support hydraulic cylinders provided by hydro-pneumatic accumulator was calculated. As a result of the calculations, the energy consumption for the uniform movement of the upper parts of plants in the interval between the upper conveyor belt and the deck were determined.
Implikasi Gaya Pembelajaran Koperatif Subjek Sains Bagi Murid Tahap Dua di Sekolah Kebangsaan Bandar Baru Rawang
Authors: Abdul Rahim Nadia , Meor Fadzir Nor Aqilah , Zaimal Nur Adilah Hani , Arias Yahaya Firli Fairulyzan , Zainol Zatul Iffah , Husin Mohd Razimi
Published: August 2021

Kajian ini adalah sebuah kajian bagi meneroka ekologi pendidikan secara spesifik. Di mana, kajian ini adalah berfokuskan kepada Implikasi Gaya Pembelajaran Koperatif dalam Stimulus Sosial terhadap pembelajaran subjek Sains. Kajian ini adalah kajian kualitatif yang bercirikan Kajian Kes. Kajian ini telah dijalankan di salah sebuah sekolah rendah di kawasan Rawang, Selangor. Responden yang terlibat dalam kajian ini adalah seorang Guru Sains, yang berpengalaman mengajar selama 16 tahun. Proses perolehan data pula, diperolehi melalui sesi temu bual bersama responden melalui kaedah temu bual separa berstruktur. Instrumen kajian yang digunakan adalah 10 soalan temu bual yang dirangka selari dengan persoalan kajian. Dapatan kajian yang diperoleh, menjelaskan bahawa, gaya pembelajaran koperatif dapat menarik minat serta pemahaman murid tahap dua dalam mata pelajaran Sains. Malah ia dapat menampilkan ciri ciri murid yang memenuhi kehendak aspirasi pendidikan negara. Ini adalah kerana, kemahiran komunikasi dan interaksi, kemahiran berfikir secara kreatif dan kritis, kemahiran penyelesaian masalah, kemahiran bekerja dalam kumpulan, kemahiran bersosial dan nilai-nilai sosial serta kepimpinan dapat diterapkan secara tidak langsung dalam pelaksanaan pengajaran dan pembelajaran koperatif.

Implications of Cooperative Learning Style of Science Subjects for Level Two Students in Sekolah Kebangsaan Bandar Baru Rawang

Abstract: This study is a study to explore the ecology of education specifically. Where, this study is focused on the Implications of Cooperative Learning Style in Social Stimulus on the learning of Science subjects. This study is a qualitative study characterized by a Case Study. This study was conducted in one of the primary schools in Rawang, Selangor. The respondent involved in this study was a Science Teacher, with 16 years of teaching experience. The data acquisition process, on the other hand, was obtained through an interview session with the respondents through a semi -structured interview method. The research instrument used was 10 interview questions designed in parallel with the research questions. The findings of the study, explain that, cooperative learning style can attract the interest and understanding of level two students in the subject of Science. In fact, it can feature the characteristics of students who meet the needs of the country's educational aspirations. This is because, communication and interaction skills, creative and critical thinking skills, problem solving skills, group work skills, social skills and social values as well as leadership can be applied indirectly in the implementation of cooperative teaching and learning.

Keywords: Learning Implications, 21st Century Learning, Cooperative Learning.
Strengths and Challenges of Distance Learning Modalities in the New Normal: Basis for Intervention Program
Authors: Hernandez Laura
Published: August 2021

The study was conducted to identify the strengths and challenges of distance learning modalities as a basis for intervention programs from a memorial high school in a schools’ division in Bulacan, Philippines. The researcher used a descriptive survey type of study. For the sample of the study, it employed eight (8) teachers and 39 learners from a junior high school chosen randomly. A self-made checklist survey questionnaire was created by the researcher which was validated by a panel of experts. Descriptive statistics were used to analyze the collected data with the help of a Microsoft Excel sheet. Results revealed that teachers and learners have a variety of strengths in distance learning modalities. In addition, teachers and learners also stressed the different challenges they encountered for distance learning modalities. Based on these findings of the study, the researcher used them for a possible formulation of an intervention program that aimed to providing solutions for the challenges of distance learning and also enhancing the strengths for both the teachers and learners.
Detection of Freezing of Gait using Convolutional Neural Networks and Data from Lower Limb Motion Sensors
Authors: Shi Bohan , Tay Arthur , Au W.L. , Tan Dawn M.L. , Chia Nicole S.Y. , Yen Shih-Cheng
Published: August 2021

Freezing of Gait is the most disabling gait disturbance in Parkinson’s disease. For the past decade, there has been a growing interest in applying machine learning and deep learning models to wearable sensor data to detect Freezing of Gait episodes. In our study, we recruited sixty-seven Parkinson’s disease patients who have been suffering from Freezing of Gait, and conducted two clinical assessments while the patients wore two wireless Inertial Measurement Units on their ankles. We converted the recorded time-series sensor data into continuous wavelet transform scalograms and trained a Convolutional Neural Network to detect the freezing episodes. The proposed model achieved a generalisation accuracy of 89.2% and a geometric mean of 88.8%.
Policy Paper on Decision Making in Intensive Care Units
Authors: Azap Alpay , Yalım Neyyire Yasemin , Cinel İsmail
Published: August 2021

Intensive Care Units (ICU) are units where vital support with advanced technology is given to critically ill patients and multidisciplinary approaches are frequently applied. As we all see during the pandemic, the ICU beds are limited in number; therefore, appropriate use of ICU beds is very important to give the necessary treatment to patients on time while spending the resources rationally and efficiently. Practices to be implemented for this purpose may cause conflicts between the patients, relatives of the patients, the society and the healthcare team. It is crucial to prevent these conflicts and to ensure that they are resolved properly when they arise. This policy paper prepared by Turkish Society of Clinical Microbiology and Infection (Klimik), Turkish Society of Intensive Care and Turkish Bioethics Association brings suggestions to physicians and healthcare administrators regarding the rational use of intensive care units. It is thought that it will become effective to the extent that it is supported by the professional organizations and medical associations operating in our country.
MODELING, ANALYSIS AND COUNTERING THE SCENARIOS OF PREPARING COMPUTER ATTACKS IN DISTRIBUTED COMPUTER SYSTEMS
Authors: Сердечный Алексей Леонидович , Пустовалов Никита Сергеевич , Тарелкин Михаил Андреевич , Дешина Анна Евгеньевна
Published: August 2021

Цель проведённых исследований заключалась в формализации действий нарушителя, совершаемых в ходе подготовки компьютерной атаки как основного этапа, на котором можно оказать противодействие нарушителю до того, как защищаемой системе будет нанесён ущерб. В настоящей статье представлены результаты разработки модели сети Петри для этапа подготовки к компьютерной атаке в распределенных компьютерных системах. Модель учитывает причинно-следственные связи между действиями нарушителя, а также условиями и последствиями реализации таких действий. Наличие таких связей позволяет определять сценарии подготовки компьютерных атак в зависимости от структурных и функциональных особенностей объекта защиты и модели нарушителя. Разработанная модель может быть использована в качестве исходных данных при моделировании угроз безопасности информации в части определения способов, используемых нарушителем при выборе объекта атаки, а также в ходе получения необходимых ресурсов для её совершения. Также в настоящей статье продемонстрирована возможность моделирования мер защиты, затрудняющих реализацию сценария к атаке.

The purpose of the research was to formalize the actions of the violator committed during the preparation of a computer attack as the main stage at which it is possible to counteract the violator before the protected system is damaged. This article presents the results of the development of a Petri net model for the preparation stage for a computer attack in distributed computer systems. The model takes into account the causal relationships between the actions of the violator, as well as the conditions and consequences of the implementation of such actions. The presence of such links allows you to determine the scenarios for preparing computer attacks, depending on the structural and functional features of the object of protection and the model of the intruder. The developed model can be used as a source data for modeling information security threats in terms of determining the methods used by the violator when choosing the object of the attack, as well as in the course of obtaining the necessary resources for its commission. This article also demonstrates the possibility of modeling security measures that make it difficult to implement a scenario for an attack.
IMPACT OF SOCIAL SERVICES PARTICIPATION OF UNDERGRADUATE STUDENTS ON THEIR ACADEMIC ACHIEVEMENT
Authors: Goutam Padhan
Published: August 2021

The objectives of the study were to investigate the impact of i) social services participation undergraduate students on their academic achievement; ii) social services participation undergraduate boys students on their academic achievement, and iii) social services participation of the undergraduate girls students on their academic achievement. A sample of 80 undergraduate students of Gangadhar Meher University, 40 each from participants and non-participants students were selected randomly. Out of which 20 each from boys and girls undergraduate students were participants groups and 20 each from boys and girls undergraduate students were from non-participants groups. Information Inventory on Social Service Participation Test was used for data collection and average academic achievement SGPA score of undergraduate students given by university was adopted for accessing the academic achievement of students. The‘t’ test revealed that i) there was no impact of social service on academic achievements of undergraduate students. Academic achievement of both social service participant and non-participant undergraduate students were similarly; ii) there was no impact of social service on academic achievements of participant and non-participant undergraduate boys students’. Academic achievement of both social service participant and non-participan boys undergraduate students’ were same line; and iii) there was no impact of social service on academic achievements of participant and non-participant undergraduate girls students. Academic achievement of both social service participant and non-participant girls undergraduate students’ were same line.
KEY WORDS: Social Services, Participation, Under Graduate, Academic Achievement
Penerapan Pajak Penghasilan (PPh) Final terhadap Usaha Mikro Kecil dan Menengah (UMKM) berdasarkan PP No 23 Tahun 2018 pada Wilayah Kerja Kantor Pelayanan Pajak Pratama Depok
Authors: Dariansyah Deddy
Published: August 2021

Dengan dikeluarkannya Peraturan Pemerintah (PP) Nomor 23 Tahun 2018 tentang Pajak Final yang khusus diberlakukan bagi pelaku usaha kecil menengah dan usaha tertentu, yang memiliki penghasilan bruto Rp 4,8 miliar dalam satu tahun. tujuan dari penelitian ini adalah penulis ingin meneliti apakah penerapan Pajak Penghasilan (PPH) Final dengan tarif 0,5 % terhadap usaha Mikro Kecil dan Menengah pada Kota Depok sudah sesuai dengan Peraturan Pemerintah No 23 tahun 2018. Metode yang digunakan penelitian ini secara kualitatif dengan observasi dan wawancara dengan menganalisis laporan keuangan distributor makanan dan minuman atas Pajak Penghasilan Final bruto dengan tarif 0.5 % pada tahun 2020, telah  sesuai dengan Peraturan Pemerintah No 23 tahun 2018 mengenakan tarif PPH Final  0,5% setiap bulannya. Pada bulan Mei sampai dengan bulan Juni adanya kenaikan pendapatan bertepatan dengan bulan puasa Ramadan, setelah akhir bulan Juli pendapatan menurun lagi dengan berakhirnya hari raya Idu Fitri, setelah dilakukan analisa dan perhitungan berdasarkan laporan keuangan maka pendapatannya tidak melebihi Rp4.800.000.000 dalam satu tahun. Wajib Pajak bisa mendapatkan tarif Pajak Penghasilan final atas penghasilan kategori peredaran tertentu.
Perataan Laba Ditinjau dari Profitabilitas, Ukuran Perusahaan, Kompensasi Bonus dan Pajak
Authors: Amin Asbi , Pahyasah M.Badri , Anugrah D Magfirah , Murdi Andriani
Published: August 2021

Abstrak

Peneliti ingin menguji perataan laba dipengaruhi oleh profitabilitas, ukuran perusahaan, kompensasi bonus dan pajak. Data yang digunakan adalah data sekunder dengan pendekatan time series yang dikumpulkan melalui website resmi perusahaan manufaktur sektor industri barang yang terdaftar di BEI dan di analisis melalui regresi liner berganda. Populasi penelitian adalah laporan keuangan perusahaan manufaktur sektor industri barang konsumtif yang terdaftar di BEI sebanyak 50 perusahaan dengan teknik sampel purposive sampling yaitu laporan keuangan dari perusahaan yang konsisten dengan kelengkapan data periode 2018 dan 2019 sehingga menjadi 38 laporan keuangan perusahaan dengan data 2 tahun sehingga total sampel menjadi 76 data laporan keuangan. Penelitian menemukan bahwa profitabilitas negatif dan signifikan terhadap perataan laba, sementara ukuran perusahaan, kompensasi bonus dan pajak berpengaruh positif terhadap perataan laba.

Kata Kunci: Profitabilitas, Ukuran Perusahaan, Kompensasi Bonus, Pajak, Perataan Laba.

Abstract

Researchers want to test income smoothing is influenced by profitability, company size, bonus compensation and taxes. The data used is secondary data with a time series approach which is collected through the official website of manufacturing companies in the goods industry sector listed on the IDX and analyzed through multiple linear regression. The research population is the financial statements of manufacturing companies in the consumer goods industry sector that are listed on the IDX as many as 50 companies with purposive sampling technique, namely financial reports from companies that are consistent with the completeness of data for the 2018 and 2019 periods so that it becomes 38 company financial reports with 2 years of data so that the total sample to 76 financial statement data. The results of the study found that profitability was negative and significant on income smoothing, while company size, bonus compensation and taxes had a positive effect on income smoothing.

Keywords: Profitability, Company Size, Bonus Compensation, Taxes, Income Smoothing.
The Relationship and Impact of Strategic Renewal on Entrepreneurial Performance: An Applied Study of a Sample of Private Bank Managers in Baghdad
Authors: Nima Asmaa Habib
Published: August 2021

This study examined the impact of strategic renewal on entrepreneurial performance through
an exploratory study of banking services in the city of Baghdad. This study aims to determine
the impact of context, content and process on entrepreneurial performance represented by
strategic orientation, resource orientation, management structure and entrepreneurial culture.
A question was distributed to 52 managers of private banks in the city of Baghdad. The
research attempts to answer a number of questions, the body of the research problem (Is there
a correlation and influence between the dimensions of strategic renewal and pioneering
performance, in order to analyze the data obtained from the questionnaires, quantitative
methods were used such as the arithmetic mean, standard deviation, coefficient of variation,
simple correlation potential and equation modeling) The results showed that the elements of
the strategic renewal activities have a significant impact on the entrepreneurial performance
.Finally, the study recommends that the management should improve the strategic renewal
activities by applying the appropriate activities for the company's work to obtain the leading
performance.
Obstetrical risks before and after bariatric surgery
Authors:   “Filantropia” Clinical Hospital, Bucharest, Romania, MAXIM Bogdan , GICĂ Corina ,   “Filantropia” Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PANAITESCU Anca Maria ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, CIOBANU Anca Marina ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, CIMPOCA-RAPTIS Brînduşa Ana ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PELTECU Gheorghe ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, GICĂ Nicolae ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: August 2021

Obesity is defined as a body mass index (BMI) greater than 30 kg/m² and it is a major healthcare issue, with an increasing number of people being obese worldwide, including reproductive-aged women. Due to the great impact it has on morbidity and mortality, finding solutions to combat this century’s health menace became an issue and a necessity. Bariatric surgery is nowadays the treatment of choice for severe obesity due to the major weight loss following the procedure and improvements in several health outcomes. But as with all surgical procedures, it can also lead to complications, such as intestinal occlusions, with severe consequences, especially during pregnancy. Moreover, bariatric surgery can favor fetal growth restriction, depending on the type of procedure applied. There are two main types of bariatric surgery, purely restrictive procedures (sleeve gastrectomy, gastric banding) and malabsorptive or mixed procedures (biliopancreatic diversion, gastric bypass). Mixed procedures have been the first choice for many years because of the greater weight loss compared to gastric banding, but they can lead to nutritional deficiencies, with a potential impact on fetal development, causing an increased incidence of small-for-gestational-age fetuses (SGA). Main nutritional deficiencies include iron, vitamin B12, folate, and calcium. On the other hand, pregnant women who underwent bariatric surgery have lower risks of GDM (gestational diabetes mellitus), gestational hypertension and fetal macrosomia.
Pneumonia in pregnancy
Authors:   “Filantropia” Clinical Hospital, Bucharest, Romania, CUDALBĂ Delia Ioana , CIMPOCA-RAPTIS Brînduşa Ana ,   “Filantropia” Clinical Hospital, Bucharest, Romania, CIOBANU Anca Marina ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, GICĂ Corina ,   “Filantropia” Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, GICĂ Nicolae ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PELTECU Gheorghe ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, PANAITESCU Anca Maria ,   “Filantropia” Clinical Hospital, Bucharest, Romania,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: August 2021

Pneumonia is a common disease worldwide and the coexistence with pregnancy increase its morbidity and mortality. Physiologic changes in pregnancy can augment susceptibility to pulmonary diseases and change their clinical course. This review article attempts to make an assessment of current information on the risks, maternal and fetal effects, etiology, clinical features and management of pneumonia in pregnancy. A systematic literature electronic search for journal articles and guidelines regarding pneumonia and respiratory disease in pregnancy was undertaken. Pathogens, clinical course and treatment of pneumonia in pregnancy is similar to the non-pregnant circumstances, with particular consideration on obstetric and fetal outcomes and drug safety during pregnancy. Prompt diagnosis and treatment reduce potential complications. Vaccination may reduce severity of pneumonia in high-risk pregnant patients.
ISOLATED ACUTE SPHENOID SINUSITIS AS AN UNEXPECTED CAUSE OF ACUTE HEADACHE IN A 9-YEAR-OLD MALE
Authors:   Department of ENT, “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Bucharest, Toader Miorita , Oprea Alina ,   Department of General Pediatrics, “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Bucharest
Published: August 2021

Isolated sphenoid sinusitis represents a rare pathology encountered in the pediatric population. The clinical presentation is often nonspecific and misleading, thus causing a delay in diagnosis. Progressive acute headache is the chief complaint, followed by cranial nerve involvement, most frequently the optic nerve. The underlying pathology and evolution towards ocular or intracranial complications reside in the particularities of the sphenoid sinus and in its close relations with the surrounding anatomical structures. Prompt diagnosis and initiation of wide-spectrum antibiotherapy are vital for an optimal therapeutic outcome with preservation of normal vision. We report a case of a previously healthy 9-year-old male who presented for an intense progressive headache without any neurological signs. Under intravenous antibiotherapy he had a rapid favourable evolution and did not develop any complications. An emphasis is put on the importance of a rapid diagnosis followed by prompt treatment with close monitoring.
RARE FINDING IN A PATIENT WITH MYCOSIS FUNGOIDES – SENSORIMOTOR AXONAL POLYNEUROPATHY
Authors:   Department of Neurology, “Colentina” Clinical Hospital, Bucharest, Romania, Obrisca Oana , Bardas Alexandru ,   Department of Hematology, “Fundeni” Clinical Institute, Bucharest, Romania, Morari Oana ,   Department of Neurology, “Colentina” Clinical Hospital, Bucharest, Romania, Elmi-Mujdaba Ayghiul ,   Department of Neurology, “Colentina” Clinical Hospital, Bucharest, Romania, Popescu Bogdan O. ,   Department of Neurology, “Colentina” Clinical Hospital, Bucharest, Romania,   Department of Neurology, “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania,   Department of Molecular Medicine, “Victor Babes” National Institute of Pathology, Bucharest, Romania, Mihaila Mariana ,   Department of Internal Medicine, “Fundeni” Clinical Institute, Bucharest, Romania
Published: August 2021

We report the case of a 62-year old patient who presented a rare association of Mycosis fungoides, a subtype of cutaneous T-cell lymphoma and sensorimotor axonal neuropathy. Usually, leptomeningeal dissemination and central nervous system involvement are much more frequently encountered in cases of Mycosis fungoides with extracutaneous spread and only few case reports describe the involvement of peripheral nerves. The challenge in our case was to correlate a possible etiopathogenic factor with the polyneuropathy. Although, it was most probably a paraneoplastic manifestation, the associated neuropathy could have had other possible pathogenic mechanisms.
EVALUATION OF SODIUM VALPROATE LEVELS IN MALNOURISHED CHILDHOOD EPILEPSY AND ITS CONSEQUENCES
Authors:   Department of Clinical Pharmacy, Vaagdevi College of Pharmacy, Warangal, Telangana State, Gampala Vishwanath Reddy , Peraboina Sampath Raj ,   Department of Clinical Pharmacy, Vaagdevi College of Pharmacy, Warangal, Telangana State, Ajmeera Sudhakar ,   Associate Professor, Department of Pediatrics, Kakatiya Medical College, MGM Hospital, Warangal, Telangana State, Kalam Sirisha ,   Head of the Department, Department of Analysis, Vaagdevi College of Pharmacy, Warangal, Telangana State, Adla Nagesh ,   Department of Clinical Pharmacy, Vaagdevi College of Pharmacy, Warangal, Telangana State, Puchchakayala Goverdhan ,   Department of Clinical Pharmacy, Vaagdevi College of Pharmacy, Warangal, Telangana State
Published: August 2021

Objectives. To measure and compare free fraction of serum levels of VPA (valproic acid) between non-malnourished and malnourished epileptic children and to evaluate the adverse effects (myopathy, hepatotoxicity). Material and methods. It is a prospective comparative observational case control study in which forty epileptic children (malnourished: 18 male/8 female, age 8.3±2.5, non-malnourished: 8 male/6 female, age 8.1±2.1) who fulfilled the inclusion criteria were recruited as study group and twenty children as control group (12male/8 female, age 6.0±2.8). Outcome measures monitored are serum VPA levels (total and free fraction of serum VPA), serum CK (creatinine kinase), SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic pyruvic-transaminase). Using screening tool for the assessment of malnutrition in pediatrics (STAMP©), subjects are categorized into mild, moderate, severe malnourished as -1SD, -2SD, -3SD respectively Outcomes. There is an elevation in mean free fraction of VPA is 17.3±6.4 μg/ml whereas in non-malnourished group it was found to be 8.7±4.2 μg/ml with P= <0.001. While mean total drug concentration in malnourished and non-malnourished was found to be 88.6±49.9 μg/ml, 70.8±33.9 μg/ml respectively. Mean CK, SGOT, SGPT in control is 29.3±9.9IU/L, 28.5±5.4 IU/L,24.5±4.2 IU/L respectively. whereas mean CK, SGOT, SGPT in malnourished subjects is 16.9±9.1 IU/L, 28.8±8.5 IU/L,25.9±9.1 IU/L Correspondingly .while Mean CK, SGOT, SGPT in non-malnourished individuals is 15.7±11.3 IU/L,32.4±8.8 IU/L, 28.7±7.8 IU/L respectively. No correlation was observed between elevated serum drug concentrations, clinical response and side effects. Conclusion. We observed that clinical response and side effects are serum concentration independent hence our research make unnecessary to monitor serum drug concentration for every individual and drug monitoring should be restricted to subjects with severe ADR’s. Our data also suggest Valproate unveiled mitochondrial myopathy is limited to subgroup of population.
ANTI AQUAPORIN 4 POSITIVE NEUROMYELITIS OPTICA SPECTRUM DISORDER AND PRIMARY SJÖGREN SYNDROME FOLLOWING SUCCESSFUL THERAPY FOR CHRONIC HEPATITIS C – REPORT OF A CLINICAL CASE
Authors:   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Predoiu Carmen , Dumitrescu Laura ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Danau Adela ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Cozma Liviu ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Orban Irina ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Lefter Antonia ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Nicolau Adriana ,   Internal Medicine Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania, Tanasescu Radu ,   Second Neurology Department, CDPC, Colentina Clinical Hospital, Bucharest, Romania,   General Medical School, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: August 2021

Neuromyelitis optica spectrum disorders (NMOSD) are a heterogeneous group of potentially disabling central nervous system inflammatory disorders. Association with other organ-specific or multisystem autoimmune disorders is commonly encountered. We report the case of a Caucasian woman with AQP4-IgG positive NMOSD and primary Sjögren syndrome - previously reported as a poster at the 14th Congress of the Romanian Society of Neurology (abstract published in ROJN, Vol. XV, Suppl). The clinical onset followed the successful treatment of chronic hepatitis C with interferon alpha and ribavirin. To the best of our knowledge, similar clinical presentations have not been described. The etiopathogenic treatment included high dose methylprednisolone, immune suppression with cyclophosphamide, and periodic plasma exchanges. In spite of an active disease with very high baseline AQP4-IgG titres, during the four years of treatment the patient has had only one relapse and has no residual disability.
A MODERATELY HIGH PROTEIN DIET IS AS EFFECTIVE DURING NEOADJUVANT CHEMOTHERAPY AS IT IS 2 YEARS AFTER BREAST CANCER SURGERY – A PILOT TRIAL
Authors:   Oncology Nutrition, “Carol Davila” Medicine University, Bucharest, Romania, Artene Diana Viorela , Bordea Cristian Ioan ,   Department II of Surgical Oncology, “Alexandru Trestioreanu” Institute of Oncology, Bucharest, Romania, Blidaru Alexandru ,   Department of Surgery, “Carol Davila” Medicine University, Head of Surgical Oncology Department at  “Alexandru Trestioreanu” Institute of Oncology, Bucharest, Romania
Published: August 2021

Introduction. Statistically, patients who achieve and maintain their optimal weight during breast cancer treatment have the best prognostic. Breast cancer associated weight gain starts during neoadjuvant chemotherapy when many patients either eat too little because of the decreased appetite or eat too much to emotionally cope with the treatment. Materials and method. To test if we can prevent weight gain during neoadjuvant chemotherapy we assigned 46 patients during neoadjuvant chemotherapy (CH) and of 50 patients 2 years after surgery (S) to follow a moderately high protein diet – based on eating only when hungry foods naturally high in protein, high quality fatty acids and carbohydrates, calcium, pre- and probiotics. We used no dietary supplements. We measured weight (W), subcutaneous fat (%SF) and visceral fat percentages (% VF) with a multi-frequency BIA scale at the beginning of the study and after 12 weeks of intervention (time needed to administrate 4 chemotherapy sessions). To validate BIA measurements, we also measured waist and hips circumferences. Results. Although S patients obtained better results on all measured parameters, CH patients also improved their body composition despite chemotherapy administration during the trial: 1.611±2.89%kg (p=0.005), 1.79±3.32% subcutaneous fat (p=0.006), 0.4±0,81% visceral fat (p=0.012) and had a 0.29±0.4 in the waist to hips ratio (p=0.001). Conclusion. A moderately lower carb diet is as effective for preventing sarcopenic obesity during chemotherapy as it is 2 years after surgery thus sarcopenic obesity prevention can begin from as early as diagnosis.
GRAVIS MYASTHENIA – ACUTE ERYTHROBLASTIC LEUKEMIA CORRELATION
Authors:   Compartimentul de Neurologie, Secţia Medicală 2, Spitalul Clinic CF1 Witting, Bucureşti, Soare Angela Mirela , Popescu Cezar Mihai ,   Secţia Medicală 2, Spitalul Clinic CF1 Witting, Bucureşti
Published: August 2021

Myasthenia Gravis is a chronic autoimmune neuromuscular disorder that is characterized by fluctuating weakness of the voluntary muscle groups. It occurs in all races, at any age (especially under 40 or over 60), both genders, with a prevalence of 20/100,000 population in the United States. About 15 percent of patients with myasthenia gravis have thymomas, much rarely another solid tumor, thyroid dysfunction and more often another autoimmune condition, such as rheumatoid arthritis, lupus, Biermer anaemia. We present a 72 year-old male patient with ocular myasthenia gravis treated with cholinesterase inhibitors, that, after many laboratory exams, was diagnosed with acute erythroblastic leukemia, a very rare clinical association.
NONMUSCLE INVASIVE TRANSITIONAL CELL CARCINOMA OF URINARY BLADDER – ADJUVANT INTRAVESICAL THERAPIES AFTER TRANSURETHRAL TUMOR RESECTION
Authors:   Faculty of Medicine, Lucian Blaga University, Sibiu, Grigore Nicolae , Pirvut Valentin ,   Faculty of Medicine, Lucian Blaga University, Sibiu, Mihai Ionela ,   Faculty of Medicine, Lucian Blaga University, Sibiu, Hasegan Adrian ,   Faculty of Medicine, Lucian Blaga University, Sibiu
Published: August 2021

Introduction. More than 70% of all bladder cancers are nonmuscle invasive involving only the mucosa and the submucosa. A large percentage of patients present local recurrence after endoscopic surgery, and many of them progress to muscle invasive disease necessitating radical cystectomy. The high recurrence and progression rate is the reason to use intravesical therapy to prevent recurrences. The aim of this study is to compare the efficacity and safety of intravesical immunotherapy with Bacillus Calmette Guerin (BCG) vs. chemotherapy (Pharmoribicin) after TUR-B for NMIBC. Material and methods. Following TURB and pathological analysis, NMIBC was stratified into low, intermediate and high-risk groups depending on the probability of recurrence and progression to muscle-invasive disease. Patients were treated with adjuvant intravesical therapies, BCG or Pharmorubicin. Results. Between 2008 and 2012, a total of 125 patients with NMIBC were diagnosed in the Urology Department Sibiu. Histopathological data show: pT1 G1 – 48 patients (38.4%), pT1 G2 – 69 patients (55.2%), pT1G3 and or Tis – 8 patients (6.4%). Adjuvant intravesical therapies with Pharmorubicin was administered to 83 patients (66.4%) and with BCG 42 patients (33.6%). Pharmorubicin, the recurrence rate was 22.8% in the first year and at 5 years there was a recurrence of 36.1%. For the group of patients treated with BCG recurrent rate was 14.2% in the first year and 33,3% at 5 years. For the whole group of patients tumor progression was 2.4% in the first year and 9.6% at 5 years. For the Pharmorubicin group, in the first year, the progression was 2.4% compared with 2.3% tumor progression in the BCG-treated group. Conclusions. Intravesical instillation treatment after TURB reduce the recurrence rate and tumor progression. In our series there are no major differences between efficacity of intravesical immunotherapy (BCG) vs. chemotherapy (Pharmoribicin). Disease-free survival and progression-free survival are comparable to the two studied lots.
THE PARTICULARITIES OF ABPM PARAMETERS IN HYPERTENSIVE PATIENTS WITH NON-DIALYSIS CKD
Authors:   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Minca Alexandru ,   Nephrology Department, University Emergency Hospital, Bucharest, Comsa Mihai ,   “Nicolae C. Paulescu” National Institute for Diabetes, Nutrition and Metabolic Disease, Bucharest, Manea Maria Mirabela ,   Neurologic Clinic, National Institute of Neurology and Cerebrovascular Diseases, Bucharest, Tanasescu Maria Daniela ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   Nephrology Department, University Emergency Hospital, Bucharest, Dragos Dorin ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   Nephrology Department, University Emergency Hospital, Bucharest, Penescu Mircea Nicolae ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   2nd Nephrology Department, “Dr. Carol Davila” Clinical Hospital of Nephrology, Bucharest, Ionescu Dorin ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   Nephrology Department, University Emergency Hospital, Bucharest
Published: August 2021

Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.
REHABILITATION OF THE BIOPSYCHOSOCIAL CONCEPT OF EUSTRESS
Authors:   Carol Davila University of Medicine and Pharmacy, Bucharest, Iamandescu Ioan-Bradu
Published: August 2021

Eustress concept was less used by researches at the end of XX century and really has disappeared from glossaries of books of Psychosomatics, Health Psychology and Behavioral Medicine. Fortunately, some authors have renewed last years this concept adding other nuances and original peculiarities beneficial for physical and mental health. This paper exemplifies, among these contributions, the strong relation of eustress with immunogenic traits (as self efficiency) and Flow concept, and some humoral markers of eustress (serotonin, oxytocin, endorphins, interferon gamma etc.). Own author’s opinion suggests a strong link between eustress and psychological well being, and underlines the role of eustress as a main component of the new Fava‘s psychotherapy, Well Being Therapy.
MALIGNANT HEMATOLOGIC FINDINGS BEYOND TYPICAL ENDOCRINE CONDITIONS
Authors:   Carol Davila University of Medicine and Pharmacy, Bucharest, Ghemigian Adina ,   “C.I. Parhon” National Institute of Endocrinology, Bucharest, Valea Ana ,   “Iuliu Hatieganu” University of Medicine and Pharmacy,   Clinical County Hospital, Cluj-Napoca, Dumitru Nicoleta ,   “C.I. Parhon” National Institute of Endocrinology, Bucharest, Carsote Mara ,   Carol Davila University of Medicine and Pharmacy, Bucharest,   “C.I. Parhon” National Institute of Endocrinology, Bucharest, Petrova Eugenia ,   Carol Davila University of Medicine and Pharmacy, Bucharest,   “C.I. Parhon” National Institute of Endocrinology, Bucharest, Cocolos Andra ,   “C.I. Parhon” National Institute of Endocrinology, Bucharest
Published: August 2021

Endocrine morbidities are a vast panel of conditions; the most frequent diseases in daily endocrine practice are typically thyroid nodules or primary osteoporosis. We aim to introduce two cases who underlined a hematologic malignancy in association with apparently low risk endocrine conditions involving thyroid, respective osteoporosis field. A 24-year female is admitted for anterior cervical lumps which she self-detected one month ago. Normal thyroid blood assays are associated with neck ultrasound anomalies as: 2 thyroid nodules of 0.5/0.3 cm, respective of 0.5/0.2 cm; 5 left cervical lumps (largest at supraclavicle level of 1.5/ 0.7/1.5 cm); 4 right lateral cervical lymph nodes; multiple similar lesions were also revealed at others neck areas – largest at submandible level of 1.3/0.9/1.2 cm (right), respective 1.1/0.9/2.4 cm (left). Evaluation at oto-rhino-laringology, infectious disease was unrevealing; diagnosis of stage IIA Hodgkin lymphoma was established starting from ganglion biopsy. This is 78-year female, admitted for evaluation of bone loss under densumab for the latest year after a decade history of bisphosphonates. Secondary causes of osteoporosis or hypovitaminosis D were ruled out; computed tomography detected a small adrenal incidentaloma, whole body bone scintigrame did not reveal metastasis while flow cytometry of peripheral lymphocytes identified B monoclonal lymphocytosis/chronic lymphatic leukaemia with B cell starting from a mild elevation of white blood cells in routine hemogram. Behind classical endocrine conditions as goitre or osteoporosis, severe diagnosis might be found in situations as associated cervical nodes involvement, respective non-response to specific anti-osteoporotic therapy if active case finding strategies in a multidisciplinary manner are performed.
Covid-19 Pandemisinde Pilates Egzersizi Sırasında Cerrahi Yüz Maskesi Takmanın Etkilerinin BORG Skalası Özelinde Değerlendirilmesi
Authors: AKGÜL Melike Nur , BALTACI Seyma , YILDIZ Kerem Can , ÖZCAN Neslihan , AKGÜL Mustafa Şakir
Published: August 2021

Covid-19 pandemisi nedeniyle bireysel ve sosyal sağlığı korumak için cerrahi yüz maskelerinin kullanılması otoriteler tarafından önerilmektedir. Bununla birlikte farklı egzersiz türlerinde maske kullanımının kişileri nasıl etkilediğini gösteren çalışma sayısı oldukça azdır. Bu bağlamda bu çalışmanın amacı pilates egzersizi yapan kadınlarda maskeli ve maskesiz yapılan egzersizlerin algılanan zorluk derecesi (AZD) özelinde değerlendirilmesidir. Çalışmaya düzenli olarak pilates egzersizleri yapan 30 kadın (yaş 26.1±0,98 yıl, boy 166.6±1.37cm, vücut ağırlığı 57.3±1.29kg) gönüllü olarak katılmıştır. Çapraz gruplu çalışma metodu uygulanmıştır. Tüm katılımcılar 2 gün ara ile cerrahi maskeli ve maskesiz olmak üzere aynı şiddette 45 dakikalık pilates egzersizleri yapmışlardır. Maskeli ve maskesiz egzersizin sırasında katılımcıların AZD skorları her 5 dakikada kaydedilmiştir. Sayısal değişkenlerin normal dağılıp dağılmadığını belirlemek için Shapiro-Wilk testi ve gruplar arasında fark olup olmadığını belirlemek için Paired Sample T-Test kullanılmıştır. Yapılan değerlendirmede, cerrahi maskeli ve maskesiz yapılan pilates egzersizleri esnasında 5. ve 10. dakikalarda AZD skoru üzerinde anlamlı bir fark tespit edilemezken, 10. dakikadan 45. dakikaya kadar her 5 dakikada anlamlı fark tespit edilmiştir. BORG skalası özelinde değerlendirildiğinde maskeli yapılan pilates egzersizlerinin maskesiz yapılana göre daha fazla egzersiz şiddeti oluşturduğu söylenebilir
Voleybol Antrenörlerinin Mesleki Öz Yeterlik Düzeylerinin Bazı Demografik Özelliklere Göre İncelenmesi
Authors: DUMANGÖZ Pero Duygu , SANLAV Ramazan
Published: August 2021

Bu araştırmanın amacı voleybol antrenörlerinin mesleki öz yeterlik düzeylerinin bazı demografik özelliklere göre farklılaşıp farklılaşmadığını belirlemektir. Araştırma konusu, nicel araştırma yöntemlerinden, betimleyici araştırma deseninde incelenmiştir. Araştırma kapsamında ulaşılabilen 120 voleybol antrenörünün (34 kadın (%28,3) ve 86 erkek (%71,7) mesleki öz yeterlik düzeylerinin belirlenmesi amacıyla Koçak ve Güven (2018) tarafından geliştirilen Voleybol Antrenörü Mesleki Öz Yeterlik Ölçeği (VAMYÖ) kullanılmıştır. Ayrıca demografik özelliklerin belirlenmesine yönelik araştırmacılar tarafından oluşturulan kişisel bilgi formu kullanılmıştır. Uygulamaya geçilmeden önce VAMYÖ’ nün kullanımına ilişkin izin, ilgili bilim insanlarından yazılı olarak alınmıştır. Araştırmaya başlamadan önce etik kurul raporu alınmıştır. Ölçekler, elektronik ortamda hazırlanarak, sosyal medya ve/veya e-mail iletişim kanalları vasıtasıyla ulaşılabilen voleybol antrenörlerine iletilmiştir. Verilerin analizi için SPSS 20.0 paket programı kullanılmıştır. Çalışmada yer alan kategorik veriler frekans ve yüzde ile sürekli veriler ortalama ve standart sapma ile ifade edildi. Veriler normal dağılım açısından Kolmogorov-Smirnov ve dağılım grafikleri ile incelendi. Sürekli verilerin iki grup arasında karşılaştırılmasında Mann-Whitney U testi, ikiden fazla grubun karşılaştırılmasında Kruskal-Wallis testi kullanıldı. Post-hoc analizler Bonferroni düzeltmesi kullanılarak Mann-Whitney U testi ile yapıldı. Hata payı 0,05 plarak kabul edilmiştir. Sonuç olarak, voleybol antrenörlerinin mesleki öz yeterlik ölçeği toplam puanlarında antrenörlük kademesine göre anlamlı bir fark ortaya çıktığı; cinsiyet, yaş, eğitim düzeyi, antrenör belgesi edinme yolu, antrenörlük deneyimi ve mesleki durumu değişkenlerine göre ise anlamlı bir fark olmadığı görülmüştür. Antrenörlerin öz yeterlik algılarının incelenmesi, onların daha fazla yeterliğe sahip olmalarına inanmalarını ve dolayısıyla daha fazla mesleki eğitime ihtiyaçları olabileceğini anlamalarına izin verir. Ayrıca bu konuda yapılan çalışmalar hem başarılı sporcular yetiştirmek hem de antrenör eğitim programları geliştirmek için faydalı bilgiler sağlar.
Predicting Spectral Parameters in the Backscattering-dominated Model for the Prompt Phase of GRBs
Authors: Vyas Mukesh K. , Pe’er Asaf , Eichler David
Published: August 2021

We present new results of the backscattering-dominated prompt emission model in which the photons generated through pair annihilation at the center of a gamma-ray burst (GRB) are backscattered through Compton scattering by an outflowing stellar cork. Using a Comptonized pair annihilation spectrum accompanied by bremsstrahlung radiation for seed photons, we show that the obtained spectra produce a low-energy photon index in the range α ∼ −1.95 to −1.1, steeper high-energy slopes β ∼ −3.5 to −2.4, and spectral peak energies approximately a few KeV to a few tens of MeV. These findings are consistent with the values covered in GRB prompt phase observations.