bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of elastic tubing versus tyre resistance training as an adjunct to the standard manipulative training program at Durban University of Technology in the development of control of the dynamics of manipulation in chiropractic students
Authors:   , Mey Tarryn Ruby
Published: February 2022

Background: Motor learning theories indicate that training improves motor performance by reducing variability and increasing task control. Elastic tubing and tyre resistance training methods may allow for the development of control over the dynamics of spinal manipulation. This study thus aimed to determine whether training with elastic tubing and tyre resistance, in conjunction with the standard manipulative training at the Durban University of Technology, resulted in the development of control of the dynamics of manipulation compared to training with the standard training alone. Methods: A quantitative, prospective, experimental cohort design was used. Fifty-three participants were randomly allocated into tyre or elastic tubing resistance training intervention groups, or the control group. All groups continued with the standard manipulative training at the Durban University of Technology. The dynamics of manipulation were measured with the Dynadjust pre-, mid- and post-training. The SPSS was utilised to compute the parametric and non-parametric analyses. Results: The results showed no statistically significant differences over time for any of the measured dynamics of manipulation. None of the groups (excluding the control group for S-I manipulation) developed control of the relationships between the dynamics. Overall, there was no difference between the groups with regards to development of control of the dynamics. Conclusion: The results suggest that the additional training methods, should be carefully considered when employed over a short term. Study limitations include the sample size and the effect of outliers, therefore any firm conclusions drawn from this study are required to be interpreted with caution.
Application of the document analysis method in the social sciences
Authors: Danilovic Nedjo
Published: February 2022

The subject of the article is the operational method for data collection –the method of document analysis, its techniques and instruments, above all, the code of terms and codes and the record form without which there is no application of this method in scientific research.The aim of this article is to present the results of many years of research by the author on the method of document content analysis with a focus on the problems of defining, origin, development and types of document content analysis methods, instruments of this method, their role and functions in scientificresearch and the relationship of the instruments of this method to other parts of the scientific idea of the research project.Hypothesis: The method of document content analysis is an operational scientific method for data collection because it meets theessential and sufficient conditions related to the subject of knowledge –the content side of science, the way of knowledge –the methodological side of science and the truthfulness of knowledge –the essential side of science.Conclusions: The research results in this paper have fully confirmed the initial hypothetical assumption that the method of document content analysis meets the essential and sufficient conditions related to the subject, manner and truthfulness of knowledge obtained by consistent application of this method in scientific research. This confirms the knowledge about the unacceptable, artificial division of this operational scientific method for data collection into qualitative –non –frequency and quantitative –frequency analysis technique. The research has shown that these two techniques of document content analysis methods form a dialectical unity, that there is no strict division between them and that they are essentially two aspects, ie two approaches to document analysis that complement and combine each other in research. In scientific research, quantitative analysis is an extended form of qualitative analysis, because quantity appears as an expression and as an statement of a certain quality. Keywords: document analysis method, qualitative analysis, quantitative analysis, code of terms, code of codes, record form.
The effect of centella asiatica extract in Zebrafish (Danio rerio) larvae as a Chronic Constant Hypoxia (CCH) model
Authors: Ariani  , Teni Widiyastuti
Published: February 2022

Backgound: Chronic Constan Hypoxia (CCH) are able to occur in cyanotic congenital heart disease and bronchopulmonary dysplasia (BPD). Centella asiatica has antioxidant and neuroprotective effects in experimental animals.This study aims to observe the effect of Centella asiatica ethanol extract on Zebrafish in chronic hypoxic conditions

Method: A laboratory experimental study with a randomized post-test controlled group design was conducted among 20 Zebrafish (Danio rerio) 3-8 day post fertilization (dpf) as samples per tube. The total group treatment was five with inclusion and exclusion criterias. Variables assessed in this study included Average body length, locomotor activity, and the relationship between average body length and locomotor activity. Data were analyzed using SPSS version 18 for Windows.

Result: There was a moderate significant correlation between Centella asiatica concentration of 1.25 µg/ml, 2.5 µg/ml, 5 µg/ml with an enhancement of body length (r=0.431) and locomotor activity (r=0.262) in zebrafish larvae CCH model (p<0.05).

Conclusion: It can be concluded that chronic constan hypoxia (CCH) inhibit the growth of body length and decrease locomotor activity in Zebrafish larvae. Centella asiatica treatment can avoid the CCH by using various concentration.
Cytogenetic and clinical features of down syndrome in malang, east java, indonesia
Authors: Ariani
Published: February 2022

Introduction: Down syndrome (DS) is the most common chromosomal disorder. DS characterized by multiple congenital anomaly caused by trisomy 21This study was designed to evaluate the karyotype pattern, clinical features and risk factors of patients with Down syndrome.

Method: Data were obtained from a retrospective analysis of a questionnaire from Down syndrome patients.

Result: A total of 34 patients were studied, with 67,6% of males. Out of 34 patients, there were 25 children (73,5%) with no cytogenetic test, 4 children (11,7%) with lost cytogenetic test, 3 children (8,82%) with free trisomy (non-disjunction), 1 (2,9%) with translocation, and 1 (2,9%) with mosaics. Maternal age categories showed one mother less than 20 years, two mothers between 21-25 years, four mothers were between 25 and 30 years, 12 mothers were between 31 and 35 years, ten mothers were between 31 and 40 years, and five mothers were over 41 years of age. The most common clinical features in this study are Congenital Heart Disease (CHD), which was recognized in 9 (26,4%) patients with five patients had Atrial Septal Defect (ASD), two patients had ASD and Ventricular Septal Defect (VSD), two patients had Patent Ductus Arteriosus (PDA). All of them followed by dental problems in 8 (23,5%) patients, ophthalmology problems in 6 (17,6%) patients, digestive problems in 4 (11,7%) patients, seizure in 1 (2,9%) patient, hormonal problems in 1 (2,9%) patient, and hearing problem in 1 (2,9%) patient. There is no significant difference in CHD prevalence between each maternal age group (p = 0776, p>0.05).

Conclusion: Down syndrome has a higher prevalence in males and is frequently seen among mothers between 31 -35 years of age, yet maternal age did not seem to influence CHD prevalence significantly. Early diagnosis and proper screening should be undertaken among these patients.
Effect Of Vitamin D3 On Transforming Growth Factor - Β1 In Pediatric Patients With Stage 1 To 3 Chronic Kidney Disease: An Experimental Study And Randomized Controlled Trials
Authors: Krisni Subandiyah  , Richi Aditya
Published: February 2022

Introduction: In Indonesia, Chronic Kidney Disease (CKD) is a severe health problem both in terms of treatment and health costs. One way to reduce mortality is by blocking the progression of the disease. Transforming Growth Factor-β1 (TGF-β1) is a marker of progression from CKD through its fibrosis pathway. One mechanism for interfering with the TGF-β1 signaling pathway is by giving vitamin D3(cholecalciferol). This study aims to find out that supplementation of vitamin D3 can increase plasma 25(OH)D levels and reduce TGF-β1 levels in children with CKD. 

Methods: The study was approved by the hospital's ethical committee, designed as a randomized clinical trial, double-blind, pre and post-test control group, which involved 30 subjects diagnosed as CKD stage 1-3. Subjects were divided into two groups; the vitamin D3-treated group and the placebo group. TGF-β1 and vitamin D plasma level was measured by ELISA method. 

Results:  Vitamin D levels increased by 9.35 compared to the placebo group. The magnitude of the increase from the Wilcoxon statistical test results obtained p=0.001 (p<0.05), so there was a significant increase in vitamin D levels after supplementing vitamin D3. In the group given vitamin D3 supplementation, it was found that TGF-β1 levels had decreased by 108.64. The reduction from the Wilcoxon statistical test results obtained p=0.001 (p<0.05), so there was a significant decrease after vitamin D3 supplementation. Based on the Spearman correlation test, there is a meaningful relationship between increased vitamin D levels with a reduction of TGF-β1 levels. The correlation coefficient is -0.753, which is harmful. The correlation coefficient is in a substantial range.

Conclusion: We concluded that vitamin D3 could increase 25(OH)D plasma level and decrease TGF-β1 levels significantly in children with stage 1 until 3 of CKD.
Correlation of Regulatory T Cells Percentage and Lung Tuberculosis in Children
Authors: Melinda  , Ery Olivianto  , HMS Chandra Kusuma
Published: February 2022

Introduction: The prevalence of TB in Indonesia reaches 1.59 new cases per 1000 population and 27.3% are pediatric patients. Currently in Indonesia, the incidence of TB in children is still high, even though the Bacille Calmette Guerin (BCG) vaccination has been a mandatory immunization program since 1977. The role of T-Regulatory Cell (Treg) in the Mtb infection is very complicated.

Method: This observational study using cross sectional analyzed quantity of Treg Cells in the circulation of pediatric TB and non-TB patients. Measurement of circulatory Treg cell percentage was performed using Flow Cytometry.

Result: We found that pediatric TB patients have significantly higher that were almost two-fold higher Treg cell percentage compared to non-TB patients (3.51% vs. 1.86%; p < 0.001). It is concluded that there is an increase in the percentage of Treg cells in children with pulmonary TB compared to children who didn’t had TB infection.

Conclusion:This finding provides an understanding of the complex mechanism of Treg cells in children with pulmonary tuberculosis, so that it can become the basis for the development of management of pediatric pulmonary TB and reduce morbidity and mortality of children due to pulmonary TB.
Factors affecting stunted growth in children aged 6-24 months in Bawean Island, Indonesia
Authors: Arini Haq  , Luthfiana Eka Sari  , Pitra Sekarhandini  , Brigitta Ida Resita Vebrianti Corebima
Published: February 2022

Background: Stunted is defined as a condition where body length and height are less than -2 SD of the WHO height-for-age z score. The number of stunted children worldwide reaches 129 million or 23.8% of the population. This study aims to scrutinize the factors affecting stunted growth in children aged 6-24 months old in Sangkapura district, Bawean.

Methods: This cross-sectional quantitative study in Bawean island, involving children aged 6-24 months old who came to posyandu for height measurement. The purposive sampling technique was used in the study, in which the samples filled a questionnaire consisting of several questions. The data analyses presented are univariate analysis, Chi-Square, and Binary Regression Analysis.  

Results: The analysis results showed that the factors affecting stunted growth in toddlers are birth weight (<2500 grams), gestational age (<37 weeks), exclusive breastfeeding, and weaning foods. If the baby’s birth weight is less than 2500 grams, is born before week 37 of pregnancy, does not get exclusive breastfeeding, and is given homemade weaning foods, the possibility of the baby being stunted is 91.5%.

Conclusion: Several factors affect stunted growth in children aged 6-24 months old in Bawean island. Children who experience all of the factors mentioned above have a 91.5% possibility of being stunted. Among the other factors, babies not exclusively breastfed are 190,019 times more likely to be stunted.
Screening for congenital hypothyroidism in Malang, East Java in 2020
Authors: Irfan Agus Salim  , Berlian Ristina Putri  , Tiara Afia Rosmalawati  , Haryudi Aji Cahyono  , Fadhilah Muttaqin
Published: February 2022

Introduction: Congenital hypothyroidism is defined as a state of thyroid hormone deficiency present at birth. Congenital hypothyroidism must be diagnosed immediately because delay in therapy may cause irreversible neurological deficits, such as mental retardation in children. However, this condition can be prevented by screening in newborns so that congenital hypothyroidism can be diagnosed and treated early, and can result in better neurological development. This study aims to determine the congenital hypothyroidism ratio in Malang from March to November 2020.

Methods: The descriptive analysis method was used in this research. The subjects were neonates aged 0 – 28 days with a gestational age of 36 weeks and were involving the Health Office in both the Regency and the City of Malang. The data about identity, gender, age at screening, and gestational age were collected. A laboratory screening test was performed by taking a blood sample from the heel or vein for a TSH test. If the result was positive with a TSH value > 20 U/mL, the subject would be recalled for having a confirmation test and referred to a pediatric endocrinologist.

Results: There were 2024 (88.34%) subjects were successfully screened from a total of 2291 subjects. The recall rate for congenital hypothyroidism was 1:2024 (0.04%).

Conclusion: The ratio of congenital hypothyroidism cases in Malang from March to November 2020 was higher than the global ratio, which was 1:3000. The high rate of congenital hypothyroidism in Malang indicated the need for congenital hypothyroidism screening in newborns.
Case distribution and survival rate in Pediatric Intensive Care Unit (PICU) at Banjarmasin, Indonesia
Authors: Choirul Anam  , Niarsari Anugrahing Putri  , Rahmad Ramadhani  , Yasmin Musfirah
Published: February 2022

Introduction: Epidemiological studies about case distribution and survival in PICU is important to do. Knowledge of these epidemiological studies can assist in decision-making to improve patient quality of care. So far there is no data about the case distribution and survival rate of the patients in the PICU in Banjarmasin, Indonesia. This study aims to provide an overview of case distribution and survival rates of patients treated at the PICU of Ulin Hospital Banjarmasin.

Methods: A retrospective study was conducted at the PICU of Ulin Hospital Banjarmasin. Data was taken from patients’ records from January 2017 to December 2018.

Results: A total of 202 patients were admitted to the PICU, males 109 and females 93. The mortality rate was 17% with a survival rate, 83% with a mean length of stay of 10 days. The most common patient diagnosis was pneumonia 23%, meningoencephalitis 10%, and dengue shock syndrome 6%. The system commonly involved was respiratory system 26%, central nervous system 17%, and infection 13%. The median length of stay for overall admission was 9 days with a mean of 10 days. The cardiovascular and respiratory systems tend to have lower survival rates, 78%, and 79% respectively.

Conclusions: This study shows that respiratory, neurological, and infectious diseases are the most common diseases that cause children to be admitted to the PICU. The mortality rate in this study was 17% with a mean length of stay of 10 days. It is necessary to focus on medical facilities and interventions to reduce respiratory-related mortality.
Toxoplasmosis among Pregnant Women in Africa: A Systematic Review and Meta-Analysis
Authors: Sharif A. Abdullahi , Hassan Yahaya , Ja'afaru S. Mohammed
Published: February 2022

Toxoplasmosis in pregnancy may have serious consequences on the pregnancy outcome. Vertical transmission to the fetus may range from obstetrics complications such as abortion, intrauterine growth restriction, stillbirth to congenital malformations. This review aimed to assess the seroprevalence rate of toxoplasmosis in pregnant women in Africa so that a proper management policy can be initiated. Four databases that include Google Scholar, ScienceDirect, Scopus, and PubMed were searched for primary studies reported on the prevalence of toxoplasmosis among pregnant women in African countries. From the search, total of 39 studies were included for the study from 1980 to 2018. Total of 11986 pregnant women were the study participants in the included studies. By using the DerSimonian-Liard random effects method, the pooled prevalence of toxoplasmosis was estimated as 47% (95%CI=38.4% to55.4%). Publication bias was assessed using Egger's test, 2.88 (95%CI= -8.8% to 14.5%) and it did not indicate any significant (P = 0.619) influence of the studies on the pool estimate. Again, the pooled estimates of toxoplasmosis among pregnant women in first, second and third trimesters were 29% (95% CI= 17.0% to 42.0%), 35.0% (95%CI= 27% - 43%) and 30.9% (95%CI= 22% - 41%), respectively. Pooled prevalence for risk factors such as 'contacts with cat', cat ownership and consumption of raw or poorly cooked meat were estimated at 50% (95% CI= 35% to 66%), 26.2% (95% CI=17.9% to 35.5%) and 43.3% (95% CI = 30% to 50%) respectively. This study estimates the overall prevalence of toxoplasmosis in pregnancy and some possible risk factors through which majority of pregnant women can be infected. Proper screening against this infection should be instituted in full capacity to curb the endemicity and consequences of the infection on the fetus.
PENERAPAN INKUIRI DALAM MENINGKATKAN KETERAMPILAN DAN PENGETAHUAN SISWA SMPN 18 MALANG
Authors: KHOIRIYAH ANNA JARROTUL
Published: February 2022

The purpose of this research is to improve the knowledge and skills of students in science learning with the inquiry learning model. This paper uses the best practice method. Skill's data is obtained from the average practicum activities score and knowledge is obtained from the average of learning outcomes. The findings in this research are when the students try to design and find their own concepts learned through the inquiry stage, the students become more skilled and more understanding. Another important part of this research is teachers must have the skills to open lessons, design lessons and facilitate students in learning. An important skill to open learning is to provide a stimulus in the form of pictures, videos, phenomena, and questions that can motivate and raise students' thinking levels. The results showed there is an improvement of skills by 32% for scores, 108% for completeness and knowledge of 13% for scores and 52% for completeness.

ABSTRAKTujuan dari best practice ini adalah untuk meningkatkan keterampilan dan pengetahuan siswa pada pembelajaran IPA dengan model pembelajran inkuiri. Tulisan ini menggunakan metode best practice. Data keterampilan diproleh dari rata-rata skor kegiatan praktikum dan pengetahuan diperoleh dari rata-rata hasil belajar. Temuan pada best practice ini adalah ketika siswa mendesain percobaan sendiri, melakukan praktik dari hasil desain, menemukan sendiri konsep yang dipelajari melalui tahapan inkuiri, siswa menjadi lebih terampil dan lebih paham. Bagian penting lain dari penelitian ini adalah pentingnya guru memiliki keterampilan membuka pembelajaran, mendesain pembelajaran, dan memfasilitasi siswa belajar. Keterampilan membuka pembelajaran yang penting adalah dengan memberikan stimulus yang berupa gambar, video, fenomena, dan pertanyaan-pertanyaan yang dapat memotivasi dan membangkitkan tingkat berpikir siswa. Hasil best practice menunjukkan, terdapat peningkatan keterampilan sebesar 32% untuk skor, 108% untuk ketuntasan dan pengetahuan sebesar13% untuk skor, 52% untuk ketuntasan.
AVANÇOS DA SUPLEMENTAÇÃO NUTRICIONAL DE BOVINOS
Authors: Simões Michele da Rosa Scholant
Published: February 2022

Para obter ganhos satisfatórios a bovinocultura demanda uma eficiência nutricional para atingir seus objetivos de produção. A capacidade de encontrar alimentos que forneça os requerimentos nutricionais necessários e com baixo custo são fatores determinantes. Nesse contexto, a proposta deste trabalho foi fazer um estudo dos avanços da suplementação nutricional de bovinos. Os objetivos deste trabalho foram fazer um estudo do histórico da suplementação nutricional de bovinos no Brasil nas últimas décadas e avaliar as mudanças que ocorreram no tipo de suplemento utilizado, desde o uso do sal comum (cloreto de sódio), passando pela mineralização com macro e microminerais, evoluindo para o sistema sal mineral/ureia, família de suplementos múltiplos (sal nitrogenado, sal proteinado, suplementos proteico-energéticos, semiconfinamento) e confinamentos.  Foi feito levantamento sobre como foram desenvolvidas as pesquisas para geração, difusão e adoção dessas novas tecnologias, enfatizando quais as instituições que mais trabalharam nesse sentido.
A EDUCAÇÃO AMBIENTAL COMO CAMINHO PARA O DESENVOLVIMENTO SUSTENTÁVEL
Authors: Nunes Nei Antonio  , Banhal Alberto Essondon 
Published: February 2022

O trabalho objetiva revisar e refletir sobre a Educação Ambiental (EA) como caminho para desenvolvimento Sustentável, no campo da educação. Este último, mais especificamente, no ensino. Para tanto, parte da historiedade e da logicidade do assunto, em sua transitoriedade, constituindo-se em um artigo de revisão. Em decorrência, este estudo foi realizado por meio de uma abordagem exploratória, com método qualitativo, de raciocínio indutivo, tomando como base revisão bibliográfica e documental para a apropriação conceitual. Sua relevância se volta para a abordagem de dois assuntos inter, multi e transdisciplinares, que se revelam e se complementam em um entendimento social mais amplo. As reflexões aqui tratadas sob o contexto da Educação ambiental apontam para o desafio do respectivo campo. Este deve conceber e disseminar conhecimentos científicos oriundos e inerentes à Educação e desenvolvimento sustentável, que sejam capazes de operar com a transformação do paradigma social atual, no qual esta ciência se amalgama, para aquele que se espera no futuro: a educação ambiental contextualizada e articulada com o paradigma do desenvolvimento sustentável. Conclui que o desafio de se incorporar a educação para o desenvolvimento sustentável no ensino deve ser enfrentado por meio da Educação Ambiental. Educação Ambiental se constitui numa forma abrangente de educação, que se propõe atingir todos os cidadãos, através de um processo participativo permanente que procura incutir uma consciência crítica sobre a problemática ambiental.
Reflexões decoloniais sobre as relações étnico-raciais nas provas de espanhol do Enem (2010-2020)
Authors: Botelho Gabriela Rodrigues
Published: February 2022

O presente artigo tem como objetivo compreender como a afrodescendência no mundo hispânico é abordada, sob a óptica das relações étnico-raciais, nos itens de língua espanhola do Exame Nacional do Ensino Médio (Enem). Metodologicamente, esta pesquisa adota uma abordagem qualitativa (FLICK, 2009), descritivo-interpretativa (MOITA LOPES, 1994) e técnica documental (BARDIN, 1977; GIL, 2002). A análise fundamenta-se nos estudos decoloniais (MALDONADO-TORRES, 2007; PALERMO, 2012; QUIJANO, 2005; VERONELLI, 2015; WALSH, 2012); nos estudos sobre relações étnico-raciais (BRASIL, 2006; GOMES, 2018); e nas diretrizes do Enem (BRASIL, 2010; INEP, 2013). Os resultados indicaram que, dos 120 itens analisados, nove permitem a discussão sobre as relações étnico-raciais, dos quais apenas dois itens colocam em discussão a racialização. Os demais itens tratam a racialização e a afrodescendência de forma estereotipada ou ignoram o tema em suas problematizações.
Legal framework for pupils’ research activity in school education: European Commission, Republic of Moldova and Germany (Saxony)
Authors:   Leipzig University, Germania, de Groote Carola , Morari Natalia ,   Institute of Educational Sciences, Republic of Moldova
Published: February 2022

To find the answers to questions nobody knows about yet, we need competences in our young generation that enable them to overcome future global problems. Research competences are considered to be a key to solving many unexpected problems. It is very important that authorities provide educational institutions with a legal framework that enables them to develop research competences in the young generation. Schools’ activities can provide a good start to develop these competences by offering the students different chances to learn all the necessary skills and abilities. The article presents the legal framework that offers the possibility to carry out pupils’ research activities in school education from the perspective of the European Commission, the Republic of Moldova and Germany (Saxony).
Promoting the linguistic identity in eminescu’s journalism: an exhibition in the context of linguistic and literary education of students
Authors:   Institute of Educational Sciences, Republic of Moldova, Dănăilă-Moisă Mihaela
Published: February 2022

It is known that Romanian writers proved to be keepers of linguistic unity, regardless of whether they were writers of literary works or publicists, and Mihai Eminescu was noted as a vehement defender of the Romanian linguistic unity which he promoted in articles dealing with language issues. Its model of language development should be a worthy model to follow for the young generation, generation Z.
Analisis Formasi Pegawai Negeri Sipil Lingkup Pemerintah Daerah Kabupaten Buton Utara
Authors: Rahmansyah Mohammad , Jopang Jopang , Mulyana Yaya
Published: February 2022

AbstractIdeally in determining the formation of civil servants based on needs in terms of the type, nature and workload of each unit of government agency. The government's policy in determining the formation of civil servants is always based on budget considerations listed in the respective Regency/City APBD. This research was conducted to determine the analysis of formations in the Procurement of Civil Servants within the Scope of the Regional Government of North Buton Regency.This study uses a qualitative approach, with the focus of research on the formation of civil servants within the North Buton Regency Government. The informants in this study were 6 people consisting of 3 officials at the North Buton BKPSDM, 1 CPNS and 2 community leaders who were selected using purposive sampling technique. Data were collected by interview, observation and document study methods. The data collected was then analyzed descriptively, with the stages of data collection, data processing, data reduction and drawing conclusions. The data that has been analyzed is then triangulated to obtain an overview of the analysis of the formation of civil servants procurement in North Buton Regency.The results show that the formation analysis in the procurement of civil servants within the local government of North Buton Regency has not fully used the job map indicators, the number of employees who retire every year and the ratio of the population to civil servants. The three indicators are not analyzed in depth so that the formation of civil servants procurement is not in accordance with the real needs of existing positions in North Buton Regency. However, the North Buton Regency Government has provided a budget through the North Buton Regency APBD in the formation of civil servants procurement, but it has not been optimal..Keywords: Formation, Civil Servants (PNS), North Buton.
Integrative Literature Review on Analgesia Protocols for Postoperative Pain Control in Orthopaedic Surgery
Authors: Marques Ana , Oliveira Inês , Rodrigues Marilene
Published: February 2022

Introduction: Pain caused by orthopaedic surgery is one of the most intense. Opioid analgesics remain the mainstay of postoperative pain therapy, increasing hospital costs and length of stay, raising the level of dissatisfaction of patients about pain management. It is important to understand how pain is approached in this context and how it is managed by the multidisciplinary teams in orthopaedic operating rooms. Aims: The general aim was analyze the evidence available in the literature on the relevance of analgesia protocols for pain control in patients undergoing orthopedic surgery in the postoperative period. Methodology: The methodology used in this Integrative Literature Review (ILR) was based on the PI[C]OD method, allowing us to answer the following question: “In adults, in the postoperative period of orthopedic surgery, what is the relevance of analgesia protocols in pain control? Research was conducted from 10 to 22 May, using the EBSCOhost, MEDLINE, Academic Search Ultimate and CINHAL. Results: The research shows a mismatch in the pharmacological prescription to post-orthopaedic surgical patients, with consequences at various levels, which may be due to the lack of implementation of adequate protocols and the lack of training of professionals in the multidisciplinary team. Conclusion: Investment in this area is crucial, to understand the relevance of the implementation of pain management protocols in postoperative orthopaedics, as well as the importance of training and empowering nurses, allowing for the optimization of healthcare, the improvement of the patients’ s quality of life and the reduction of the impact of pain on their lives.
A Bop and Beyond: A Second Order Optimizer for Binarized Neural Networks
Authors: Suarez-Ramirez Cuauhtemoc , Gonzalez-Mendoza Miguel , Chang Leonardo , Ochoa-Ruiz Gilberto , Duran-Vega Mario
Published: February 2022

The optimization of Binary Neural Networks (BNNs) relies on approximating the real-valued weights with their binarized representations. Current techniques for weight-updating use the same approaches as traditional Neural Networks (NNs) with the extra requirement of using an approximation to the derivative of the sign function - as it is the Dirac-Delta function - for back-propagation; thus, efforts are focused adapting full-precision techniques to work on BNNs. In the literature, only one previous effort has tackled the problem of directly training the BNNs with bit-flips by using the first raw moment estimate of the gradients and comparing it against a threshold for deciding when to flip a weight (Bop). In this paper, we take an approach parallel to Adam which also uses the second raw moment estimate to normalize the first raw moment before doing the comparison with the threshold, we call this method Bop2ndOrder. We present two versions of the proposed optimizer: a biased one and a bias-corrected one, each with its own applications. Also, we present a complete ablation study of the hyperparameters space, as well as the effect of using schedulers on each of them. For these studies, we tested the optimizer in CIFAR10 using the BinaryNet architecture. Also, we tested it in ImageNet 2012 with the XnorNet and BiRealNet architectures for accuracy. In both datasets our approach proved to converge faster, was robust to changes of the hyperparameters, and achieved better accuracy values.
Mobile Convolutional Neural Network for Neonatal Pain Assessment
Authors: Carlini Lucas , Ferreira Leonardo , Coutrin Gabriel , Varoto Victor , Marcondes Tatiany , Balda Rita , Barros Marina , Guinsburg Ruth , Thomaz Carlos
Published: February 2022

More than 500 painful interventions are carried out during the hospitalization of a newborn baby in an Intensive Care Unit. Since a direct and objective verbal communication by neonates is unlikely, this work proposes and implements a computational framework to automatically classify the neonatal pain based on its facial expression. Our findings showed promising results to correctly identify the facial expression of pain in neonates with high accuracy and generalization capability, highlighting as well sound facial regions that agree with pain scales used by neonatologists and with the visual perception of adults when assessing pain in neonates, whether they are health professionals or not.
Use of the endoscopic vacuum therapy technique for the treatment of esophageal fistulas: an integrative review and clinical case series study
Authors: De Souza Amorim Wolfram Weber , Gonzalez Gabriel Lima de Souza , Mont’Alverne Thiago Nepomuceno de Sabóia , De Oliveira Francisco Antônio Araújo , Pereira Tiago César Uchôa , De Oliveira Alessandrino Terceiro
Published: February 2022

Esophageal fistula is a rare disease with a mortality rate of up to 31% of cases and with multifactorial causes. The most common etiologies of esophageal perforation are associated with iatrogenic, foreign body ingestion, as well as cases of lesions of neoplastic origin. Consisting of an innovative therapy with efficiency not yet evaluated in clinical studies, the present study sought to report a series of cases of patients with esophageal fistulas undergoing treatment with endoscopic vacuum therapy (VTE) assisted by the service team of a tertiary public hospital. from the state of Ceará in order to contribute with evidence that reinforces the role of VTE in the closure of esophageal perforations of different etiologies. In addition, in order to contextualize the importance of the cases presented, we carried out an integrative review in order to list the main clinical findings on the use of VTE available in the world scientific literature. There was a need for continuous development of new clinical studies that seek to improve and validate the use of VTE for the safe and effective treatment of esophageal fistulas, emphasizing that treatment with VTE can maximize the therapeutic response, bringing a greater and better clinical patient satisfaction.
Einstein-operations on fuzzy soft multi sets and decision making
Authors: Mukherjee Anjan , Das Ajoy Kant
Published: February 2022

In this paper, we define Einstein product and Einstein sum of fuzzy soft multi sets (FSM-sets) and using these products, we introduce an adjustable approach to FSM-set based decision-making, for solving decision-making in an uncertain situation. The feasibility of our proposed FSM-set based decision-making procedure in practical application is shown by some numerical examples.
On the iterations of generalized bi-derivation on prime ring
Authors: Shujat Faiza , Fallatah Ahlam
Published: February 2022

In the present paper we obtain some results in connection of the symmetric generalized biderivations on prime ring which are the generalization of the results of existing literature in [1, 2, 6].
Evaluating Disaster Risk Reduction Preparedness Strategies in Primary Schools in Kenya: Gaps, Challenges and Implications
Authors: Gichuhi Loise
Published: February 2022

Globally disasters have increased unprecedentedly creating havoc on households and communities despite well-documented awareness levels. Governments and people levels of disaster preparedness have remained unabated in many countries in Africa. However, disasters’ impact can be reduced if people are sensitized about fundamental steps and strategies to reduce risks. Documented literature shows that if taken seriously, disaster risk reduction (DRR) measures are likely to cost less compared to the cost of loss of livelihoods, possessions and the cost of managing its consequences including loss of life. Preparing teachers and the schools for disasters is very important in creating sustainable strategies that can be integrated in day-to-day school activities. Using both quantitative and qualitative methods of data collection, this paper presents the evidence on the potential of preparedness and readiness of public primary schools to cope during and after a pandemic. With a sample of 240 teachers and 24 headteachers from 80 schools in 8 Sub-Counties distributed across Kenya, the findings show that the effectiveness of a school DRR mitigation measures can be a great indicator of how a school and its inhabitants: teachers and children can be prepared or not in times of a disaster. Disaster risk reduction strategies must be both supply-driven and demand-driven for buying in and to motivate teachers and learners to avoid disasters. This study brings out what the gaps and challenges are in primary schools in Kenya and suggests what can be done at both national and regional levels to help the schools cope with disasters.
Naming of Cain in Genesis 4:1 and Its Consequence
Authors: Pinker Aron
Published: February 2022

Verse 4:1 in Genesis was the subject of extensive exegetical discussion, which led to a wide spectrum of nuanced interpretations. Much of the discussion focused on the meaning of the particle אֶת in context. The purpose of this study is to suggest that the problematic particle אֶת is a misreading of the original תֵתּ, caused by the א/ת similarity in the paleo-Hebrew script. The emended reading suggests that Cain, being afraid of Eve's intention to sacrifice him to God, murdered Abel out of fear for his life.
The Identity of “The Messenger of the Covenant” in Malachi 3:1-Lexical and Rhetorical Analyses
Authors: Petterson Anthony R.
Published: February 2022

Many studies of the identity of “the messenger of the covenant” in Mal 3:1 conclude that it is a reference to Yhwh or his covenant angel. This article offers a close reading of this verse with special attention to lexical and rhetorical analyses and concludes that the figure is the same as “my messenger” in 3:1 and later identified as “Elijah the prophet” in 4:5 (HB 3:23). Some brief observations are given concerning the messianic use of Mal 3:1 in the Gospels.
Meeting “Me”: Charles Dickens's Moments of Self-Encounter
Authors: Charles Katherine G.
Published: February 2022

In short stories and novels ranging from A Christmas Carol (1843) to Great Expectations (1860–61), Charles Dickens again and again reiterated close encounters between his fictional characters' adult and childhood selves. Turning to the journalistic context of The Uncommercial Traveller essays, this article identifies moments of self-encounter that are similar but staged between adult Dickens and avatars of his child or adolescent self. Drawing on research into media studies, temporality, and form, I argue that Dickens developed the new formal technology of the self-encounter in response to the pressure of his desire to connect personally with a mass audience, a cultural politics and marketing practice that Juliet John has termed “intimate publicity.” I propose a skeptical reading of Dickens's moments of self-encounter that finds evidence of the author's vexed approach to autobiographical form and a resulting pivot outward to his audience. Through a logical doublethink that sanctions the narrator's recognition of the child as simultaneously me and not me, these self-with-self-encounters create both ironic detachment and sentimental irony, while leaving the task of calibrating their tonal balance to the reader. Attending to these artful moments of self-encounter carries insight into the creation of Dickens's public persona and to the reception of his novels.
Cranford and the Gothic Everyday
Authors: Werner Winter Jade
Published: February 2022

Though generally characterized as a work of gentle humor, Cranford has also been recognized by critics such as Franco Moretti, Hilary Schor, and Anna Koustinoudi as a novel about “panic,” “a place under siege, hardly alive,” one that “literally abounds in scenes/images of castration, mutilation, dismemberment and devouring.” This essay looks to account for this seeming disjunction between the genial tone of the novel and its dark undercurrents. Cranford, it argues, deploys a narrative strategy that I call the “Gothic everyday.” Here, the Gothic mode does not interrupt but rather is integrated into Mary Smith's “proto-ethnographic” narration. The “Gothic everyday,” I suggest, constitutes Gaskell's attempt to represent what she perceived to be a paradoxical state of affairs: although modern life was “haunted,” “unnatural,” oppressive, and morbid, these conditions had also been normalized and were perceived mostly as routine and unexceptional. In other words, she recognized that modernity had not intensified and literalized the kinds of instability traditionally associated with the Gothic so much as it had multiplied and diffused them. Thus, Cranford is an experiment in a sort of stylistic hybridity, representing an experience of everyday life in which Gothic tropes, conventions, and occurrences are less fantastical than simply business-as-usual.
Management Standard Certification and Firm Productivity: Micro-evidence from Africa
Authors: Goedhuys Micheline , Mohnen Pierre
Published: February 2022

Using micro evidence from manufacturing and services firms located in 41 African countries, this paper shows that better management practice, reflected by international management certification, helps firms to raise productivity. Larger and older firms and firms operating closer to the technological frontier are more likely to possess international management standards certification, as do firms engaged in international transactions. Certification in turn raises productivity levels further, in line with a process of continuous improvement. The findings hold for both manufacturing and services firms.
Does School Quality Matter? Primary Schools' Characteristics and Child Labor Intensity in Senegal
Authors: Ehouman W. V. Ahouakan , Diene M'Baye
Published: February 2022

This study analyzes the relationship between school quality and child labor in Senegal. Unlike previous studies that consider child labor as primarily due to household poverty, economic shocks or market imperfections, it tries to assess whether the perceptions that households have about the capacity of investments in education to provide their children with a significant gain can motivate their interest or their disinterest to send them to school and / or to involve them immediately into work. From a simple theoretical model we develop, we show how school quality may influence the choices that households make for their children concerning schooling or labor. We then assess empirically that relationship using the Senegal's DHS-MICS data of 2010-2011 and the Statistical Yearbook of the Ministry of National Education. The Heckman's two-step model combined with the two-step approach proposed in Card and Krueger (1992) have been employed to deal with the problems suggested by the theoretical model. Our empirical findings confirm the theoretical model's results. They indicate that the labor options that households make for their children in Senegal depend on the schools' characteristics in this country. More precisely, we find that an increase of the pupils-teacher ratio and of the rate of grade repetition, seems be considered by households as a signal of bad quality of school. They lead respectively to an increase of the burden of works performed by children in economic and domestic activities.
Cost Effectiveness Analysis of Family Planning Provision in Kenya
Authors: Mugo Mercy G. , Muriithi Peterson J.
Published: February 2022

In Kenya, total fertility rate and contraceptive prevalence rate have shown marginal changes since the 1990s, raising questions about efficiency and effectiveness of provision of reproductive health services, which has received little attention in the country and elsewhere in Africa. We use data from Thika sub-county in central Kenya to conduct a cost-effectiveness analysis of family planning service provision alternatives. The results show that costs per couple year of protection vary widely across facilities within government and non-government providers, but are slightly higher amongst the former. The cost-effectiveness ratios were sensitive to exclusion of certain commodity costs. We conclude that family planning provision systems found in Thika are efficient but call for strengthening of lower level facilities, which are more cost effective and largely serve the poor.
Exploring the Nexus between Child Immunization and Child Mortality in Rural Nigeria
Authors: Adeoti Adetola , Oni Omobowale
Published: February 2022

Nigeria's economic growth has not been pro-poor. Health indices remain poor with high child mortality rate particularly in the rural sector. This study provides insights into child immunization as a complement to unobservable factors responsible for mortality reduction. The ratio of the number of children not alive to the number of children born alive in a household is the measure of the household's child mortality rate. The National Living Standards Survey is the main source of data and the control function approach is the preferred estimation procedure. The estimation results reveal a strong link between access to immunization and reduction in mortality. The results show a robust inverse relationship between child immunization and child mortality. Literacy of mothers emerges as an important determinant of demand for child immunization. It is argued that improving girl-child education would increase demand for child immunization and reduce child mortality in rural Nigeria.
Distributional Impact of Agricultural Technology Adoption on Rice Farmers' Expenditure: The Case of Nerica in Benin
Authors: Alia Didier Yélognissè , Diagne Aliou , Adegbola Patrice , Kinkingninhoun Florent
Published: February 2022

In this paper, we assess the impact of Nerica, a family of high-yielding hybrid rice varieties, on welfare in Benin. Our empirical analysis utilizes instrumental variable and quantile treatment effects methods to estimate the impacts of cultivating Nerica on welfare along the income distribution. We find that Nerica adoption increases households' expenditure across the entire distribution of income. The quantile treatment effects are statistically different from the average treatment effects, suggesting substantial heterogeneity in the impacts of the adoption of Nerica on welfare. We also find that, in absolute terms, the impact for farmers located in the upper half of the income distribution is the largest. However, farmers at the bottom of the income distribution also experienced large proportional increase in welfare. Altogether, our results suggest that the adoption of improved rice seeds reduces poverty and has the potential to contribute to the reduction of income inequality among farmers.
God and Paul (in Christ) on Three Visits as the “Two or Three Witnesses” of 2 Corinthians 13:1
Authors: Berding Kenneth
Published: February 2022

There is no current consensus on how Paul employs his citation of the two-or- three-witness injunction in 2 Cor 13:1. After reviewing recent proposals, it will be argued that the most satisfactory solution to Paul’s problematic use of Deut 19:15 in 2 Cor 13:1 must include three elements: (1) God as witness, (2) Paul himself (in Christ) as witness, and (3) Paul’s three visits to Corinth (two past and one upcoming) as the three occasions when the testimony is given. Combining the witnesses of God and Paul-in-Christ with the three visits satisfies the demands of the literary context, avoids the weaknesses of other views, and offers real (nonmetaphorical) witnesses who validate the truth of Paul’s ministry against the accusations of the Corinthians.
Thiessen and Kaden on Paul and the Gentiles
Authors: Hayes Christine
Published: February 2022

While Matthew Thiessen’s Paul and the Gentile Problem and David Kaden’s Matthew, Paul, and the Anthropology of Law employ different methods to explore Paul’s inclusion of Gentiles, their results are complementary and can be drawn together in a way that advances scholarly understanding of this critical issue.