bluuebunny/crossref_metadata_2025 huggingface dataset:
Estrategias para la gestión integrada y sostenible del recurso hídrico en el municipio de Pauna (Boyacá)
Authors: Villalobos-Gualteros Juan , Ruiz-Martínez Lida
Published: August 2019

Introducción: el presente artículo es producto de la investigación “Estrategias para gestión integrada y sostenible del recurso hídrico”, realizada durante 2017 y 2018 en el municipio de Pauna, ubicado en el occidente del departamento de Boyacá (Colombia). Problema: el uso insostenible del recurso hídrico por parte de la población del municipio constituye una problemática de prioridad social y ambiental; el agua en el municipio se ha utilizado con fines cada vez más numerosos, en aras de atender las necesidades que surgen del desarrollo económico y turístico. Objetivo: formular estrategias de gestión para el uso eficiente del agua en los sectores de consumo residencial, comercial y turístico del municipio. Metodología: el uso eficiente del agua implicó comprender y caracterizar los hábitos, además de los sectores de consumo, y verificar la calidad del agua en aras de crear estrategias de gestión ambiental mediante encuestas descriptivas de tipo abierto. Para revisar la variación de la calidad del agua se tomaron muestras puntales. Resultados: el uso insostenible del recurso hídrico está ligado al uso de grifería obsoleta, a la creciente demanda del agua debido al desarrollo y al turismo, y al mantenimiento general de balnearios. Conclusión: con este proyecto se generó un cambio en el comportamiento del uso hacia la eficiencia y la modificación de prácticas de los usuarios, a fin de favorecer la sustentabilidad de los habitantes. Originalidad: se formularon estrategias de gestión integrada y sostenible del recurso hídrico por primera vez en el municipio de Pauna. Limitaciones: la carencia de información suministrada por el municipio y el acceso a los puntos de muestreo.
Apuntes para una economía política de la solidaridad
Authors: Endara Sebastián
Published: August 2019

Propósito: Este artículo propone una mirada analítica y crítica de algunos de los componentes de la economía solidaria entendida fundamentalmente como actividad destinada a la “reproducción de la vida”. Descripción: Se discuten concepciones que no están en coherencia con este núcleo de sentido, mientras se abordan fuentes que podrían complementar y fortalecer su visión. Punto de vista: La economía solidaria entendida como el proceso social que permite la reproducción de la vida, debe ser asumida de manera multidimensional. En ella convergen varios elementos que permiten imaginar el complejo proceso que supone tal actividad vital y se nutre de vertientes como las del pensamiento andino y su rica y profunda trama valórica, que plantea principios como la relacionalidad, la correspondencia, la complementariedad, y la reciprocidad. Conclusiones: En la economía solidaria, al contrario de la lógica capitalista, se subsume lo económico a la realización de la vida. Por eso se dice que los productos de la economía solidaria no son solo económicos, sino fundamentalmente políticos y culturales.
RELAÇÃO TERAPEUTA PACIENTE E DIMENSÕES DA HUMANIZAÇÃO EM REABILITAÇÃO ORTOPÉDICA
Authors: Oliveira Eloisa Cereda , Baptistella Antuani Rafael , Taglietti Marcelo
Published: August 2019

Para promover a qualidade de vida aos pacientes atendidos em um programa de reabilitação, há a necessidade e obrigação de humanizar o atendimento. O fisioterapeuta exerce um papel fundamental na reabilitação dos pacientes com sequelas ortopédicas, e, além de qualidade técnica, deve prezar pela qualidade relacional de sua assistência. avaliar a relação terapeuta paciente, investigando se há humanização do atendimento fisioterapêutico na especialidade de ortopedia. Estudo de corte transversal, no qual foi aplicado um questionário adaptado avaliativo individual, contendo 15 questões fechadas em nove domínios, em uma amostra de 59 indivíduos, os quais receberam atendimento na especialidade de fisioterapia ortopédica. Os dados foram analisados e apresentados em frequência e porcentagem. O atendimento fisioterapêutico foi caracterizado como humanizado, obtendo-se resposta com 100% em todos os domínios do questionário, nos quesitos que dizem respeito à relação terapeuta-paciente. A assistência fisioterápica, na especialidade de ortopedia, foi caracterizada como humanizada pelos pacientes.
AVALIAÇÃO DA ESTRUTURA NA ATENÇÃO PRIMÁRIA EM SAÚDE PARA O SUPORTE BÁSICO DE VIDA
Authors: Cassinelli Fernanda , Melo Elizabete Santos , Costa Christefany Régia Braz , Reis Renata Karina
Published: August 2019

Descrever a estrutura das Unidades Básicas de Saúde (UBS) no atendimento para o Suporte Básico de Vida (SBV). Trata-se de um estudo transversal, descritivo, com abordagem quantitativa, desenvolvido em 13 Unidades Básicas de Saúde de um município do interior paulista, no período de dezembro de 2013 a junho de 2014, por meio de entrevistas estruturadas com os responsáveis e observação da estrutura. Foi elaborado um roteiro específico para esse estudo. As unidades estudadas não dispunham de todos os materiais, equipamentos e espaço necessários para o atendimento de SBV. Apenas os itens bolsa-válvula-máscara adulto e luvas de procedimento foram encontrados em 100% das unidades. Constatou-se a não adequação de grande parte das UBS a requisitos estruturais mínimos para o atendimento de SBV, bem como lacunas frente à organização e disposição dos materiais.
COMPARAÇÃO DO USO DO LASER DE BAIXA POTÊNCIA (660 NM E 830 NM) EM ESTRIAS ATRÓFICAS DE MULHERES JOVENS
Authors: Kruger Amanda , Amadori Ana Beatriz Campanhoni , Vergutz Claudia Caroline , Vilaca Nathyelle Cristiane Golyjewski , Hickmann Patrícia Regina , Peres Celeide Pinto Aguiar , Bertolini Gladson Ricardo Flor
Published: August 2019

O laser de baixa potência é um recurso utilizado em lesões de pele, contudo ainda pouco explorado no tratamento de estrias alba. Objetivo: comparar dois comprimentos de laser de baixa potência (660 nm e 830 nm) sobre estrias albas. Um grupo de 24 mulheres foi dividido em três: G1 – 660 nm; G2 – 830 nm; G3 – placebo. Realizaram-se 12 aplicações de laser, durante quatro semanas. Foram avaliadas fotos das estrias no antes, depois e após duas semanas das aplicações do laser para mensurar a área ocupada pelas estrias por meio de planimetria digitalizada, bem como seus aspectos. Pela planimetria observou-se redução estatisticamente significativa na área ocupada em G1. Na análise qualitativa, o grupo tratado com laser de 660 nm apresentou melhora no aspecto das estrias. A aplicação utilizando o laser de baixa potência com comprimento de onda de 660 nm demonstrou efeitos positivos na área analisada, bem como no aspecto das estrias.
Upper‐Crustal Anisotropy of the Conjugate Strike‐Slip Fault Zone in Central Tibet Analyzed Using Local Earthquakes and Shear‐Wave Splitting
Authors: Wu Chenglong , Tian Xiaobo , Xu Tao , Liang Xiaofeng , Chen Yun , Zhu Gaohua , Badal José , Bai Zhiming , Yu Guiping , Teng Jiwen
Published: August 2019

Remarkable V‐shaped conjugate strike‐slip faults extend along the Bangong–Nujiang suture in central Tibet. Motions of these faults are considered to accommodate ongoing east–west extension and north–south contraction. Fabrics within the fault zone that are anisotropic to seismic waves can provide clues as to the unusual scale and style of lithospheric deformation. With the goal of determining the upper‐crustal anisotropy pattern in central Tibet, we measured shear‐wave splitting parameters (fast wave polarization direction and delay time) using waveforms generated by 194 local earthquakes recorded by 49 stations of the SANDWICH network. Stations located in eastern and western zones of the study area show anisotropy directions that agree well with the maximum horizontal compressive stress direction. The fast polarization directions at stations near active strike‐slip faults generally run parallel to the strikes of these faults. Pervasive inactive thrust faults caused by Cretaceous–Tertiary shortening in central Tibet also clearly correlate with the anisotropy detected at nearby stations. These results demonstrate that both local structures and stress contribute to upper‐crustal anisotropy in the region. Combining the new results with previous SKS‐wave splitting results and other seismic evidence, we propose that deformation in the upper crust is mechanically decoupled from that in the upper mantle, due to eastward middle‐lower crustal flow. This crustal flow causes basal shearing required for the formation of conjugate strike‐slip faults in central Tibet.
O habitar solitário em Campo de sangue, de Dulce Maria Cardoso / The Lonely Dwell in Campo de Sangue, by Dulce Maria Cardoso
Authors: Barros Bruno Mazolini de
Published: August 2019

Resumo: Esta leitura de Campo de sangue (2002), romance de estreia de Dulce Maria Cardoso, busca observar o modo pelo qual o protagonista habita; ou seja, a maneira pela qual ele vivencia o espaço, especialmente suas relações com o ambiente da casa. Utilizando-se de apontamentos da socióloga Marion Segaud, do antropólogo Marc Augé ou do filósofo Gaston Bachelard, entre outros, a interpretação desta obra da autora portuguesa explicita não só um sintoma da contemporaneidade, mas também uma tendência da literatura de Portugal deste início de século.Palavras-chave: romance português do século XXI; habitar; Dulce Maria Cardoso.Abstract: This paper about Campo de sangue (2002), a novel by Dulce Maria Cardoso, aims to observe the way in which the protagonist dwells; that is, the way in which he experiences space, especially his affiliations with the environment of the house. Using notes of the sociologist Marion Segaud, of the anthropologist Marc Augé or of the philosopher Gaston Bachelard, among others, this interpretation of Mrs. Cardoso’s narrative reveals not only a symptom of contemporaneity, but also a tendency of the Portuguese literature of the beginning of this century.Keywords: 21st Century Portuguese novel; dwell; Dulce Maria Cardoso.
SAMPAIO, Cláudia R. Outro nome para a solidão. Lisboa: Douda Correria, 2018.
Authors: Batista Adriane Figueira
Published: August 2019

.
A realidade das sensações: uma teoria filosófica e ética no romance A Costa dos Murmúrios, de Lídia Jorge / The Reality of Senses: A Philosophical and Ethic Theory in the Novel A Costa dos Murmúrios, by Lídia Jorge
Authors: Vieira Cristina Costa
Published: August 2019

Resumo: O artigo pretende provar que a valorização das sensações do mundo material como acesso ao real subjaz ao romance A Costa dos Murmúrios, de Lídia Jorge, e aí traduz uma teoria ético-filosófica. O realismo perceptivo de A. D. Smith e o valor cultural das sensações de Nadia Serematakis alicerçam teoricamente este artigo, numa metodologia comparativista, porque semiótico-contextual, comprovando, a partir de vários passos romanescos, que as sensações físicas estruturam e reestruturam a percepção do real: assim os murmúrios de atrocidades silenciadas, cometidas em contexto de Guerra Colonial, ou o verdadeiro “eu” por detrás da máscara de um noivo galante. A memória dos cheiros e cores da boda de Evita, o toque erótico de Luís Alex, serão, por isso, tão reais quanto a visão do sangue derramado de flamingos e das fotos escondidas de moçambicanos massacrados em contexto de Guerra Colonial, transformando a percepção que Evita, isto é, Eva Lobo, tem de Moçambique e do seu noivo Luís Alex e obrigando a reler a verdade do conto inicial inserido no romance, intitulado “Os Gafanhotos”.Palavras-chave: Lídia Jorge; A Costa dos Murmúrios; romance histórico português; Guerra Colonial; Moçambique; sensações; ética.Abstract: The article intends to prove that the valuation of senses as direct access to reality underlies the novel A Costa dos Murmúrios, by Lídia Jorge, and here sustains a ethical-philosophical theory. The perceptual realism by AD Smith and the different cultural valuation of senses by Nadia Serematakis base theoretically this article, following a comparative, semiotic-contextual, methodology, proving, from several novel passages, that physical sensations structure and restructure the perception of reality. As the murmurs from silenced atrocities committed in the context of Colonial War or the real “Me” behind the mask of a charming fiancé. The memory of the smells and colours of Evita’s wedding, the erotic touch of Luís Alex, will therefore be as real as the sight of the blood spilled from flamingos and the hidden photos of Mozambicans massacred in the context of the Colonial War, transforming the perception that Evita, that is, Eva Lobo, has of Mozambique and her fiancé Luís Alex and forcing to reread the truth of the initial tale inserted in the novel, titled “Os Gafanhotos”, The Grasshoppers.Keywords: Lídia Jorge; A Costa dos Murmúrios; Portuguese historical novel; Colonial War; Mozambique; senses; ethics.
A Review of the Association Between Environmental Harshness, Neurogenesis and Caching Behaviour
Authors: Yang Hunster
Published: August 2019

Memory is one of the most crucial cognitive functions in many organisms. It is highly implicated in everyday functioning and is an essential component for survival. Past research has revealed that spatial memory facilitates bird caching behaviours such as remembering the exact locations of their hidden food. However, there are many factors that alter the demands on memory and consequently impact the function of caching. Specifically, neurogenesis, the process of forming new neurons, has been shown to affect this behaviour. Likewise, environmental variables and selective pressures (i.e., severity of the environment) can also influence caching in birds. In this review, we present evidence for a link between environmental harshness, hippocampal neurogenesis, and caching behaviour in chickadees, with specific focus on work by Chancellor et al. [6]. Neurogenesis in chickadees may be a mechanism subject to selective pressures, in which chickadees from harsher environments have increased neurogenesis rates and consequently enhanced caching ability. However, there remain gaps in the understanding of how exactly hippocampal neurogenesis, environmental harshness, and caching behaviour interact, and future studies are needed to further explore this interaction and its implications.
Comparative study of tubal patency by sonosalpingogram hysterosalpingography and diagnostic laparoscopy
Authors: Reddy Spoorthy , Padma M.
Published: August 2019

Background: Sonosalpingography has been suggested as the first-line method to study tubal patency. This study is to bring into focus the value of pelvic sonogram in accessing tubal patency in order to overcome the radiation hazard associated with hysterosalpingogram reduce the cost of examination and encourage it at first-line office. Objective of this study was to compare the diagnostic efficacy of sonosalpingogram, hysterosalpingography and diagnostic laparoscopy for tubal patency as a cause for female infertility.Methods: It is a prospective study in 100 patients attending for evaluation of infertility for a period of 2 years were chosen for this study. All cases with primary and secondary infertility who have attended infertility clinic for tubal causes.Results: 68 cases were found to have bilateral patency as per SSG while 58 cases had bilateral patency as HSG. Similarly 24 cases had bilateral block as per SSG while 28 cases had bilateral block as per HSG. 8 cases had unilateral block as per SSG while 14 cases had unilateral block as per HSG.  This difference in observations may probably attribute to tubal spasm in HSG. Bilateral patency was observed in 68 cases as against 64 cases in laparoscopy.  Out of these 68 cases 9 cases were false positive as bilaterally patent.  However bilateral blocks were shown to be 24 in both methods. Out of 12 cases of unilateral block as per laparoscopy 8 cases were detected by SSG. There was false negative rate of 5%. There was false negative rate of 10% for tubal patency with HSG.Conclusions: For low risk subjects for tubal factors in infertility, sonosalpingogram can be employed as a screening test of choice and for high risk subjects HSG and laparoscopy can be used.
Chronic kidney disease in pregnancy and fetomaternal outcome
Authors: Gupta Pooja , Chawla Indu , Ara Anjum , Malik Renuka
Published: August 2019

Background: Chronic kidney disease is a heterogeneous group of renal dysfunctions with complex and varied presentations in pregnancy. With a long asymptomatic course, timely diagnosis and management is crucial for fetomaternal wellbeing.Methods: A retrospective cohort study over a period of 3 years and 4 months included all obstetric in patients with known or newly diagnosed renal disorders. Maternal outcome was measured with regard to biochemical parameters presence /absence of proteinuria, hypertension, mode of pregnancy termination and complications. Fetal outcome was noted with respect to antenatal complications, weight, Apgar, NICU stay. Computation of results was done using percentages, mean and proportions.Results: Out of 13 women studied, 53.8% were pre-diagnosed cases of renal dysfunction and 46.2% were diagnosed during pregnancy. 38% had proteinuria at first visit and 50% remained so even after delivery. 60% had history of pregnancy induced hypertension in their previous pregnancies. Secondary hypertension and superimposed preeclampsia were seen in 30% and 38% cases respectively, with only one patient requiring magnesium sulphate prophylaxis in post-partum. Cardiac dysfunction was found to be coexisting in 15.3% cases with pre-existing renal leision. Intrauterine growth restriction was seen in 61.5% cases Average fetal weight was 2. 26kg with 30% having NICU stay. 30.6% had preterm delivery. Mode of delivery was caesarean section in 46% cases.Conclusions: Pregnancy with CKD is a high-risk pregnancy with adverse fetomaternal outcomes. For optimal pregnancy outcomes, an expert multidisciplinary team is required. With limited studies in south Asian population, there needs to be an upgradation in registry system.
Neuro-imaging study in eclampsia
Authors: Swain Sujata , Jena Paresh Kumar
Published: August 2019

Background: Eclampsia is associated with increased risk of maternal death varying from 1.8 % in developed countries to 14 % in developing countries. Cerebral complications are the major cause of death in eclampsia patients. Eclampsia along with hypercoagulopathy of pregnancy is a high risk fact for patient in respect of development of cerebrovascular thrombosis/haemoorhage. Eclampsia patients have been found to have various CNS pathological conditions amenable to the medical treatment. The aim of the study is to know the neuropathophysiology behind an eclamptic seizure to reduce the morbidity associated with it.Methods: Prospective study design included 50 patients for the study. All patients were admitted in the eclampsia room with h/o convulsions. All patients were put on MgSO4 therapy and anti-hypertensive. Cranial CT scan examinations were performed for all patients within 24hours of last convulsion without intravenous contrast material injection. Time taken to recover from all the clinical symptoms like altered consciousness, defective vision, headache and seizure and the maternal outcome are compared.    Results: 62% of patients with eclampsia had detectable pathological changes in CT scan. Cerebral edema was the most common CT scan finding with parietal lobe was the most common site (90.32%) of pathological changes. Mortality rate was high among eclamptic patients with cerebral hemorrhage.Conclusions: CT scan was found to be effective in detecting cerebral pathology in more than half of the eclamptic patients. The most common pathological changes detected are cerebral edema and cerebral infarction. CT scan may not be required for the diagnosis of eclampsia, but it must be used in certain complicated patients to detect cerebral pathology at the earliest so that specific management could be provided to reduce the maternal mortality.
A study of cervical cytology in females above 21 years of age
Authors: Singh Nidhi , Gehlot Hanslata
Published: August 2019

Background: Cancer cervix is the leading cause of mortality and morbidity in developing countries like India most probably due to lack of proper screening facilities or due to the lack of awareness amongst the women of developing countries. Worldwide, cervical cancer is the second most common and 5th deadliest cancer in women. This study was conducted in department of obstetrics and Gynaecology, Umaid hospital, Dr. S. N. Medical College, Jodhpur Rajasthan, India. The objective of this study was to study the various high risk factors involved in premalignant and malignant lesions of cervix. To study the incidence of different epithelial abnormalities of cervix in females above 21 years of age. To study premalignant and malignant lesions of the cervix in relation to the presenting complaintMethods: The study was conducted in 500 females above 21 years of age and who were not pregnant, who had been attending Umaid Hospital, Jodhpur for various gynaecological complaints, of different parity, residential status and socioeconomic class. Detailed history was taken and thorough examination was done. Pap smear was prepared and all smears were reported as per the Bethesda system.Results: Maximum numbers of patients were in the age group of 21-40 years (70.2%). Majority of patients were from rural area (52.4%) and from lower socioeconomic class (30.2%). Most of women were found to have duration of marriage between 10 to 30 years (63.4%). Most of the women in our study had age at marriage between 17 to 19 years (49.4%). Multiparity was seen in 84.2% of cases. The commonest presenting complaint was white discharge (46.8%). On Pap smear, maximum cases were of inflammatory smear (91.4%), 1.4% had ASCUS, 1.2% AGC, 1.4% LSIL, 1% HSIL and 0.4% had SCC.Conclusions: Cervical cytology is an important tool for early detection of premalignant and malignant lesions of cervix. Regular pap smear screening should be conducted in vulnerable age groups.
Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses
Authors: Bahadur Badugu Rao , Koneru Gangadhara Rao , Kodey Prabha Devi , Melam Jyothi
Published: August 2019

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3.
A cross-sectional study to evaluate sonographic foetal humerus length for estimation of gestational age in normal singleton pregnancies at a tertiary care centre
Authors: Mital Premlata , Ainani Richa , Hooja Nupur , Sonkhya Priya , Pradodh Vishwas , Chaudhary Kavita , Kharbas Urmila , Sethi Saloni , Singh Jeetendra , Chaudhary Ankita
Published: August 2019

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances.
A comparative study of pregnancy outcomes among women with and without threatened miscarriage in the first trimester in Abakaliki Southeast Nigeria
Authors: Nwafor Johnbosco Ifunanya , Onuchukwu Victor Jude Uchenna , Obi Vitus Okwuchukwu , Ugoji Darlinghton-Peter Chibuzor , Onwe Blessing Idzuinya , Ibo Chukwunenye Chukwu , Obi Chuka Nobert
Published: August 2019

Background:Threatened miscarriage is the commonest complication of pregnancy and has been aBackground: Threatened miscarriage is the commonest complication of pregnancy and has been associated with adverse pregnancy outcomes. Therefore, the aim of this study is to determine the association between threatened miscarriage and adverse maternal and perinatal outcomes.Methods: This was a retrospective case-control study undertaken at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The study involved 228 women presenting with threatened miscarriage in the first trimester and 228 asymptomatic matched controls. The statistical analysis was done using Epi info version 7.1.5, March 2015 (CDC, Atlanta, Georgia, USA).Results: Women with threatened miscarriage were more likely to have preterm delivery (OR = 7.1, 95% CI = 3.51-14.32, P <0.0001), placenta praevia (OR = 2.4, 95% CI = 1.13 - 5.26, P = 0.03), placental abruption (OR = 3.6, 95% CI = 1.40 - 9.03, P = 0.01) and retained placenta (OR = 2.9, 95% CI = 1.18 - 6.97, P = 0.02). Similarly, women with first trimester threatened miscarriage were more likely to develop postpartum haemorrhage (OR = 2.4, 95%               CI = 1.17 - 5.06, P = 0.02). There was no significant differences in the stillbirth rate, Apgar scores at 5 minutes less than 7, admission into neonatal intensive care unit and early neonatal death. Threatened miscarriage was associated with intrauterine growth restriction (OR = 3.5, 95% CI = 1.77 - 6.88, P <0.0001) and low birth weight <2.kg                 (OR = 3.2, 95% CI = 1.33 - 7.69, P = 0.01).Conclusions: Women with threatened miscarriage in the first trimester are at increased risk of adverse pregnancy outcomes and the risk factors should be taken into consideration when deciding upon antenatal surveillance and management of their pregnancies.
Knowledge about obstetric danger signs among pregnant women attending antenatal clinic in a tertiary care hospital of Delhi: a cross sectional study
Authors: Kumar Ashok , Yadav Geeta , Zutshi Vijay , Bodat Suman
Published: August 2019

Background: According to UNICEF, globally 800 million women die due to preventable causes related to pregnancy and childbirth; 20% of which occur in India. It is therefore imperative to understand the level of knowledge about danger signs among pregnant women to augment timely redressal of preventive obstetric causes of mortality.Methods: A hospital based, cross sectional study was conducted at the ANC Clinic in Safdarjung Hospital, New Delhi from 2nd July to 27th July 2018. Convenient sampling was used to identify and interview 354 pregnant women, using a semi structured questionnaire. Data was entered and analysed with SPSSv21. Results were presented as frequencies and proportions. Chi square was used to test for association between qualitative variables, and p-value less than 0.05 was considered significant.Results: 48.3%, 35.6%, and 40.1% of pregnant women had knowledge about danger signs during pregnancy, labour and postpartum respectively. Majority of the women had knowledge about abdominal pain (58.4%) and severe fatigue (80.7%) as danger signs of pregnancy, while bleeding (82.5%) was the most common response as danger sign of labour. More than half had knowledge about heavy bleeding (59.9%) as danger sign of postpartum. The women lacked awareness about Convulsions (92.9%) as danger signs of pregnancy and labour, as well as smelly vaginal discharge (79.6%) in postpartum.Conclusions: Knowledge of obstetric danger signs among pregnant women is still lower. It needs further awareness as it can help in early diagnosis and referral of patients thus reducing maternal mortality and morbidity.
Study of medical disorders in pregnancy among in patients at a tertiary care hospital in Haryana, India
Authors: Chaudhary Sushila , Singhal Savita Rani , Chauhan Meenakshi B. , Gupta Anjali , Dalal Monika
Published: August 2019

Background: Pregnancy is a physiological condition in which various changes occur in pregnant women just to accommodate growing fetus. Pregnancy is a stress test for woman and may unmask certain underlying chronic diseases like, DM, hypertension which were silent or asymptomatic prior to pregnancy. This study was done to know the incidence, type and demographic profile of medical disorders in pregnancy among in patient at a tertiary care hospital.Methods: It was a retrospective study conducted on 578 patients of medical disorders in pregnancy admitted in a tertiary care hospital from January 2017 to December 2017. Data collected from record room and analysis done.Results: Total antenatal admissions were 4721. Incidence of medical disorders was 12.24%. Majority of women were in age group 20-30 years (65.5%). Low-parity (P0, P1). Hypertensive disorders in pregnancy was commonest reported disorder (42.3%), followed by hematological disorder (38.7%), liver disorder 5%, endocrine disorder 4.8%, epilepsy 3.8% and HIV 2.6% in present study.Conclusions: Hypertensive disorders were commonest medical disorder followed by hematological, liver, endocrine and epilepsy. All medical disorders in pregnancy to be managed by team approach.
A clinical study in distal femur fractures management with locking compression plate without C-arm images
Authors: Singla Gaurav
Published: August 2019

Background: Distal femur fractures pose a surgical challenge to the orthopaedic surgeons. Multiple implants are available but locking compression plate is a good implant to be used in this anatomical location. LCP may reduce the tendency of varus collapse and offers higher stability than other implants. Aim of our study was to review functional outcome, union time and complications in distal femoral fractures treated with distal femoral locking plate without C-arm imaging modality.

Methods: 25 patients with closed or open type grade1 and 2 distal femur fractures managed with open method locking compression plate without C-arm image. Pritchett rating system was used for evaluation of outcome.

Results: All patients in this series united well with an average time of 13 weeks with minimal complications. Functional outcome was excellent in 4 patients, good in 19 patients, fair in 2 patients.

Conclusions: Open reduction and locking compression plate is suitable implant available for fixation of distal femur fractures with minimal complications. Even it can be done without C-arm. Surgical technique and proper anatomical reduction and alignment are the key for good results.
Evaluation of tranexamic acid in reducing blood loss and transfusions in total knee replacement
Authors: Baig Mirza Atif , Kommera Srujith
Published: August 2019

Background: Total knee replacement (TKR) is associated with substantial blood loss and thus the need for blood transfusions. Risks and costs of allogenic blood transfusions requires strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of tranexamic acid treatment in reducing blood loss and blood transfusion requirements during TKR.

Methods: A randomized controlled trial was conducted on 60 patients who were operated for unilateral TKR from January 2016 to January 2019 in Shadan Institute of Medical Sciences. 30 patients were in each control and study groups. In study group 12 mg/kg bolus of tranexamic acid was given as a slow IV dose, 40 minutes before deflation of tourniquet followed by 1.2 mg/kg/hr infusion for 12 hours with standard treatment of hospital and compared to the control group. Later blood loss was compared both intra and post operatively. Fall in haemoglobin after surgery was also compared.

Results: Total blood loss in tranexamic acid group was 543.3±184.85 ml (control group 685.83±176.74 ml) which is statistically significant (p<0.05). Blood loss was markedly decreased in tranexamic acid group (379.16±174 ml in tranexamic acid vs. 513.33±143.89 ml in control group) statistically significant (p<0.05).

Conclusions: Tranexamic acid is an effective strategy to reduce blood loss in patients undergoing total knee replacement and thus minimizing the need for blood transfusions.
A study on management of paediatric supracondylar humerus fractures with lateral percutaneous Kirschner wire fixation
Authors: Jan Wazir Fahad , Khan Umer Mushtaq , Bhat Haamid Rafiq , Zeerak Sumaya
Published: August 2019

Background: Supracondylar fracture of the humerus in children is a common injury encountered in orthopaedic practice. Undisplaced fractures can be managed conservatively, however displaced fractures need proper reduction and adequate fixation for attainment of optimal functional and cosmetic outcomes. The purpose of this study was to evaluate the effectiveness of lateral percutaneous Kirschner (K) wire fixation in the management of displaced supracondylar fractures in relation to achievement of union and functional results.

Methods: This was a prospective observational study conducted on 70 patients of either sex with an average age of 5.98 years, presenting to the Orthopaedic Department of S.H.K.M. Government Medical College Hospital, Nalhar, Nuh, Haryana between February 2016 and February 2018, with displaced supracondylar fractures of humerus. All the patients were managed by closed reduction and percutaneous lateral K wire fixation. The patients were followed up for a period of 1 year. The patients were analyzed for union and functional results.

Results: All the fractures united with an average time of union of 3.8 weeks. Functional results were assessed using Flynn’s criteria, which were excellent in 58 (82.86%), good in 7 (10%), fair in 3 (4.28%) and poor in 2 (2.86%) patients.

Conclusions: Thus results of our study demonstrate that the lateral percutaneous K wire fixation is a safe and effective method of treatment of displaced paediatric supracondylar humerus fractures.
Gradual distraction for treatment of severe knee flexion contractures using the Ilizarov’s apparatus
Authors: Sud Ajay Deep , Kaul Rajiv , Prasad Manish , Pande Hrishikesh , Philip Vivek M.
Published: August 2019

Background: Knee flexion contractures result in a significant amount of functional disability due to reduced mobility and limb length discrepancy. Treatment options include non-surgical methods like serial casting, dynamic splinting and traction or surgical methods like osteotomies and soft tissue procedures. External fixation has emerged as a highly successful means of achieving controlled gradual correction of joint contractures with low rates of complications including recurrence. The aim of this study is to evaluate the functional outcome in terms of residual deformity and change in ambulatory status following correction using the Ilizarov’s apparatus.

Methods: 12 patients with knee flexion contractures ranging from 20°-70° underwent correction using the Ilizarov’s external fixator (IEF). The use of simple mathematic formulae enabled us to calculate and estimate the rate and duration of distraction. End results were assessed at one year by the residual contracture as: Excellent: 0-5°, Good: 6-15°, Fair: 16-30° and Poor: >30°.

Results: The functional assessment was graded as excellent in 7, good in 4 and fair in 1 out of 12 patients. All patients were independent ambulators and only 1 out of 12 patients required an additional orthosis for maintenance of the correction.

Conclusions: The IEF is a safe and precise modality even for the most complex contractures of the knee. Accurate placement of the hinges along the center of rotation of the knee avoids undue subluxation of the tibia during correction. In order to ensure a low rate of complications, it is imperative to have a detailed pre-operative plan and all principles of fixation should be meticulously adhered to. 
ÜÇ BOYUTLU GENOM ORGANİZASYONUNA GENEL BAKIŞ
Authors: Arıkan Terzi Evrim Suna , Özdemir Erdoğan Müjgan , Solak Mustafa
Published: August 2019

Genomların temel özelliği hücre çekirdeğindeki üç boyutlu topolojik organizasyonudur. “Kromozom alanları” terimi nükleusun belli bölgelerinin belli kromozomlar tarafından kullanılmasını ifade etmektedir. Yani kromozomların nüklear boşlukta rastgele düzenlenmediği, genom içindeki bazı genlerin tercih ettikleri bölgeleri işgal ettikleri tespit edilmiştir. Kromozom alanlarının organizasyonu gen yoğunluğu ve boyutu ile ilişkilidir. Bu durumda gen bakımından zengin kromozomların interior pozisyonları, gen bakımından zayıf kromozomların perifer pozisyonları tercih ettiği rapor edilmiştir. Kromozom alanları ayrıca dinamik yapılardır böylece genler açılacağı zaman periferden interior pozisyona doğru yer değiştirebilirler.İnsan genomunun mekansal organizasyonunun genlerin transkripsiyonel kontrolünde önemli bir rol oynadığı bilinmektedir. DNA ilmeklenmesiyle promotör ve enhansır etkileşimleri temelli çalışmalar gen ekspresyonunun uzaktaki kromatin temaslarıyla düzenlendiğini göstermiştir. Düzenleyici DNA elemanları ve genlerin hücreye spesifik transkripsiyon düzenleyici programları nasıl yürüttüğü başta gelen araştırma konularındandır. Genetik çalışmalar enhansır promotör birlikteliğinin üç kuralı etrafında tamamlanır: Doğrusal yakınlık durumları, enhansır promotör uyumu ve enhansır aktivitesini bloklayabilen sekansların varlığı. Bu kuralların arkasında yatan moleküler mekanizmaları anlamak için regülatör bölgelerin uzak mesafelerde nasıl faaliyet gösterdiğini bilmeye ihtiyacımız vardır.Herhangi bir hücre tipinin binlerce ya da daha fazla düzenleyici bölge içerdiği bulunmuştur. 200 hücre tipi göz önüne alındığında insan genomunun karmaşık bir düzenleyici sistem olarak çalıştığı görülmektedir. Doğrusal DNA’dan üç boyutlu nükleusa kadar kromatin organizasyonu küçük ve büyük ölçekte çok iyi karakterize edilmiştir ancak ara seviyelerdeki kromatin organizasyonu hakkında bilgilerimiz hala sınırlıdır. Kromozom konformasyonunu yakalama (3C) teknolojilerinin gelişmesi interfaz nükleusunun üç boyutlu kromatin organizasyonuna yeni bakış açısı getirmiştir.Bu derlemede, genomun mekânsal organizasyonundan, bu organizasyondaki bazı etkileşimlerden ve son yıllarda yapılan bazı çalışmalardan bahsedilmiştir.
BİR EĞİTİM HASTANESİNDE PEDİATRİK HASTALARDA GASTROENTERİT ETKENLERİNİN DEĞERLENDİRİLMESİ
Authors: Topal İsmail
Published: August 2019

AMAÇ: Akut gastroenteritlerin erken teşhis ve doğru tedavisi için bölgesel verilerin ortaya konması büyük önem arz etmektedir. Bu yüzden bölgemizdeki verilerin paylaşılması amaçlanmıştır.GEREÇ VE YÖNTEM: Çalışmamızda hastanemiz çocuk polikliniğine başvuran 0-18 yaş arasındaki akut gastroenterit olgularında rotavirus, adenovirus, Entamoeba histolytica, Giardia lamblia antijenleri immunokromatografik yöntemle, Clostridium difficile toxin A/B ise ELFA yöntemiyle araştırılmıştır.BULGULAR: 2173 hastanın 194’ünde (%8.9) rotavirus, 1347 hastanın 28’inde (%2) adenovirus, 2096 hastanın 54’ünde (%2.57) Entamoeba histolytica, 1736 hastanın 9 unda (%0.52) Giardia intestinalis antijen pozitifliği, 488 hastanın 34’ünde (%6.97) Clostridium difficile toxin A&B pozitifliği bulunmuştur. 5 hastada hem rotavirus hem de adenovirus antijen pozitifliği tespit edilmiştir. Cinsiyete göre pozitiflik oranları incelendiğinde sadece Giardia lamblia grubunda erkeklerde anlamlı bir yükseklik tespit edilmiştir. Rotavirus enfeksiyonlarında 0-2 yaş grubunda diğer yaş gruplarına göre anlamlı olarak yükseklik saptanmıştır. Rotavirus dışındaki diğer gruplarda yaşa göre anlamlı bir fark görülmemiştir. Rotavirüs antijen pozitifliği kış mevsiminde diğer mevsimlere göre çok daha yüksektir. Benzer şekilde Entamoeba histolytica’ya bağlı enfeksiyon en çok yaz mevsiminde görülmektedir. Diğer gruplar için mevsimsel farklılık söz konusu değildir.SONUÇ: Çalışmamızda elde ettiğimiz bulgular literatürle genel olarak uyumlu bulunmuştur.
Formar en participación ciudadana
Authors: Rojas Ronderos María Claudia
Published: August 2019

El ciudadano no nace por cuenta de un documento de identidad, se hace en un proceso inacabado gracias a su relación con los demás. Esa alteridad se refuerza con la educación, siempre que al menos cinco condiciones se apropien. Aquí, la universidad cumple un papel central.
De los retos a las ideas y de las ideas a la innovación
Authors: Luque Diana
Published: August 2019

Diseñadores, artistas, científicos, pensadores; la comunidad académica en la Universidad El Bosque tiene un mismo objetivo: que los resultados de una investigación vayan más allá de un marco teórico para que puedan ser aplicados en la realidad. Que las ideas no queden en los salones de clase, la biblioteca o los laboratorios sino que todas las personas puedan sacar provecho de ello. Los biciparqueaderos de la Universidad El Bosque son el ejemplo perfecto de ello, de cómo una idea de diseño y creatividad puede solucionar una necesidad, volverse una realidad para que todos la usen y se apropien de ella. Pero además, esta idea y su aplicación se convirtieron en la primera patente de invención que tiene la Universidad.

¿Cómo se logra que un problema pase a ser una idea, de ahí a una solución y de ahí a una patente? Les contamos el proceso que vivieron los integrantes del Centro de Diseño y Comunicación con la ayuda de la Vicerrectoría Administrativa y la Vicerrectoría de Investigaciones a través del Centro de Transferencia de Resultados de Investigación (CETRI).
Una mirada a la contabilidad ambiental en Colombia desde las perspectivas del desarrollo sostenible
Authors: Sánchez Guevara Alejandro , Martínez Galvis María Rita
Published: August 2019

Resumen: A partir del interés por identificar los problemas y las perspectivas por las que la academia contable colombiana ha transitado en el campo de la contabilidad ambiental, el presente trabajo propone realizar una revisión literaria conducente a una reflexión sobre las vertientes con las cuales se ha trabajado el tema en Colombia. Para tal efecto, se analizaron 56 textos identificados en 10 revistas colombianas de investigación contable, que fueron publicados en el periodo de 1996 a 2015. Esta revisión se erige a la luz de algunas consideraciones sobre el medio ambiente, la crisis ambiental y el desarrollo sostenible ―en sus vertientes fuerte y débil―, que sirven para comprender el origen de la contabilidad ambiental en el país.
Acerca de la edición del libro académico en acceso abierto
Authors: Camargo Mayorga David Andrés
Published: August 2019

El libro es como la cuchara, el martillo, larueda, las tijeras. Una vez se han inventado, nose puede hacer nada mejor. El libro ha superadola prueba del tiempo […] Quizá evolucionensus componentes, quizá sus páginas dejen deser de papel, pero seguirá siendo lo que es.Umberto Eco
Entre la deferencia y la indiferencia: margen de apreciación, democracia y situaciones de vulnerabilidad en la jurisprudencia del Tribunal de Derechos Humanos
Authors: Aldao Martín
Published: August 2019

La doctrina del margen de apreciación (MoA) de los Estados es presentada como un avance en términos de democratización de los sistemas regionales de protección de los derechos humanos. No obstante, la mayor deferencia que la doctrina implica respecto de los Estados puede operar en favor de los poderes políticos locales y no necesariamente de la democracia entendida como la participación paritaria de toda la ciudadanía. Poner en evidencia esto requiere explorar la concepción de democracia que supone la doctrina del MoA y que ha sido poco abordada. El artículo muestra las insuficiencias del uso genérico del argumento democrático en el contexto de la determinación del margen de apreciación de los Estados por parte del Tribunal Europeo de Derechos Humanos analizando en especial el giro procedimental del MoA. Esto es particularmente relevante en los casos que involucran colectivos en situación de desigualdad estructural y que, por ende, requieren de un escrutinio más estricto que el mero funcionamiento de las instituciones representativas tradicionales.
Justicia constitucional, deliberación y democracia en Colombia: Jeremy Waldron reflexivo en Bogotá
Authors: Roa Roa Jorge Ernesto
Published: August 2019

Este artículo contesta el argumento de Jeremy Waldron en contra de la revisión judicial de las leyes. La tesis principal del artículo es que las cuatro condiciones waldronianas (core of the case) necesarias para que exista una sociedad bien ordenada son demasiado exigentes para el sistema democrático de Colombia. Por esa razón, las objeciones formuladas por Waldron al control de constitucionalidad no son aplicables al caso colombiano. Solo una interpretación excesivamente minimalista de las cuatro condiciones de una sociedad core of the case permitiría aplicar esa crítica al control de constitucionalidad en Colombia. Además, el artículo mantiene que el argumento de Waldron resulta afectado por una paradoja. Esta consiste en que una interpretación exigente de las cuatro condiciones del core of the case deja fuera a la mayor parte de las democracias del mundo. Por el contrario, una interpretación flexible de esas condiciones aumenta el potencial aplicativo de las objeciones waldronianas, pero les resta fuerza. El artículo demuestra que, en contextos que apenas satisfacen las cuatro condiciones bajo mínimos, el control de constitucionalidad puede resultar necesario y útil para el propio sistema democrático con el fin de superar las cargas de inercia y los puntos ciegos del proceso legislativo que afectan la protección efectiva de los derechos constitucionales. En estos casos, los jueces ordenan remedios directos que no pueden ser objeto de reproche democrático en virtud de que el propio legislador ha defraudado las expectativas respecto del rol que le corresponde dentro de la organización política.