bluuebunny/crossref_metadata_2025 huggingface dataset:
SISTEM PENDUKUNG KEPUTUSAN DALAM MENENTUKAN KETUA HIMAPRODI MENGGUNAKAN METODE WEIGHTED PRODUCT
Authors: Utomo Yudo Bismo , Yuliana Dian Efytra , Kurniadi Harso
Published: January 2023

Himaprodi Tekkom is one of the student organizations at the level of the Computer Engineering Study Program on the Uniska Kediri campus and includes intra-campus organizations as well as extra-curricular activities that can be selected and participated in by each student. The term of office of the chairman of Himaprodi is one year; when the term of office ends, the selection of the new Himaprodi chairman will be held at the time of the musma. In its selection, Himaprodi Tekkom still uses manual methods that make it too time-consuming and less efficient. In order to be effective and efficient, and moreover, the study program is a computer engineering study program, a website-based recommendation system was created to determine the candidate for the new Himaprodi Chairman using the weighted product method as a data processor based on six criteria that have been given, including leadership, wisdom, competence, responsibility, communicativeness, creativity, and innovation. The results achieved from this study were to use the weighted product method, so Arif Nur Huda's name was chosen as the new head of the Himaprodi Teknik Komputer with a value of 0,447.
Learning Orientation and Customer Retention Practices in Micro and Small Enterprises: Lessons from Agro-processing Firms in Tanzania
Authors: Nnko Eliakira , John Elia
Published: January 2023

Over years Micro and Small Enterprises (MSEs) have been struggling to build their competitiveness in retaining customers in the highly dynamic business environment in which they operate. Learning has been identified as one of the strategic weapons that influence the the development of appropriate business practices in a turbulent environment. However, there is scanty development of appropriate business practices in a turbulent environment. However, there is scanty literature that relates learning orientation and customer retention practices in agro-processing MSEs specifically in developing economies like Tanzania. This study examines the influence of learning orientation on customer retention practices. The quantitative research approach and cross-sectional research design were adopted. We obtained a total response of 302 questionnaires distributed to owner-managers of micro and small agro-processing enterprises in Arusha, Morogoro and Dar es Salaam regions in Tanzania. Structural Modelling Equation was used in data analysis. The study established that, learning orientation dimensions of learning orientation were positively and significantly influence customer retention practices except shared vision which posted only a positive relationship with competitor analysis and inter-functional coordination practices of agro-processing MSEs. The results provide implications that owner-managers who wish to form appropriate customer retention practices should enhance their learning orientation by putting commitment to learning, opening their doors to new ideas and knowledge and having a shared share vision towards learning. The study recommends that business practitioners and institutions that oversee and support the activities of micro and small business enterprises in Tanzania need to develop a well-built learning environment to accelerate the learning behaviour, competitiveness and sustainability of these firms.
Effectiveness of back care education program among school children: a systematic review of randomized controlled trials
Authors:   University of Nigeria, Nsukka, Anyachukwu Canice Chukwudi , Amarah Confidence chinemerem , Okoye Blessing Chiagozikam , Ifeanyi Anthony , Nweke Martins , Abaraogu Ukachukwu
Published: January 2023

Review question / Objective: i. What are the back care education programmes in different schools? ii. How effective has these back care education programmes been in treatment and prevention of future occurrence of back pain in children? iii. What are the factors that may affect the effectiveness of these back care education programmes? iv. What benefits can be derived from these back care education programmes in schools to the children, parents and society at large Information sources: i. PubMed ii. PEDro iii. Cochrane library iv. Google scholar v. HINARI.
Current role of Endoscopic Endonasal Approach for Craniopharyngiomas. A 10-year Systematic review and Meta-Analysis Comparison with the Open Transcranial Approach
Authors:   Mayo Clinic Florida, Figueredo Luisa , Martinez Liliana , Almeida Joao Paulo
Published: January 2023

Review question / Objective: To identify and review studies published in the last ten years, presenting the efficacy and outcomes of EEA and TCA for patients with cranio-pharyngiomas. Eligibility criteria: Studies meeting the following criteria were included: (a) retrospective and prospective studies and (b) observational studies (i.e., cross-sectional, case-control, case-series). The outcomes included visual outcomes (improvement, no changes, worsening), endocrinological outcomes (permanent diabetes insipidus and hypopituitarism), operatory site infection, meningitis, cerebrospinal fluid leak, stroke, hemorrhage, and mortality. Studies were excluded if they were determined to be: (a) case-report studies, (b) studies testing genetic disorders, (c) poster presentation abstracts without full-text availability, (d) systematic reviews, and (e) metanalyses.
Efficacy and effectiveness of Oliceridine in acute postoperative pain, a systematic review and meta-analysis
Authors:   University Hospital Knappschaftskrankenhaus Bochum, WolfvWolf Anne , Unterberg Matthias , Witowski Andrea , Adamzik Michael , Wolf Alexander
Published: January 2023

Review question / Objective: Oliceridine is a relatively novel so called bias opioid which is approved for severe opioid requiring pain. Due to its biased agonism, it is said to have fewer side effects than conventional opioids. This systematic review and meta-analysis will analyze the efficacy and effectiveness of oliceridine compared to placebo or morphine in acute postoperative pain for up to 72 hours. This will be the first meta-analysis on this topic. Our aim with this work is to evaluate the clinical utility of this relatively new substance in a broad postoperative context. The lead questions of this systematic review and meta-analysis are: 1. Does Oliceridine demonstrate comparable analgesia to morphine with an improved side effect profile? 2. Does oliceridine demonstrate a superior analgesia compared to placebo with a comparable side effect profile? Transfered to PICOS, the study questions present as follows: Patients: Postoperative (up to 72hours) patients with moderate to severe pain Intervention: Oliceridine (TRV130) Comparison: Morphine and Placebo Outcome: Efficacy (pain reduction), effectiveness (side effects, adverse events) Study: Randomized controlled trials, at least single-blind.
Empowering and Disempowering Motivational coaching: a scoping review
Authors:   University of Lisbon, Faculty of Human Kinetics, Birr Caroline , Hernández-Mendo Antonio , Monteiro Diogo , Rosado António
Published: January 2023

Review question / Objective: The multidimensional model of empowering and disempowering coach climates created by Duda (2013) has a great relevance within the scope of intervention in the context of Sport Psychology. This scoping review of studies summarizes the scientific production about the empowering and disempowering motivational climates created by Duda (2013). The search included the, Web of Science, Scopus, Psycinfo, and Pubmed databases for English, Portuguese and Spanish articles published between 2013 and 2022. A total of 44 studies were found, which 22 were included in the present study. From the 22 studies, 16 were cross- sectional studies, 4 were psychometrics validation studies, 1 concerned a transversal cohort study and 1 concerned a qualitative study. The coach-created Empowering and Disempowering motivational questionnaire (EDMCQ-C) is, the most used and with the necessary psychometric qualities when it comes to assessing the empow-ering and disempowering motivational climates and their various impacts. We describe results concerning the measurement, antecedents and effects of empowering and disempowering coach climates and future research should invest in the study of empirical evidence that could be added to the existing nomological framework, considering antecedents, development, direct and indirect effects, moderating effects, aggregated effects and qualitative studies.
Un modelo alternativo para ciencia abierta: teatros, árboles, rizomas y máquinas retóricas
Authors: Fernández Galán Montemayor Carmen , García Guerrero Montserrat
Published: January 2023

En este texto se analizan las representaciones sobre la ciencia abierta como nuevo paradigma del conocimiento, y se realiza un recorrido por la tradición de organización de saberes en Occidente. Con base en esos modelos se pretende construir uno propio, en el marco del cambio epistémico de los paradigmas a los giros (lingüístico, semiótico, pictorial y afectivo). La estrategia metodológica consiste en un análisis contrastivo sobre la historia de las imágenes del saber con el debate actual sobre ciencia abierta. A manera de resultados preliminares se presentan dos propuestas de abordaje en géneros discursivos diferentes: una narración distópica y un poema binario como modelos alternativos multimodales para la ciencia.
Análisis y documentación del flujo migratorio de Bahía de Caráquez, del siglo XIX al XXI
Authors: Pablo Otero Nicolás
Published: January 2023

Este proyecto intenta exponer el desarrollo migratorio de la ciudad de Bahía de Caráquez, desde el siglo XIX, hasta la actualidad. La investigación de este tema busca presentar algunos indicadores clave, como el flujo migratorio, sus cambios demográficos y sus acontecimientos más importantes, a través de un documental, el cual señala quienes fueron los primeros migrantes y los grupos familiares extranjeros más notables. También busca exponer otros acontecimientos, como el movimiento telúrico del año 2016 que causó una drástica disminución de la población. El objetivo principal del proyecto es presentar toda esta información al público general y a las personas que estén interesadas en el tema, para que pueda ser accesible tanto en proyecciones, como en las redes sociales, y que, con el uso de las técnicas de posproducción, logre mostrar todos estos hechos migratorios de manera cronológica, visual, atractiva y amigable.
Inclusión de nuevas herramientas digitales en la comunicación comunitaria: comunas de Olón y Cadeate, provincia de Santa Elena, Ecuador
Authors: Suntaxi Andrade Martha
Published: January 2023

A medida que se desarrollaba la pandemia, muchas comunas de la provincia de Santa Elena cambiaron su forma de comunicación, modificando su interacción con los pobladores. Este es el caso de la comuna de Olón y Cadeate, en las que su comunicación incluye las nuevas tecnologías como un medio de difusión de información a la ciudadanía. En la actualidad, interactúan entre “La voz de los techos”, Whatsapp y Facebook, donde se envían y se comparten temas de interés comunitario. Estas herramientas de comunicación interactúan, yes ahí donde la ecología de medios explica cómo se adaptan al nuevo ecosistema para sobrevivir. Poco a poco, las comunas han ido incorporando nuevas herramientas digitales. Los beneficios que ofrecen las nuevas tecnologías para la comunicación comunitaria son necesarios para una transformación que ayude no solo en lo económico, sino en lo cultural, educación y social.
Las narrativas audiovisuales en el diseño de videojuegos, aproximaciones teóricas, un acercamiento a sus particularidades
Authors: Lambert Sarango Yamil Edinson
Published: January 2023

Los videojuegos han sido investigados y analizados desde diferentes aristas y están dentro de la clasificación de las narrativas. En su diseño se evidencias particularidades como una propuesta de narrativas audiovisual diferente que se ajusta mejor a las necesidades del desarrollo contemporáneo. Esta investigación pone en contexto las narrativas audiovisuales, el objetivo es hacer una mirada teórica sistematizando principios conceptuales que sustenten el análisis de la relación entre narrativas audiovisuales, videojuegos, sociedad de la información y los nuevos medios. La metodología es de tipo cualitativa, se aplicó el método inducción-deducción, análisis-síntesis, revisión bibliográfica documental y el análisis de contenido cualitativo partiendo de la descomposición del objeto “videojuego”, los resultados muestran que los videojuegos como dispositivo cultural aportan transformaciones al nuevo lenguaje cinemático interactivo, que su narrativa audiovisual tiene un vínculo con la historia de las computadoras como un reflejo de su época y que como cualquier medio de comunicación son un producto cultural que se corresponde con un contexto, una sociedad y unos fines; que aprovechan la narrativa para expandir nuevas experiencias de comunicación.
Impacto de la implementación de contenido multimedia como estrategia para la creación de cursos digitales inclusivos
Authors: Navarro Suárez Armando
Published: January 2023

La presente investigación reflexiona en torno a los procesos comunicativos y los medios tecnológicos dentro del ámbito educativo. Toma como punto de partida las generalidades que vive la sociedad y sus nuevas formas de interacción tecnológicas, su impacto dentro de los procesos de enseñanza y, a su vez, el impacto en la generación de cursos incluyentes. Se destacan aspectos particulares de las nuevas prácticas docentes, así como el papel del estudiante, para posteriormente analizar el impacto que tienen los procesos de enseñanza basados en las TIC dentro de nuestra sociedad.
Materialidades y procesos de materialización de la etnografía como escritura académica
Authors: Rosas Flores Alba
Published: January 2023

Debido al predominio de una perspectiva semiótica y representacionalista en la escritura y la etnografía, las materialidades y los procesos de materialización de la etnografía apenas empiezan a ser estudiados por los propios antropólogos y etnógrafos. En este texto, luego de delimitar a la etnografía como escritura académica y diferenciarla de la antropología, una práctica que Tim Ingold define como de observación corresponsal, cito tres casos de investigaciones que han tomado en serio las materialidades de la etnografía. Posteriormente, haciendo referencia a mi investigación con ladrilleros e ingenieros electrónicos en México, reflexiono sobre el proceso de materialización de mi propia etnografía y me pregunto qué es actualmente escribir con la computadora portátil. Para ello, retomo el concepto de mediación que proponen Sarah Kember y Joanna Zylinska, así como la noción de aparato que presenta Karen Barad. Sugiero que escribir una etnografía es una práctica material- discursiva que implica agencias humanas y no humanas. Y también que, como aparato, la computadora produce dos cuerpos: la etnografía y la etnógrafa.
Arte como investigación. Sombras y repeticiones para ensayar otros modos de conocimiento y escritura
Authors: Reyero Alejandra , Navas Maia , Iribarne Gabriel , Bentolila Héctor
Published: January 2023

Este artículo discute los vínculos entre arte, ciencia e investigación. En términos teórico-metodológicos, concibe y practica la escritura como experiencia de composición multimodal en clave de invención ficcional. A través de la activación de procesos heurísticos y poéticos, mediados por el montaje, ensaya una propuesta de escritura que busca tensar los procedimientos habituales del discurso académico. Las operaciones desplegadas se basan en la repetición como procedimiento de experimentación textual. Recuperamos postulados de Gertrude Stein acerca de la “composición como explicación”, algunos argumentos de Gilles Deleuze sobre la filosofía como arte de fabulación de conceptos y la potencialidad de las repeticiones para hacer emerger diferencias que no se subordinan a lo idéntico. Por último, ciertos principios decoloniales nos permiten desarmar las gramáticas lumínicas del paradigma ocularcéntrico occidental que establece formas de saber, mirar y sentir.
Indiscernibilidade transdisciplinar e o sentido da literatura (Versión en portugués)
Authors: Torelly Gabriel , Zordan Paola
Published: January 2023

O artigo discute o problema da inscrição do sentido na linguagem. Via revisão bibliográfica, objetiva evidenciar aporias entre as tendências do estruturalismo e do pós-estruturalismo. Argumenta-se que tais sistematizações epistêmicas produzem incidências nas próprias noções de método e objeto científico. Como especificidade, propõe-se uma leitura particular de Lógica do sentido e outros escritos de Gilles Deleuze e seus intercessores. Apresenta-se ressonâncias e deslocamentos entre os limiares epistemológicos e expressivos da literatura e da filosofia. Conclui-se que tais debates teóricos, especialmente o que se apresenta em Lógica do sentido, induzem os sentidos da filosofia e da literatura a romper com seus limites disciplinares e postular uma objetidade paradoxal, a qual chamamos indiscernibilidade transdisciplinar.
A Aracuã & Outros Modos de Viver e de Dizer em Educação (Versión en portugués)
Authors: Uchaki de Matos Dayana
Published: January 2023

Este artigo se propõe como cultivo de um gesto especulativo ao imaginar as consequências de compreendermos os mundos como pluriontológicos e multiespecíficos. Propondo que a educação ocidental seria um corolário da metafísica ocidental circuntanciada como controle da continuidade de um modo de existir, mediante uma discussão entre autoras como Anna Tsing, Haraway, Stengers e Viveiros de Castro, reivindico a premência ética de um pausar e olhar ao redor para com-fabularmos-com diferentes modos de viver e narrar. Ao decidirmos dilatar o espectro de realidades de existentes que participam em nossas práticas e decisões, incorporando outras temporalidades como critério de elegibilidade, o que proponho aqui é assumir a atitude possível de gaguejar referida por Stengers, alegando que escrever de outros modos significa viver com e a partir de outros modos de existências.
Razões para escritas e guerrilhas espaço-temporais em educação (Versión en portugués)
Authors: Quirino da Silva Luiz Carlos
Published: January 2023

Neste texto, apresentamos alguns precedentes responsáveis pela emergência do que chamamos de procedimentos de guerrilha escritural. Tais procedimentos têm como principal objetivo a tentativa de produzir rachaduras no tipo de subjetividade engendrada pelos inúmeros dispositivos semióticos capitalísticos que nos demandam adaptação àvelocidade informacional. O efeito mais imediato de tal aceleração contínua é o empobrecimento da experiência e consequentemente a redução das expectativas quanto ao futuro. Este percebido, cada vez mais, como algo catastrófico ou, no limite, impossível. Sobretudo em educação, os procedimentos propostos ambicionam promover experimentações com o espaço, o tempo e um si mesmo articulados em modulações imprevistas.
Entre esculpir e fissurar: a escritura da docência (Versión en portugués)
Authors: Martins de Morais Tiago
Published: January 2023

Filmmaker Andrei Tarkovski wrote he often wondered if it was worth writing about cinema. Wouldn't it be better just make films and find practical solutions to theoretical problems throughout the work? Although there was doubt, he bet on writing as a way to transform the plane of the ordinary where one acts in theme of investigation and, thus, capture, with the text, bulges in the perpetual flow of the real. In dialogue with Tarkovski, we can understand writing as a toll of attention to teaching – write about it, produce fiction about it and disturb the pedagogical thinking investing in a non-essentialized way, mobilizing, in writing, the marks and singularities of our pedagogical experiences. Aligned with Nietzsche's writing, a self- genealogical scripture is produced as an exercise, in a practice that is not restricted to an individual, but extends to a broader field of forces of which he or she belongs.
Escrituras creativas en la universidad. Algunas ideas, experiencias e indisciplinas
Authors: Elisondo Romina Cecilia
Published: January 2023

The objective of this paper is to reflect on the role of creative writing in the university. Our proposal is based on cognitive studies of creativity and current development on creative teaching. We present four experiences, in our opinion, of creative writing at the university: travel notebooks, paths of life, a class in a word and tips to become a creative scientist. Finally, we try to articulate creative writing, teaching, research and university connection. In the writing we take some licenses, we include images of the experiences and some brief stories. The text intends to challenge from questions and not answers or certainties. We seek, at least in part, to tell our experiences by appealing to different formats and modalities. We invite readers to generate creative spaces in the university where spaces are enabled for indiscipline, border writing and divergent actions.
Learning Arabic Reading Skills Based on E-Learning Using SIKULI during the Covid-19 Pandemic
Authors: Wibowo Budi Santoso , Yul Widiya , Andrian Riko
Published: January 2023

Abstract
This paper explores the steps for learning Arabic reading skills based on e-Learning using SIKULI and the advantages and disadvantages of e-Learning. The approach is a descriptive qualitative approach with three data collection techniques, namely: (1) observation, (2) interviews, and (3) documentation. The results showed that there were three steps taken by lecturers in implementing e-Learning-based Arabic reading skills using SIKULI, namely: (1) pre-learning, (2) implementation of learning, and (3) evaluation of learning. Researchers also found several advantages of implementing e-Learning-based Arabic reading skills using SIKULI, namely: (1) assisting the internal quality assurance system (SPMI) through monitoring and evaluation, (2) practical and flexible, (3) providing supporting features and menus. However, besides having various advantages, as an e-Learning that has just been built and used, SIKULI is also not free from multiple shortcomings, namely: (1) frequently interrupted system, (2) no notifications, (3) poor internet network. Nevertheless, The results of this sytudy are hoped to provide insight and alternative solutions for lecturers in carrying out online learning of Arabic reading skills during the Covid-19 pandemic.
Keywords: Learning, Arabic Reading Skills, e-Learning, SIKULI, Covid-19
ERİŞKİN GEBELERDE BAKILAN NÖTROFİL/LENFOSİT ORANI, PLATELET/LENFOSİT ORANI VE HEMOGLOBİN DEĞERLERİNİN DOĞUM AĞIRLIĞI İLE İLİŞKİSİ VE BU SONUÇLARIN ADÖLESAN GEBELER İLE KARŞILAŞTIRILMASI
Authors: SAYAR İlknur , YİĞİT Ece , SAPMAZ Mehmet Alican , YİLMAZ Elif , KÜÇÜKÖZKAN Tuncay
Published: January 2023

AMAÇ: Adölesan ve erişkin gebelerde hemoglobin, nötrofil/lenfosit oranı, platelet/lenfosit oranı değerlerinin fetal doğum ağırlığı ile olan ilişkisinin değerlendirilmesi ve her iki grubun birbiri ile karşılaştırılarak anne yaşının bu değerler üzerine etkisinin araştırılmasıdır.

GEREÇ VE YÖNTEM: Çalışmaya kliniğimizde doğum yapmış, canlı, tekil gebeliği olan adölesan ve erişkin hastalar dahil edilmiştir. Dosyalarından sosyodemografik ve obstetrik bilgilerine ve ikinci trimestera ait hemogram parametrelerine ulaşılmıştır. Fetal doğum ağırlığı, hemoglobin, nötrofil, lenfosit, platelet değerleri kaydedilmiş ve nötrofil/lenfosit, platelet/lenfosit oranları hesaplanmıştır. Bu değerlerin adölesan ve erişkin gebelerdeki durumu ve fetal ağırlık ile olan ilişkisi değerlendirilmiştir.

BULGULAR: Erişkin grupta fetal doğum ağırlığı ve hemoglobin değerleri adölesan gruba göre anlamlı düzeyde daha yüksek, nötrofil, platelet ve nötrofil/lenfosit değerleri ise anlamlı düzeyde düşük bulunmuştur. İki grup arasında lenfosit ve platelet/lenfosit değerleri açısından anlamlı bir fark tespit edilmemiştir. Gebelerin yaş gruplarına göre fetal ağırlık ve kan parametreleri ilişkisi incelendiğinde her iki grupta da gebelerin hemoglobin değeri arttıkça fetal ağırlığın arttığı ve nötrofil, platelet, nötrofil/lenfosit, platelet/lenfosit değerleri arttıkça fetal ağırlığın azaldığı görülmüştür. Lenfosit değerleriyle fetal ağırlık arasında anlamlı bir ilişki saptanmamıştır.

SONUÇ: Adölesan gebeler anemi, düşük doğum ağırlığı gibi obstetrik komplikasyonlar açısından daha yüksek risk altındadır. Tüm yaş gruplarında aneminin erken tanısı ve tedavisi fetal gelişim açısından önemlidir. Maternal inflamasyon fetal gelişimi olumsuz etkilemektedir. Nötrofil/lenfosit oranı ve platelet/lenfosit oranı inflamasyonun erken tespitine ve tedavisine dolayısı ile komplikasyonların engellenmesine yardımcı olabilecek markerlardır.
İlk Trimester Serum Belirteçlerinin Plasenta Akreta Spektrumu Öngörüsündeki Önemi: Vaka Kontrol Çalışması
Authors: YILDIRIM Muradiye , OLUKLU Deniz , TURGUT Ezgi , SAHİN Dilek
Published: January 2023

Amaç: Plasenta previa (PP) tanılı olgularda plasenta akreta indeks (PAI) skoru ile ilk trimester serum belirteçlerinin (PAPP-A, serbest β HCG) Plasenta Akreta Spektrumu (PAS) öngörüsündeki yerini araştırmayı amaçladık.

Gereç ve Yöntemler: Çalışmamıza 30 PAS, 30 adezyon anomalisi saptanmayan plasenta previa olgusu ile 60 sağlıklı gebe dahil edildi. Çalışmaya dahil edilen olguların, üçüncü trimesterda PAI skoru belirlendi, ardından ilk trimester serum belirteçleri ve operasyon sonuçları (sezaryen, histerektomi) kaydedildi.

Bulgular: Çalışmamızda da PP ve kontrol grubundaki olgular karşılaştırıldığında PAPP-A(mIU/ml), PAPP-A MoM ve serbest β HCG MoM değerleri PP grubunda istatistiksel olarak anlamlı derecede daha yüksekti (p
Doğum eyleminde maternal ve fetal kanda melatonin ve beta-endorfin düzeylerinin değerlendirilmesi
Authors: YAMAN Selen , EROL KOÇ Esin Merve , HANÇERLİOĞULLARI Necati , MORALOĞLU TEKİN Özlem
Published: January 2023

Amaç: Melatonin vücutta birçok biyolojik düzenlemede görev alan ve oksidatif stresle ilişkili bir nörotransmitterdir. Β-endorfin ise morfin benzeri özelliği olan ve benzer şekilde ağrı ve oksidatif stresle ilişkili durumlarda hipofiz bezinden salgılanan doğal bir narkotiktir. Biz bu çalışmada, elektif sezaryen ile doğum yapan veya normal doğum eylemi başladıktan sonra sezaryen ile doğum yapan gebelerde, maternal kanda ve kord kanında, melatonin ve β-endorfin seviyelerini araştırmayı amaçladık.

Gereç ve Yöntem: Çalışmamıza, sezaryen ile doğum yapan 80 gebe dahil edilmiştir. Normal doğum eylemi başladıktan sonra sezaryen ile doğumun gerçekleştiği olgular Grup 1 (n=30), elektif sezaryen ile doğumun gerçekleştiği olgular Grup 2 (n=50) olarak adlandırıldı. İki grubun demografik ve klinik verileri kaydedildi. Maternal ve kord kanından alınan venöz kandan elde edilen serum örneklerinde melatonin ve β-endorfin düzeyleri analiz edildi. Elde edilen datalar iki grup arasında karşılaştırıldı.

Bulgular: Umbilikal kord melatonin ve maternal β-endorfin düzeyleri karşılaştırıldığında ise her iki hormon düzeyinin de grup 1’de grup 2’ye kıyasla anlamlı olarak daha yüksek olduğu tespit edildi (sırasıyla; p=0.04, p=0.001). Maternal melatonin ve maternal β-endorfin düzeyleri açısından iki grup arasında istatiksel anlamlı fark saptanmadı (sırasıyla; p=0.18, p=0.16).

Sonuç: Melatonin ve β-endorfin düzeylerinin oksidatif stres ile ilişkili olduğu bilinmektedir ve bu hormonların düzeyinin normal doğum başladıktan sonra yapılan sezaryen doğumlardaki kord kanında anlamlı olarak daha yüksek olduğu saptanmıştır. Bu bulgular, melatonin ve β-endorfinin spontan doğumun başlangıcında veya spontan doğum sürecinde rol alabilecek olası fizyolojik yolaklarda görev alabileceğini düşündürmektedir. Melatonin ve β-endorfinin yenidoğandaki olası etkilerini de araştırmak için, elektif sezaryen doğumlardan ve spontan doğum eylemi başladıktan sonra gerçekleştirilen sezaryen doğumlardan sonraki yenidoğan izlemini de dahil eden çalışmalar planlanabilir.
Evaluation of placental pathologies in cases of placenta previa
Authors: TUĞRUL ERSAK Duygu , ŞERBETÇİ Hakkı , ZORLU Uğurcan , LALELİ KOÇ Bergen , KARA Özgür , SAHİN Dilek
Published: January 2023

Objective: The primary aim of our study was to evaluate the underlying placental pathologies of placenta previa (PP).

Materials and Methods: Over two years data of patients diagnosed to be PP in a tertiary center were obtained retrospectively. Routinely, the placentas of patients diagnosed to be PP were sent for pathological examination. Clinicodemographic data of the patients were recorded. The placental pathological findings were classified and evaluated in 5 main groups: maternal vascular lesions, fetal vascular lesions, inflammatory situations, umbilical cord findings, and normal. Additionally, complete blood count results at admission time for hospitalization and the outcomes of the neonates were recorded.

Results: Thirty-two patients diagnosed to be PP were included in the study. The median age was 34 (22-42), and the median gravidity number was 3 (1-6). Maternal vascular lesions were observed in nearly half of the PP patients as a pathological finding (43.75 %). Inflammation was observed in 10 patients (31.25 %), umbilical cord findings in 8 patients (25.0 %), and fetal vascular lesions in 2 patients (6.25 %), respectively. 3 patients were reported to have normal placentas. In addition, the median neutrophile, neutrophile lymphocyte ratio, and white blood count were found to be high at admission time for hospitalization

Conclusion: Maternal vascular lesions and inflammation were the most common detected placental pathological reports in PP patients. However, studies including the placentas of uncomplicated pregnancies will shed light on the literature to distinguish the pathological condition from the physiological condition.
Dördüncü derece perineal laserasyon görülen vajinal doğum olgularının maternal-fetal sonuçları ve klinik yönetimi
Authors: EROL KOÇ Esin Merve , YAMAN Selen , HANÇERLİOĞULLARI Necati , ÇELEN Şevki , MORALOĞLU TEKİN Özlem
Published: January 2023

Amaç: Dördüncü derece perineal laserasyon, anal sfinkter boyunca ve rektum mukozasının da dahil olduğu şiddetli perineal yırtıklardır. Çalışmamızda, hastanemizde doğum yapmış olan dördüncü derece perineal laserasyon görülen olguların klinik ve demografik özelliklerini, fetal sonuçlarını ve klinik yönetimini sunmayı amaçladık.

Gereç ve Yöntem: Çalışmamızda, Ocak 2014-Mayıs 2018 tarihleri arasında hastanemizin Obstetri kliniğinde doğum yapmış olan ve düşük riskli gebelik grubuna dahil olarak değerlendirilen hastaların verileri incelendi. Dördüncü derece perineal laserasyon gelişen olgular tespit edilerek çalışmaya dahil edildi. Çalışma retrospektif olarak dizayn edilmiş olup, etik kurul onayı ardından hastalara ait veriler hastanemizin güvenilir resmi veri tabanı ve hasta arşivleri kullanılarak elde edilmiştir. Çalışmamızda, dördüncü derece perineal laserasyon gelişen hastaların demografik özellikleri, klinik bulguları ve doğum sonuçları ile birlikte olguların yönetimi, erken ve uzun dönem izlemine ait veriler sunulmuştur.

Bulgular: Dördüncü derece perineal laserasyon tespit edilen 58 olgu çalışmaya dahil edildi. Olguların n=33’ü (%79) primipardı. Toplamda n=39’u (%67) hastaya doğum indüksiyonu uygulanmıştı. Hastaların 42 tanesi epizyotomili doğum yapmıştı, bunlardan 1 tanesine medyan epizyotomi uygulanmıştı. Yenidoğanların 1. ve 5. dk APGAR skorları normal aralıkta olup, 6’sının doğum ağırlığı >4000 gramdı. Rektovajinal fistül 2 hastada, fekal inkontinans 3 hastada görülmüştür. 2 hastada kolostomi ihtiyacı duyulmuştur.

Sonuç: Dördüncü derece perineal laserasyonlar, kadınların yaşam kalitesini son derece olumsuz etkileyen doğum travmalarıdır. Anal sfinkter hasarının önlenmesi için yalnızca fetal başın çıkışı sırasında değil, gebenin travay izleminin başından itibaren risk faktörleri göz önüne alınarak doğum eyleminin yönetimi planlanmalıdır.
Comparação da fibra acrílica e da fibra de borracha nas propriedades físicas e mecânicas do concreto f'c= 280 kg/cm2
Authors: Tamariz Aldair Enrique Sandoval , Vega Jeremi Jheferson Solano , Condori Luis Jimmy Clemente , Flores Leopoldo Choque
Published: January 2023

O objetivo deste artigo é mostrar a diferença de desempenho nas propriedades físicas e mecânicas entre a fibra de borracha e a fibra acrílica incorporada ao concreto f'c=280 kg/cm2. A pesquisa é do tipo aplicada, com abordagem quantitativa e em nível experimental. Foram confeccionados 126 espécimes com as proporções de FA (0,3%, 0,6%, 0,9%) e FC (3%, 5%, 7%) avaliados aos 7 e 28 dias. Nosso propósito é encontrar novos materiais ecológicos que possam produzir concretos sustentáveis que atuem com mais eficiência na construção civil. Os resultados obtidos no artigo mostram que a adição de 0,3% de FA aumenta a resistência à compressão e tração em 13,14% e 9,81%, porém, nos ensaios no estado fresco, qual é o peso unitário e o recalque, uma redução.
Adição de resíduos de café e cana-de-açúcar na resistência à compressão e à tração do concreto estrutural
Authors: Mendoza Ana Iris Castro , Pereda Fiorela Yselina Perez , Condori Luis Jimmy Clemente , Flores Leopoldo Choque
Published: January 2023

A pesquisa sobre a adição de resíduos de café e cana-de-açúcar na resistência à compressão e à tração do concreto estrutural teve como objetivo principal melhorar a resistência à compressão e à tração do concreto estrutural através da adição de resíduos da casca de café e cana-de-açúcar na proporção de GE 1 (2% CCC + 0.25% FBCA), GE 2 (4% CCC + 0.25% FBCA), GE 3 (2% CCC + 0.50%) e GE 4 (4% CCC + 0.50% FBCA) em substituição ao agregado miúdo, portanto, a investigação se justifica para melhorar as propriedades do concreto e sua contribuição para o ambiente. A metodologia usado um tipo e delineamento de pesquisa aplicada - experimental, que foi de amostragem não probabilística em que houve um padrão e amostra experimental de acordo com os critérios relevantes do pesquisador com Nesta investigação, o foram realizados os respectivos testes do concreto com base em 3 tubos de ensaio por dose de incorporação de cinza de casca de café e fibras de bagaço de cana para comodidade do pesquisador que incluiu vários fatores, posteriormente foram realizados os testes em laboratório e por fim foram analisados pelo Minitab ferramentas estatísticas.
Pain Mechanisms Associated With Disease Activity in Patients With Rheumatoid Arthritis Treated With Disease-Modifying Antirheumatic Drugs: A Regression Tree Analysis
Authors: Wohlfahrt Alyssa , Muhammad Lutfiyya N. , Song Jing , Dunlop Dorothy D. , Neogi Tuhina , Bingham Clifton O. , Bolster Marcy B. , Marder Wendy , Clauw Daniel J. , Lee Yvonne C.
Published: January 2023

Objective

Although pain affects the assessment of disease activity in patients with rheumatoid arthritis (RA), pain is not always directly related to peripheral joint inflammation. Peripheral and central nervous system regulatory mechanisms also affect pain perception. We used regression tree methodology to identify mechanisms most predictive of disease activity after disease-modifying antirheumatic drug (DMARD) treatment.

Methods

Disease activity was evaluated using the Disease Activity Score in 28 joints (DAS28) in 176 patients with RA, before and after starting a DMARD. Quantitative sensory testing (QST), including pressure pain thresholds (PPTs), temporal summation, and conditioned pain modulation (CPM), were used to assess pain mechanisms. Regression tree methodology was used to determine the QST modalities most predictive of DAS28 after DMARD treatment.

Results

This analysis identified 4 groups defined by baseline DAS28 category and either knee PPT (a combined measure of peripheral and central nervous system dysregulation) or CPM (a measure of descending pain inhibition). Among patients starting with low/moderate disease activity, lower knee PPT (PPT ≤ 4.65 kgf) most strongly predicted higher posttreatment disease activity (group 1 mean DAS28 2.8 [SD 1.0] vs group 2 mean DAS28 3.5 [SD 1.0]). Among patients starting with high baseline disease activity, less efficient descending pain modulation (CPM ≤ 1.55) most strongly predicted higher posttreatment disease activity (group 3 mean DAS28 3.4 [SD 1.4] vs group 4 mean DAS28 4.6 [SD 1.1]).

Conclusion

These results highlight the importance of identifying and treating aberrant peripheral and central pain regulation in patients with RA starting or switching DMARD therapy.
Cigarette Smoking Increases the Prevalence of Hip Joint Involvement in Ankylosing Spondylitis: A Real-World Case-Control Study
Authors: Hu Zhengyuan , Li Yan , Hu Lidong , Ji Xiaojian , Wang Lei , Li Kunpeng , Zhu Jian , Zhang Jianglin , Huang Feng
Published: January 2023

Objective

To investigate the association between cigarette smoking and hip joint involvement in ankylosing spondylitis (AS).

Methods

This case-control study compared patients with AS with and without hip involvement, as defined by the Bath Ankylosing Spondylitis Radiology Hip Index. Logistic regression analysis, subgroup analysis, and sensitivity analysis were conducted to estimate the association between smoking and hip involvement in AS.

Results

This study included 103 patients with hip involvement (cases) and 89 patients without hip involvement (controls). In univariate analysis, patients who had juvenile-onset AS (JAS), were younger, were male, had peripheral arthritis history, or had cigarette exposure were prone to hip involvement. After adjusting for confounding factors, JAS (adjusted odds ratio [aOR] 2.52, 95% CI 1.26-5.06), male sex (aOR 2.89, 95% CI 1.14-7.33), and cigarette smoking (aOR 7.23, 95% CI 2.27-23.05) were regarded to be independently associated with hip involvement in AS. Moreover, patients who smoked with exposure of less than 10 pack-years were 2.2 times more likely to have hip involvement than those without (aOR 2.21, 95% CI 1.09-4.47). This association was reproduced in subgroup analyses of males and propensity score–matched subjects, and it withstood sensitivity analysis.

Conclusion

Smoking is a novel independent risk factor for hip involvement in AS; even exposure of less than 10 pack-years could contribute to increased prevalence of hip involvement in AS, which underlines the significance of smoking cessation in patients with AS, especially for JAS.
Preferences for COVID-19 Vaccination in People With Chronic Immune-Mediated Inflammatory Diseases
Authors: Hazlewood Glen S. , Colmegna Ines , Hitchon Carol , Fortin Paul R. , Bernatsky Sasha , Clarke Ann E. , Mosher Dianne , Wilson Todd , Thomas Megan , Barber Claire E.H. , Harrison Mark , Bansback Nick , Proulx Laurie , Richards Dawn P. , Kaplan Gilaad G.
Published: January 2023

Objective

To understand how people with chronic immune-mediated inflammatory diseases (IMIDs) trade off the benefits and risks of coronavirus disease 2019 (COVID-19) vaccine options.

Methods

We conducted an online discrete-choice experiment in people with IMIDs to quantify the relative importance (RI) of attributes relevant to COVID-19 vaccination. Participants were recruited between May and August 2021 through patient groups and clinics in Canada, and completed 10 choices where they selected 1 of 2 hypothetical vaccine options or no vaccine. The RI of each attribute was estimated and heterogeneity was explored through latent class analysis.

Results

The survey was completed by 551 people (89% female, mean age 46 yrs) with a range of IMIDs (inflammatory bowel disease [48%], rheumatoid arthritis [38%], systemic lupus erythematosus [16%]). Most had received 1 (94%) or 2 (64%) COVID-19 vaccinations. Across the ranges of levels considered, vaccine effectiveness was most important (RI = 66%), followed by disease flare (21%), rare but serious risks (9%), and number/timing of injections (4%). Patients would accept a risk of disease flare requiring a treatment change of ≤ 8.8% for a vaccine with a small absolute increase in effectiveness (10%). Of the 3 latent classes, the group with the greatest aversion to disease flare were more likely to be male and have lower incomes, but this group still valued effectiveness higher than other attributes.

Conclusion

Patients perceived the benefits of COVID-19 vaccination to outweigh rare serious risks and disease flare. This supports COVID-19 vaccine strategies that maximize effectiveness, while recognizing the heterogeneity in preferences that exists.
Sleep and Sleep Complaints in Juvenile Fibromyalgia Syndrome
Authors: Malattia Clara , Chiarella Lorenzo , Sansone Miriam , Pistorio Angela , Lavarello Claudio , Carpaneto Manuela , Ferri Raffaele , Ravelli Angelo , Nobili Lino
Published: January 2023

Objective

To investigate sleep quality in juvenile fibromyalgia syndrome (JFS) and its effect on the global burden of the disease.

Methods

Consecutive patients with JFS who performed full-night polysomnography (PSG) were included in this cross-sectional study. JFS-related symptoms, neuropsychiatric features, and sleep quality were assessed using self-report measures. PSG sleep parameters, including N3 distribution index, were obtained from patients and age-matched healthy controls.

Results

We included 25 patients (20 females, median age 15.7 yrs). Nonrestorative sleep was reported by 22 of 25 (88%) patients. Patients with JFS showed significantly longer sleep period time (P= 0.004) and increased wake after sleep onset (P= 0.03) compared to healthy peers. The N3 distribution index was significantly lower in patients than in the control group (P= 0.02). Subjective poor sleep quality was related to Widespread Pain Index (WPI;rs−0.65), Symptom Severity Scale (rs−0.64), depressive symptoms (rs−0.58), fatigue (rs−0.44), and symptom severity upon awakening (rs−0.65). The N3 distribution index was correlated to depressive symptoms (rs0.41) and irritability (rs0.40). On multiple regression analysis, WPI was predicted by subjective sleep quality (β −0.32,P= 0.04), whereas depressive symptoms were predicted by subjective sleep measures (β −0.32,P= 0.04) and PSG parameters (N3 min: β −0.07,P= 0.03).

Conclusion

Sleep complaints are a key hallmark of JFS and have significant effect on relevant clinical domains of the disease, such as pain and depression.
Investigating Associations Between Access to Rheumatology Care, Treatment, Continuous Care, and Healthcare Utilization and Costs Among Older Individuals With Rheumatoid Arthritis
Authors: Barber Claire E.H. , Lacaille Diane , Croxford Ruth , Barnabe Cheryl , Marshall Deborah A. , Abrahamowicz Michal , Xie Hui , Aviña-Zubieta J. Antonio , Esdaile John M. , Hazlewood Glen S. , Faris Peter , Katz Steven , MacMullan Paul , Mosher Dianne , Widdifield Jessica
Published: January 2023

Objective

To examine the association between rheumatologist access, early treatment, and ongoing care of older-onset rheumatoid arthritis (RA) and healthcare utilization and costs following diagnosis.

Methods

We analyzed data from a population-based inception cohort of individuals aged > 65 years with RA in Ontario, Canada, diagnosed between 2002 and 2014 with follow-up to 2019. We assessed 4 performance measures in the first 4 years following diagnosis, including access to rheumatology care, yearly follow-up, timely treatment, and ongoing treatment with a disease-modifying antirheumatic drug. We examined annual healthcare utilization, mean direct healthcare costs, and whether the performance measures were associated with costs in year 5.

Results

A total of 13,293 individuals met inclusion criteria. The mean age was 73.7 (SD 5.7) years and 68% were female. Total mean direct healthcare cost per individual increased annually and was CAD $13,929 in year 5. All 4 performance measures were met for 35% of individuals. In multivariable analyses, costs for not meeting access to rheumatology care and timely treatment performance measures were 20% (95% CI 8-32) and 6% (95% CI 1-12) higher, respectively, than where those measures were met. The main driver of cost savings among individuals meeting all 4 performance measures were from lower complex continuing care, home care, and long-term care costs, as well as fewer hospitalizations and emergency visits.

Conclusion

Access to rheumatologists for RA diagnosis, timely treatment, and ongoing care are associated with lower total healthcare costs at 5 years. Investments in improving access to care may be associated with long-term health system savings.
The Role of Complement in Autoimmune Disease-Associated Thrombotic Microangiopathy and the Potential for Therapeutics
Authors: Java Anuja , Kim Alfred H.J.
Published: January 2023

The complement system is a tightly regulated, cascading protein network representing a key component linking the innate and humoral immune systems. However, if misdirected or dysregulated, it can be similarly damaging to host-tissue. The role of complement dysregulation on vascular endothelial cells has been well established in atypical hemolytic uremic syndrome (aHUS), a thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and target organ injury. Yet, a great deal of complexity exists around the role of complement in TMA associated with other diseases. A further complicating factor is the cross-talk between complement, neutrophils, and coagulation pathways in the pathophysiology of TMA. Advancements in the understanding of the etiopathogenesis of aHUS paved the way for the successful development of anticomplement therapies (complement C5 inhibitors), which have revolutionized the treatment of aHUS. Therefore, a clearer understanding of the role of the complement system in TMA associated with other conditions will help to identify patients who would benefit from these therapies. This review aims to provide an assessment of the nature and extent of complement involvement in TMA associated with autoimmune diseases such as systemic lupus erythematosus, antiphospholipid syndrome, and scleroderma renal crisis. Defining the role of complement in TMA in these conditions will help to guide timely diagnosis and management.
Patient Care Pathways for Pregnancy in Rare and Complex Rheumatic Diseases: Results From an International Survey
Authors: Tani Chiara , Zucchi Dina , Bellis Elisa , Birru Talabi Mehret , Frise Charlotte , de Jesús Guilherme Ramires , Koksvik Hege Svean , Lledó Gema Maria , Mekinian Arsène , Marinello Diana , Palla Ilaria , Mehta Puja , Comet Luis Sáez , Shaimaa Shoela , Smeele Hieronymus T.W. , Talarico Rosaria , Brucato Antonio , Khamashta Munther , Shoenfeld Yehuda , Tincani Angela , Mosca Marta
Published: January 2023

Objective

To map existing organizational care pathways in clinical centers of expertise that care for pregnant women affected by rare and complex connective tissue diseases (rcCTDs).

Methods

An international working group composed of experts in the field of pregnancy in rcCTDs co-designed a survey focused on organizational aspects related to the patient’s pathway before, during, and after pregnancy. The survey was distributed to subject experts through referral sampling.

Results

Answers were collected from 69 centers in 21 countries. Patients with systemic lupus erythematosus and/or antiphospholipid syndrome were followed by more than 90% of centers, whereas those with disorders such as IgG4-related diseases were rarely covered. In the majority of centers, a multidisciplinary team was involved, including an obstetrician/gynecologist in 91.3% of cases and other healthcare professionals less frequently. Respondents indicated that 96% of the centers provided routine pre-pregnancy care, whereas the number of patient visits during pregnancy varied across centers. A formalized care pathway was described in 49.2% of centers, and 20.3% of centers had a predefined protocol for the monitoring of pregnant patients. Access to therapies during pregnancy also was heterogeneous among different centers.

Conclusion

In international referral centers, a high level of care is provided to patients with rcCTDs before, during, and after pregnancy. No significant discrepancies were found between European and non-European countries. However, this work highlights a potential benefit to streamlining the care approaches across countries to optimize pregnancy and perinatal outcomes among patients with rcCTDs.