bluuebunny/crossref_metadata_2025 huggingface dataset:
Miadında Gebelerde Membran Stripping Yönteminin Gebelik Süresine Etkisi
Authors: ADANACIOĞLU Fatih , GÜZİN Kadir
Published: March 2023

Amaç: Doğum indüksiyon metodlarından membran sıyırma veya stripping yöntemi obstetrikte miadında gebelerde sık kullanılan işlemlerden biridir, non-farmakolojik yöntemlerdendir. Çalışmada bu yöntemin doğum sürecindeki etkileri, doğumu başlatma ve gebelik süresini kısaltma, postterm gebeliği önleme, indüksiyon gereksinimini azaltma yönlerinden etkinliği, etkinliğine etki eden faktörleri ve bu yönteme bağlı fetal ve maternal sonuçları araştırmak hedeflendi.
Gereç ve Yöntemler: Çalışmaya, ilk obstetrik değerlendirmede tekil canlı gebeliği olan, 38-40 hafta arası miadında olan, C/S (sezaryen) veya herhangi bir uterin cerrahi geçirmemiş olan, Bishop skoru 4 veya daha küçük olan, vajinal yoldan doğum için kontrendikasyonu olmayan olgular alındı. Çalışma toplam 216 olgu üzerinde yapıldı. 108 olgu (42 multipar, 66 nullipar) çalışma, 105 olgu (48 multipar, 57 nullipar) kontrol grubunu oluşturdu.
Bulgular: Çalışma grubunda uygulamadan doğuma kadar geçen süre (gün) ortalaması 7,04 ± 3,96 kontrol grubunda ise 9,24 ± 5,01 bulundu. Çalışma grubunda 7 gün içerisinde vajinal doğum yapma oranı (%68,5), kontrol grubundan (%43,8) istatistiksel olarak ileri düzeyde anlamlı yüksek bulundu. Çalışma grubunda 41. Gebelik haftasından önce doğum yapma oranı (%84,3), kontrol grubundan (%69,5) istatistiksel olarak anlamlı düzeyde yüksek bulundu. İndüksiyon gereksinimi çalışma grubunda (%11,1) kontrol grubuna (%23,8) kıyasla istatistiki olarak anlamlı düzeyde düşük bulunmuştur. Her iki grup doğum şekli, erken membran rüptürü, neonatal sonuçlar, maternal enfeksiyon açısından karşılaştırıldıklarında sonuçlar benzer bulundu.
Sonuç: Membran sıyırma yönteminin, komplike olmayan 38-40 hafta arasındaki term gebelerde, maternal-fetal sonuçları değiştirmeden, uygulamadan doğuma kadar geçen süreyi, postterm gebelik oranlarını ve indüksiyon gereksinimini azaltma açısından etkili ve güvenilir bir yöntem olduğu gözlemlenmiştir.
COVID-19 Tanısı Alıp Yoğun Bakımda Takip Edilen Sürekli Renal Replasman Tedavisi İhtiyacı Olan Hastaların APACHE-II ve SOFA Skoru ile Değerlendirilmesi
Authors: AKIN ŞEN İrem , ARSLAN Şenol , ŞEN Cem
Published: March 2023

Amaç: Dünya Sağlık Örgütü (DSÖ) tarafından Aralık 2019 yılında pandemi ilan edilen COVID-19 salgını sonrası, Mart’ın ikinci haftasından itibaren ülkemizde olgular bildirilmiştir. COVID-19 olgularının %5’inde hastalığın seyri sırasında yoğun bakım ünitesine (YBÜ) yatış ihtiyacı gelişmektedir. Bu çalışma ile YBÜ’de izlediğimiz kritik durumdaki COVID-19 hastalarından sürekli renal replasman (CRRT) tedavisi ihtiyacı olan hastaların mortalite oranlarını APACHE-II ve SOFA skoru ile değerlendirmesi amaçlanmıştır.
Gereç ve Yöntemler: Mart–Eylül 2020 arasında Eğitim Araştırma Hastanesinin Anestezi Yoğun Bakım Ünitesine yatırılıp CRRT ihtiyacı olan 13 hasta APACHE-II ve SOFA skorlama sistemi ile değerlendirildi. CRRT uygulamasından önce ve uygulamadan 2 gün sonra APACHE-II ve SOFA skorları kaydedildi. Mortalite açısından skorlama sistemleri kıyaslandı.
Bulgular: CRRT öncesi ve sonrası APACHE-II ve SOFA skorlama sitemlerine bakıldığında; CRRT öncesi APACHE-II skorlama sisteminin tahmini ölüm oranın öngörmede daha belirleyici olduğu; fakat CRRT sonrası APACHE-II ve SOFA skorlama sisteminin birbiriyle farkı olmadığı görülmüştür. Hastanede yatış süreleri değerlendirildiğinde APACHE-II ile SOFA skorlama sistemi arasında negatif yönde bir ilişki bulunmuştur.
Sonuç: Çalışmamız literatür ile uyumlu olarak erkeklerde ve hipertansiyonu olan hastalarda mortalitenin daha yüksek olduğunu göstermiştir. Ayrıca APACHE-II ve SOFA skoru arasında CRRT sonrasında mortalite açısından fark olmadığını her iki sisteminde kullanılabileceğini gösterilmiştir. Bu sonuçların gelecekteki takip ve tedavi yöntemlerine katkı sağlayabileceği düşünülmekle birlikte yeni çalışmalara ihtiyaç vardır.
Yanık Merkezinde Tedavisi Yapılan Elektrik Yanıklı Hastaların Kronik Yaraya Dönüşümünün Değerlendirilmesi
Authors: IRMAK KAYA Zeynep , BİLGİN Çağlar
Published: March 2023

Amaç: Yanık merkezi yoğun bakımında elektrik yanığı nedeniyle takip edilen hastaların yaralarının kronik yaraya dönüşümleri değerlendirilmiştir.
Gereç ve Yöntemler: Mayıs 2019 - Ekim 2021 tarihleri arasında Eskişehir Şehir Hastanesi Yanık Merkezi yoğun bakımında elektrik akımına maruziyet ile takip edilen, elektrik akım giriş ve çıkış yerleri ekstremitelerde belirgin olan, 3. derece ve üzeri yanık oluşmuş hastalar retrospektif olarak incelenerek, hastaların elektrik akımı maruziyeti sonrası takipleri ile taburculuk sonrası poliklinik izlemlerinde yara yerleri değerlendirilmiştir.
Bulgular: Yanık merkezi yoğun bakımda takip edilen 121 hastanın %28.9’u elektrik yanığı (n=35) olup, çalışmaya 30 hasta dahil edilmiştir. Çalışma kapsamına alınan 30 hastanın tamamı erkekti. Ortanca yaşları 31 yıl olup hastaların hiçbirinin kronik hastalığı yoktu. Hastaların %83.3’ü (n=25) iş kazası, %16.7’si (n=5) ev kazası olarak kayıtlara geçmiştir. Hastalarda 4-6 haftadan uzun süren, iyileşmeyen yaralar kronik yara olarak kabul edilmektedir. Çalışmamızda elektrik yanığından 4 hafta sonrasında yarası iyileşmeyenler kronik yara olarak kabul edilmiştir. Erken dönem başvuran 20 hastanın 7’sinin (%35), geç dönem başvuran 10 hastanın 8’inin (%80) kronik yaraya dönüşümü (p=0.02) saptanmış olup, yanık merkez yoğun bakımında takip edilen elektrik yanıklı hastaların %50’sinde (n=15) kronik yaraya dönüşüm olduğu belirlenmiştir.
Sonuç: Elektrik yanıkları her yaş grubundan sağlıklı insanın maruz kalabileceği, hayati riski olan yaralanmalar grubunu oluşturmaktadır. Çalışmamızda erken dönemde başvuran hastalarda geç başvurulara göre daha düşük oranda kronik yaraya dönüşüm gözlenmiş olup, elektrik yanıklarında erken başvuru ve müdahale ile kronik yaraya dönüşümünün azaltılmasının önemine dikkat çekilmek istenmiştir.
Evaluation of Hematological Indices in Acromegalic Patients
Authors: TOPUZ Emek , TÜZÜN Dilek , ÖZBAY Ümit Nur , ŞAHİN Murat
Published: March 2023

Objective: Acromegaly is a chronic systemic disease characterized by autonomous and excessive secretion of growth hormone (GH). Acromegaly is most
commonly caused by ais a somatotroph adenoma of the anterior pituitary. In acromegaly, mortality primarily results from are cerebrovascular, cardiovascular,
respiratory diseases and malignancies. Monocyte/lymphocyte ratio (MLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW),
platelet distribution width (PDW) and delta neutrophil index (DNI) are popular inflammatory markers. This study’s purpose was to assess pre/post-treatment
levels of NLR, GH, RDW, MLR, PDW and DNI in acromegalic patients and to investigate the impact of acromegaly treatment on these markers.
Materials and Methods: Twenty-six patients with acromegaly, treated and followed at our endocrinology outpatient clinic between April 2014 and February
2022 were included in the study. Age, sex, comorbidities, medications, complete blood count, kidney and liver function tests, pathology reports, tumor
size, pre/post-treatment levels of IGF-1, GH, DNI, NLR, MLR, RDW and PDW were retrieved from patients’ files and outcomes were evaluated.
Results: Among 26 patients included in the study, 12 (46%) were female and 14 (53%) were male. The average age of the patients was 53.73±16.21 years
(range, 25-79). There were 11 (42%) patients with type 2 diabetes mellitus and 9 (34%) patients with hypertension. A statistically significant reduction was
observed in post-operative GH, IGF-1, NLR, DNI, PDW and RDW values compared to preoperative values (during active disease phase) and at 6 months in
patients with postoperative cure, and compared to pretreatment values in patients without postoperative remission who received medical treatment. A reduction
was also observed in post-treatment MLR compared to pretreatment ratio but the difference was non-significant. There was no statistically significant
correlation between the IGF-1 levels at the time of diagnosis and NLR, RDW, PDW in patients with acromegaly.
Conclusion: Studies on the values of circulating inflammatory biomarkers in patients with acromegaly and their relationship to treatment remain unclear. In
our study, higher pre-treatment GH, IGF-1, NLR, DNI, PDW, RDW values were found compared to post- treatment. This suggests that having chronically
higher than normal values of IGF-1 may also lead to increased inflammatory markers such as NLR and increased atherosclerotic risk. Chronic subclinical
inflammation caused by uncontrolled disease might lead to an increase in mortality and morbidity in acromegalic patients. Therefore, early diagnosis and
treatment of acromegaly are crucial.
The Impact of Coronavirus-19 Lockdowns on The Number of Cranial and Spinal Trauma Cases in Geriatric Patients
Authors: KESİLMEZ Emrullah Cem , YÜKSEL Zafer
Published: March 2023

Objective: Geriatric patients are more prone to traumatic injuries, particularly cranial traumas and spinal fractures resulting from falls, due to osteoporosis
and sedentary lifestyles. As a primary measure against the Coronavirus-19 (Covid-19) pandemic, Turkey put into effect a lockdown for people aged 65 and
above. This study aimed to compare the change in the number of cranial and spinal trauma cases in the age group of 65 and above who were placed under
lockdown between 21st March and 3rd June 2020 with the number in the previous year.
Materials and Methods: The study included patients aged 65 and above who presented to the emergency departments and neurosurgery clinics of two
trauma centers in our city with cranial and spinal traumas between 21st March and 3rd June in 2019 and 2020. The patients were retrospectively categorized
in terms of age, gender, type of trauma and treatment.
Results: In total, 83 patients presented to the hospital between 21st March and 3rd June 2019 while only 12 patients presented between 21st March and 3rd
June 2020 (p<0.001). Of the 83 patients hospitalised in 2019, 43 were male and 40 were female, and of the 12 patients admitted in 2020, 4 were male and
8 were female (p=0.232). In 2019, 37 of the patients presented with isolated cranial trauma, 27 with isolated spinal trauma and 19 with spinal+orthopaedic
trauma. In 2020, 3 patients presented with isolated cranial trauma, 6 with isolated spinal trauma and 3 with spinal+orthopaedic trauma (p=0.33). Falls were
the most common cause of geriatric injuries in 2019 and during the lockdown period.
Conclusion: Our study reported that trauma was most likely to occur outside the home. Therefore, further research should be conducted to identify the
causes of trauma outside the home for this age group and measures need to be taken accordingly to the reduce occurrence of such traumas.s.
Experimental Study for Determining the Diameter of Plasma Channel and Energy Distribution Ratio into Workpiece during WEDM Process of AISI 316
Authors:   School of manufacturing, University Malaysia Perlis, Kampus Tetop U/u Pauh, Jalan Arau- Changlun 02600 Arau, Perlis, Malaysia, Warregh Adel S.O. , Md. Zain Zahiruddin M. ,   School of manufacturing, University Malaysia Perlis, Kampus Tetop U/u Pauh, Jalan Arau- Changlun 02600 Arau, Perlis, Malaysia
Published: March 2023

Electrodes removal phenomena of WEDM is importantto understand the efficiency and the process accuracy. To clarify and understand the phenomenon, the plasma channel diameter and distribution of energy into electrodes are required. However, reports on the distribution of energy and plasma channel diameter are scarce. In this work, the energy distribution and plasma diameter of WEDM process were obtained. By comparing the melted material boundary in the crater obtained by the metallographic approach with the curve isothermal of the thermo-physical model obtained by finite element modelling (FEM), the distribution of energy besides that diameter of the plasma channel of the WEDM process were estimated. From this study, results indicate that the expansion of the diameter of the plasma channel must be taken into consideration in order to be more consistent with the real WEDM process. By applying the proposed method in this study, the distribution of energy and diameter of plasma channel, in various dielectrics with different polarities were investigated. However, by comparing the findings of the current study with the previous works, it turns out that the distribution of energy into the workpiece and the diameter of the plasma channel may be calculated by this approach.
Material Characterization of Follower Assembly of G5 155mm Gun Howitzer Breach Mechanism Block
Authors:   Department of Engineering Business Management, Universiti Kuala Lumpur Malaysia Italy Design Institute, Cheras, 56100 Kuala Lumpur, Malaysia, M. Nayan Amran , Idris M.R. ,   Department of Engineering Business Management, Universiti Kuala Lumpur Malaysia Italy Design Institute, Cheras, 56100 Kuala Lumpur, Malaysia, Bakar S.R.S. ,   Science & Technology Research Institute for Defence (STRIDE), 43000 Kajang, Selangor, Malaysia, Ahmad M.Y. ,   Science & Technology Research Institute for Defence (STRIDE), 43000 Kajang, Selangor, Malaysia
Published: March 2023

Medium alloy steel is widely used as a material for guns and rocket launchers due to its high strength and excellent machinability characteristics. The purpose of this study is to determine the material properties of the follower assembly used in a breech block gun launcher which is significantly important f or t he future product improvement. The microstructure and the effect of alloying elements in the follower assembly is evaluated in this study. The SPECTRO Optical Emission Spectroscopy (ES) method is used to analyse the chemical composition of the material and the Field Emission Scanning Electron Microscope coupled with Energy Dispersive X-Ray (FESEM-EDX) were used to analyse the inclusions of the sample. Results of the ES chemical composition analysis found that Nickel (Ni) is the major alloying elements beside Molybdenum (Mo), Chromium (Cr), Manganese (Mn), Silicon (Si), Sulphur (S), and Carbon (C) while chemical mapping and line scanning analysis of FESEM-EDX on inclusions distributed in the material microstructure identified as a compound of Manganese Sulphur(MnS). Fine dendritic microstructure arrangement and distribution in the microstructure analysis showed that the sample had been quenching in the heat treatment process, which also played a significant role in the material characterization. From the analysis, it is found that the material can be defined as medium alloy steel that is also typical for high strength material for ballistic application.
Multiple Renewable Input and Output Emergency Portable Power Supply
Authors:   Department of Science & Maritime Technology, Faculty of Science and Defence Technology, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia., Thanakodi Suresh , Ahmad Zaidi Ahmad Mujahid ,   Department of Science & Maritime Technology, Faculty of Science and Defence Technology, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia., Miskon Azizi ,   Department of Electrical and Electronic Engineering, Faculty of Engineering, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia., Moh Nazar Nazatul Shiema ,   Department of Electrical and Electronic Engineering, Faculty of Engineering, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia., Nik Hanapi Nik Zamiri ,   95 Royal Signal Regiment, Sungai Besi Camp, 57000 Kuala Lumpur, Malaysia.
Published: March 2023

Currently portable power supply unit either powered by diesel generator or solar powered are only able to supply for alternating current (AC) or single direct current (DC) loads. In this work, multiple renewable input and output emergency portable power supply (E-PPS) prototype were developed and the functionality were explored. The developed prototype usage duration was determined by varying electrical loads. Verifications were carried out to demonstrate E-PPS functionality and usage during emergency with Malaysian Health-care Department, Malaysian Civil Defence Agency, and Malaysian Royal Signals Regiment. It was found that E-PPS managed to successfully supply simultaneous power for both alternating current (AC) and various direct current (DC) loads at an average of 88% efficiency.
Design of Aircraft Lateral Control Laws Simulation for Teaching and Learning
Authors:   Faculty of Engineering, National Defense University of Malaysia, Sg. Besi Camp, Kuala Lumpur, Malaysia., Abdul Rashid Zuhairi , Budinger Valérie ,   Institut Supérieur de L'aéronautique et de L'espace (ISAE-SUPAERO), Pastor Philippe ,   Institut Supérieur de L'aéronautique et de L'espace (ISAE-SUPAERO), Syed Mohd Dardina Syed Mohd Fairuz ,   Faculty of Engineering, National Defense University of Malaysia, Sg. Besi Camp, Kuala Lumpur, Malaysia., Nordin Norzaima ,   Faculty of Engineering, National Defense University of Malaysia, Sg. Besi Camp, Kuala Lumpur, Malaysia.
Published: March 2023

This paper studies the design of a simulator to simulate the general behaviour of an aircraft in its lateral motion. The study will be in two parts: the aircraft lateral natural system and the design of the control laws. In the aircraft lateral natural system, all modes will be discussed including the Pure Roll mode, the Dutch Roll mode, and the Spiral mode. In the design of the control laws, two types of control laws were discussed which are the yaw damper and the poles placement method. The result is a complete simulator for aircraft lateral motion which allows the user to simulate and study the lateral characteristic of an aircraft given the desired input. The simulator resulted from this study is suitable to be used for teaching and learning as the changes in parameters yield instantaneous results that can be displayed.
Investigation on the Electrical Properties of Palm Oil Under Different Concentration of Recycle Organic Material (Pepper Seed) Doping in Transformer Application
Authors:   Faculty of Engineering, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia, Md Din Muhamad Faiz , Zakaria Mohd Faiz ,   Faculty of Engineering, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia, Makmor Nazrul Fariq ,   Faculty of Engineering, National Defence University of Malaysia, 57000 Kuala Lumpur, Malaysia, W. Zamri Wan Fathul Hakim ,   Department of Mechanical & Manufacturing Engineering (JKMP), Universiti Kebangsaan Malaysia (UKM), Malaysia, Wang Jianli ,   Institute for Superconductivity and Electronic Materials, University of Wollongong, New South Wales 2522, Australia, Dou Shi Xue ,   Institute for Superconductivity and Electronic Materials, University of Wollongong, New South Wales 2522, Australia
Published: March 2023

Many researchers nowadays are looking to find another alternative to replace the use of mineral oil as an insulation fluid used in transformer due to the amount of minerals oil that are depleted. One of the alternatives is by using palm oil as an insulation fluid. However, something must be done to improve the breakdown voltage of palm oil if it wants to replace the use of mineral oil as an insulation fluid. One of approved methods to improve the dielectric strength of palm oil is by inserting another particle inside the oil. In this study, an investigation will be carried out to observe the effect of recycling organic material (black pepper) doping on Refined Bleached Deodorized Palm Oil (RBDPO) for AC breakdown voltage application will be carried out. It is concluded that, 2.5 mm gap between two electrodes produce the highest breakdown voltage compared with 1.5 mm and 2.0 mm. Other than that, the smallest size of black pepper which is 150 mm shows having the highest breakdown voltage compared to 300 mm and 600 mm. A test with different concentration of pepper seed with 0.01%, 0.05%, 0.1%, 0.15%, 0.2%, 0.4%, and 0.5% were conducted and shows that the breakdown voltage starts to increase as the concentration increases from 0.01% until 0.15% and start decreasing from 0.02% until 0.5%. Black pepper doping inside the palm oil does increase the performance of palm oil up to 13% from 49.66 kV to 57.4 kV
Nonlinear Algorithms for Controlling a Group of Mobile Agents on a Segment
Authors: Aleksandrov A. Yu. , Ruzin S. B.
Published: March 2023

A group of mobile agents on a straight line is considered. Agents are understood as numbered points that can change their position. It is assumed that the dynamics of agents is modeled by second-order integrators, with each agent receiving information from one of its left and one of its right neighbors (not necessarily nearest neighbors). It is required to provide a given nonlinear-uniform (uniform with respect to a prescribed nonlinear function) deployment of agents on a straight line segment. It is worth mentioning that, in numerous applications such as optic, acoustics, physiology, information theory, thermodynamics, etc., instead of linear scale, nonlinear ones (for instance, logarithmic) are used. In addition, it should be noted that an important class of formation control problems is synchronization of processes with respect to certain functions of phase coordinates. To solve the stated problem, nonlinear decentralized protocols are proposed. The conditions on the control parameters are determined, under which the agents converge to the required positions. The robustness of the constructed control protocols with respect to communication delay and network topology switching (replacing chosen neighbors by the other ones) is investigated. In this case, it is assumed that information about the magnitude of the delay and about the switching law may be absent. It is shown that for any constant non-negative delay and any admissible law for switching connections, a given deployment of agents is guaranteed. The proofs of the stated statements are based on the application of the Lyapunov direct method and a special form of the decomposition method. Original constructions of Lyapunov functions and Lyapunov—Krasovskii functionals are used. The results of numerical simulation are presented, confirming the obtained theoretical conclusions.
Re‐Embedding Trade in the Shadow of Populism
Authors: Kolben Kevin , Rioux Michèle
Published: March 2023

In the last 75 years of international economic cooperation, we have witnessed tremendous changes. The global trade and investment regime is under pressure and undergoing a significant transformation. Supply chains are being restructured, new trade blocks are forming based on strategic and political considerations, support for trade among citizens is weak and inconsistent, and populist opposition to the global economic and political order is ascendant. In this time of uncertainty about the future of the world order, the articles for this thematic issue address how and if the global trade and investment regime can be re-embedded into society.
Analysis of the breast cancer progression frequency depending on the amount of surgical treatment performed after neoadjuvant drug therapy
Authors: Rykov M. Yu. , Maksimov D. A.
Published: March 2023

Purpose. To compare the incidence of breast cancer (BC) relapse after subcutaneous mastectomy and Madden radical mastectomy.

Patients and methods. The study included 102 patients diagnosed with BC with stages IIB – III, who underwent neoadjuvant drug therapy with a subsequent surgical stage of treatment on the basis of the Tver Regional Clinical Oncology Dispensary from 2017 to 2020. The main group included 50 patients who underwent subcutaneous mastectomy with simultaneous installation of an endoprosthesis: stage IIB – 31 (62 %) patients; stage III – 19 (38 %) patients. The comparison group included 52 patients who underwent surgical treatment in volume – radical mastectomy according to Madden (RME): Stage IIB – 34 (65.4 %) patients; stage III – 18 (34.6 %) patients. Depending on the subtype of the tumor, patients received neoadjuvant drug therapy.

Results. During the three-year follow-up period, the progression of the disease after subcutaneous RME was detected in 7 (14 %) patients. Locoregional relapses accounted for 4 cases (8 %), progression to distant organs 3 cases (6 %). After the Madden RME, disease progression was detected in 6 (11.5 %) patients. Locoregional relapses accounted for 3 cases (5.7 %), progression to distant organs 3 cases (5.7 %). The detected foci did not always coincide with the primary subtype of the tumor: in 5 cases the subtype was different (38.5 %), in 8 cases it coincided (61.5 %).

Conclusion. The frequency of development of locoregional and distant metastases did not statistically depend on the volume of surgical intervention (p > 0.05). It is reasonable to conduct a histological examination in case of progression to determine the tactics of treatment.
Preoperative chemotherapy usage experience for intrahepatic cholangiocarcinoma
Authors: Polyakov A. N. , Granov D. A. , Patyutko Yu. I. , Pokataev I. A. , Polikarpov A. A. , Kagacheva T. I. , Bazin I. S. , Umirzokov A. Sh. , Frantsev D. Yu. , Zhuikov V. N. , Podluzhny D. V.
Published: March 2023

Purpose of the study was to evaluate the safety and feasibility of preoperative chemotherapy in intrahepatic cholangiocarcinoma (IHCC).

Patients and methods. A total of 171 liver resections for IHCC were performed between 2007 and 2021, of which 24 were preceded by preoperative therapy (14.0 %). Systemic therapy was conducted in 11 patients (45.8 %). Regional chemotherapy was provided to 13 patients (54.2 %). In two cases, regional chemotherapy was supplemented with systemic therapy.

Results. A significant increase in the proportion of patients with clinical stage IIIb and higher was observed in the group of patients who had received preoperative therapy (83.3 % vs. 35.4 %, p < 0.0001). Complications of preoperative therapy occurred in 45.8 % of patients, with grade three and above complications identified in three patients (12.5 %). The incidence of postoperative complications (37.5 % vs. 42.9 %, p = 0.79), post‑resection liver failure (8.3 % vs. 13.6 %, p = 0.7) and postoperative mortality (4.2 % vs. 3.4 %, p = 0.68) in the preoperative therapy group were similar to those in the control group. The rate of radical resections was also identical, 83 % in both groups (p = 0.8). The relapses rates within the first six months after the surgery were similar: 25 % of patients in both groups (p = 0.62). The median OS reached 36 months in the main group and 32 months in the control one (p = 0.81).

Conclusion. Since the main group predominantly included patients with more advanced stages of the disease and yet the treatment resulted in comparable immediate and long‑term outcomes, it can be concluded that preoperative therapy can be justified in patients with IHCC who have factors predisposing to poor prognosis. Randomized trials are necessary to determine the rationality, as well as the type and regimen of preoperative therapy to be used in patients with IHCC.
Depression, suicide ideation, and irrational beliefs: Explanatory models in psychology students
Authors: Rosas-Fuentes Pedro David , Valdés-García Karla Patricia , Monroy-Velasco Iris Rubí , Pérez-Pedraza Bárbara de los Ángeles , Sánchez-Loyo Luis Miguel
Published: March 2023

Introduction. In rational emotive behavioral therapy, irrational beliefs are significant in mental health since their presence leads to conditions such as depression and suicidal ideation. Since these conditions have been increasing worldwide, it is essential to explore the factors that contribute to their understanding. Objective. To design explanatory models for depression and suicidal ideation based on irrational beliefs in psychology students. Method. Quantitative, non-experimental, cross-sectional study with multivariate analysis. Results. Two explanatory models were designed: one for depression and the other for suicidal ideation. Thirty-nine per cent of depressive symptomatology can be explained by the presence of irrational beliefs concerning perfectionism, avoidance of responsibilities, concern over the future, and the determinism of the past. At the same time, 54% of suicidal ideation can be explained by the presence of beliefs centering on perfectionism, avoidance of responsibilities, external locus of control, and the determinism of the past. Discussion and conclusion. Depression and suicidal ideation in psychology students can partly be explained by irrational beliefs concerning perfectionism, external locus of control, concern over the future, avoidance of responsibilities, and the determinism of the past. Clinical care approaches can modify these beliefs to reduce symptoms and promote mental health.
An assessment of mental health of Mexican and Colombian medical students during the COVID-19 pandemic
Authors: Pacheco-Tobón D. Xipe , Bautista-Soto Edgar , Arellano-Ramírez Claudia , Orozco-García Daniela , Ramos-Ruiz Lucia , Herbales-Martinez Eliana , Porchia Leonardo M. , Pérez-Fuentes Ricardo , Gonzalez-Mejia M. Elba
Published: March 2023

Introduction. The COVID-19 pandemic caused the cessation of academic activities from the face-to-face format to confinement and virtual classes, in which little is studied about its effect on mental health. Objective. Determine levels of depression, anxiety, and stress in medical students in Mexico and Colombia during the COVID-19 pandemic. Furthermore, depression, anxiety, and stress were compared by gender, education status, and country. Method. A cross-sectional study was carried out with 426 medical students. Data was collected using an online survey containing the Depression, Anxiety, Stress Scale (DASS-21) questionnaire. Results. Overall scores for depression, anxiety, and stress were 6.7 ± 1.2, 8.8 ± 1.2, and 5.6 ± 1.2, respectively. Females had significantly higher overall scores for depression (.24-fold increase), anxiety (.25-fold increase), and stress (.40-fold increase) than males (p ≤ .01). The risk for anxiety and stress by school year showed that basic years were associated with higher scores than advanced years (.25 and .38-fold increase, respectively). For females, starting medical school did show an increased risk of depression when compared to male students in their basic years (.38-fold increase). Lastly, students from Mexico had an increased risk for depression and anxiety (p ≤ .022 and p ≤ .004, respectively) but not for stress (p ≤ .402), when compared to students from Colombia. Discussion and conclusion. Significant anxiety and depression were observed in medical students from Mexico and Colombia. Factors associated with an increased risk of depression and anxiety are students in their basic years as well as being female.
Mental illness attitudes in medical education: Assessing the stigma in medical students
Authors: Márquez-Cervantes Ernesto , Romero-Guerra Daniela Haydé , Costilla-Esquivel Antonio
Published: March 2023

Introduction. Factors affecting the quality of physician care include a shortage of trained staff, stigma, and discrimination. Objective. The objective was to compare the intensity of stigmatization before and after a Psychiatry course, as measured by the scale of clinicians’ attitudes towards mental illness, a version for medical students (MICA-2) designed to identify stigmatic attitudes towards mental disorders. Method. The fifth-year Medicine students enrolled in the Psychiatry course answered anonymously using the MICA-2 test at the start and the end of their course. Additionally, we asked the students to answer a question about their interest in learning more about mental illness. Results. Three hundred and thirty students were invited; 300 agreed to participate in the first application of the scales, and 291 in the follow-up. The average age was 22 ± 2 years, with a range of 20-30 years, and there was a similar gender distribution in both applications. In the initial application, the average score of the MICA-2 was 41.34 (SD = 7.86, 95% CI = [40.43, 42.25]). The follow-up application’s mean was 37.10 (SD = 8.15, 95% CI = [36.30, 38.15]). Also, there was a decrease in interest in learning more about mental illness. Discussion and conclusion. A reduction in the average scores of the MICA-2 was observed after a Psychiatry course, suggesting that attitudes toward mental disorders improved. A Psychiatry clerkship with close supervision modified the attitudes of medical students toward mental disorders. However, it did not increase their interest in learning more about mental illness.
New Methodology for Unbiased Ground-Motion Intensity Conversion Equations
Authors: Gallahue Molly , Abrahamson Norman
Published: March 2023

Ground-motion intensity conversion equations (GMICEs) allow for conversions between ground-motion amplitude and shaking intensity. The current methods used to develop GMICEs model the dependence of the intensity on the peak ground-motion (PGM) parameter. For some models, there is a second step that models the magnitude and distance dependence of the residuals from the initial regression. We show that this approach for developing GMICEs works well for estimating the intensity from median ground motions, but for ground-motion values away from the medians, the intensities estimated by the GMICE can have large bias, with overprediction for positive PGM residuals and underprediction for negative PGM residuals. The bias is due to an implicit assumption in the current approach that there is a direct causal relation between intensity and the ground-motion parameter and that the residuals of the intensity and ground-motion parameter are fully correlated. We present two alternative methodologies for developing GMICEs that do not suffer from this bias. The first method includes the magnitude and distance scaling of the GMICE in the initial regression for the scaling with the PGM. The second method excludes the magnitude and distance terms but includes the number of standard deviations of the PGM (ϵ) as an additional parameter in the GMICE. Using a synthetic data set of intensity and peak ground acceleration values, we show that the GMICE developed using the proposed method leads to more accurate estimates of the intensity than current methods. We also discuss implications of using GMICEs based on the proposed methods for the evaluation of probabilistic hazard maps and as input to ShakeAlert estimates.
BRICS-T Ülkelerinde Erkek ve Kadın Genç İşsizlik ile Doğuşta Beklenen Yaşam Süresi İlişkisi: Toda-Yamamoto Nedensellik Analizi
Authors: BASKAK Tuba Esra
Published: March 2023

Ülkelerin temel amaçları arasında ekonomik büyüme hedefini gerçekleştirmek yer almaktadır. Bu bağlamda sağlık göstergeleri ve makroekonomik göstergeler ülkelerin bu hedeflerini gerçekleştirmelerinde büyük etkiye sahiptir. Ülke ekonomisini iyileştirmek ve iyileşen ekonomiyi stabil kılmak için toplumu oluşturan bireylere yatırım yapmakta fayda vardır. Çünkü bu bireylerin fiziksel ve ruhsal açıdan sağlıklı olması işgücü piyasalarında daha aktif yer almalarına neden olmaktadır. Bu çalışmada sağlık göstergesi olarak doğuşta beklenen yaşam süresi, makroekonomik gösterge olarak kadın ve erkek genç işsizlik kullanılmıştır. Brezilya, Rusya, Hindistan, Çin, Güney Afrika, Türkiye ülkelerinden oluşan BRICS-T olarak adlandırılan 6 ülke için doğuşta beklenen yaşam süresi, genç kadın işsizlik ve genç erkek işsizlik arasındaki ilişki araştırılmıştır. Araştırmada 1990 ve 2021 arası yıllık veriler üzerinden Toda-Yamamoto nedensellik testi kullanılmıştır. Ampirik bulgulara göre genç erkek işsizlik ile doğuşta beklenen yaşam süresi; genç kadın işsizlik ile doğuşta beklenen yaşam süresi ve genç kadın işsizlik ile genç erkek işsizlik arasında çift yönlü nedensellik ilişkisi tespit edilmiştir.
Osmanlı Modernleşme Sürecinde Kadın Mahkumlar İçin Erken Tahliye, Firar ve Af Uygulamaları: 1839-1918
Authors: ÇEVİK Abidin , ÇAYCİ Muhammet Emin
Published: March 2023

Bu çalışmada Osmanlı Devleti’nin belirli bir tarih kesitindeki kadın mahkumların firar, af örnekleri ve hapishane süreçleri ele alınmıştır. Bu bağlamda, kadın hapishanelerinin ortaya çıkışı ve genel durumu, bu kurumlarda yaşanan firar olaylarının sebepleri ve bunlara ne gibi önlemler alındığı incelenmiştir. Hapishanelerin genel durumunun yanında kadın mahkumların af talepleri araştırılmış, bu taleplere verilen cevaplar irdelenmiştir. Kaynak olarak öncelikle Osmanlı Arşivi’nde bulunan firar ve af belgeleri incelenerek kadın mahkumlara özel olarak çıkarılan aflar ve firar olayları derlenmiş; ayrıca konuya yönelik daha önce yapılmış olan akademik literatür incelenmiştir.
Theoretical Saturation in Grounded Theory Studies: An Evaluative Tool
Authors: ÜNLÜ Züleyha , QURESHİ Henna
Published: March 2023

The three Grounded Theory (GT hereafter) schools, Classic, Straussian, and Constructivist GT, differ from each other based on their paradigmatic perspectives. The major difference is in terms of the data analysis procedure. Common features exist among the three GT traditions such as constant comparison method, simultaneous data collection and analysis, memos, theoretical sensitivity, theoretical sampling, and theoretical saturation. Among these features, theoretical saturation acts as a key factor that initiates each coding stage of GT while ending the preceding one. This paper focuses on Theoretical Saturation in GT and evaluates how different GT paradigms approach the concept of Theoretical Saturation. Additionally, facilitating novice GT researchers, the paper suggests the Q-Ü Theoretical Saturation instrument to offer possible solutions to overcome the paradigm-related and practical challenges.
Diseño de una herramienta para identificar las habilidades gerenciales de los servicios de salud
Authors: Builes Ocampo Diana Vanesa , Valencia Rodríguez Julián David , Rivas García Wuendy Lizeth , Fuertes-Bucheli Jose Fernando , Granada Aguirre Luis Felipe
Published: March 2023

Antecedentes: La gestión de los servicios de salud entraña retos que deben ser abordados por gerentes hábiles, flexibles y capaces de adaptarse a ellos. Las habilidades que requieren los gerentes de los servicios de salud son poco claras.
Objetivo: Identificar las habilidades gerenciales en el sector salud y proponer una herramienta que permita valorarlas de manera estandarizada.
Métodos: Revisión de tema de habilidades gerenciales en el sector salud de estudios disponibles en Scielo, ScienceDirect y PubMed entre 2011-2021. Se incluyeron manuscritos en inglés y español, según la evaluación crítica de JBI para estudios cualitativos y que representaron las tendencias más ponderables en el tema. Se realizó una síntesis narrativa usando el proceso de cuatro elementos de Popay, y se extrajeron detalles relevantes mediante abstracción estandarizada que incluyó principales hallazgos y observaciones. Finalmente, se diseñó una herramienta con el potencial de identificar las habilidades gerenciales.
Resultados: Se analizaron 13 manuscritos. Se definieron las funciones gerenciales, y se caracterizaron de acuerdo con el perfil gerencial en salud aplicado a las Instituciones Prestadoras de Servicios de Salud en Colombia. Se identificaron cuatro habilidades gerenciales fundamentales propias del sector salud, las cuales se constituyen en variables independientes; con esto, se diseñó una herramienta con el potencial de identificarlas.
Conclusiones: Para gerenciar en salud se requiere fundamentalmente de habilidades en la toma de decisiones, liderazgo, habilidad comunicativa y manejo del tiempo. La herramienta propuesta tiene el potencial de identificarlas, pero futuras investigaciones deben validarla.
Sistemas de información de salud en Colombia
Authors: Añasco Noguera Jennifer , Cobo Larrahondo Yuri Fernanda , Martínez Caicedo Ana Elisa , Osorio Cuellar Gisel Viviana , Granada Aguirre Luis Felipe
Published: March 2023

Objetivo: Caracterizar los sistemas de información en salud disponibles y reconocidos en Colombia.
Métodos: Análisis documental con revisión de literatura en red y diseño de un instrumento para recolectar, clasificar y analizar la información sobre las bases de datos encontradas en Colombia y algunas relevantes en el mundo.
Resultados: Existe diversidad de información en la web que no siempre es reconocida y utilizada, con ventajas y desventajas. Respecto a temáticas, 34.4 % de la información en las bases de datos está relacionada con morbilidad, 28 % con mortalidad y 28 % con registros y atención en salud.
Conclusión: Las diferentes bases de datos de información en salud existentes en Colombia tienen funciones específicas que aportan a los actores interesados y facilitan su búsqueda, a pesar de las limitaciones en términos de interoperabilidad y totalidad de la información.
Factores asociados a la mortalidad en pacientes con cáncer de próstata
Authors: Mejía Lina Marcela , Acosta Jhonny Fernando , Gómez Gutiérrez Rigoberto , León Giraldo Hoover , Villada Alzate Sandra Milena
Published: March 2023

Objective: To identify factors associated with mortality in patients with prostate cancer.
Methods: An epidemiological design of an analytical observational case-control study nested in a cohort of patients with prostate cancer was performed. Cases were defined as deceased patients and controls were patients who were still alive at the end of the study.
Results: The mortality observed in patients with prostate cancer was 41.8%. The associated factors of dying from prostate cancer were patients aged ≥60 years, living in a rural area, without a partner, overweight, and in advanced stages of the disease including metastasis. The estimated survival in this population was 71% (95%CI: 67.5%-74.6%) during the study period.
Conclusions: The decrease in survival according to years of follow-up coincides with the evidence found in studies in Colombia.
Caracterización clínica de gestantes con embarazo de alto riesgo en hospital de referencia del Departamento del Cauca
Authors: Fajardo Ruiz Valentina , Torres-Gómez Juan Sebastián , Montaño García Julio , Collazos Malagon Yuri Marcela , Rojas Quintero Kevin , Merchan Angela Maria
Published: March 2023

Antecedentes: La mortalidad materna es un indicador de calidad en la atención de las embarazadas y se considera un problema de salud pública por las repercusiones que tiene para los infantes y sus familias. Su principal factor desencadenante es el embarazo de alto riesgo.
Objetivo: Identificar las condiciones que llevaron al diagnóstico de embarazo de alto riesgo y describir las alteraciones de salud en las gestantes de un hospital de nivel III.
Métodos: Estudio retrospectivo en embarazadas que consultaron por embarazo de alto riesgo durante el 2017.
Resultados: La edad media de las pacientes fue 26 años; 54% procedían del área urbana; el 72.7% pertenecían al régimen subsidiado, el antecedente personal más frecuente fue la cirugía previa (20.9%); la media de controles prenatales fue de 4.7 iniciados alrededor de la semana 11.7. La condición que originó el diagnóstico de embarazo de alto riesgo fue el control prenatal insuficiente con un 25.6%, determinado durante la gestación. El tipo de parto más común fue el vaginal espontáneo con un 38.8% y no se presentaron muertes maternas.
Conclusión: De acuerdo con perfil epidemiológico de las gestantes con embarazo de alto riesgo, se resalta el control prenatal insuficiente como principal causa, lo que sugiere reforzar o rediseñar las estrategias de atención por parte de los actores involucrados que permitan implementar controles de calidad en la caracterización y cuidado de las gestantes del Departamento.
Casos clínicos en osteoporosis
Authors: Rivera Martínez Wilfredo Antonio , Castaño Ceballos Pablo Alberto
Published: March 2023

Introducción: La osteoporosis se define como un “Trastorno sistémico caracterizado por masa ósea baja y deterioro de la microarquitectura, con el consecuente incremento de la fragilidad ósea y una mayor susceptibilidad a las fracturas.
Objetivo: Presentar dos casos de interés en el abordaje de la osteoporosis, resolviendo los principales interrogantes que surgen en su intervención.
Resultados: Inicialmente, se describe un adulto mayor masculino a quien se realizó diagnóstico y manejo en contexto de fracturas patológicas y posteriormente una paciente femenina postmenopáusica con historia de cáncer de mama en manejo con inhibidor de aromatasa y predisposición a fracturas asociada.
Conclusión: La disminución de la calidad ósea en poblaciones especiales como los hombres y mujeres expuestas a inhibidores de aromatasa requieren para prevenir las fracturas que desde el inicio del seguimiento se controlen los factores de riesgo y las posibles causas secundarias. El inicio del manejo antirresortivo/osteoformador si están indicado cambia el pronóstico de la enfermedad y los desenlaces.
Puntos clave de insuficiencia cardiaca en algunas situaciones especiales
Authors: Aristizabal Colorado David , Valencia Garcia Mauricio , Weir Restrepo Danilo
Published: March 2023

Introducción: La insuficiencia cardiaca (IC) es una patología de alta prevalencia en todo el mundo, su tratamiento no solo va de la mano de la patología en sí, la optimización de algunas de las enfermedades que suelen rodear esta patología impacta de manera directa sobre el curso de la enfermedad.
Metodos: Se realizó una revisión narrativa de la literatura.
Resultados: En pacientes con IC con Fracción de eyección preservada los iSGLT-2 son los únicos medicamentos que han mostrado utilidad en esta subpoblación independiente de su estado comórbido con diabetes, además en paciente con IC con fracción reducida con o sin diabetes su inicio puede realizarse de forma temprana desde el alta generando impacto en los desenlaces de MACE, hospitalización y mortalidad. En cuanto a enfermedad renal crónica los medicamentos usados en IC ya no son considerados nefrotóxicos, ya que su uso si bien produce una reducción de la Tasa de Filtración Glomerular (TFG) a largo plazo retrasan su deterioro y mejoran pronostico. Además el adecuado manejo de la deficiencia de Hierro y la fibrilación auricular disminuyen los desenlaces adversos y mejoran la calidad de vida.
Conclusiones: el manejo oportuno de la diabetes mellitus tipo 2 y la Enfermedad Renal crónica es fundamental para controlar la progresión de la insuficiencia Cardiaca, así mismo las terapéuticas como el uso de hierro carboximaltosa y el adecuado abordaje terapéutico de la fibrilación auricular son determinantes para disminuir desenlaces adversos y mejorar la calidad de vida.
Insuficiencia cardíaca con fracción de eyección ligeramente reducida. Retos, realidades y futuro
Authors: Aristizabal David , Pineda Moreno Mario , Moreno Soto Karen Juliana
Published: March 2023

Introduction: Heart failure with mildly reduced ejection fraction has been a sensitive point in cardiology throughout its history, since it has had multiple names and a pathophysiology that can belong to both heart failure with Heart failure with reduced ejection fraction (less than 40%) and heart failure Heart failure with preserved ejection fraction (greater than 50%), which makes it difficult to generate standard  recommendations for this entity.
Objective: Recognize Heart failure with mildly reduced ejection fraction as an individual entity both for its diagnosis and follow-up, for which currently efforts are being made to develop phenotypes that allow us to go beyond the ejection fraction, mainly consolidated from characteristics valued by cardiac magnetic resonance imaging, as well as for its management
Methods: Narrative review of the literature
Results: Traditional therapies such as beta-blockers, ACE (Angiotensin converting enzyme) inhibitors, ARBs (Angiotensin receptor blockers), mineralocorticoid receptor antagonists, barely manage to give rise to guidelines for their use for medical consideration (IIb recommendation), as a novelty, iSGLT2 have been positioned as the standard therapy in heart failure syndrome regardless of the left ventricular ejection fraction.