bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiomyofibroblastoma of the uterine cervix in a patient with triple negative breast cancer: a case report
Authors: ÖZYİĞİT BÜYÜKTALANCI Dilara , YİĞİT Seyran , ALTINDAĞ Sultan Deniz , AYDOĞMUŞ Hüseyin , GENÇDAL Servet
Published: April 2021

Angiomyofibroblastoma is an uncommon, benign mesenchymal tumor which generally occurs in the vulvovaginal region. Uterine cervix localisation is uncommon. A 40-year-old female patient, who had been operated becasue of breast carcinoma, presented vaginal bleeding. Examination revealed a polypoid mass located in both vagina and cervix. She underwent total abdominal hysterectomy and bilateral salpingectomy. With the help of typical histopathology and immunohistochemical findings, a diagnosis of “angiomyofibroblastoma” was made. Angiomyofibroblastoma is a benign mesenchymal tumor of unknown pathogenesis. A recognition of this entity is important to avoid misdagnosis of other angiomyxoid neoplasms such as aggressive angiomyxoma.
Evaluation of long-term effect of tuberculosis chemoprophylaxis in patients using anti tumor necrosis factor alpha agents
Authors: BAŞLILAR Şeyma , AYDIN Mehtap
Published: April 2021

Introduction and Aim: There is an increased risk of tuberculosis (TB) in patients with rheumatoid diseases(RD) treated with anti TNF alpha agents. Screening and, if necessary, chemoprophylaxis is recommended in patients undergoing anti TNF alpha treatment. This study aimed to determine the incidence of active TB due to long term anti TNF alpha usage in patients with RD and to evaluate the effectiveness of tuberculosis chemoprophylaxis regimen.

Materials and Methods:

Patients treated with anti TNF alpha agents for more than 5 years with RDs were evaluated retrospectively. Demographic and clinical characteristics, use of chemoprophylaxis, laboratory tests before and after anti TNF alpha treatment and development of TB were examined.

Results: A total of 150 patients (79 male [52.7%], 71 female [47.3%]) with a mean age of 45±13 years were evaluated. The tuberculosis rate over 5 years follow up was found as 1.3%. One male developed pulmonary TB 5 years and 1 female developed miliary TB 10 years after the beginning of anti-TNF alpha therapy despite chemoprophylaxis with isoniazid. The mean number of neutrophiles and lymphocytes were significantly decreased after treatment(p
Local plus sedoanalgesia or spinal analgesia in endovascular aortic aneurysm repair experiences in a single center
Authors: DOĞUKAN Mevlüt , ULUDAG Öznur , DURAN Mehmet , ERCİŞLİ Murat Abdulhamit , CEYHAN Kıymet , GÜVEN Cengiz , BAYSAL Ayşe
Published: April 2021

Aim: In this study, we aimed to discuss the local anesthesia + sedo-analgesia (LA-SA) and spinal anesthesia methods applied during Endovascular Aortic Repair (EVAR) by retrospectively comparing the patients' data

Materials and Methods: Our study was carried out by retrospectively evaluating the data of 36 patients who underwent endovascular surgery for aortic aneurysm between 1 January 2013 and 31 December 2018. Three cases who were applied general anesthesia were not included in the study. The patients included in the study were divided into two groups according to the anesthesia method as LA-SA group (Group 1, n = 19) and spinal anesthesia group (Group 2, n = 14).. This study was planned as a retrospective observational controlled study. Demographic data, comorbidities, American Anesthesiologists Association (ASA) risk classification scores, mortality rates, duration of anesthesia and surgery, length of stay in the hospital and intensive care unit, and laboratory values were analyzed.

Results: In our study, the mean age of 33 patients who underwent EVAR procedure was 69.04 ± 13 (32-86). Local anesthesia + sedo-analgesia was applied to 19 (52.7%) patients and spinal anesthesia was applied to 14 (38.8%) patients. No significant difference was found between demographic data, comorbidities and smoking rates in both groups. (Table 1). ). The length of stay in the hospital and the intensive care unit and the rates of death before discharge were similar in both groups (P = 0.22) (. (P = 0.15). (P = 0.73), while the duration of anesthesia and operation The durations were statistically shorter in the localanesthesia + sedo-analgesia group, respectively (P = 0.001) and (P = 0.004). Laboratory examinations of both groups were similar.

Conclusion: For arterial stents requiring percutaneous implantation, LA-SA provides a safe anesthesia method with stable hemodynamics, less invasive intervention and shorter operation times than neuraxial anesthesia.
The effects of folic acid on vascular reactivity in a hyperhomocysteinemic rat model
Authors: YILMAZ Melek , GEMALMAZ Hüseyin , YÜCEL Cihan , KETENCİLER Serkan , GÜRCÜN Uğur , DİŞÇİGİL Berent
Published: April 2021

Abstract

Objective: This study aimed to investigate the antioxidant effects of folic acid and its effects on contraction and relaxation responses in rat aorta in hyperhomocysteinemic rats.

Methods: Thirty-four male Wistar Albino rats were allocated into four groups. Rats in the hyperhomocysteinemia group (Group 1, n=9) received 1g/kg/day methionine via orogastric gavage for 30 days and then injected with intraperitoneal saline for the next 7 days. In the hyperhomocysteinemia+folic acid group (Group 2, n=9), following the administration of methionine for 30 days, folic acid (4mg/kg/day) was delivered intraperitoneally for 7 days. Sham group rats (Group 3, n=8) received orogastric saline for 30 days, which was followed by an IP injection of saline for another 7 days. Animals allocated into the folic acid group (Group 4, n= 7) had orogastric saline for 30 days and intraperitoneal folic acid for 7 days. After 5 weeks of treatment, blood samples were obtained, all animals were sacrificed, and hearts were harvested. Thoracic aortic segments were suspended on individual organ baths, and acetylcholine-induced (endothelium-dependent) relaxation responses of isolated aortic rings were evaluated.

Results: Relaxation responses in Group 1 thru 4 were 73.889.96, 76.159.28, 76.618.83, and 69.2615.68, respectively. There was no significant difference in the organ bath in terms of relaxation response to acetylcholine at a dose of 10-9 mM between the groups (F=0.716, p=0.550).

Conclusion: Folic acid therapy failed to produce a significant improvement in vascular reactivity.

Keywords: Hyperhomocysteinemia, folic acid, vascular reactivity
The thorax tomography correlation in COVID-19 RT-PCR positive patients
Authors: KESMEZ CAN Fatma , ALAY Handan , YILMAZ Sinan , YILMAZ ÇANKAYA Bahar , ALBAYRAK Ayse , ÖZDEN Kemalettin , PARLAK Emine , ÖZKURT Zülal , GÜR Ali , AKGOL GUR Sultan Tuna
Published: April 2021

Aim: Although the RT-PCR test of pharyngeal swabs is the gold standard for diagnosing coronavirus disease 2019 (COVID 19), radiological imaging techniques, particularly thoracic computerized tomography (CT) were also used frequently as needed during the pandemic. The aim of this study is to investigate thorax CT findings in patients with COVID-19 confirmed by RT-PCR and to evaluate its relationship with clinical features.
Methods: This study included 311 consecutive patients who were hospitalized between April 1, 2020, and June 1, 2020, with COVID 19 diagnosis based on RT-PCR (+) results and underwent a thorax CT within 24-48 hours of admission. Symptoms, clinical status, co-morbidities of the patients were evaluated. Thorax CT findings were assessed by the Department of Radiology and the results were analyzed in relation to clinical status of the PCR (+) patients.
Results: The study group consisted of 170 male (57.7%) and 141 female (42.3%) patients with mean age 46.7 ± 33.7 years. Among the COVID 19 cases, 51 (16.4%) were asymptomatic, clinical course was mild-moderate in 197 (63.3%) and severe in 63(20.3%). During follow-up 21 (6.8%) required intensive care and 10 (3.2%) died. The most common symptoms observed were cough (33.4%), weakness (30.2%) and fever (28%). The most commonly encountered co-morbidity in COVID-19 patients was hypertension (10.3%) followed by diabetes mellitus (7.7%), coronary artery disease (5.1%). Thorax CT findings were assessed as normal in 21.9% of the patients; viral pneumonia was detected in 20.9% and 27.7% were reported as compatible with COVID 19. Bilateral involvement was seen on CT scan in 49.2% of the patients. In regard to thorax CT imaging characteristics that suggest COVID 19 disease, the most common was ground-glass opacities observed in 181 (27.2%) and the least common was vascular enlargement in 4(0.6%) of the patients.
Conclusion: COVID 19 is an air-borne disease that primarily affects the lungs. Thus, it is essential to define radiological lung involvement. The common CT findings of COVID 19 disease are similar to other viral pulmonary infections. The clinicians being familiar with common imaging features of COVID 19 would contribute to earlier detection and thus reduced mortality associated with the disease.
Nosocomial infection rates of three-years in neurological intensive care unit and relationship to mortality
Authors: BİLGE Nuray , YEVGİ Recep , CEYLAN Mustafa , PARLAK Emine , ŞİMŞEK Fatma
Published: April 2021

ABSTRACT

Aim: The risk of developing nosocomial infections (NI) is higher in intensive care units (ICU). Recognition and treatment of NI is important in reducing mortality and morbidity. The aim of this study was to investigate the clinical and demographic characteristics, rates of mortality and nosocomial infection, agents of infection and antibiotic resistance rates of patients the neurological ICU.

Material and Method: The study was carried out between the dates of 01/06/2015 and 01/06/2018 in Neurological ICU. Data of all patients aged were retrospectively analyzed in accordance with the National Nosocomial Infections Surveillance System. SPSS 23 software was used for statistical analysis.

Results: Throughout the 3-year period, a total of 641 patients were followed up in the Neurological ICU and the most common diagnosis was ischemic cerebrovascular disease. It was found that 641 NIs developed in 55 patients in 5334 days of hospitalization in three years and the mortality rate was significantly higher in those with a NI (83.6%) compared to patients without a NI. The rate of NI the mean rate in three years was 9.98% and the most common NI was device-associated infections. In the 3-year period, the most common pathogen was A.bauamannii which was susceptible to colistin in 100% of the cases, and resistant to imipenem in 96% of the cases.

Conclusions: The use of invasive tools should be reduced in order to reduce nosocomial infection and mortality rates in the ICU. Each ICU should monitor its own nosocomial infection agents and resistance rates and develop a rational antibiotic use.
Alopecia areata after hepatitis C virus infection treatment: a case report
Authors: EROĞLU Esma
Published: April 2021

Interferon-free direct-acting antiviral (DAA) therapies in the chronic hepatitis C virus (HCV) infections have low side effects. Sofosbuvir / ribavirin (SOF / RBV) therapy combination is among in the currently approved treatment regimens. Aleopecia areata is a very rarely comlication of this treatment. A case of alopecia areata developed after SOF / RBV combination therapy in a patient with chronic hepatitis C infection is presented.
Relationship between vitamin D levels and mortality rates of critically ill patients in intensive care unit
Authors: SAĞIR Müslüm , KAPLAN Mustafa , TANOĞLU Alpaslan , DEMİREL Fevzi
Published: April 2021

Introduction: Vitamin D have a pivotal role in bone metabolism. It regulates immunity and inflammation. In this current research, it was aimed to determine whether there is an association between the mortality rate and the vitamin D level of critically ill patients who were followed in intensive care unit (ICU).

Material and Methods: Fifty two patients (30 (58%) female and 22 (42%) male) admitted to ICU with the diagnosis of respiratory failure, sepsis, acute renal failure, multiple organ failure, GIS bleeding were included in the study. During the admission to the ICU, all of the patients’ complete blood count, C-reactive protein, serum calcium, albumin, urea, creatinine, 25-OH vitamin D, potassium, and arterial/venous blood gas levels were measured. Their acceptable mortality risk was calculated according to the APACHE II scoring system.

Results: The level of vitamin D was found at least 1 up to 78.6 range, and the average was 19.61 ng/dl. Eighteen (35%) patients were discharged and 34 (65%) of the ICU patients were died. Vitamin D deficiency was observed to be a very common issue in our critically ill patients (65.4%). The difference between the two groups of age, accepted mortality and urea levels were found to be statistically significant (p
Relics of Supermassive Black Hole Seeds: The Discovery of an Accreting Black Hole in an Optically Normal, Low Metallicity Dwarf Galaxy
Authors: Cann Jenna M. , Satyapal Shobita , Rothberg Barry , Canalizo Gabriela , Bohn Thomas , LaMassa Stephanie , Matzko William , Blecha Laura , Secrest Nathan J. , Seth Anil , Böker Torsten , Sexton Remington O. , Kamal Lara , Schmitt Henrique
Published: April 2021

The detection and characterization of supermassive black holes (SMBHs) in local low mass galaxies is crucial to our understanding of the origins of SMBHs. This statement assumes that low mass galaxies have had a relatively quiet cosmic history, so that their black holes have not undergone significant growth and therefore can be treated as relics of the original SMBH seeds. While recent studies have found optical signatures of active galactic nuclei (AGNs) in a growing population of dwarf galaxies, these studies are biased against low metallicity and relatively merger-free galaxies, thus missing precisely the demographic in which to search for the relics of SMBH seeds. Here, we report the detection of the [Si vi]1.963 μm coronal line (CL), a robust indicator of an AGN in the galaxy SDSS J160135.95+311353.7, a nearby (z = 0.031) low metallicity galaxy with a stellar mass approximately an order of magnitude lower than the LMC (M
* ≈ 108.56
M
⊙) and no optical evidence for an AGN. The AGN bolometric luminosity implied by the CL detection is ≈1042 erg s−1, precisely what is predicted from its near-infrared continuum emission based on well-studied AGNs. Our results are consistent with a black hole of mass ≈105
M
⊙, in line with expectations based on its stellar mass. This is the first time a near-infrared CL has been detected in a low mass, low metallicity galaxy with no optical evidence for AGN activity, providing confirmation of the utility of infrared CLs in finding AGNs in low mass galaxies when optical diagnostics fail. These observations highlight a powerful avenue of investigation to hunt for low mass black holes in the James Webb Space Telescope era.
La guerre et l’errance
Authors: Brousse Marie-Hélène
Published: April 2021

La guerre n’est pas à opposer à la civilisation dont elle fait partie intégrante. C’est une des formes du lien social et du commerce interhumain. La guerre est toujours un fait de discours, errance se déployant dans un langage qui, par voie métaphorique, peut colorer d’un sens guerrier toute activité. Mais c’est aussi un mode de jouissance spécifique en prise directe avec la pulsion que Lacan a réduit, après Freud, à la pulsion de mort. Enfin, le rapport entre la psychanalyse et la guerre, affirmé par les premières prises de position de Freud sur les blessés psychiques de la première guerre mondiale, renouvelé par les psychanalystes anglais lors de la seconde, noue tant épistémiquement qu’éthiquement la psychanalyse à la guerre.
On twistor almost complex structures
Authors: Cahen Michel , Gutt Simone , Rawnsley John
Published: April 2021

In this paper we look at the question of integrability, or not, of the two natural almost complex structures \begin{document}$ J^{\pm}_\nabla $\end{document} defined on the twistor space \begin{document}$ J(M, g) $\end{document} of an even-dimensional manifold \begin{document}$ M $\end{document} with additional structures \begin{document}$ g $\end{document} and \begin{document}$ \nabla $\end{document} a \begin{document}$ g $\end{document}-connection. We measure their non-integrability by the dimension of the span of the values of \begin{document}$ N^{J^\pm_\nabla} $\end{document}. We also look at the question of the compatibility of \begin{document}$ J^{\pm}_\nabla $\end{document} with a natural closed \begin{document}$ 2 $\end{document}-form \begin{document}$ \omega^{J(M, g, \nabla)} $\end{document} defined on \begin{document}$ J(M, g) $\end{document}. For \begin{document}$ (M, g) $\end{document} we consider either a pseudo-Riemannian manifold, orientable or not, with the Levi Civita connection or a symplectic manifold with a given symplectic connection \begin{document}$ \nabla $\end{document}. In all cases \begin{document}$ J(M, g) $\end{document} is a bundle of complex structures on the tangent spaces of \begin{document}$ M $\end{document} compatible with \begin{document}$ g $\end{document}. In the case \begin{document}$ M $\end{document} is oriented we require the orientation of the complex structures to be the given one. In the symplectic case the complex structures are positive.
OD PREOKUPIRAJUĆEG VEZIVANJA DO DEPRESIJE: SERIJSKI MEDIJACIJSKI MODEL NA UZORKU ŽENA
Authors: Stefanović Stanojević Tatjana , Tošić Radev Milica , Bogdanović Aleksandra
Published: April 2021

FROM PREOCCUPIED ATTACHMENT TO DEPRESSION: SERIAL MEDIATION MODEL EFFECTS ON A SAMPLE OF WOMEN Existing studies have confirmed the existence of a relation between depressive symptoms and insecure attachment, an undeveloped ability to mentalize, social anxiety and rumination, as well as their increasingly more frequent presence in the population of women. However, none of the studies have analyzed the mutual relations between the aforementioned phenomena. In this study we tested a multiple serial mediation model in which a preoccupied attachment style has an effect on depressive symptoms among women, mediated by the ability to mentalize one’s own state of mind, social anxiety and a tendency towards rumination, successively, in that order. The research was carried out on a geographical cluster sample and included 1258 working-age adults, respondents from 37 urban and rural locations, 20 administrative districts of Serbia, from which a sample of women was extracted (N= 791). The Relationships Questionnaire – RQ (Bartholomew and Horowitz, 1991), the Mentalization Scale – MentS (Dimitrijević et al., 2015), the Scale of Social Anxiety (Tovilović, 2004) and the Ruminative Thought Style Questionnaire – RTSQ; Brinker and Dozois, 2009) were all used in the study. The results have indicated that there is a significant specific indirect effect of the preoccupied attachment style on depression mediated by all three mediators sequentially (estimated indirect effect = .004, boot-strapped 95% CI = .002 - .007), suggesting that the preoccupied attachment style has an effect on depression by leading to a decrease in the ability to mentalize one’s own state of mind, which increases social anxiety, in turn leading to an increase in rumination, which ultimately leads to depression. These findings could be of importance for the treatment of a specific group of female patients with a preoccupied attachment style who suffer from depression.
ULOGA RODITELJSKOG PONAŠANJA I SAMOPOŠTOVANJA OCA I MAJKE U SAMOPOŠTOVANJU I SAMOKONTROLI DJEČAKA I DJEVOJČICA
Authors: Martinić Pia , Brajša Žganec Andrea
Published: April 2021

THE ROLE OF PARENTAL BEHAVIOUR AND SELF-ESTEEM OF FATHER AND MOTHER ON SELF-ESTEEM AND SELFCONTROL OF BOYS AND GIRLS The aim of the research was to analyse the connection between parental behaviours and self-esteem of the parents on the self-esteem and self-control of the children. The pupils of the seventh and eighth grade of six primary schools in the area of the city of Zagreb and the city of Split and their parents participated in the research. The children filled out the Coopersmith Self-Esteem Inventory, the Brief Self-Control Scale and the Perception of Parental Behaviour Scale, while the parents filled out the Rosenberg Self-Esteem Scale. Regression analysis was used and it has determined that the parental control is the best predictor for the child’s self-esteem. Self-esteem of boys is better predicted by the sets of parental predictors and it is somewhat more connected with the father’s self-control, while self-esteem of girls is more connected with the mother’s self-control. Self-control of girls is best predicted by the mother’s acceptance and control, so that the sets of parental variables, more specifically the mother’s variables, are significant only for predicting self-control of girls. The assumption about the greater role of the mother in the development of self-esteem and self-control of children was confirmed, while the assumptions about the gender differentiation in upbringing were confirmed only in the case of the child’s self-control, but not in the case of their self-esteem, which shows that there are differences in the direction of transition towards more modern upbringing practices. The results, as well as the existing studies and theoretical assumptions, point out the importance of the parental role as the model for the development of the child’s self-esteem and self-control, and the different approaches in the upbringing of boys and girls can be addressed specifically.
How Small Hotel Owners Practice Resilience
Authors: Skokic Vlatka
Published: April 2021

Through three dramatic periods—the period of communism, the period of the war and transition during the 1990s, and the period of EU admission—this longitudinal study investigates how small hotel owners in Croatia understand and practice resilience. Findings demonstrate that entrepreneurs have proactive understanding of resilience and practice different actions before the shock of a disruptive event/s occur/s. Interestingly, entrepreneurs perceive this disruption as opportunities to exploit for their business development. One of the most prevalent practices is diversification, where entrepreneurs start another firm in different, often unrelated, sectors.
The Risk Perception of Family Business Owner-Manager in the Tourism Industry
Authors: Glowka Gundula , Tusch Martin , Zehrer Anita
Published: April 2021

Successfully dealing with risk has become a major challenge for firms to stay competitive in the long run. The tourism industry is vulnerable to any crisis and therefore has to deal with a high degree of uncertainty including many risks. The Alpine tourism industry is shaped by small and medium-structured family businesses. Such firms have more informal decision-making processes and more generations involved, while risk taking depends on the decisions of an owner-manager. Understanding the risk perception owner-managers is thus a complex task. This study conducts n=12 qualitative interviews with senior and junior owner-managers of family SME in tourism. Understanding the risk perception for tourism family SME might therefore contribute to build resilience and long-term competitiveness.
A Global Framework for E-Learning
Authors: Khan Badrul Huda
Published: April 2021

With the Internet's and digital technologies' rapid growth, the web has become a powerful, global, interactive, dynamic, economic, and democratic medium of learning and teaching at a distance. The Internet provides an opportunity to develop learning-on-demand and learner-centered instruction and training. There are numerous names for digital learning activities, including e-learning, remote learning, Web-Based Learning (WBL), Web-Based Instruction (WBI), Web-Based Training (WBT), Internet-Based Training (IBT), Distributed Learning (DL), Advanced Distributed Learning (ADL), distance learning, Online Learning (OL), mobile learning (or m-learning) or nomadic learning, remote learning, off-site learning, a learning (anytime, anyplace, anywhere learning), microlearning, etc. In this book, the term e-learning is used to represent open, flexible, and distributed learning. This chapter explores a global framework for e-learning.
Building Effective Blended Learning Programs
Authors: Singh Harvey
Published: April 2021

The term ‘remote learning' became very common during the COVID-19 pandemic as remote work and remote learning became common practices across the globe. Education and training programs have shifted to self-paced eLearning and virtual classrooms. Post COVID-19, even when learning returns to the physical classroom, the trend toward blended learning will continue. In this chapter, the authors explore how eLearning has evolved toward blended learning and how we can use modern technologies like artificial intelligence and learning models such as microlearning and spaced learning to improve blended learning.
A Quantum Particle Swarm Optimization Algorithm Based on Self-Updating Mechanism
Authors: Wu Shuyue
Published: April 2021

The living mechanism has limited life in nature; it will age and die with time. This article describes that during the progressive process, the aging mechanism is very important to keep a swarm diverse. In the quantum behavior particle swarm (QPSO) algorithm, the particles are aged and the algorithm is prematurely convergent, the self-renewal mechanism of life is introduced into QPSO algorithm, and a leading particle and challengers are introduced. When the population particles are aged and the leading power of leading particle is exhausted, a challenger particle becomes the new leader particle through the competition update mechanism, group evolution is completed and the group diversity is maintained, and the global convergence of the algorithm is proven. Next in the article, twelve Clement2009 benchmark functions are used in the experimental test, both the comparison and analysis of results of the proposed method and classical improved QPSO algorithms are given, and the simulation results show strong global finding ability of the proposed algorithm. Especially in the seven multi-model test functions, the comprehensive performance is optimal.
An Improved Generalized Quantum-Inspired Evolutionary Algorithm for Multiple Knapsack Problem
Authors: Bansal Sulabh , Patvardhan C.
Published: April 2021

This article describes how the 0/1 Multiple Knapsack Problem (MKP), a generalization of popular 0/1 Knapsack Problem, is NP-hard and harder than simple Knapsack Problem. Solution of MKP involves two levels of choice – one for selecting an item to be placed and the other for selecting the knapsack in which it is to be placed. Quantum Inspired Evolutionary Algorithms (QIEAs), a subclass of Evolutionary algorithms, have been shown to be effective in solving difficult problems particularly NP-hard combinatorial optimization problems. QIEAs provide a general framework which needs to be customized according to the requirements of a given problem to obtain good solutions in reasonable time. An existing QIEA for MKP (QIEA-MKP) is based on the representation where a Q-bit collapse into a binary number. But decimal numbers are required to identify the knapsack where an item is placed. The implementation based on such representation suffers from overhead of frequent conversion from binary numbers to decimal numbers and vice versa. The generalized QIEA (GQIEA) is based on a representation where a Q-bit can collapse into an integer and thus no inter conversion between binary and decimal is required. A set of carefully selected features have been incorporated in proposed GQIEA-MKP to obtain better solutions in lesser time. Comparison with QIEA-MKP shows that GQIEA-MKP outperforms it in providing better solutions in lesser time for large sized MKPs. The generalization proposed can be used with advantage in other Combinatorial Optimization problems with integer strings as solutions.
Quantum Cognition and Its Influence on Decrease of Global Stress Level Related With Job Improvement Strategies
Authors: Stojanovic Aleksandar , Starcevic Ana
Published: April 2021

The quantum mind or quantum consciousness group of hypotheses propose that classical mechanics cannot explain consciousness. Quantum theory is used to insert models of cognition that target to be more innovative than models based on traditional classical probability theory, which includes cognitive modeling phenomena in science. At the moment we can say that there is no clearly defined neurophysiological mechanisms of creation of the quantum-like representation of information in the brain, but we can mention the hypothesis of matching the information processing in the brain with quantum information and probability with contextuality as the key word. Using limited cognitive resources, incompatibility provides humans the means for answering an unlimited number of questions, thus promoting parsimony and cognitive economy.
Performance Comparison of Microchannel Heat Sink Using Boron-Based Ceramic Materials
Authors: Sarowar Md Tanbir
Published: April 2021

Microchannel heat sink plays a vital role in removing a considerable amount of heat flux from a small surface area from different electronic devices. In recent times, the rapid development of electronic devices requires the improvement of these heat sinks to a greater extent. In this aspect, the selection of appropriate substrate materials of the heat sinks is of vital importance. In this paper, three boron-based ultra-high temperature ceramic materials (ZrB2, TiB2, and HfB2) are compared as a substrate material for the microchannel heat sink using a numerical approach. The fluid flow and heat transfer are analyzed using the finite volume method. The results showed that the maximum temperature of the heat source didn’t exceed 355K at 3.6MWm-2 for any material. The results also indicated HfB2 and TiB2 to be more useful as a substrate material than ZrB2. By applying 3.6 MWm-2 heat flux at the source, the maximum obtained surface heat transfer coefficient was 175.2 KWm-2K-1 in a heat sink having substrate material HfB2.
Study on the Time-Effectiveness of Exercise Preconditioning on Heart Protection in Exhausted Rats
Authors: Su Ye , Wang Yang , Xu Peng , Sun Yawei , Ping Zheng , Huang Heling , Cao Xuebin
Published: April 2021

To investigate the persistence time and the effectiveness of exercise preconditioning (EP) on myocardial protection in exhausted rats from myocardial enzymes, electrocardiogram (ECG), cardiac function, and mitochondrial respiratory function after cessation of exercise training. One hundred and twelve healthy male Sprague–Dawley rats were randomly divided into seven groups (n = 16): control group (CON), exhaustive exercise (EE) group, EP group, and EE after EP (EP + EE); furthermore, EP + EE group was randomly divided into 1D, 3D, 9D, and 18D groups (1D, 3D, 9D, and 18D) and performed exhaustive treadmill exercise at a speed of 30 m/min on the 1st, 3rd, 9th, and 18th days separately after EP exercise stopped. We detected the serum contents of N-terminal pro B type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) by the enzyme-linked immunosorbent assays method, recorded ECG, detected heart function by pressure volume catheter, measured the respiratory rates of rat myocardial mitochondria state 3 and 4 of complex I, complex II, and IV by high-resolution breathing apparatus. EP could decrease the serum content of NT-proBNP and cTnI, improved the electrical derangement and the left ventricular function in exhausted rats. Moreover, the protective effect was more obvious in the 9th day after EP stopped, whereas it would disappear when EP stopped for more than 18 days. Compared with EE group, the respiratory rate value of myocardial mitochondrial complex increased in 1D, 3D, and 9D groups. Therefore, the protective effect of EP on the heart of exhausted rats decreased with the prolongation of stopping training time, and the effect was significant within 3 days of discontinuing training, then decreased gradually, and completely disappeared in the 18th day. EP enhanced the cardiac function in exhausted rats through raising the nicotinamide adenine diphosphate hydride (NADH) electron transport chain and increased the respiration rates of mitochondrial respiratory complex I and IV state 3, thereby improved myocardial mitochondrial respiratory function and energy metabolism.
Denosumab biosimilar in postmenopausal osteoporotic women
Authors: Singh Inderjeet , Jose Vinu , Patel Ronak , Arora Sumit
Published: April 2021

OBJECTIVE:

The study assessed the efficacy, safety, pharmacokinetic (PK), and immunogenicity profiles of denosumab-biosimilar and denosumab-reference in postmenopausal osteoporotic women from India.

MATERIALS AND METHODS:

In this randomized, assessor-blind, active-control, multicenter trial, 114 patients were randomly allocated to receive denosumab-biosimilar (n = 58) or denosumab-reference (n = 56) at a subcutaneous dose of 60 mg every 6 months, for a year. Vitamin D and oral calcium were given daily. Lumbar spine bone mineral density (BMD) change was the primary end point.

RESULTS:

Of 114 randomized patients, 111 (denosumab-biosimilar, n = 56; denosumab-reference, n = 55) completed the study. All 114 patients were part of safety and immunogenicity analyses, 110 (denosumab-biosimilar, n = 56; denosumab-reference, n = 54) were part of efficacy analysis, and 20 (denosumab-biosimilar, n = 10; denosumab-reference, n = 10) were part of PK analysis. The bone mineral density (BMD) (lumbar spine) percent change at 1 year with denosumab-biosimilar and denosumab-reference (7.22 vs. 7.62; difference:−0.40; 95% confidence interval: −5.92, 5.12) showed no statistically relevant difference. Likewise, alkaline phosphatase (bone-specific) and PK parameters also did not show statistically relevant differences. Adverse events were reported in 44.83% of patients on denosumab-biosimilar versus 33.93% of patients on denosumab-reference; most events were mild or moderate and not related to the study drugs. No patients showed anti-denosumab antibody positivity.

CONCLUSIONS:

Denosumab-biosimilar and denosumab-reference showed biosimilarity in osteoporotic postmenopausal women. Availability of denosumab-biosimilar provides a treatment alternative for patients.
Modulation of Liver P-Glycoprotien Expression May Contribute to Gossypin Protection against Methotrexate-Induced Hepatotoxicity
Authors: Mohamed Mervat , El Sheikh Azza Kamal , Mohammed Hanaa Hassanien
Published: April 2021

OBJECTIVES:

Methotrexate (MTX) is a broadly used anticancer. Its major side effect is hepatotoxicity. Gossypin is a flavonoid has a hepatoprotective effect as well as antitumor property. The study aimed at inspecting the protective effect of gossypin against MTX hepatotoxicity.

MATERIALS AND METHODS:

Twenty-four adult male rats arranged into four groups (six rats each): control, gossypin control, MTX, and MTX+ gossypin. Animals were orally administered gossypin at 10 mg kg-1 day-1 for 7 days. MTX was injected i.p. (20 mg/kg-1 once) on 5th day. Liver enzyme and oxidative stress markers were assessed. BAX, transforming growth factor-beta (TGF-β) gene expressions, and P-glycoprotein (P-gp) were assessed. The histopathological study as well as the immunohistochemical study for hepatic caspase 3 and nuclear factor kappa-B (NFκ-B) was done.

RESULTS:

MTX produced a significant increase of liver enzymes and distortion of hepatic architecture alongside with increased the hepatic collagen content. MTX administration significantly increased the oxidative stress markers and upregulated the pro-apoptotic BAX and the pro-fibrogenic TGF-β. MTX increased caspase 3 and NFκ-B expression, while diminished the expression of P-gp. Gossypin pretreatment improved the previous parameters, restored the normal hepatic architecture, reduced the hepatic fibrosis, and regained nearly normal expressions for BAX, TGF-β, caspase 3, and NFκ-B. Gossypin caused more reduction in P-gp hepatic expression.

CONCLUSIONS:

Gossypin may be a valuable adjuvant therapy that protects the liver against MTX toxicity through antioxidant, anti-inflammatory, antiapoptotic mechanisms, and mediated P-gp expression reduction.
A study of medication compliance in geriatric patients with chronic illness
Authors: Punnapurath Savithri , Vijayakumar Priya , Platty Princy L. , Krishna Shari , Thomas Thressiamma
Published: April 2021

Introduction:

Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome.

Materials and Methods:

The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS).

Results:

A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%.

Conclusion:

The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit
Patient satisfaction with services at the Family Medicine Employee Clinic in a tertiary hospital in Riyadh
Authors: Allafi Abrar H. , Alqhatani Jarman S , Alruwayshid Mashael S. , Alshuniefi Abeer S. , Alarik Enas F. , Alreshidi Fatmah , Almughais Ebtehaj S. , AlQudairy Reem A
Published: April 2021

Background:

Patient satisfaction reflects the healthcare quality of the facility. Therefore, it is important to determine satisfaction level of the patient satisfaction in order to improve services'quality provided to patients.

aim:

to assess the satisfaction level of patients at the Family Medicine Employee Clinic at a tertiary hospital in Riyadh, Saudi Arabia. This study is a cross-sectional that included 224 patients.

Method:

The study was conducted in King Fahad Medical City at the Family Medicine Employee Clinic between March and December 2019. Self-administered questionnaires were used to gather the data. The questionnaire included questions regarding the demographics of patients and questions to examine their satisfaction with the services provided by the clinic. SPSS version 21 was used for data analysis.

Results:

The study comprised 90 patients, 71.1% of which were female; 77.8% of participants lived in Riyadh; 92.2% of patients were in the age range of 25–75 years; 51.1% were single; 56.7% had income lower than 10,000 SR; 63.3% had college education; and 95.6% were employees of King Fahd Hospital. The mean ± SD of satisfaction was determined to be at 8.6 ± 1.7. There was a significant inverse correlation between income and satisfaction (P = 0.03).

Conclusion:

Patients reportedly showed high levels of satisfaction, especially regarding the experience of nurses, ease of registration and making appointments, treatment by receptionists, and cleanliness of clinics. The results of the survey reflect the effectiveness and efforts of the employees of the clinic.
Respectful maternity care in public health care facilities in Gujarat
Authors: Raval Hiral , Puwar Tapasvi , Vaghela Prakash , Mankiwala Manshi , Pandya Apurva Kumar , Kotwani Priya
Published: April 2021

Introduction:

Respectful maternity care (RMC) is not only the marker of quality maternity care but also ensures the protection of basic human rights of every child-bearing woman. This paper discusses the assessment of RMC services during the intrapartum period at public health care facilities in Gujarat state.

Material and Methods:

A cross-sectional research design was used for the study. The data were collected from three different levels of public health facilities such as primary health center (PHC), community health center (CHC), and district hospital (DH) in one of the districts in Gujarat. A standardized tool developed by the United States Agency for International Development based on the RMC charter was used for data collection. A total of 41 pregnant women across three public health facilities were observed during intrapartum care.

Findings:

Most women experienced disrespectful intrapartum care provided at the public health care facilities; however, at-least two performance standards of the RMC charter were met during intrapartum care at each public health care facility. Comparatively, the PHC demonstrated higher RMC performance compliance than DH and the CHC. Most often violations of RMC standards included beneficiaries were not greeted, privacy not maintained, they were not encouraged to ask questions, and support not provided during labor.

Conclusion:

Respectful maternity care is evidently not practiced in public health care facilities. Designing comprehensive behavioral training on RMC, especially for primary, secondary, and tertiary care physicians and nursing staff can improve the adaption of RMC standards in respective public health care facilities. Positive experiences of intrapartum care can potentially improve the uptake of maternal care facilities. Further research is needed to understand local contextual factors, social norms, and patient-provider interactions.
Optimizing the impact of health and related programmes / policies to address the issue of Childhood Obesity in India----A narrative review
Authors: Bera Om Prakash , Saleem Sheikh Mohd , Singh Dhananjay Kumar , Gokdemir Ozden , Tripathi Shailesh , Ghatak Nishantadeb , Hossain Md Mahbub , Bhattacharya Sudip
Published: April 2021

Non-communicable diseases are already acknowledged as a double burden, and now childhood obesity is putting extra strain on our health system. The current paper aimed to analyze the ongoing health and related programmes/policies in India, and we discussed the existing opportunities in the programmes to address the issue of childhood obesity in India. We searched the “MEDLINE,” “PsycINFO,” “Scopus,” “Web of Science,” and “Google Scholar” databases using the following keywords: (“overweight”) and (“obesity”), (“childhood obesity”), (“nutritional programmes in India”), (“Health policies in India”), (“malnourished children in India”) in combination with each other and in truncated form. All the relevant articles and policy documents (MOHFW, INDIA) available in the public domain were included to support the argument for this narrative review. We found that we have programme gaps like guidelines issues by Food Safety Standards Authority of India to tackle childhood obesity and it has not been strictly implemented due to multiple reasons. School health programme has an opportunity to address the issue of childhood obesity, but at the ground level the outcomes are not very promising. The National Nutrition Mission have only focussed on undernutrition and anemia problem, ignoring the overweight/childhood obesity. Primary care physicians are key players in the treatment of childhood obesity, yet rates of obesity management in the primary care setting are low. National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke is dealing with health promotion and prevention, early diagnosis, and management of all ages, except children. Diet provided in Integrated Child Development Scheme is calculated based on calories, not by the quality which is a concern to us. The breastfeeding promotion programme named Mothers Absolute Affection programme has not been implemented with letter and spirit. Other than health programmes, we assume that Ministry of Urban Planning, Foreign Direct Investment policy, Advertisement Council of India and many more sector/policy/programme are indirectly responsible for the increasing burden of childhood obesity in India. Lack of awareness and wrong perception also responsible for the development of childhood obesity. We have multiple National Health Programmes and Policies to address the childhood malnutrition, but are focussing the undernutrition component only, ignoring overnutrition problem in the children, which is emerging as quadruple burden to our health system. Appropriate actions and inclusion of suggestions provided in this study for the improvement of the programmes at the practical level needs to be considered by the policy makers to halt the ever-rising trend of childhood obesity and primary care physicians should play a leadership role.
SARS CoV-2 infection in a patient with sickle cell disease – Atypical presentation
Authors: Al-Naami Awaji Q. , Khan Liaqat A. , Zaidan Faisal I. , Al-Ibrahim Yousef Y. , Al-Neami Ibrahim A. , Awad Akram S. , Hobani Abdulwahab I. , Shaikh Ali H. , Ahmadini Mousa A.
Published: April 2021

Severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection causes the disease known as coronavirus disease that started in Wuhan (China) in December 2019, leading to the current COVID-19 pandemic. The common presenting symptoms include fever, dry cough, shortness-of-breath, while sore throat, diarrhea, and abdominal and chest pain are the least. The atypical presentation of SARS CoV-2 infection poses a challenge for family physicians to screen and manage such patients for COVID-19 and specifically those at high risk with underlying disease such a sickle cell disease. Herein, we report a case of SARS CoV-2 infection in a known patient of sickle cell disease (SCD) with an atypical presentation, in whom the course of the disease was mild to moderate, uncomplicated, and the patient had an uneventful recovery. Primary care physicians should be vigilant to screen and manage such patients with established protocols, especially in the ongoing COVID-19 pandemic.
Chemical plaque control - A brief review
Authors: Vyas Tarun , Bhatt Garima , Gaur Abhishek , Sharma Chetan , Sharma Akshya , Nagi Ravleen
Published: April 2021

Dental plaque is a complex microbial population of bacterial and salivary polymers present on the tooth surface. It is understood that human diseases must be avoided and a high social concern for the population as a whole. The argument for the implementation of successful prevention measures is strong for life-threatening diseases or those with serious morbidity. However, regardless of seriousness, the case for avoiding any disease may be based on the belief that it is easier to be healthy than dead or sick. Thus plaque prevention is an efficient way to both treat and avoid periodontal diseases, it is an important component of gingival and periodontal diseases' primary management.