bluuebunny/crossref_metadata_2025 huggingface dataset:
Life cycle assessment of processing for chrome tanned cowhide upper leather
Authors: YANG Heng , AN Dexin , GAIDAU Carmen , ZHANG Jinwei , ZHOU Jin
Published: August 2021

Pollution has become a serious problem in leather industry, however, current method to evaluate its environmental effect usually used data from literature review, those data generated while leather manufacturing were rarely collected and analyzed. Thereby, the aim of this study was to evaluate the environmental effect of manufacturing process of chrome tanned cowhide upper leather by applying the Life Cycle Assessment protocols. Following the guidance of ISO 14010, we first combined data obtained from field study and empirical review; and then these data were input into eFootprint for calculation. Results, including four environmental indicators (global warming potential [GWP], primary energy demand [PED], water utility [WU] and acidification [AP]), show that producing 1 kg of cowhide upper leather releases 7.040 kg of CO2 eq, consumes 106.793 MJ of energy and 89.144 kg of water and emits 0.058 kg of SO2 eq. Sensitivity analysis of inventory data demonstrated that chrome tanning and retanning processes accounted for more than 40% of PED, AP and GWP, whereas the beamhouse was more than 78% of WU. Therefore, we could optimise the tanning process by using alternative materials or technologies in the critical sections to achieve cleaner production and sustainable leather manufacturing.
Quasi-1500-Year-Cycle Signal in Length-of-Day Change
Authors: MA Lihua
Published: August 2021

Length-of-day (LOD) change, i.e., variations in Earth’s rotation rate, includes the long-term slowdown trend, as well as periodic and irregular fluctuations. The current continuous sequence of the LOD change covers a time span of <400 years. Using astronomical records in ancient historical documents, combined with a modern astronomical ephemeris, it is possible to obtain ancient LOD change. Some scholars have given a discontinuous LOD data series for the past 4000 years. In this paper, the author uses the Lomb–Scargle periodogram to study the LOD series and finds a significant quasi-1500-year-cycle signal. Furthermore, with weighted wavelet Z-transform, time-varying characteristics of the cycle in the LOD change are obtained.
Hedonic Price for Amenities in Rural and Urban Residential Condominiums in Costa Rica
Authors: Paniagua-Molina Javier , Solórzano-Thompson Johanna , González-Blanco Carlos , Barboza-Navarro David
Published: August 2021

As the number of homes located in condominiums increases, investigations should be promoted to determine the implied price of additional amenities over the total price of the property. This study evaluated the impact of multi-attribute and construction variables on the value of condominiums in Costa Rica, using a hedonic pricing model of the amenities that influence the total price. Information from condominiums located in all provinces of the country was used to determine the importance of the variables studied. Through multiple regression analysis, it was determined that nine amenities explain the behavior of the total price. This study shows that the project’s internal and external variables have a significant effect on sales prices and consumers’ purchasing decisions. The most significant variables were income, construction area, access to a pool and gym, and the type of condominium.
Determinants of Variance in Cost Method of Valuation in Uyo, Nigeria
Authors: Anih Paul C. , Usenemana Sunday
Published: August 2021

Variance in the cost method of valuation as caused by certain variables is objectionable in the profession of estate surveying and valuation at both local and international best practices. The study aimed at determining the variables for the variance in the application of the cost method of valuation for estate surveying and valuation practice in Uyo. The sample of the population used for the research comprised 110 estate surveyors in Uyo. The survey method was used for the research. The sampling technique was purposive sampling. The data were analyzed using standard deviation and analysis of variance (ANOVA). The findings showed that depreciation rates of σ2 =113.974 and σ = 10.676 were over 60% of the total variance of values among estate surveyors and valuers. The construction rates and errors in manual measurements and computation of areas, volumes and dimensions showed σ2 = 6.004 and σ = 2.4503, which accounted for 15% of total variance. The study recommends the use of a regional-based scientific approach to measure depreciation for consistency and high precision. Automated techniques, such as GPS, AutoCAD, Google Earth pro, are recommended to minimize variance in measurements.
Assessing the Impact of Outbreaks on Malaysian Listed Property Companies in Mixed-Asset Portfolios
Authors: Razali Muhammad Najib , Jalil Rohaya Abdul , Shayuti Ahmad Faisal
Published: August 2021

This paper assesses the impact of outbreaks from the perspective of volatility of Malaysian Listed Property Companies in mixed-asset portfolios, concentrating on periods of time between outbreaks. The real issue of this study is the health crisis that has troubled institutional investors, as it has already significantly impacted the returns on investments. Investors need to be better informed on the impact of health outbreaks on investments in order to minimize their impact. To assess the impact of the outbreaks, the GARCH method has been employed to examine the dynamic volatility of listed property companies in mixed-asset portfolios. The volatility level will give investors better information from point of view of the dynamics of volatility of the Malaysian listed property companies’ performance within mixed-asset portfolios. The findings show that listed property companies demonstrate high volatility compared to other mixed-asset portfolios during the periods of outbreaks. This indicates Malaysian listed property companies were the most volatile investment in mixed-asset portfolios. This empirical study will contribute significantly to institutional investors, especially in terms of the investment decision-making process during outbreaks.
Malignant granular cell tumor of the arm – case report
Authors: Mehedinţu Mihai , Danciu Răzvan , Toma Anca I. , Ştefan Corina , Jecan Cristian R.
Published: August 2021

Granular cell tumor (GCT) is a rare form of soft tissue cancer that is usually benign. Its malignant evolution is encountered in less than 2% of cases, having a more rapid and unfavorable evolution. Clinical presentation betraying malignant features could be increased tumor size, rapid growth, deep localization, and female gender.

This paper presents the case of a 52-year-old patient with a hard, rapidly evolving tumor in the left arm. The diagnosis of granular cell tumor was made based on histopathological examination using the Fanburg and Smith criteria to differentiate the formation as malignant, but with certainty this was subsequently confirmed by the existence of a metastasis. Surgical excision was performed and the evolution was favorable.

Evolution and treatment differ depending on the benign or malignant form, but surgical treatment with wide local excision is recommended. This may be followed by chemotherapy or radiotherapy, and follow-up of patients for the rest of their lives is mandatory.
Posterior interosseous nerve entrapment by intramuscular lipoma arising from the supinator muscle - a case report
Authors: Refai Omar , Elsherif Mohamed Eslam , Khalifa Ahmed A.
Published: August 2021

Background: Lipomas are benign, slow-growing tumors frequently subcutaneous and asymptomatic, intramuscular lipoma constituting a rare subtype. However, a lipoma occurring nearby the proximal radius may cause posterior interosseous nerve (PIN) entrapment.

Case presentation: We described an uncommon case of a 45-year-old-man with a history of progressive, painless proximal right (dominant) forearm swelling for 4 months associated with PIN entrapment syndrome, presenting as fingers extension weakness. Intramuscular lipoma was observed in the supinator muscle in the magnetic resonance imaging (MRI). Lipoma surgical excision and release of the PIN through proximal forearm direct anterior approach was performed.

Results: The histopathological examination confirmed the diagnosis of benign intramuscular lipoma. The follow-up of the patient showed full recovery within three months postoperatively.

Discussion: Intramuscular lipoma is rare; however, it could originate from supinator muscle in the forearm, presenting with vague pain and could lead to compression of nearby neurovascular structures such as the PIN. Clinical evaluation and imaging studies, especially MRI, are crucial for diagnosis. If neural compression is evident, surgical resection is mandatory.

Conclusion: Intramuscular lipoma entrapping PIN is rare and requires early clinical diagnosis confirmed by imaging and neurophysiological studies, surgical excision being the method of choice for optimum functional outcomes.
Current review of surgical management options for total knee arthroplasty in the rheumatoid knee
Authors: Iordache Sergiu Andrei , Şerban Bogdan , Popa Mihnea Ioan Gabriel , Cursaru Adrian
Published: August 2021

Rheumatoid arthritis (RA) represents a condition that can erode cartilage and damage joints, leading to inflammation and loss of movement, characterized by inflammatory synovitis. While the widespread use of potent disease-modifying medications has increased opportunities for RA patients, orthopedic surgery and complete joint arthroplasty remain an important option in end-stage joint treatment. The knee is one of the most frequently affected joints in chronic rheumatoid arthritis patients. The severity of RA ranges from a moderate illness to a serious, rapidly progressing, destructive version, gradually leading to incessant pain and joint deformity. Despite recent advances in biological agents and therapeutic modalities in the field of rheumatology, certain patients with RA, who ultimately undergo joint surgery, tend to experience progressive joint damage. Though, TKA can be performed in these patients, increased complications and poorer outcomes may result after total knee arthroplasty, because of the particularities given by RA. They are associated with extended operating time, specifically resulting in increased infection, blood loss and deep vein thrombosis. However, because RA patients present additional risk factors for complications, certain critical preoperative examination and surgical aspects need to be considered in order to maximize TKA outcomes in this subgroup of patients.
Non-operative management of blunt splenic injuries beyond safety conditions A short narrative review
Authors: Aliuş Cătălin , Zivari Mirela , Dumitrescu Dan , Cursaru Adrian , Şerban Bogdan , Dumitru Adrian , Şerban Dragoş
Published: August 2021

Although the introduction of specific guidelines regarding the acute management of trauma patients have resolved many inconsistencies in the acute treatment pathways, grey areas are still preventing consensus and unitary standards of care. The treatment of splenic injuries has seen a notable shift from splenectomy only in the early 20th century to mainly non-operative contemporary approaches. However, there is no current agreement on the optimum timing of switching from conservative to operative decisions, raising the legitimate question of whether some patients are put at risk by waiting too much or other patients are deprived of a necessary organ by not waiting enough.

This paper focuses on the non-operative paradigms of blunt splenic injuries and their immediate and long-term clinical implications presented as a short narrative review. It presents the historical perspective on the treatment of splenic injuries, the role of surgery and selective angioembolisation and their repercussions on the immunological functions of the spleen.
Prevalência de dermatoses em um ambulatório universitário no ano 2019: um estudo transversal
Authors: Patrus Ângela , Moreira Mariana Luiza , Bacha Fernanda Vaz de Melo , Porto Anna Clara Colen , Vianna Gláucia dos Santos
Published: August 2021

Objetivo: Analisar a prevalência geral e de acordo com as variáveis “sexo” e “faixa etária” das dermatoses de um serviço no ano 2019 e descrever o perfil epidemiológico dos pacientes.  Métodos: Trata-se de estudo transversal, que analisou prontuários de 717 pacientes atendidos no serviço de dermatologia de um ambulatório universitário de uma capital brasileira no ano de 2019. Analisou-se o perfil epidemiológico dos pacientes, considerando as variáveis: sexo, idade, profissão e naturalidade. Avaliou-se a prevalência dos diagnósticos de forma global e de acordo com faixas etárias e sexo. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: As variáveis mais prevalentes foram: sexo feminino, 20 a 59 anos, naturalidade no estado de Minas Gerais e profissões aposentado, do lar e estudante. O grupo de diagnósticos mais prevalente foi discromias, seguido por tumores epiteliais benignos, micoses superficiais, erupções eczematosas e foliculoses. Conclusão: O perfil epidemiológico encontrado, incluindo sexo, faixa-etária, profissão e naturalidade, foi condizente com literatura. Ainda, a prevalência dos principais diagnósticos diferiu conforme a variável epidemiológica dos pacientes. Este resultado condiz, de forma não ordinal, com as principais hipóteses dos demais estudos. Entretanto, a falta de trabalhos com avaliações epidemiológicas semelhantes limita a análise comparativa adequada.
Síndrome de Guillain-Barré como complicação da infecção arboviral da Dengue: revisão de literatura
Authors: Andrade Pedro Duarte Moreira , Santiago Ana Cláudia Felipe , Carminate Camila Baquieti , Maziero Camilla de Freitas , Costa Camila Moreira , Batista Daniele Milagres , Paiva Isabela Guedes , Assis Layandra Vittória de , Sena Paula Moreira , Assis Layara de
Published: August 2021

Objetivo: Correlacionar a infecção pela dengue e o desenvolvimento da Síndrome de Guillain-Barré (SGB). Revisão bibliográfica: Os resultados demonstram que existe uma associação da infecção pela dengue, e o desenvolvimento da SGB, principalmente no verão, período de predominância do vírus. De acordo com a Organização Mundial da Saúde (OMS), a dengue é uma patologia febril associada a dois ou mais dos sintomas: cefaléia, dor retroorbital, mialgia/ artralgia, exantema e petéquias com prova do laço positiva, de início agudo com duração de 2-7 dias. Já a SGB é uma polirradiculoneuropatia inflamatória desmielinizante aguda de caráter autoimune, ou seja, o sistema imunológico reconhece e ataca o sistema nervoso levando à lesão da bainha de mielina. Considerações finais: Portanto, este estudo revelou uma associação entre SGB com essa arbovirose, sendo que a febre é a principal sintomatologia para identificação da infecção pelo arbovírus, seguido de mialgia, artralgia e exantema, bem como paresias e/ou plegias progressivas e ascendentes são fatores determinantes para a identificação da SGB. Dessa maneira, a prevenção contra os vetores é fundamental para diminuir o índice de infecções e consequentemente diminuir os casos de possível desenvolvimento da SGB, melhorando o prognóstico dos pacientes.
Identification and in vitro antifungal susceptibility of dermatophyte species isolated from lesions of cutaneous dermatophytosis: A cross-sectional study
Authors: Kurup Amritha Sabitha , Parambath Fairoz Cheriyalingal , Khader Anza , Raji Thazhathekandy , Jose Beena Philomina
Published: August 2021

Objectives:

The objectives of the study were to determine the in vitro susceptibility of dermatophyte species, isolated from the clinically diagnosed lesions of cutaneous dermatophytosis to fluconazole, and terbinafine.

Materials and Methods:

The skin scrapings from clinically diagnosed lesions of cutaneous dermatophytoses were cultured in Sabouraud dextrose agar to identify the causative dermatophyte. Antifungal susceptibility testing was performed using microbroth dilution assay.

Results:

During the study period, 94 specimens from clinically diagnosed lesions of cutaneous dermatophytoses were received for fungal culture. Dermatophytes were identified as the causative agent in 44 specimens (Trichophyton rubrum was identified in 18/44 (40.9%), Trichophyton mentagrophytes in 17/44 (38.6%), Trichophyton interdigitale in 5/44 (11.4%), and Nannizia gypsea in 4/44 (9.1%) isolates). Minimum inhibitory concentration (MIC) of fluconazole was ≥64 µg/ml in 22.7% (10/44) and MIC of terbinafine was ≥0.5 µg/ml in 36.4% (16/44) of specimens. When compared to fluconazole, terbinafine showed a lower MIC 50 of 0.0019 µg/ml for Nannizia gypsea.

Limitations:

Small sample size and lack of clinical correlation were the major limitations of the study. Antifungal susceptibility testing limited to fluconazole and terbinafine was another limitation of the study.

Conclusion:

Trichophyton rubrum was the most common isolate identified in culture of scrapings from clinically diagnosed lesions of cutaneous dermatophytosis. A rising trend in MIC values of isolates to terbinafine and fluconazole was observed.
Transdural reduction of a bone fragment protruding into the spinal canal during surgical treatment of lumbar burst fracture: A case report
Authors: Saruta Wakiko , Takahashi Toshiyuki , Kumabe Toshihiro , Minami Manabu , Kanematsu Ryo , Ohtaki Hiroya Shimauchi , Otsuka Ryotaro , Hanakita Junya
Published: August 2021

Background:

There have been many reports on the clinical, radiographic, and surgical management of thoracolumbar burst fractures attributed to high-energy trauma. Interestingly, few reports have described how to extract bone fragments associated with these injuries protruding into the spinal canal contributing to significant neurological deficits.

Methods:

An 18-year-old male presented with a severe L3-level paraparesis (i.e., loss of motor/sensory function below L3 lower extremity hyporeflexia, and sphincter dysfunction: American Spinal Injury Association [ASIA] Impairment Scale B) following a high-speed crash. The computed tomography and magnetic resonance studies revealed a L3 burst fracture with bone fragments protruding into the spinal canal causing marked cauda equina compression. Following a L3-L4 laminectomy, and opening of the dorsal dura, the bone fragments were ventrally impacted into the fractured L3 vertebral body a pedicle/screw L1-L5 fusion was then completed.

Results:

One month later, the patient recovered to an ASIA Scale of C, (i.e., residual proximal 3/5 and distal 2/5 motor deficits, with partial sensory sparing).

Conclusion:

Transdural ventral impaction of protruded bone fragments attributed to high speed lumbar burst fractures contributing to significant cauda equina compression can be safely/effectively accomplished.
Tolerance and intolerance of the optic nerve in primary open-angle glaucoma
Authors:   The S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd Branch, Fokin V.P. , Balalin S.V. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd Branch, Boriskina L.N. ,   The S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd Branch
Published: August 2021

Монография посвящена изучению влияния факторов риска на уровень индивидуально переносимого(толерантного) внутриглазного давления, исследованию чувствительности (интолерантности) зрительного нерва к компрессионной офтальмогипертензии, определению индивидуального внутриглазного давления у больных первичной открытоугольной глаукомы. В монографии представлено оригинальное программное обеспечение для определения индивидуального ВГД с учетом факторов риска и прогнозирования скорости прогрессирования глаукомного процесса. Описаны рекомендуемые алгоритмы медикаментозного, лазерного и хирургического лечения первичной открытоугольной глаукомы применительно к тактике снижения интолерантного ВГД до уровня индивидуальной нормы. Предложен способ оценки эффективности фототермолизиса пигментных гранул трабекулярной мембраны после селективной лазерной трабекулопластики. Сформулированы понятия толерантности и интолерантности зрительного нерва при глаукоме. Книга рассчитана на врачей-офтальмологов, интернов и клинических ординаторов.
Modern possibilities of immunotherapy in the treatment of extensive-stage small cell lung cancer: experience of durvalumab application. Case report
Authors: Zhabina Albina S. , Moiseenko Fedor V. , Volkov Nikita M. , Abduloeva Nuriniso Kh. , Moiseenko Vladimir M.
Published: August 2021

Extensive-stage small cell lung cancer (ES-SCLC) is characterized by an aggressive course, a high recurrence rate and fast progression. For a long time, the survival prognosis for the most patients suffering from this disease remained unfavorable. The situation changed with the appearance of chemoimmunotherapy in clinical practice. Chemotherapy based on durvalumab in comparison with the standard chemotherapy demonstrated the statistically and clinically significant increase in median overall survival in patients with previously untreated ES-SCLC in the CASPIAN international trial. This article deals with the case of the application of standard chemotherapy in combination with durvalumab as a first-line ES-SCLC therapy. The patient started receiving durvalumab therapy in June 2017 as a part of the CASPIAN international trial. In March 2021 the duration of therapy was 45 months, the patient had a complete regression of the disease.
Refractory metastatic colorectal cancer: challenges and solutions during the COVID-19 pandemic
Authors: Sekacheva Marina I. , Fatyanova Anastasia S. , Meretukov Daur A. , Zhilenkova Angelina V , Rusanov Aleksandr S. , Rozhkov Aleksandr A. , Guryanova Anastasiia A. , Bagmet Nikolay N.
Published: August 2021

Colorectal cancer (CRC) is one of the leading cancers in terms of prevalence and mortality. Almost 1/4 of patients with CRC have metastases at the initial presentation. The survival rate of this group of patients remains low. With the onset of the COVID-19 pandemic, cancer patients have faced difficulties in getting diagnosis or treatment, which could potentially lead to an increase in late-stage tumors and mortality. This situation required changes in approaches to the treatment of cancer patients, such as replacing drugs with tablet forms, schemes with long intervals, and much more. It is known that about 50% of patients with metastatic colorectal cancer survive in satisfactory condition until the 3rd line drug therapy or longer. One of the main drugs for this category of patients is regorafenib, which, thanks to the tablet formulation, has become especially important in the COVID-19 pandemic. In numerous clinical studies, the drug showed an increase in patient overall survival and good safety profile. In addition, there is growing evidence of the effect of regorafenib on tumor sensitivity to treatment with platinum drugs, irinotecan, and EGFR inhibitors.
Synchronous thyroid gland metastases from breast cancer. Case reports
Authors: Ognerubov Nikolai A. , Antipova Tatyana S. , Palkina Elena E.
Published: August 2021

Background. Breast cancer is the leading cause of death in women. Distant metastases in different organs, including the thyroid gland, are still an urgent problem. Distant metastases are very rare in clinical practice. Nevertheless, the accumulated clinical and surgical experience in treatment has shown that breast cancer is the second most common primary tumor, leading to thyroid gland metastases, after kidney cancer.
Aim. Present the clinical observations of synchronous thyroid gland metastases from breast cancer.
Materials and methods. We observed two patients, aged 55 and 72 years, suffering from metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical and mediastinal lymph nodes, to the lungs, to the ovaries and to the bones.
Results. A 55-year-old woman with a left sided neck mass and hoarseness has been suffering from the metastatic breast cancer with simultaneous metastases to the thyroid gland, to the cervical lymph nodes, to the lungs, to the ovaries and to the bones. The biopsy of the primary tumor has been performed. The tumor has the structure of invasive ductal carcinoma, G2, luminal A subtype, HER2-negative type in histological and immunohistochemical analysis. The spread of the tumor has been determined by positron emission tomography/computed tomography (PET/CT). Metastases from breast cancer have been cytologically proven during thin needle biopsy. A 72-year-old woman with a mass in the region of thyroid gland has been suffering from breast cancer with metastases to the thyroid gland, to the mediastinal and cervical lymph nodes, to the bones, and to determine this process PET/CT, the thyroid fine needle aspiration biopsy and core biopsy of primary tumor have been applied. The histological variant was represented by invasive ductal cancer, G2, luminal A subtype, HER-2 negative type. Taking into account the spread of the process, the patients were given polychemotherapy, targeted therapy and hormone therapy. There is no disease progression for 6 months.
Conclusion. Synchronous thyroid gland metastases in case of primary breast tumors are rare. In such cases, PET/CT is the important diagnostic method. The main therapeutic option in this case is systemic therapy, including chemotherapy, targeted and hormone therapy, the nature of the agent depends on the biological variant of the tumor.
The use of atezolizumab in combination with chemotherapy in first-line of metastatic small cell lung cancer. Case report
Authors: Ognerubov Nikolai A. , Antipova Tatyana S.
Published: August 2021

Background. Lung cancer (LC) occupies a leading position among malignant tumors in the world, it accounts for 11.4% of the total malignant neoplasms. In 2020, there were 2 206 771 new cases of LC and 1 796 144 deaths worldwide. Among the histological variants, small cell LC (SCLC) has the most unfavorable outcomes. This variant is considered highly sensitive to chemotherapy. Despite some successes in the treatment of this disease, the results of treatment remain problematical. In recent years, the use of immune checkpoint inhibitors has provided significant control of the course of the disease.
Aim. To show the efficacy of atezolizumab in combination with chemotherapy in patients with metastatic SCLC.
Materials and methods. A 76-year-old patient with left lung cancer, IVA T4N3M1b, the right supraclavicular lymph node metastases, exudative pleuritis of the left lung was under observation. The histological investigation showed SCLC. Brain metastases were not detected. ECOG 0.
Results. The patient was treated using atezolizumab 1200 mg in combination with carboplatin 5 AUC and etoposide 100 mg/m2 on days 1, 2, 3 for four cycles, followed by a maintenance therapy regimen with atezolizumab 1200 mg every 21 days. The patient received 21 injections during 14 months. The assessment of treatment effect was evaluated using combined 18F-fluorodeoxyglucose positron emission and X-ray computed tomography. As a result of the treatment, after 7 months, a complete clinical and morpho-metabolic regression of the tumor was reached, which persisted throughout the period of the treatment. Among the adverse events were detected grade 2 anemia and first-stage sensory neuropathy. No immune-related adverse events were observed.
Conclusion. The addition of atezolizumab to etoposide + carboplatin as the first-line therapy for extensive-stage SCLC provides the long-term overall and disease-free survival with achieving the satisfactory quality of life in patients and acceptable drug tolerance.
Metastatic cervical cancer: clinical experience with pembrolizumab application. Case report
Authors: Protasova Anna E. , Strakh Liubov V. , Lando Elena I. , Sidorkina Elena V.
Published: August 2021

Cervical cancer (CC) ranks fourth for cancer incidences in women after breast cancer, colorectal cancer and lung cancer. There is a steady increase in the incidence of invasive forms of CC in Russia. Over the past quarter of a century, the mortality rate of reproductive age group women with cervical cancer has increased by 2 times. The standard treatment options for cervical cancer progression were the regime of paclitaxel plus cisplatin (carboplatin). The addition of an antiangiogenic therapy (bevacizumab) to the standard chemotherapy regimen increases overall survival of only 4%. The response to other lines of chemotherapy does not exceed 10% after the therapy using the combination of paclitaxel + carboplatin + bevacizumab. The results of KEYNOTE-158 trial demonstrated objective responses in 91% of CC patients lasting for more than 6 months in case of application of pembrolizumab 200 mg every 3 weeks in cases of PD-L1 expression (CPS1) with acceptable toxicity. The presented clinical case of successful treatment using pembrolizumab in women with PD-L1 expression in metastatic CC has a beneficial effect on further accumulation of experience and could help to choose the right treatment options in order to increase the efficacy of the therapy and to increase the survival rates for this category of patients.
MODELO SK: UM GUIA PARA UTILIZAÇÃO DAS TECNOLOGIAS DIGITAIS NO PROCESSO ENSINO-APRENDIZAGEM DE CIÊNCIAS E MATEMÁTICA
Authors: Silva Wender Antonio da , Kalhil Josefina Barrera
Published: August 2021

Este artigo descreve o produto de um estudo de doutoramento que buscou identificar de que forma as tecnologias digitais podem propiciar o desenvolvimento de habilidades e competências para a construção do conhecimento científico em cursos de formação inicial de professores. Apresenta uma proposta didática intitulada “Modelo SK” que possui como objetivo orientar educadores do ensino superior, em especial da área de Ciências e Matemática, a refletir sobre as competências digitais necessárias para o planejamento, execução e avaliação de estratégias pedagógicas com a utilização das tecnologias digitais. Para tanto, verificou-se junto a alunos e professores dos cursos de Ciências e Matemática, na modalidade licenciatura presencial de uma instituição de ensino superior pública do estado de Roraima, quais seriam suas competências digitais e como estas poderiam ser utilizadas no processo educacional. Na coleta de dados, foram aplicados questionários Likert para uma amostra de 173 alunos e realizadas entrevistas com 14 professores da área de Ciências e Matemática. A pesquisa é de abordagem mista, com tratamento estatístico dos questionários, análise das diretrizes curriculares nacionais brasileiras e dos projetos pedagógicos dos cursos de Ciências e Matemática (Biologia, Química, Física, Matemática e Ciências da Natureza), bem como a transcrição e análise dos conteúdos das entrevistas.  Com o auxílio da técnica de categorização, elaborou-se um conjunto de estratégias educacionais que apresentam uma proposta para o desenvolvimento das competências digitais necessárias para o planejamento, execução e avaliação de metodologias de ensino.
Comparative study of postdural puncture headache in midline and paramedian approach of spinal anaesthesia at a tertiary hospital
Authors:   Assistant Professor, Department of Anaesthesiology, Dr Ulhas Patil Medical College, Jalgaon, Maharashtra, INDIA, Sonawane Bharat Ramchandra
Published: August 2021

Background: Postdural puncture headache (PDPH) is a known complication of spinal anaesthesia. It is an iatrogenic cause,results after either intentional or accidental dural puncture.It begins typically within 2 days but regresses spontaneously in a few days. Present comparative study was conducted in patients who underwent elective lower abdominal surgery under spinal anaesthesia by midline or paramedian approach to evaluate incidence of postdural puncture headache at our tertiary hospital. Material and Methods: This prospective and comparative study was conducted 120 patients undergoing elective lower abdominal surgery under spinal anaesthesia were considered for present study. Patients were randomly divided in double‑blind fashion (patient and observer were blind to procedure) into two groups of 60 each. Numeric visual analog pain score was used to assess the postdural puncture headache in both the groups. Any case of persistent postdural puncture backache after discharge was followed up to 7 days through telephonic communication with the patient. The data collected was analysed statistically. Quantitative variables were expressed as Mean ± SD (standard deviation) while qualitative variables were expressed as relative frequency and percentage. The PDPH was analysed using Chi square test. P-value <0.05 was considered as statistically significant. Results:120 patients undergoing elective lower abdominal surgery under spinal anaesthesia were randomly divided in double‑blind fashion (patient and observer were blind to procedure) into two groups as Group M (median approach) and Group P (paramedian approach) of 60 patients each. General characteristics such as age, weight, gender and ASA status were comparable in both groups. Intra-operative hypotension was noted in 10% patients of group M and 8% patients of group P, difference was not statistically significant. 3 % patients of group M and group P required medications (tramadol / paracetamol) to treat PDPH.In present study postdural puncture headache was mild in 8 % and moderate in 3% patients in group M. While 7% patients had mild and 3% patients had moderate postdural puncture headache in group P. Incidence of postdural puncture headache was 10% in group M and 8% in group P, difference was not statistically significant. Conclusion: There was no difference regarding the incidence of PDPH in median and paramedian approach for spinal anaesthesia.
Dexmedetomidine infusion on subarachnoid block with bupivacaine in inguinal herniorrhaphies - A prospective study
Authors:   Assistant Professor, Department of Anaesthesiology, SVS Medical College, Mahabubnagar, Telangana, INDIA., Chaitanya Savala
Published: August 2021

Background: Dexmedetomidine (D) is alpha-2 agonist that acts as an anaesthetic and analgesic substitute. The goal of this study was to see how intravenous (I.V.) dexmedetomidine affected the length of sensory and motor block, postoperative analgesia, sedation degree, and side effects. Aims: To assess the effect of Dexmedetomidine infusion on the duration of analgesia with spinal Bupivacaine for adult patients undergoing herniorrhaphy and to assess side effects. Materials and methods: Prospective study was done under the for a period of 11 months. In 80 adults aged 20 to 60 years scheduled for herniorrhaphies were allocated into two study groups, named B and BD using computer generated randomization. The enrolled patients were divided into 2 groups each 40 patients to receive either 0.5 µg/kg dexmedetomidine intravenous bolus over 10 min (Group BD) or saline infusion (Group B) prior to subarachnoid block with 0.5% hyperbaric bupivacaine 12.5 mg Results: Numerical pain rating scale scores were significantly lower in group BD. Total analgesic requirement was significantly less in group BD. Time to request for first analgesic dose was longer in group BD as compared to group B. The duration of analgesia was longest in patients received intravenous dexmedetomidine along with spinal bupivacaine. Hemodynamic parameters and incidence of side effects were similar in both the groups. Conclusion: Premedication with single dose of intravenous dexmedetomidine 0.5 µg/kg prior to subarachnoid blockade with 0.5% hyperbaric bupivacaine hastens the onset and increases duration of sensory and motor block, with maintenance of stable hemodynamics and arousable sedation in Inguinal Herniorrhaphies.
Comparative study of Intraoperative Haemodynamics and recovery characteristics of desflurane and sevoflurane in patients receiving General Anaesthesia
Authors:   Shridevi Institute of Medical Sciences and Research Hospital, Tumkur 572101, Karnataka, INDIA., M Kavya
Published: August 2021

Background: Inhaled anesthetics used for general anaesthesia have a rapid onset and offset of action. The Induction and recovery depends on anaesthetic drug solubility, cardiac output and minute ventilation. Sevoflurane and desflurane have low blood gas partition coefficients, and therefore share the advantage of faster onset and recovery from anaesthesia when compared to other inhaled anesthetics. Hence, we designed this prospective randomized study to compare the intraoperative haemodynamic parameters and recovery characteristics of desflurane and sevoflurane. Methods: Sixty patients aged between 18-50 years belonging to ASA I and II scheduled for elective general anaesthesia were enrolled in the study and randomly divided into two groups to receive desflurane(group D) and sevoflurane(group S) for the maintenance of anaesthesia. Both groups were premedicated, pre oxygenated and induced with propofol. Muscle relaxation maintained with vecuronium. Desflurane and sevoflurane concentrations were adjusted according to entropy parameters and clinical variables like HR, NIBP, MAP and SPO2. Neuromuscular blockade reversed with neostigmine and glycopyrrolate. Recovery characteristics assessed using modified Aldrete scoring. Results: The intraoperative haemodynamics was similar with both desflurane and sevoflurane, and was maintained within 20% of baseline values. However, early recovery characteristics were significantly better in group D. Time to eye opening was 6.63 + 2.17 min in group S versus 4.77 + 1.41 min in group D (P< 0.001). Time to Extubation was 8.03 + 2.54 min in group S and 5.93 + 1.44 min in group D (P < 0.001). Response to verbal commands was 8.77 + 3.01 min in group S and 6.97 + 1.67 min in group D (P < 0.001). Modified Aldrete score were significantly better in group D than group S at 1st min, 2nd min and 3rd min. Thereafter, modified Aldrete score assessed at 5, 10, 15, 30 and 60 min were similar in both groups. Conclusion: Both desflurane and sevoflurane produce similar stable haemodynamic profile. Despite the faster early recovery with desflurane, no significant differences were found between the two volatile anaesthetics after 5 minutes during intermediate recovery period.
Standalone use of Laryngeal mask airway supreme for primary airway management in adults undergoing laparoscopic surgeries: A prospective observational study
Authors:   Assistant Professor, Department of Anesthesiology, D.Y. Patil Medical College, D. Y. Patil Education Society (Deemed University), Kolhapur-416 006, Maharashtra, INDIA., Desai Sheetal K
Published: August 2021

Background: Laryngeal mask airway (LMA) does not provide definitive airway protection from pulmonary aspiration of potential regurgitated gastric contents. LMA supreme, a recent supraglottic (extraglottic) airway device, shows promising results. Thus, aim of study to evaluate the role of supreme laryngeal mask airway (SLMA) in airway management of patients operated with laparoscopic procedures under general Anaesthesia. Methods: The prospective observational study comprised of 274 patients of ASA grade 1 and 2 scheduled for short elective laparoscopic procedures (<1hr.30min) who provided consent. Patients were anaesthetised according to standard protocol, appropriate size of SLMA was chosen and inserted; and complications were noted. Post SLMA removal, recovery and trauma of throat were noted. Postoperative complications such as nausea, vomiting, and throat pain were noted. Binary logistic regression model and Chi-square test of association was performed to analyse data (P<0.05). Results: Most participants were female (n=260) with mean age of 31.42±7.24 years. Mean duration of surgery and recovery time was 37.3±5.84 min and 5.85±1.93 min respectively. SLMA size 3 was commonly used (n=245) and majority of insertions were successful in the first attempt (n=244). Post insertion, SLMA had adequate length (n=208) Throat pain (n=37) and vomiting (n=38) were common post-operative complications observed in the patients. A significant association was observed between operative procedure and complication (P=0.0004) and number of attempts (P=0.0004) with trauma being significant (P=0.0039). Trauma was associated with gender (P=0.08) and body weight (P=0.006). Conclusion: SLMA can be used as a standalone supraglottic (extraglottic) airway device for airway management in laparoscopic surgeries.
Comparative study between isobaric levobupivacaine and isobaric chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia
Authors:   Assistant Professor, Department of Anesthesiology, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, INDIA., R Abhishek
Published: August 2021

Background: With development of safer local anesthetic agents and advances in minimally invasive surgical techniques, the performance of day care surgeries are increasing in prevalence. Many local anesthetic drugs with varying concentrations and physical properties are used in spinal anesthesia to achieve early recovery, mobilization with minimal adverse effects. In the present study we are comparing the efficacy of Isobaric 0.5% Levobupivacaine with isobaric 1% 2-chlorprocaine in patients undergoing ambulatory surgeries under spinal anesthesia. Material and Methods: Sixty patients aged 18 to 60 years belonging to ASA physical status I-II, scheduled for various elective ambulatory surgeries under spinal anesthesia were randomized into two groups. Group A patients received 3ml of 0.5% Levobupivacaine and Group B received 4ml of 1% chlorprocaine. The time of onset, duration of sensory and motor block, hemodynamic changes and adverse effects were studied. Results: The time of onset of sensory block and motor block was significantly shorter (p<0.001) in Group B compared to Group A. Similarly, the duration of sensory and motor block in Group B was shorter (p<0.001). Intraoperative hemodynamic parameters including heart rate, systolic blood pressure and diastolic blood pressure were comparable in both groups. Conclusion: Intrathecal isobaric 1% 2- chloroprocaine has a shorter onset and duration of both Sensory and motor blockade compared to Isobaric 0.5% Levobupivacaine thereby, enabling early recovery and ambulation
Влияние уровня денежных доходов населения на структуру продажи алкоголя в России
Authors: Разводовский Ю.Е. , Зотов П.Б.
Published: August 2021

Значительные изменения в объеме и структуре рынка продажи алкоголя, а также меняющиеся экономические циклы макроэкономической активности делают Россию удобным объектом для изучения влияния уровня номинальных доходов населения на структуру и динамику продажи алкоголя. Целью исследования было изучение хронологической связи между доходами и структурой продажи алкоголя в России на современном популяционном уровне. Материал и методы: проведен ретроспективный сравнительный анализ динамики валового внутреннего продукта (ВВП) и уровня продажи различных видов алкогольных напитков/структуры рынка продажи алкоголя в России за 25-летний период (с 1990 г. по 2015 г.) Статистическая обработка данных проводилась с помощью пакета STATISTICA10. Результаты: согласно результатам корреляционного анализа наличия и силы связи ВВП с продажей алкогольных напитков, обнаружена отрицательная корреляционная связь с продажей водки (r=-0,63; p<0,000)/долей водки в структуре продажи (r=-0,8; p<0,000), а также положительная корреляционная зависимость с продажей пива (r=0,5; p<0,000)/долей пива в структуре продажи (r=-0,72; p<0,000) и с продажей вина (r=0,73; p<0,000)/долей вина в структуре продажи (r=0,67; p<0,000). Выводы: в связи с государственной политикой улучшения благосостояния населения в макроэкономической ситуации в России зарегистрирован рост доходов населения, что является одной из определяющих величин изменения структуры продажи алкоголя в России в пользу предпочтения слабоалкогольных напитков.
Analysis and Control of Single Phase Grid Connected Modular Multilevel Converter in Per Unit
Authors: BEYHAN Elif , AKPINAR Eyüp
Published: August 2021

In this paper, a mathematical model and control methods of a modular multilevel converter are examined in per unit. Some control algorithms, like a sorting algorithm, circulating current control, proportional resonant controller and pulse width modulation techniques which are applicable on this converter are investigated. The average value model is used in per unit for the converter and it is combined with circulating current control method and propotional resonant current controller to suppress the second harmonic component in the circulating current. The effect of the circulating current harmonics on the resonance frequency is investigated. A Matlab/Simulink model is prepared for the simulation of converter modeled on the approach of the average value model and the results are generated from the simulation and they are discussed.
A Detailed Analysis of Daily, Seasonal and Yearly Performance Values of Photovoltaic Modules Using by a Simplified Method
Authors: AKTACİR Mehmet Azmi , YILDIRIM Erdal , İŞIKER Yusuf
Published: August 2021

The performance of panels for PV system design is determined according to the performance values in standard test conditions specified in the panel catalog, without knowing the performance under actual operating conditions. However, the operating performance of the PV panel depends on meteorological characteristics of place where the PV system is installed. Especially, if outside temperature values are above test conditions, the efficiency of the PV panel decreases and generation losses are observed. In this study, performance parameters of photovoltaic panel were calculated for four different PV panel technologies only by using their catalogue values like NOCT temperature, power-temperature coefficient etc. For this purpose, real working conditions were simulated using 3-year climate data for the meteorological conditions of Sanliurfa, Turkey. In the end, PV panel efficiency, electricity generation values and performance ratios were calculated in accordance with the temperature. According to the results obtained, the PV panels’ performance ratios decreased up to 0.75 during the summer months. The highest unit energy generation was achieved with thin film PV technology.
Characterization of Mechanical of CTBN Liquid Rubber‐Modified Epoxy Cured by Anhydride- and Amine-Based Agent
Authors: SEPETÇİOĞLU Harun
Published: August 2021

The main purpose of this work is to reveal the effects of carboxyl-terminated butadiene–acrylonitrile (CTBN) rubber particles on the fracture and tensile behavior of anhydride-and amine-cured epoxy/CTBN blends. In this study, 1 wt.%, 3 wt.%, 5 wt.%, 7 wt.%, 10 wt.% and 15 wt.% CTBN were added to two different epoxy-hardener systems. The CTBN/epoxy blends were prepared by ultrasonic mixing device and curing processes were determined by DSC analysis. As CTBN fraction by weight increased in both epoxy systems, a decrease in tensile strength and modulus was detected, but deformation ability improved. The fracture toughness of CTBN/epoxy blends cured with amine-based hardener increased up to 10 wt.% CTBN addition and then decreased. The average rubber particle size was found to have a significant effect on the fracture toughness of CTBN/epoxy blends. Compared to pure epoxy, fracture toughness increased approximately 3.5-fold in amine-cured 10% CTBN / epoxy blend. In CTBN/epoxy blends cured by amine-based curing agent, CTBN shifted the reaction rate and thus it was provided better control over CTBN particle size in the cured CTBN/epoxy. The toughening mechanisms induced by CTBN, such as rubber cavitation and matrix shear banding, contributed to the enhanced fracture toughness of the amine-cured CTBN/epoxy.