bluuebunny/crossref_metadata_2025 huggingface dataset:
Terapinės hipotermijos reikšmė išnešiotų naujagimių, patyrusių hipoksiją arba asfiksiją gimstant, atokiosioms baigtims
Authors: Iskevičiūtė Ieva , Kudrevičienė Aušrelė , Tamelienė Rasa
Published: April 2021

Tyrimo tikslas. Nustatyti terapinės hipotermijos (TH) reikšmę naujagimių, patyrusių hipoksiją arba asfiksiją gimstant, atokiosioms baigtims. Tyrimo metodai. Atlikta sisteminė literatūros apžvalga naudojantis „PubMed“ (MEDLINE) ir ,,Cochrane“ bibliografinėmis medicininėmis duomenų bazėmis. Atrinkti straipsniai, nagrinėjantys terapinės hipotermijos dažnį bei įtaką išnešiotų naujagimių ankstyvosioms ir vėlyvosioms baigtims, kurie gimdami patyrė hipoksiją arba asfiksiją. Paieškai naudotos reikšminių žodžių kombinacijos anglų kalba: therapeutic hypothermia in neonates, neonatal cooling, hypoxic-ischemic encephalopathy and cooling, cooling asphyxiated newborns. Taip pat naudotas filtras: anglų kalba, straipsniai, ne senesni nei penkerių metų. Rezultatai. Įvykdžius sisteminę paiešką, į analizę įtraukti septyni viso teksto moksliniai straipsniai. Iš viso bendra tiriamųjų imtis buvo 2014 naujagimių. Į sisteminę analizę įtraukti straipsniai iš šių šalių: JAV, Jungtinės Karalystės, Nyderlandų, Bosnijos ir Hercegovinos. Visuose tyrimuose analizuota TH reikšmė naujagimių, patyrusių perinatalinę asfiksiją (PA), atokiosioms baigtims. Taip pat visi tyrėjai aprašė, jog TH buvo taikyta visiems gaivintiems naujagimiams, atitikusiems atrankos kriterijus pagal protokolus. Išvados. Esant TH atrankos kriterijams, visiems naujagimiams, patyrusiems asfiksiją gimstant, skiriama TH. Ankstyvosios atokiosios baigtys naujagimių, kuriems buvo taikyta TH: mirtis, hipoksinė išeminė encefalopatija (HIE), traukuliai. Nuo 10,8 iki 32 proc. tiriamųjų mirė stacionare. Lengva HIE buvo nustatyta nuo 14,3 iki 16,9 proc. tiriamųjų, vidutinio sunkumo – nuo 52,1 iki 88 proc. tiriamųjų, sunki – nuo 12,1 iki 28,6 proc. tiriamųjų. Traukulių dažnis – nuo 17,9 iki 75,9 proc. atvejų. Ankstyvųjų baigčių dažnis, netaikant TH, reikšmingai nesiskyrė. Vėlyvosios atokiosios baigtys naujagimių, kuriems buvo taikyta TH: negalia, motorinės raidos sutrikimai, cerebrinis paralyžius (CP), klausos, regos, kalbos ir intelekto sutrikimai. Lengva negalia buvo nustatyta nuo 10 iki 21 proc., vidutinio sunkumo – nuo 1,3 iki 10 proc., sunki – nuo 11,5 iki 25 proc. atvejų. Motorinės raidos sutrikimų arba CP dažnis – nuo 11,9 iki 68,9 proc. Lengvų klausos sutrikimų dažnis – nuo 1 iki 98,6 proc., lengvų regos sutrikimų dažnis – nuo 4 iki 85,3 proc., lengvų kalbos sutrikimų dažnis – nuo 21 iki 74,3 proc. Vėlyvųjų baigčių dažnis, netaikant TH, reikšmingai nesiskyrė. Tik lengvų kalbos sutrikimų dažnis buvo reikšmingai mažesnis, o intelekto koeficientas buvo didesnis taikant TH.
Uždegiminės žarnyno ligos, reprodukcinė sveikata ir nėštumas
Authors: Rimdzevičiūtė Vytautė , Petrauskaitė Ieva , Ulevičius Jonas
Published: April 2021

Santrauka. Uždegiminės žarnyno ligos (UŽL) – tai lėtinių uždegiminių virškinamąjį traktą pažeidžiančių ligų grupė, kuriai priklauso Krono liga bei opinis kolitas. Dažniausiai šios ligos diagnozuojamos reprodukcinio amžiaus žmonėms, o jų metu juntami simptomai bei taikomas imunosupresinis arba chirurginis gydymas daro neigiamą įtaką įvairioms gyvenimo sritims. Straipsnio tikslas – išanalizuoti uždegiminėmis žarnų ligomis sergančių pacientų reprodukcinės sveikatos aspektus: vaisingumą, nėštumo planavimą, priežiūrą bei gimdymą. Naudojantis „PubMed“, „Medscape“, „Cochrane Library“, „UpToDate“ duomenų bazių ištekliais, atlikta mokslinės literatūros analizė. Rezultatai ir išvados. UŽL veikia įvairias reprodukcinės sveikatos sritis, todėl labai svarbus tinkamas multidisciplininės komandos darbas konsultuojant pacientę vaisingumo, nėštumo planavimo, UŽL gydymo klausimais, taip pat parenkant optimalią nėštumo priežiūros bei gimdymo taktiką.
Naujagimių vėjaraupiai. Klinikinis atvejis ir literatūros apžvalga
Authors: Einikytė Rūta , Sabonytė-Balšaitienė Živilė , Pilypienė Ingrida , Ramašauskaitė Diana , Volochovič Jelena
Published: April 2021

Vėjaraupiai – tai ūminė virusinė liga, kurios sukėlėjas yra žmogaus herpes virusas, vadinamas Varicella zoster virusu (VZV) ir priklausantis Herpes viridae šeimai [1]. Didžiausią pavojų šis virusas sukelia nėščiosioms ir asmenims, kurių imunitetas nusilpęs. Nustatyta, kad nėštumo laikotarpiu vėjaraupiais suserga 2–3 iš 10 000 nėščiųjų [2]. Nėščiosioms po 16 nėštumo savaitės, ypač trečią nėštumo trečdalį, komplikuotų vėjaraupių rizika yra dar didesnė nei kitiems suaugusiems asmenims. VZV infekcija nėštumo laikotarpiu siejama su tokiomis komplikacijomis kaip pneumonija, įgimtu vėjaraupių sindromu ir naujagimių vėjaraupiais. Straipsnyje pristatomas klinikinis nėščiosios ir naujagimio vėjaraupių atvejis bei literatūros apžvalga.
THE FACTORS INFLUENCING THE PROJECTION OF PRESUPPOSITIONS IN CHUVASH: AN EXPERIMENTAL STUDY
Authors:   National Research University Higher School of Economics (Moscow), Natalia A. Zevakhina , Daria V. Gornshteyn ,   National Research University Higher School of Economics (Moscow), Anastasia D. Egorova ,   Lomonosov Moscow State University
Published: April 2021

The current paper experimentally studies the projection diversity of the following presupposition triggers in the Standard Chuvash language in assertive sentences, in negated assertive sentences and in conditional sentences: kallex ‘again’ (adverbial), ta ‘too’ (conjunction), mansa kaj ‘forget’ and pəl ‘know/find out’ (mental factive verbs), and pəter ‘finish’ (aspectual verb). Relying upon the presupposition projection in various contexts, [Abusch 2002] suggested to distinguish between hard vs. soft presupposition triggers. According to this view, the former two Chuvash items belong to hard triggers, whereas the latter three items represent soft triggers. The papers by [Xue and Onea 2012; Smith and Hall 2012] among others experimentally confirmed the distinction between hard vs. soft triggers in several West-European languages. The current paper verifies the hypothesis about the distinction between hard vs. soft triggers on the basis of a non-Indo-European language and suggests using a verification task: participants have to choose one of the values on the five-point Likert scale while answering a given question with respect to a given context. The paper only partially confirms the distinction between hard vs. soft triggers. As in [Xue and Onea 2012], the paper shows that soft triggers exhibit a more heterogeneous group than hard triggers. Moreover, contrary to the recent paper by [Tonhauser et al. 2018], the paper does not reveal further distinctions either within each of the presupposition trigger groups or between the presupposition trigger groups. The paper gives two plausible interrelated reasons for the obtained results that are a linear position and a syntactic status (independent vs. embedded) of the first clause in a question that contains the denied presupposition.
PHONETIC FEATURES OF NENETS LOANWORDS IN THE OB-UGRIC LANGUAGES
Authors:   Institute of Linguistic Studies, RAS (St. Petersburg), Anna Yu. Urmanchieva
Published: April 2021

The article deals with the Nenets borrowings in the Ob-Ugric languages: Khanty and Mansi. The main list of these borrowings was compiled by Wolfgang Steinitz in a work published more than half a century ago. In the paper I focus on phonetic features of the borrowed words. These borrowings represent predominantly the cultural vocabulary and are geographically quite limited being presented only in the northern dialects of Mansi and Khanty. Despite of this many of these words retain very archaic features of Nenets phonetics. This allows us to consider linguistic contacts between the Ob-Ugrians and the Nenets as rather old. Consideration of the corpus of the borrowings also allows to shed some light on the relative chronology of historical sound changes in the Nenets language. In the paper all Nenets loans in Mansi and Khanty are compared with their possible sources in Tundra Nenets and in Forest Nenets. This comparison shows that in Forest Nenets a potential corresponding word is often missing or looks phonetically too different and therefore can not be regarded as the source of borrowing. Thus, the donor language was definitely the Tundra Nenets, and not the Forest Nenets language. Mansi and Khanty words borrowed from Tundra Nenets may reflect the following archaic features of Nenets historical phonetics: final vowels (before reduction into °); final consonants, changed into the glottal stop in modern Nenets; intervocalic -m-, changed into - w- in modern Nenets; final glide -w, disappeared in modern Nenets. All words borrowed in Ob-Ugric languages from Nenets can be divided in two groups with respect to these parameters: some of them definitely preserve a more archaic state of Nenets phonetics, whereas others are phonetically much closer to modern Nenets words. Another feature that allows to evaluate the relative age of borrowings is the labialization of vowels in Kazym Khanty and in Mansi: in earlier borrowings Nenets vowel a has changed in Kazym Khanty and Mansi into a labial vowel, whereas in later ones it has preserved its original quality.
VERB MORPHOLOGY IN THE MONUMENT OF MARI WRITING “THE BEGINNINGS OF CHRISTIAN DOCTRINE...” (1839 / 1841)
Authors:   Mari Scientific Research Institute of Language, Maria A. Klyucheva ,   Literature and History named after V. M. Vasilyev, Mari State University (Yoshkar-Ola),   Ivannikov Institute for System Programming, RAS (Moscow)
Published: April 2021

The article deals with the verbal morphology in the monument of Mari writing “The Beginnings of Christian doctrine...” (published in Kazan in 1841). Among the earliest publications in the Mari language, this is one of the most voluminous texts, including Concise Sacred History and Catechism. The dialectal basis of the considered text is a Meadow dialect, at the same time the verbal morphology (mainly in the plural forms) differs significantly from the literary norm of the contemporary Mari (Meadow-Eastern) language. As a result of comparison with dialectological data, the correspondence of the verbal morphology in the monument to the conjugation in the western subdialects (Volga, Yoshkar-Ola) of the Meadow dialect is revealed. (These dialects turned out to be peripheral during the formation of the literary Meadow-Eastern Mari language in the 20th century. The verbal morphology of the literary language is based on the Morki-Sernur subdialect of the Meadow dialect and the Eastern dialect of the Mari language.) At the same time, the specific verb forms of Western subdialects of the Meadow dialect revealed in the monument and described in the article largely correlate with the conjugation in Western Mari dialects (Hill and North-Western), including the literary norm of the Hill Mari language. In general, the analysis of the verbal forms (with preliminary consideration of phonetic and vocabulary data) allows us to define the “The Beginnings of Christian Doctrine…” (1839 / 1841) as a most important early written monument of the Volga subdialect of the Meadow dialect and a valuable source on the historical dialectology of the Mari language. Keywords: Finno-Ugric languages, Mari language, Vol
THE GRAPHIC ANALYSIS OF THE FIRST SYLLABLE VOWEL SYSTEM IN NENETS DICTIONARIES FROM A. M. SJÖGREN’S ARCHIVE
Authors:   Institute for System Programming, RAS (Moscow), Polina I. Li ,   Institute of Philology of the Siberian Branch of the RAS (Novosibirsk)
Published: April 2021

This article describes the graphic features of the first syllable vowels in Pustozersk and Obdorsk dictionaries from A. M. Sjögren’s archive. The graphic analysis is carried out against the background of the Proto-Samoyed reconstructions by J. Janhunen, Nenets current literary norm, “Nenets-Russian Dictionary” by N. M. Tereschenko, “A Morphological Dictionary of Tundra Nenets Language” by T. Salminen, and “Dialectal Dictionary of the Nenets Language” by S. I. Burkova et al. The dialectal features of the dictionaries are compared to the modern ones. The area of the Pustozersk region is referred to as the territory where the central (Bolshezemelskiy) dialect is spoken. In one word the graphic representation of the 18th century Pustozersk dictionary coincides with the form of the modern Eastern dialect word. At the same time, in another word, the Western variant is attested. The territory where the Obdorsk dictionary was recorded is the territory where the speakers of the Eastern dialects of the Nenets language reside. In the Obdorsk dictionary, a variant that coincides with the Eastern variant is recognized. Some outstanding consonant features of the first syllable are also taken into consideration. For example, in the Pustozersk dictionary, the initial /ŋ/ is not represented graphically, as in Proto-Samoyedic reconstructions. The Obdorsk dictionary contains three graphic variants of the modern initial /ŋ/. The results are presented in comparison tables. The word examples are presented accordingly. In many ways, the reflexes presented in the Pustozersk dictionary correspond with modern ones. The reconstructed diphthongoids are graphically represented by the diphthongs in the Pustozersk dictionary, which is not the case for modern dictionaries. In comparison with modern dictionaries, reflexes in the Obdorsk dictionary are more diverse. The diphthongs are also used in the place of reconstructed diphthongoids.
VOTIC-INGRIAN CONVERGENCE AND INTRA-IDIOLECTAL CONTINUUM (A CASE STUDY OF A CHAIN RUNE)
Authors:   Institute for Linguistic Studies, RAS (St. Petersburg), Fedor I. Rozhanskiy ,   University of Tartu (Tartu)
Published: April 2021

This paper analyses different variants of the Votic chain rune Kuza piippu? “Where is the pipe?” in the context of Votic-Ingrian convergent processes. The main focus is made on the alternation between the lexemes “granary” and “fence”, and the structure of postpositional phrases containing these lexemes. The analysis is based on 13 variants of the rune published by several researchers, and three variants of the same rune recorded by the author in the village of Luuditsa of the Kingisepp region. In different variants of Kuza piippu?, three lexemes alternate within the same line: ratiz ‘granary’, aitta ‘granary’, and aita ‘fence’. The paper concludes that the first variant is the original Votic lexeme meaning ‘granary’, the second one is an Ingrian word that was not fully adopted by Votic, and the third variant emerged as a substitution of the unfamiliar Ingrian word with the phonetically closest Votic word. The Ingrian influence is observed also in the postpositional phrase with the discussed lexemes (‘under the granary ~ fence’). In the earlier versions of the rune, one finds the postposition alla ‘under’ as a separate word. In more recent variants, the head noun and postposition are usually written together as one word, with a formative n between them. This n is the Ingrian marker of the genitive case that was later re-analyzed as the initial consonant of the postposition (alla > nalla). The research has revealed that even in the variants recorded from the same speaker, the combination of Votic and Ingrian elements is almost arbitrary. The Votic-Ingrian ratio is not as much a characteristic of the idiolect, but rather a characteristic of a particular text. Therefore, the idiolect cannot be considered as a minimal sociolinguistic object. The author introduces the notion of “variolect” as a language variant with a particular ratio of languages in contact that characterizes a given speech sample. The mixing of Votic and Ingrian in the western Votic villages is a vivid example of iterative convergence. The Lower Luga Ingrian that emerged as a convergent variety on the basis of several Finnic languages (Ingrian and Votic, most of all), gives birth to new contact varieties when acquired by Votic speakers.
A PRE-STANDARD CHUVASH TEXT WITH A DATIVE-ACCUSATIVE DISTINCTION
Authors:   Institute of Linguistics, RAS (Moscow), Alexander V. Savelyev
Published: April 2021

This paper introduces the linguistic evidence extracted from the first translation of the Gospel of Matthew into Chuvash, which was published in Kazan in 1820. On the basis of a detailed analysis of dialect-specific features, and especially phonological and morphological innovations, the attested variety should be classified among the Kărmăš—Xĕrlĕ Čutay varieties of Viryal Chuvash. Such a conclusion is consistent with the available extra-linguistic evidence regarding the dialect affiliation of this early Bible translation. Many of the archaic features found in the first translation of the Gospel of Matthew into Chuvash were previously documented in other preStandard Chuvash texts from the 18th—19th centuries. One salient feature that distinguishes the Gospel translation from the other contemporary sources is that the attested variety retains the old distinction between the dative and accusative case markers (after a limited number of lexical and grammatical morphemes). Modern Chuvash makes use of the syncretic dative-accusative case suffix -(n)A, dial. -(j)A, which developed through the merger of reflexes of Proto-Turkic dative and accusative case markers, owing to phonological and paradigmatic factors. The loss of the dative-accusative distinction is usually considered an early phenomenon in the history of Chuvash because there is no trace of such a distinction in the modern Chuvash dialects. However, the fact that at least one of the Viryal Chuvash varieties featured the dative-accusative distinction as late as the 19th century provides evidence for a recent origin of the case syncretism in Chuvash. This makes the first translation of the Gospel of Matthew into Chuvash a key source on the development of the Chuvash case system prior to the emergence of the dative-accusative syncretism.
Consumer Preferences of Ijen Raung’s Coffee Bag
Authors: Wiyono Andi Eko , Rusdianto Andrew Setiawan , Putri Meiji Wanarni
Published: April 2021

Coffee bag is pure coffee packaged in a dip bag. The first advantage of this product is that consumers can enjoy black coffee with the right taste because it already has a one-time dose. Some drinkers who do not pay attention to the rest of the coffee, by consuming coffee bag they will not get the remaining coffee grounds in their drinks. This study have purpose to see the attributes that become preferences and indicators that measure the taste of the best variation of coffee bag that consumers want. The result of this research is that the coffee is dyed based on consumer preference which is coffee that has a bitter taste, an aroma that represents the taste of coffee, a strong mouth weight, and a long-lasting taste. The taste of the coffee bag with the best variation that consumer input is the natural sample, namely 4169 100% natural coffee bag with an average of 3.79. Respondents argued that the natural sample has a strong mouth weight, bitter taste, and the aroma of the sample represents coffee (has a characteristic). Coffee produced from the dry process is usually superior in the body, fruity taste (fruity), more bitter, low acidity.
Developing Rural Tourism with the Participation of Related Parties in Bac Kan Province
Authors: Nuong Le Ngoc , Trang Ngo Thi Huyen , Trang Nguyen Thi Thuy , Lam Nguyen Tien
Published: April 2021

Tourism development policy will pay attention to stakeholders, especially the people, who play an important role. However, in reality, when people participate in rural tourism development, they are not equipped with basic knowledge and skills in managing and serving tourists. Because the benefits between stakeholders are still not clear, the participation of people in rural tourism development is currently only passive. Active participation need to be directed from the Government and local authorities because the concept that rural tourism development is not only about creating economic benefits but also associated with conservation and preservation, together with keeping and promoting cultural - historical values in rural areas.
Mégaprojets numériques internationaux : une gestion d’équilibriste
Authors: Abboud Nouredine
Published: April 2021

Le développement de jeux vidéo “blockbuster” est complexe. D’un côté, il s’agit de tirer son épingle du jeu par la qualité et par la créativité dans un marché hyperconcurrentiel. De l’autre, il faut coordonner pendant plusieurs années le travail d’équipes gigantesques réparties dans plusieurs studios de par le monde. La gestion de ces projets est un exercice d’équilibriste qui doit composer avec l’évolution des jeux vers le service, l’augmentation critique de la taille des équipes et les leçons de la crise de la Covid-19.
Les composantes morale et politique du travail parental des agricultrices
Authors: Comer Clémentine
Published: April 2021

Cet article s’intéresse aux fondements familialistes des pratiques parentales et domestiques promues par les agricultrices. À la fois ressource identitaire et levier d’expression politique pour des femmes professionnellement déclassées au sein de l’espace agricole, l’adhésion à une stricte division des rôles sexués est moralement défendue et collectivement prescrite. L’immersion auprès de groupes de développement agricole féminins et la réalisation d’entretiens avec leurs participantes donnent ainsi à voir une quête de respectabilité bâtie sur la promotion d’une morale familiale et le respect des normes de genre. En se faisant les porte-voix d’un ordre familial et d’un modèle culturel agricole présumé authentique et vertueux, les agricultrices inventent ainsi des formes honorables d’engagements qui, sans être ouvertement contestataires, n’en sont pas moins défensives.
Des femmes rurales face à l’histoire coloniale patriarcale au Brésil
Authors: Prévost Héloïse
Published: April 2021

Cet article analyse les conditions de politisation des femmes rurales dans leur rapport à la terre, comme territoire, comme objet de travail et de soins. À partir d’une démarche socio-historique, le mouvement des femmes rurales est appréhendé dans ses liens avec les luttes pour la terre passées et présentes. Fondée sur l’étude de cas de l’ assentamento Maceió, dans le Nordeste du Brésil, l’analyse explore l’articulation du travail productif, militant et de care . Trois axes sont présentés : le croisement de l’histoire locale avec l’histoire coloniale, patriarcale et néolibérale ; les conditions de politisation et l’organisation du travail militant et de care à l’échelle d’un groupe de femmes rurales ; la dimension politique du travail productif imbriqué au travail de care socio-environnemental. Ces axes permettent de rendre compte d’une série de stratégies paysannes pour se réapproprier le territoire et construire un projet de résistance/r-existence.
Des rebelles au travail. Faire front entre ouvrières dans la (post) révolution tunisienne
Authors: Barrières Sarah
Published: April 2021

Au cours de la révolution tunisienne, démarrée fin 2010, les rapports sociaux de sexe sont redéfinis par la participation massive des femmes aux protestations. Dans ce contexte, une lutte d’ouvrières, singulière tant par sa durée que par ses modes d’organisation et d’actions, se déroule de 2011 à 2014 dans une filiale d’une multinationale française. Pour faire face aux conditions de travail déplorables : humiliations, harcèlements sexuels, horaires extensifs, etc., les ouvrières s’organisent sous la bannière de la principale centrale syndicale du pays, l’Union générale tunisienne du travail. Quasi exclusivement féminin, le syndicat de base, en privilégiant un fonctionnement et des modes d’action inclusifs et peu hiérarchisés, libère la parole et permet de déplacer les lignes du genre. Centrée sur les deux leadeuses syndicales dotées de dispositions à l’engagement qui se réactualisent et se transforment au contact de l’événement, cet article montre aussi comment sont mobilisés des registres d’action divers du fait du rapport ambivalent de la lutte aux structures syndicales et de sa radicalisation face à une répression patronale de plus en plus dure.
Clinico-radiological profile of connective tissue disease related-interstitial lung diseases from a tertiary care centre of India: a cross sectional study
Authors: Agarwal Mehul , Gupta Manohar Lal , Deokar Kunal , Shadrach Benhur Joel , Bharti Neha , Sonigra Maldev
Published: April 2021

Interstitial lung diseases (ILDs) are a frequently occurring pulmonary manifestation in patients of connective tissue diseases (CTD). Detailed understanding of this subset of lung diseases is vital, hence the study was conducted to analyze the clinico-radiological characteristics of CTD-ILD. The present study was conducted between March 2017 to February 2018 at a tertiary care teaching hospital from western India. A total of 100 patients having respiratory symptoms suggestive of ILD, who were either diagnosed cases of CTD or had clinical manifestations of underlying CTD, were included in the study.  27% of patients belonged to age group 41-50 years and 78% were females. Chief respiratory complaints were dyspnea and cough. Clubbing was present in 29% patients. The most common CTDs were rheumatoid arthritis [RA] (26%), systemic sclerosis [SSC] (21%), mixed connective tissue disorder [MCTD] (19%) and Sjogren’s syndrome [SS] (16%). Restrictive defect on spirometry was seen in 58% cases and was most significant among patients with RA (65%) and SS (62%). Pulmonary arterial hypertension was seen in 40% cases and was most evident in MCTD (78%) and SSC patients (58%). Chest radiograph was normal in 47% of subjects. Most common radiological pattern on high resolution computed tomography (HRCT) thorax was non-specific interstitial pneumonia (42%) followed by usual interstitial pneumonia (21%). ILD is a common manifestation of CTD. Work-up for an underlying CTD should be offered to all ILD patients and vice versa.
Effect of three different levels and patterns of positive end-expiratory pressure on arterial oxygenation of obese patients under general anesthesia in beach-chair position
Authors: Waly Salwa H.
Published: April 2021

Background

Obese patients are increasing among surgical population.

Aim

To detect the most beneficial level and pattern of positive end-expiratory pressure (PEEP) to mechanically ventilate obese patients under general anesthesia in beach-chair position.

Patients and methods

A prospective randomized study was conducted that included 45 ASA II patients (21–65 years) of both sexes who were randomized into three groups: group I (n=15), ascending PEEP (5, 7, 10 cmH2O); group II (n=15), steady PEEP5; and group III (n=15), descending PEEP (10, 7, 5 cmH2O).

Results

Arterial oxygenation (PaO2/FiO2) was significantly higher in group III at PEEP10 (470±10) than groups I (418±19) and II (422±12) at that time. At PEEP10, PaO2/FiO2 was significantly higher in group III (470±10) than group I (448±11). After 40 min, it was significantly higher in group III (456±66) than groups I (432±12) and II (428±14). After 60 min, it was significantly lower at group II (426±12) than groups I (448±11) and III (444±24). Postoperatively, it was significantly higher in group III (460±24) than group I (436±11) and II (415±61). Peak airway pressure was significantly higher with PEEP10 in group I (34.6±2.2) than groups II (26.5±3.8) and III (27.7±3.2). It was also significantly higher with PEEP10 in group III (34.1±2.1) than groups I (26.7±3.7) and II (27.3±3.8). Plateau pressure was significantly higher with PEEP10 in group I (23.8±2.1) than groups II (15.1±3) and III (15.2±2.6). It was also significantly higher with PEEP10 in group III (23.3±1.7) than groups I (15.3±2.9) and II (15.9±2.6). Driving pressure was significantly higher in group III (13.3±1.7) than groups I (10.3±2.9) and II (10.9±2.6) with PEEP10. It was also significantly higher in group I with PEEP10 (13.8±2.1) than groups II (10.1±3) and III (10.2±2.6).

Conclusion

Descending pattern of PEEP (10, 7, and 5) improves oxygenation more effectively than ascending pattern of PEEP (5, 7, and 10) or steady pattern (PEEP5) for mechanical ventilation of obese patients under general anesthesia in beach-chair position.
Cardiorespiratory changes and outcome during noninvasive and invasive mechanical ventilation in ARDS
Authors: Awadallah Mohamed F. , Taha Abdelgawad T. , Sarhan Tarik S.
Published: April 2021

Background

A lung-protective strategy of ventilation is now suggested as a standard of care for patients with acute respiratory distress syndrome (ARDS). The cost of such protective strategy may be prolongation of mechanical ventilation (MV) and poorer prognosis owing to weaning difficulties from the ventilator.

Aim

The aim was to evaluate the efficacy and outcome of noninvasive ventilation (NIV) as a possible alternative to IMV in patients with ARDS with respect to hemodynamics, gas exchange parameters, incidence of complications, duration of MV, length of hospital stay, ICU survival, and weaning from MV.

Patients and methods

This randomized controlled study included 52 patients with ARDS of different etiologies; they received either NIV or conventional MV. Data regarding hemodynamics and respiratory changes, including Respiratory Rate (RR), lung compliance, airway resistance, Arterial Blood Gases (ABG), pH, PaCO2, PaO2/FiO2, and LIS, were collected and compared. The reported complications, duration of ventilation, ICU stay, and patients’ outcomes were also compared.

Results

There was a similar improvement in oxygenation and hemodynamic stability between the NIV group and the IMV group. However, the serious complications were fewer and mortality was lower in the NIV group. There was a statistically significant rise in duration of ventilation in MV (8.33 days) in comparison with NIV (2.52 days). Regarding ICU stay, it ranged from 3 to 18 days, with a mean of 9.02±3.776 days, and there was statistically significant increase in MV group (10.59±1.6 days) in comparison with NIV group (7.32±4.64 days). Weaning was succeeded in 65.4% of NIV group, whereas it was 61.5% in MV group, and there was no statistically significant difference between the studied groups. Mortality was reported in four (15.4%) cases in NIV group, whereas it was reported in 11 (42.3%) cases of invasive MV.

Conclusion

Considering the advantages and disadvantages of NIV, we believe NIV could be a good alternative option in patients with ARDS. Physicians should try NIV early if there is a respiratory failure risk to reduce mortality, to reduce complication risk, to avoid endotracheal intubation, and to reduce treatment failure.
Caudal versus intravenous ketamine for supplementation of analgesia in children undergoing hypospadias repair
Authors: Rayan Ayman Aly
Published: April 2021

Background

Different additives have been reported to prolong the duration of caudal anesthesia in pediatrics. Although these drugs successfully increased the duration of the block, ketamine has been found to effectively increase the duration of caudal block in pediatrics.

Aim

This study aimed to assess the clinical effectiveness of ketamine after caudal or intravenous administration in pediatric patients who underwent hypospadias repair to distinguish between local and systemic analgesia.

Patients and methods

After induction of general anesthesia, 48 patients, aged 1–6 years, assigned to undergo hypospadias repair, received a caudal injection of bupivacaine and were randomly blinded into two groups: K1 group received 1 mg/kg S-ketamine as the caudal group, and K2 group received 1 mg/kg S-ketamine as the intravenous group. Postsurgical measurements included the effectiveness of postsurgical analgesia, which was assessed by using observational pain scale, duration of analgesia, sedation score, and hemodynamic and complications.

Results

The caudal block was successful in all the patients included in the study. None of the patients in either groups required intraoperative rescue analgesia. All patients remained vitally stable during the procedure, and intraoperative hemodynamic parameters were comparable in the two groups. The time to the administration of first analgesia was statistically longer in K1 group (11.5±4.6 h) than in the K2 group (8.7±3.1 h). Time to spontaneous leg movement and time to first micturition were statistically nonsignificant between both groups. The number of patients requested for additional analgesic drugs (acetaminophen and ibuprofen) was statistically significant, being higher in the K2 group than the K1 group.

Conclusion

This study demonstrates that ketamine if added to caudal epidural in a dose of 1 mg/kg provided prolonged postoperative analgesia with improved quality, had longer duration of analgesia, decreased the supplemental acetaminophen analgesia during the first 24 h postoperatively, had stable hemodynamic changes, and had comparable adverse effects and complications in comparison with systemic ketamine in a dose of 1 mg/kg.
Effect of palatable lidocaine gel versus dexmedetomidine on gag reflex during propofol-based sedation for patients undergoing elective upper gastrointestinal endoscopy
Authors: Abd Ellatif Shereen E. , Medhat Marwa M.
Published: April 2021

Background and objective

Upper gastrointestinal tract endoscopy (UGIE) is widely performed under propofol sedation, which is considered as a safe sedation agent and alleviates the sympathetic response to the procedure. However, retching and gag reflex still disturb ∼29% of those patients despite being under propofol sedation.

Patients and methods

A total of 120 adult patients scheduled for elective UGIE were randomly allocated into three equal groups (40 patients each): group C was given propofol 50 mg, group D was given propofol 50 mg+dexmedetomidine 0.5 μg/kg, and group L was given propofol 50 mg+15 g palatable lidocaine gel. The outcome measures included incidence of gag reflex, propofol consumption, recovery time, intraoperative hemodynamics, and patients’ and endoscopist’s satisfaction.

Results

The incidence of gag reflex was statistically significantly reduced in groups L and D compared with group C; however, the reduction was more in group L but with no significant difference when compared with group D group. Propofol consumption was statistically significantly lower in groups L and D compared with group C, as well as recovery time was significantly shorter in groups L and D compared with group C. Group L showed the least hemodynamic changes among the three groups, and the endoscopist as well as the patients were statistically significant more satisfied in both groups L and D when compared with group C.

Conclusion

Using palatable lidocaine gel in addition to propofol in patients undergoing UGIE was safe and effectively reduced the incidence of gag reflex and the dose of intravenous propofol with its subsequent complications, shortening recovery time and improving patient and endoscopist satisfaction.

Trial registration

This clinical trial was registered with ClinicalTrials.gov (NCT04213833).
Maternal hypotension and fetal outcome
Authors: Durodola Adekunle O. , Adekola Oyebola O. , Agbamu Pamela A. , Akinwilliams Olusolape O. , Olatosi John O.
Published: April 2021

Background

Profound hypotension during cesarean section can compromise fetal circulation and cause cardiac arrest in the parturients. We compared the incidence of hypotension, adequacy of anesthesia, and neonatal outcome using a height-adjusted and weight-adjusted dose and a fixed dose of 0.5% intrathecal hyperbaric bupivacaine.

Patients and methods

This was a randomized controlled double-blind trial involving 80 parturients aged 18–40 years scheduled for elective cesarean section under spinal anesthesia. They were randomly allocated by blind balloting into one of two groups: group FD received 12 mg of 0.5% hyperbaric bupivacaine, whereas group AD received a height-adjusted and weight-adjusted dose of 0.5% hyperbaric bupivacaine according to Harten’s chart. Parturients were preloaded with 10 ml/kg of 0.9% sodium chloride.

Results

The median dose of bupivacaine was significantly higher in group FD (12 mg) than group AD (9.5 mg) (P=0.001). The incidence of hypotension was significantly higher in group FD (60%) than in group AD (32.5%) (P=0.014). The median time to attain the maximal level of sensory block (T5) was significantly faster in group FD (10 min) than group AD (13 min) (P=0.021). The Apgar score and incidences of other complications were comparable between both groups (P>0.05).

Conclusion

It is concluded that a lower dose of bupivacaine was required to provide comparable sensory and motor block, with less incidence of hypotension when the bupivacaine dose was adjusted to the height and weight of parturients than when a fixed dose was used.
Can preoperative neutrophil-to-lymphocyte ratio predict in-hospital mortality in postoperative patients with Stanford type A aortic dissection? Evidence-based appraisal by meta-analysis and GRADE
Authors: Chung Bing-Ru , Huang Yen-Ta , Lai Pei-Chun
Published: April 2021

Objectives:

In-hospital mortality in postoperative patients with type A aortic dissection (AAD) is high. Neutrophil-to-lymphocyte ratio (NLR) is a novel predictor of adverse outcomes in many cardiovascular diseases. We examine NLR as a predictive tool in AAD in this meta-analysis.

Materials and Methods:

We systematically searched in four databanks. Risk of bias was appraised using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The midas and metandi commands in Stata 15 were used for the meta-analysis. The certainty of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation methodology (GRADE).

Results:

Four studies with 502 cases in total were included. Pooled sensitivity and specificity were 0.71 (95% confidence interval [CI] = 0.52–0.79) and 0.64 (95% CI = 0.55–0.71), respectively. Area under the hierarchical summary receiver operating characteristic curve yielded 0.73 (95% CI = 0.68–0.76). The diagnostic odds ratio was 4.42 (95% CI = 2.56–7.62). Pooled positive and negative likelihood ratios yielded 1.98 (95% CI = 1.53–2.55) and 0.45 (95% CI = 0.32–0.62), respectively. When the pretest probabilities were 25%, 50%, and 75%, the positive posttest probabilities were 40%, 66%, and 86%, and the negative posttest probabilities were 13%, 31%, and 57%, respectively, according to the Fagan's nomogram plot. The overall certainty of evidence in GRADE was low and very low in sensitivity and specificity, respectively.

Conclusion:

The pooled diagnostic values of preoperative NLR, an inexpensive and routine laboratory examination, provide a practicable help for predicting in-hospital mortality for patients with postoperative AAD in our meta-analysis.
Correlation between intraoperative mapping and monitoring and functional outcomes following supratentorial glioma surgery
Authors: Wu Han-Lin , Hsu Po-Cheng , Hsu Sanford P. C. , Lin Chun-Fu , Liao Kwong-Kum , Yang Kai-Ming , Chou Chen-Liang , Yang Tsui-Fen
Published: April 2021

Objectives:

Intraoperative neurophysiological monitoring (IONM) has long been regarded as the “gold standard” when resecting a supratentorial glioma, as it facilitates the goals of maximal tumor resection and preservation of sensorimotor function. The purpose of the present study was to evaluate the ability of motor evoked potentials (MEPs) monitoring or subcortical mapping (SCM), alone or in combination, to predict postoperative functional outcomes in glioma surgery.

Materials and Methods:

We retrospectively reviewed patients with supratentorial glioma that underwent craniotomy for tumor removal with IONM. Statistical analyses were used to evaluate whether the following criteria correlated with postoperative functional outcomes: Reduced amplitude (>50% reduction) or disappearance of MEPs (criterion 1), SCM with a stimulation intensity threshold less than 3 mA (criterion 2), the presence of both two phenomena (criterion 3), or either one of the two phenomena (criterion 4).

Results:

Ninety-two patients were included in this study, of whom 15 sustained new postoperative deficits, 4 experienced improved functional status, and 73 were unchanged. Postoperative functional status correlated significantly with all four criteria, and especially with criterion 3 (r = 0.647, P = 0.000). Sensitivity of IONM was better if using criteria 2 and 4, but specificity was better if using criteria 1 and 3. Criterion 3 had the most favorable overall results.

Conclusion:

Using statistical methodology, our study indicates that concomitant interpretation of MEPs and SCM is the most accurate predictor of functional outcomes following supratentorial glioma surgery. However, accurate interpretations of the monitoring results by experienced neurophysiologists are essential.
ÖRGÜTSEL DESTEK ALGISI VE YENİLİKÇİ İŞ DAVRANIŞI İLİŞKİSİNDE İŞE ANGAJE OLMANIN ROLÜ
Authors: ERER Beyza
Published: April 2021

Çalışmanın amacı, örgütsel destek algısı ve yenilikçi iş davranışı arasındaki ilişkide işe angaje olmanın durumsal aracı rolünü belirlemektir. Bu amaç doğrultusunda, araştırma verileri teknokente bağlı firmalarda çalışan 223 kişiden kolayda örnekleme yoluyla elde edilmiştir. Araştırma verilerinin toplanmasında çevrimiçi anket tekniği kullanılmıştır. Elde edilen verilerin analizinde, tanımlayıcı istatistikler, doğrulayıcı faktör analizi, korelasyon ve regresyon analizlerinden yararlanılmıştır. Yapılan korelasyon analizi sonucunda değişkenler arasında pozitif yönlü ve orta kuvvet seviyesinde ilişkiler tespit edilmiştir. Hipotezlerin test edilmesi için yapılan regresyon analizi sonucunda, örgütsel destek algısı hem yenilikçi iş davranışının hem de işe angaje olmanın yordayıcısı olarak belirlenmiştir. Ayrıca işe angaje olma da yenilikçi iş davranışının yordayıcısı olarak belirlenmiştir. Son olarak, örgütsel destek algısının işe angaje olma aracılığıyla yenilikçi iş davranışı üzerindeki dolaylı etkisinin anlamlı olduğu tespit edilmiştir.
TÜRKİYE’DEKİ YAŞLI BAKIMI EĞİTİMİ ÜZERİNE GENEL BİR DEĞERLENDİRME
Authors: BİRİNCİ Emre
Published: April 2021

Tüm dünyada yaşlı nüfus oranları artmaktadır. Toplumlarda yaşlı nüfus oranının artması, bir çok sorunu da beraberinde getirmektedir. Bu sorunlardan biri de yaşlının bakım sorunudur. Ortalama ömürlerin uzaması ve yaşlı nüfus oranlarının bu hızla artmaya devam etmesiyle birlikte bakıma ve desteğe ihtiyacı olan yaşlı birey sayısının önümüzdeki yıllarda artması beklenmektedir. Yaşlı bakım sektörünün gelişmesiyle birlikte bakım personeline duyulacak ihtiyaç da artacaktır. Geleneksel toplum yapısına sahip olan ülkelerde yaşlının bakımı aile içerisinde yapılabilirken, modern toplumlarda aile yapılarındaki değişim ve kadınların iş hayatına aktif katılımı gibi nedenler ile sorun haline gelebilmektedir. Bu çalışmanın amacı, Türkiye’deki yaşlı bakımı eğitim modellerini incelemektir. Araştırma kapsamında Türkiye’deki yaşlı bakımı eğitimi, üniversitelerde önlisans düzeyinde ve çeşitli kamu ve özel sektörler aracılığıyla sertifika eğitimleri şeklinde verilmektedir. Eğitimler konusunda bütünlüğün olmadığı, gerek nitelik gerekse de nicelik olarak farklılıklar gösterdiği görülmektedir.
Okul Öncesi Eğitim Programları Geliştirme Sürecinde “1953 Ana Okulları Eğitim Programı
Authors: TURAN Fethi
Published: April 2021

Okul öncesi eğitim, zorunlu ilköğretimin başladığı yıllara kadar olan dönemde çocuğa sunulan eğitim olanaklarını içerir. Bu dönemde kazanılan davranışlar, bireyin yetişkinlikteki kişilik yapısı ile birlikte tutum ve alışkanlıklarını önemli ölçüde etkiler. Eğitim kurumlarında hedeflere ulaşılması ve eğitim sürecinin etkili, verimli sürdürülmesi, ancak çok yönlü etkinliklerin kapsamı önceden belirlenmiş programlara bağlı kalınarak yürütülmesi ile mümkündür. Eğitim programlarının ulaşılabildiği kadar tarihsel perspektif içinde ele alınması ve tartışılması, zaman akışı içerisinde program geliştirme sürecinin nereden nereye geldiğini görmek, bu alanda yürütülen çabaları göz ardı etmemek açısından önemlidir. Alanyazında okul öncesi eğitim programları tarihsel süreç içersinde inceleyen çok sayıda çalışma olmasına rağmen, 1953 yılı “Ana Okulları Eğitim Programı” hakkındaki çalışmaların yetersiz olduğu anlaşılmaktadır.
Bu çalışmanın amacı 1953 Ana Okulları Eğitim Programı’nı eğitim kamuoyuna tanıtıp alanyazında yer almasını sağlamaktır. Böylece okul öncesi eğitim programları geliştirme sürecinin temellerini güçlendirmektir. Araştırmada nitel araştırma yöntemlerinden doküman incelemesi yöntemi kullanılmıştır. Araştırma sonuçlarına göre, Program’da çocukların gelişim özelliklerinin dikkate alındığı, eğitim sürecinin yaş gruplarına göre planlanıp yürütülmesinin öngörüldüğü, çok sayıda açık veya örtük ifade ile hedeflerin yer aldığı, etkinlik çeşitlerine, eğitimin planlı yürütülmesine, eğitim ortamları ve materyaller hakkında açıklamalara, değerlendirme ve aile katılımına yer verildiği anlaşılmaktadır.
Moda’nın Son On Yıl İçerisindeki Değişimi ve Pandemi Modası
Authors: KETMEN Irem , ÇORUH Ebru
Published: April 2021

Moda olgusunun var olduğu durum, düşünce ve topluma ayna görevi ile yaşam faaliyetlerinde etkili olduğunu söylemek mümkündür. Dolayısıyla niteliğini değişiminden sağlayarak insan varlığını trend olgusuyla yaşam döngümüzün içerisinde bulunan belirleyici bir etkendir. 2010'lu yıllar, moda dünyasında önemli değişikliklere tanık olmuştur. Tüketiciler hazır giyim üretimi ile hızlı modanın iklim değişikliğine olumsuz etkisi üzerindeki farkındalığın artmasıyla sürdürülebilir moda akımı desteklenmiştir. Bu doğrultuda çeşitliliğin ve imkanların artmasıyla, moda ve tekstil alanında farkındalık oranının azalması ile, el emeği ürünlerin yerinin gittikçe azaldığı dönemde doğallık akımı ön plana çıkmıştır. Ancak doğal ürünlerin getirdiği sadelik vurgusu moda alanında tüketime yönelik yeterli etkiyi oluşturamamıştır. 2020 yılında küresel salgın ve önlemler moda dünyasında oluşturulan tüketime yönelik olguyu değiştirmiş, bu alanda düzenli tüketim modellerini ön plana çıkartmıştır. Pandemi moda ve tekstil alanında yeni bir vizyon oluşturma noktasında yeni çeşitliliklerin ortaya çıktığı bir dönem olmuştur. Bu çalışma da modanın son on yıl içerisinde geçirdiği değişimle birlikte gelinen son durumda kriz oluşturan küresel salgının  trendleri ile birlikte hayatımızda olan etkileri ve pandemi sonrası moda dünyasında oluşabilecek değişiklik ve yenilikleri farklı kaynaklardan araştırılarak yeni döneme yönelik durum değerlendirilmesi ve bilimsel alanda ilerlemesi mümkün moda olgusu üzerindeki pandemi etkeni anlatılması hedeflenmiştir.
Impact of Covid-19 on Work Life: A Study for Public Sector
Authors: KUL Bekir
Published: April 2021

Since Covid-19 started in December 2019, it was that the general perception epidemic would remain regional only in China and its effects would be limited. However, later the epidemic spread to the whole world due to enhancing and facilitated mobilization and increased its effect. The fact that public authorities demanded citizens to comply with social distance and stay at home afterwards - even though there are extreme examples in many countries, have had reflections in many areas. Turkey among the countries affected by the COVID-19 is located in the front row. Immediately after the start of the pandemic in Turkey, it has been raised a number of measures.
In this study, it was aimed to determine the changes in the working life of public personnel during the Covid-19 process, work / family / social life balance, advantages and disadvantages of working from home, efficiency in public services and expectations of public employees from institutions. The study group consists of 17 public personnel working in the central organizations of public institutions determined by purposeful sampling method and reporting to at least one manager.