bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech-language-hearing teletherapy for children with autism spectrum disorders during the covid-19 pandemic
Authors: Santos Ariely Carla Felix da Silva , Xavier Ivana Arrais de Lavor Navarro , Queiroga Bianca Arruda Manchester de , Rosal Angélica Galindo Carneiro , Lima Rafaella Asfora Siqueira Campos , Montenegro Ana Cristina de Albuquerque
Published: May 2023

ABSTRACT This paper aimed to investigate the contribution of speech-language-hearing teletherapy to the development of communication skills in children with autism spectrum disorders during the coronavirus-19 pandemic. This qualitative, interventive, longitudinal case series study analyzed data from the medical records of patients, based on instructions given to their families via speech-language-hearing teletherapy during social isolation. It was part of a public outreach program conducted in a speech-language-hearing teaching clinic, aiming to analyze results in the field of language. All children progressed in various aspects, such as the development of communication skills, expanded vocabulary, increased naming and asking, morphosyntactic development, and advancements in the use of augmentative and alternative communication. Also, shared attention and eye contact increased, the interaction with the family improved, and inadequate behaviors decreased; there was greater autonomy in daily routine and greater attention during activities; increased interest in toys during play and longer and more frequent playing, associated with decreased screen time. In conclusion, the results demonstrated progress in communication and social interaction after the speech-language-hearing teletherapy for children presented with autism spectrum disorders during the coronavirus-19 pandemic.
Item analysis of the Teacher’s Gifted Rating Screening Scale
Authors: Nakano Tatiana de Cassia , Peixoto Evandro Morais
Published: May 2023

Abstract Objective: The present study aimed to add new evidence of construct validity of the Teacher’s Rating Giftedness Screening Scale. The analysis of its items, in relation to the adjustment indices to the Graduated Response Model, as well as to interpret the sense of the scales formed by the items. Method: The sample was composed of 666 students (64.7% males). The instrument consisted of 42 items that assess five areas (general intellectual abilities, leadership, creativity, specific academic abilities, and artistic talent), being answered by 224 teachers. Results: The results indicated that all items had infit/outfit adjustment indexes within the expected value, between 0.5 and 1.5. The factor accuracy, estimated by the graduated response model, varied between 0.74 to 0.85. Conclusion: The results allowed the elaboration of an interpretation proposal referenced in the item, as well as the identification of the most effective items in discriminating individuals with above average ability level.
Prevalence of internet addiction and associated factors in students
Authors: Brito Alexandre Botelho , Lima Cássio de Almeida , Brito Kewla Dias Pires , Freire Rafael Silveira , Messias Romerson Brito , Rezende Luiz Fernando de , Brito Maria Fernanda Santos Figueiredo , Pinho Lucinéia de , Silveira Marise Fagundes
Published: May 2023

Abstract Objective: A cross-sectional study that estimated the prevalence of Internet Addiction and associated factors among High School and College students in Montes Claros - Minas Gerais, Brazil. Methods: Internet Addiction was evaluated through the Internet Addiction Test, and demographic, socioeconomic, and lifestyle factors, as well as internet usage profile characteristics, were examined. Descriptive analysis and the Poisson regression model were applied. Results: Of the 2,519 participants, 52.3% were considered with Internet Addiction Problems. In High School, the following factors were identified: are women and girls, age over >16, class C, alcohol consumption, impaired sleep, frequent use of social networks, and time spent connected. In Higher Education, the following factors: are women and girls, age over >23, paid activity, class C and D/E, alcohol consumption, impaired sleep, imbalanced diet, frequent use of social networks, and time spent connected. Conclusion: There was an expressive prevalence of Internet Addiction Problems, an outcome associated with the demographic, socioeconomic, lifestyle, and internet use characteristics.
Teacher’s motivation for teaching: questionnaire validity evidence
Authors: Oliveira Poliana Chinelli de , Rufini Sueli Édi , Bzuneck José Aloyseo
Published: May 2023

Abstract Objective: The teacher’s motivation is associated with his/her achievements, health and well-being, which reflect on the quality of teaching. Based on the Theory of Self-Determination, validity evidence of an instrument to assess teacher’s motivation for teaching was developed, containing 26 items to be answered on a Likert-type scale. Method: The questionnaire Teacher’s motivation for teaching was applied online in a sample of 509 higher education teachers, 50.39% female and 49.41% male, with ages ranging from 25 to 73 years. Data were analyzed using Exploratory Factor Analysis, using the Parallel Analysis method. Results: Exploratory Factor Analysis revealed a two factors structure with a few structural problems that required the deletion of some items. The 17-item version of the teacher’s motivation for teaching was simple and the estimated adjustment indexes were very good. Conclusion: The high factor loadings obtained among the items and the two factors to which they clustered allow to consider them representatives of the constructs Autonomous and Controlled Motivation.
COOLING PERFORMANCE PREDICTION OF A METAL FOAM INTERNAL HEAT EXCHANGER: AN ARTIFICIAL NEURAL NETWORK APPROACH
Authors: Sisman Suleyman , Ipekoglu Mehmet , Parmaksizoglu Ismail Cem
Published: May 2023

Although HFC refrigerants have high global warming potential (GWP) values, they are preferred due to their satisfactory cooling performance and A1 fire protection classification. If possible, alternatives of HFC-type refrigerants should be used; if not, they should be used with the least charge value. In this study, the effect of metal foam heat exchanger was investigated to reduce the amount of refrigerant in the refrigeration system. The performance of the metal foam incorporated internal heat exchanger (IHX) was estimated by trained artificial neural networks (ANNs) using the correlations given in the literature, and the results were compared with the experimental data presented in the literature. For the same cooling capacity, a higher performance is achieved by using IHX with metal foam additives. Although the developed correlation has been extracted for IHX, it could be applied for all HE with gas flow.
LOW-COMPLEXITY MPA FOR MULTI-USER DETECTION BASED ON MAXIMAL LOG AND MINIMAL THRESHOLD
Authors: Balaji L , Dhanalakshmi A.
Published: May 2023

Sparse code multiple access (SCMA) is a distinct sort of non-orthogonal multiple access technology employed in 5G mobile communications. This present technology algorithm holds a traditional message passing algorithm (MPA) that is more complex and has a slower convergence speed. The threshold-
based MPA is met with a huge bit error rate (BER) at low threshold values. In SCMA technology, maximal-logarithm MPA (Max-Log-MPA) approximations are used that do not ensure data reliability or data loss, thus leading to poor detection. To address these issues, in this paper, we propose a lowcomplexity
MPA for multi-user detection based on maximal log and minimal threshold values. The proposed work integrates both the minimal-logarithm threshold MPA (TMax-Log-MPA) and serial
maximal-logarithm MPA (SMax-Log-MPA) to minimize BERs and computational complexity, which reduces the processing time. Both user node and resource node messages are updated simultaneously by initially setting the minimum threshold value to enhance the stability of the user node in TMax-Log-MPA. The exponentials in Max-Log-MPA are replaced with the sum of the maximum values in SMax-Log-MPA. The BER and computational-complexity reduction-ratio performances of the proposed
algorithm were obtained through simulations and the results were compared with the traditional MPA.
İslam Aile Hukukunda Evlilik Öncesi ve Sonrası Uygulamalarda Kadın-Erkek Eşitliği ve İstisnaları
Authors: DOĞAN Lokman
Published: May 2023

Bu çalışmada İslam Aile Hukuku’nda evlilik öncesi ve evlilik sonrası uygulamalarda kadın ve erkekte eşitlik mensubu ve istisnaları Kur’an-ı Kerim, Sünnet ve çeşitli İslam bilginlerinin görüşleri ışığında irdelenmeye çalışılmıştır. Eşitlik kavramı hakkında İslam Aile Hukukunda kendine özgü ifadeler yer aldığı görülmektedir. İslam Aile Hukuku eşitlik kavramından ziyade adalet kavramı üzerinde durmaktadır. İslam Aile Hukuku temel haklarda bütün insanları eşit görmüş fakat yaratılış ile kabiliyetlerdeki farklılıkların göz ardı edilmemesi hususuna dikkat çekmiştir. Bazı durumlarda kişiye hakkını teslimde eşitliği bozan durumların ortaya çıktığı söylenebilmektedir. Özetle, değişen yaşam koşulları, Kur’an ayetlerinin ve hadislerin farklı bakış açılarıyla yorumlanışı söz konusu eşitlilik mefhumu için farklı görüşlere de neden olduğu açıktır. Bu durumlar din ayrılığı, sıhhat, fiziki, cinsiyet, psikolojik farklılıklar vb. gibi unsurlardan kaynaklandığı görülmektedir. Söz konusu belirtilen unsurların zahirde eşitliği bazen bozduğu görülse de İslam Aile Hukuku’nda adaletsizliği önleyen ve aksine adaleti sağlayan unsurlar olarak belirtilmektedir. İslam Aile Hukuku’nda “her eşitsizlik, adaletsizlik değildir” kavramının vurgulandığı söylenebilir. İslam Aile Hukukunda adalet kavramının eşitlik kavramından daha ön planda tutulduğu söylenebilir.
Loteamentos fechados em Itupeva-SP: uma forma de morar em expansão
Authors: Macedo Adilson Costa , Sigolo Leticia Moreira , Imbronito Maria Isabel , Silva Sandra Pinheiro da
Published: May 2023

Desde os anos 1990, assiste-se à proliferação de loteamentos residenciais fechados em diversas cidades brasileiras. A partir de um levantamento quantitativo e qualitativo dos loteamentos fechados em Itupeva-SP, buscou-se consolidar um estudo sobre o modelo de desenvolvimento urbano disperso, em ascensão neste município, caracterizado pela crescente presença de loteamentos fechados e pela progressiva ampliação de seu perímetro urbano. À luz deste processo em curso, pretende-se contribuir para a reflexão sobre a dinâmica do crescimento urbano segregado, o desenvolvimento destes loteamentos fechados e sua integração com a malha urbana. A metodologia empregada consiste em levantamento de dados fornecidos pela prefeitura de Itupeva e por loteamentos; visita técnica aos locais de estudo; revisão da legislação que incide sobre o fenômeno; identificação, mapeamento e caracterização dos vetores da expansão urbana de Itupeva que concentram os loteamentos, que foram, neste trabalho, denominados setores. Com o objetivo de compreender os impactos urbanísticos positivos e negativos desse fenômeno, buscou-se construir um panorama da presença destes loteamentos em Itupeva e aferir seu impacto nas questões de transporte público e infraestrutura urbana.

 

PALAVRAS-CHAVE: Loteamento residencial fechado; legislação de parcelamento do solo; impactos urbanísticos e ambientais; Itupeva/SP.
A journey through pedestrian mobility and the sustainable city: discussing walkability
Authors: Carvalho Gabriel Lincoln Lopes , Silva Emmanoel Marques da , Silveira José Augusto Ribeiro da , Canova César Renato , Negrão Ana Gomes
Published: May 2023

The form of the built environment, walkability, and society are directly related, being points that influence not only mobility but several structural areas of a city, ranging from its social dynamics as well as the health of individuals, local and global politics, economy, comfort, safety, the identity of spaces, attractiveness and several other influencing factors. The perception of passers-by is influenced by several aspects, such as lighting, sense of safety, the width of sidewalks, attractiveness of facades and of the public space itself, as well as the potential of the space to promote social interaction, which is one of the essential focuses of contemporary urban planning. This research has the general objective of listing the essential factors when analyzing the walkability of spaces, discussing the aspects of the form of the built environment that favors walkability, thus expressing concepts, indexes, methods, and studies that enable and contextualize pedestrian mobility and its relationship with users, urban form and its potentials. As a methodological contribution, bibliographic review research was used, using studies already done in the thematic axes to systematize and generate the result that meets the objectives of the work.  Therefore, a dynamic portrait was obtained concerning walkability and its multisystemic relations with the city, as well as applications in techniques and methods of urban studies.
The possible clinical correlation between preterm neurodevelopment and alterations in gut eubiosis
Authors: Giulio Perrotta
Published: May 2023

In the literature, the topic of neurocognitive development of preterm infants is of current interest. For more than a century, efforts have been made to study and demonstrate what factors may facilitate or interfere with normal neurodevelopment in preterm infants. Recently, attention seems to have focused on the role of gut microbiota. Several studies have shown that the cognitive performance of infants born preterm is lower in general and specific skills; behavior is also reduced in the first year of life; and, by school age, the cognitive development of infants born preterm is lower than that of full-term infants (these deficits are evident in the areas of learning, reading, writing, and mathematical skills, fine motor skills, communication, memory, and attention); however, there is currently no scientific evidence to confirm the existence of premature alterations in the gut microbiota concerning these morbid conditions, although there is evidence for the existence of the gut-brain axis and adverse outcomes on neurobiological function following physical afflictions, such as sepsis, necrotizing enterocolitis and other diseases. Supplementation of prebiotics and probiotics does not appear to correlate with improvement or worsening of future neurobiological and cognitive status, except in the ability to positively influence pathological conditions that indirectly may interfere with healthy neurodevelopmental outcomes of the premature infant.
Lesão de septo nasal em recém-nascidos hospitalizados: estudo descritivo exploratório
Authors: Grebinski Ana Tamara Kolecha Giordani , Silva Cristiane Cosmo da , Tonial Daniela Aparecida , Zilly Adriana , Silva Rosane Meire Munhak da
Published: May 2023

Objetivo: Identificar recém-nascidos que apresentaram lesão de septo nasal em uso de Ventilação Não Invasiva, descrever os fatores relacionados e o tratamento utilizado. Método: Pesquisa descritiva, exploratória, com coleta de dados documental entre janeiro/2020 a dezembro/2021, por meio de um instrumento estruturado, com análise dos resultados por estatística descritiva. Resultados: A incidência de lesão de septo nasal foi 19,0%. O Estágio da lesão mais frequente foi I, tratado com Askina spray + rodízio de prongas, seguida de Hidrocoloide + Dersani Hidrogel, entre 1-7 dias (36,4%). O peso <1.500 gramas (27,3%-18,2%), tempo de tratamento >7 dias (27,3%) e maior tempo de hospitalização (18,2%) foram relacionadas ao Estágio II e III. Conclusão: A equipe de enfermagem depara-se em seu cotidiano com dificuldades na abordagem ao recém-nascido submetido a ventilação não invasiva com pronga, tornando-se relevante o investimento na qualificação desses profissionais para o dese
SPATIAL-FUNCTIONAL TRANSFORMATIONS ALONG THE MAIN ROADS OF A CITY: THE CASE OF KYIV
Authors:   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, MEZENTSEV Kostyantyn , KHLOBYSTOV Daniil ,   Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
Published: May 2023

The article is aimed at the analysis of the development of the city of Kyiv along the linear main roads and the identification of the related spatial-functional transformations. As a result of the city’s spatial development and growth, numerous functional transformations are taking place. They are manifested differently in different urban zones and sectors – from the centre to the periphery and at the same time in different directions. The main roads diverging from the central business district to the city outskirts and further to the suburbs usually become the key axes of transformations. The study of spatial-functional transformations along the main roads of the city is stemmed from the studies on the justification of urban space zoning (functional zoning), identification of their features and ways to improve them, analysis of various transformations of the urban space and problems of spatial expansion of the city along the highways. Two Kyiv’s linear main roads from the city centre to the periphery and nearby suburbs were chosen as research cases – in the western direction (Lesia Ukrainka Boulevard – Taras Shevchenko Boulevard – Beresteysky Avenue) and in the south-eastern direction (Mykola Bazhan Avenue – Boryspilske Highway). The research involves a combination of both observations and GIS analysis and mapping. The article claims that the differently directed linear main roads in Kyiv have a different characteristics of concentration and spatial scale of functional zones, their combination and degree of fragmentation, different specifics of the formation of local gravity centres, which is caused both by the nature of the city's development, planning shortcomings of the previous period, and current urban planning restrictions. Closer to the city centre, there is an increase in multi-functionality and functional fragmentation of space along the main roads. Industrial spaces located closer to the periphery are transforming mainly into residential spaces with varying degrees of combination with administrative-office and service functions. In the nearby suburbs, manifestations of urban sprawl are observed as a result of primarily residential and commercial suburbanisation.
SUSTAINABLE URBAN MOBILITY AS A FACTOR OF URBAN SPACE TRANSFORMATION IN LVIV
Authors:   Ivan Franko National University of Lviv, Ukraine, POLIANSKYI Yurii , KARPYSHYN Marta ,   Lviv Polytechnic National University, Ukraine, ARTYMOVYCH Pavlo ,   Lviv Polytechnic National University, Ukraine
Published: May 2023

The article presents results of the analysis of sustainable urban mobility implementation in Lviv in the context of the impact on urban space and providing comfort for the residents. Considering cases of major streets (Gorodotska Street and Vyacheslavа Chornovola Avenue), the positive impact of the newly created dedicated lanes for public transport and bicycle infrastructure (bicycle lanes and bicycle paths) on the transport system of the city as a whole is reflected. During the last 10 years in Ukraine, the issue of sustainable mobility and movement of residents on various types of transport within urban territorial communities has become very acute. In 2019, the city of Lviv joined the initiative of many European cities to develop a Sustainable Urban Mobility Plan, which defines the policy in the field of urban transportation and provides an understanding of ways to optimize the spatial development of the city. The main advantage of this document is human-centricity. Strategically, this provides a new step in the balanced development of sustainable types of movement in the city. Analysis of the results of the authors’ observations on the two most active sections of public transport in the city showed the effectiveness of creating lanes for public transport. Moreover, the conducted survey of city residents confirmed that for the majority of the population, the creation of public transport lanes increased the comfort of using them and significantly relieved traffic. A study of the city’s bicycle infrastructure revealed a number of shortcomings in its planning and implementation. Despite this, the latest practices of popularizing the bicycle as a form of urban transport had a positive effect on the steady growth of the number of residents for whom the bicycle became the main form of urban transport, and the development of new bicycle infrastructure. Thus, new approaches to the transformation of the Lviv’s urban space on the basis of sustainable urban mobility determine the further priorities of the city’s development on the way to the implementation of advanced European standards of urban planning.
PROSPECTS FOR THE REGENERATION OF DUMPSITES IN KRYVYI RIH REGION
Authors:   Taras Shevchenko National University of Kyiv, Ukraine, PATSIUK Viktoriia
Published: May 2023

The transformation of urban spaces is one of the key issues that should be addressed in the geographical discourse in Ukraine, taking into account both the ongoing processes of war-induced urbicide and the need of a scientifically based framework for post-war reconstruction. At the same time, urban regeneration should have a multi-vector nature and take into account various aspects of urban functions. One such aspect is a regeneration of industrial spaces (browfields), which cover significant areas in Ukrainian industrial cities. This is confirmed by the significant experience of leading countries in Europe and throughout the world in providing “a second life” to their former industrial areas. The article discusses the use of somewhat synonymous concepts, which, however, reflect different aspects of urban regeneration: reorganization, reconstruction, renovation, redevelopment, brownfield, revalorization, and revitalization. The empirical study focuses on the prospects for the regeneration of dump complexes as a component of the mining landscapes in Kryvyi Rih. The author analyzes possibilities for their transformation and groups the dumps according to their potential for regeneration. Presenting the current state of the dumps and prospective for their regeneration, the author focuses on their potential use for recreation and tourism, as well as for various types of leisure activities. The author's own methodology for rating the suitability of the most attractive city dumps for regeneration is proposed. According to this methodology, the selected dumps received rating points for each of the specified criteria, which resulted in the identification of their overall rating place. The article outlines a project for the creation of an industrial landscape park on the site of the Burshchytsky dump, highlighting possibilities for its future use as a touristic attraction.
Effect of Style of Faulting on the Orientation of Maximum Horizontal Earthquake Response Spectra
Authors: Poulos Alan , Miranda Eduardo
Published: May 2023

Horizontal earthquake ground motions have intensities that vary with changes in orientation, that is, they depend on the azimuth. Previous studies have found that the maximum horizontal spectral acceleration at mid-to-long periods is more likely to be closer to the strike-normal orientation than to the strike-parallel orientation for ground motions recorded very close to earthquake ruptures. However, this trend disappears relatively quickly as the distance to the rupture increases and becomes almost nonexistent for rupture distances longer than 5 km. Using a database of ground motions from shallow crustal earthquakes in active tectonic regimes, this work studies the orientation of maximum horizontal spectral acceleration of ground motions from earthquakes with strike slip and reverse faulting. For strike-slip earthquakes, these orientations of maximum intensity are found to be close to the transverse orientation, that is, an orientation that is perpendicular to the line segment between the recording station and the earthquake epicenter. Contrary to what occurs with respect to the previously studied strike-normal orientation, the orientation of maximum spectral response remains close to the transverse orientation regardless of source-to-site distance. Moreover, on average, the orientations of maximum spectral response tend to become closer to the transverse orientation as the period increases. On the other hand, ground motions from reverse earthquakes do not show any trend in the orientation of maximum spectral response relative to the transverse orientation. Probability distributions of the angular difference between the orientation of maximum spectral response and the transverse orientation for strike-slip earthquakes were fitted at several periods between 0.01 and 10 s. These directionality effects from strike-slip earthquakes could be considered in future seismic hazard analyses.
New Insights into the Role of the Insulin-Like Growth Factors in Breast Cancer
Authors: Werner Haim
Published: May 2023

The insulin-like growth factor-1 hormonal axis has emerged in recent years as a promising therapeutic target in oncology. Empirical support to this view was provided by pre-clinical studies showing that insulin-like growth factor-1 receptor expression and activation constitute fundamental prerequisites for breast cancer development. Unfortunately, the vast majority of phase III clinical trials using monoclonal antibodies against the receptor have been disappointing. As a result of these negative outcomes there is an urgent need to identify predictive biomarkers that may identify potential responders. The present review article is aimed at providing an overview of the role of the insulin-like growth factor-1 axis in breast cancer. Circulating insulin-like growth factor-1 constitutes a risk factor for a number of malignancies, including breast cancer, and various members of the insulin-like growth factor-1 system are produced by the tumoral cells or by stromal cells. In addition, we provide evidence that the mechanism of action of insulin-like growth factor-1 involves interactions with the estrogen receptor as well as with the breast cancer gene-1. Finally, lifestyle factors that are related to insulin-like growth factor-1, such as obesity, have been suggested to have an effect on breast cancer.
Disposition of Adolescents toward Receiving Covid-19 Vaccinations in Villavicencio: Myths and Beliefs
Authors: Balaguera César , Osorio María , Echavarría María , Garzón María
Published: May 2023

Background: Global efforts regarding the COVID-19 pandemic have been focused on preventive activities, such as vaccination, since the disease is expected to become endemic. Adolescents were among the last population groups to be included in the vaccination program in Colombia, and adequate coverage has not yet been achieved in this group and in infants. Aims: It is important to understand their motivations to improve the willingness of this population to be vaccinated. Methods: A cross-sectional study was designed via an online survey in adolescents aged 14–19 years in Villavicencio Meta after validation of the survey and informed consent. The following options were provided for the question on vaccine disposition: willing, undecided, and unwilling. We described the disposition toward receiving COVID-19 vaccine using graphs and absolute and relative frequencies based on age group. A multinomial regression model was used to assess the relationship between our predictor variables and vaccine disposition in adolescents. Results: In this study, 288 adolescents were surveyed. The risk variables for unwillingness to be vaccinated were being male (odds ratio [OR] 2.18, 95% confidence interval [CI] 0.8–5.7, p = 0.62), belonging to low social stratum (OR 2.29, 95% CI 0.9–5.88, p = 0.19), having a monthly family income of less than 1 million Colombian pesos (250 USD) (OR 2.01, 95% CI 0.8–5.16, p = 0.19), and having basic education (OR 2.59, 95% CI 0.33–20.14, p = 0.18). Conclusions: Unproven myths and beliefs have a profound influence on adolescents, resulting in an unwillingness to get vaccinated. Social networks have a high influence on these behaviors, which affect vaccination coverage in adolescents and young people not only for COVID, but also for human papillomavirus, Tetanus and rubella. Therefore, innovative public health strategies must be designed to improve willingness to be vaccinated in this population group.
Finding and Being a Mentor through a Lifetime
Authors: Lansdale Thomas , Gratwick Geoffrey , Gupta Samar , Shoor Stanford , Flower Cindy , Liang Matthew
Published: May 2023

Mentor has roots in Greek mythology. Its current practitioners have lent their own interpretation and meaning by their actions. We offer the case studies and lived experience of a select group who have never met all the others. Each asked the same questions, they tell the story of how each found their mentor(s), try to be mentors themselves, and what they try to impart to their mentees through the vicissitudes of their professional responsibilities and personal lives over a career.
Cellular morphology and functional characteristics of breast cancer cells
Authors: Okamoto Masami
Published: May 2023

When traction forces are generated in the cells underlying extracellular matrix (ECM) including artificial scaffolds, the cells feel essentially stiffness of the surrounding microenvironment and respond to applied forces and exert forces in the matrix, in which the traction forces can change cellular morphology and cytoskeletal structure. To date, analysis of cell morphology, including quantitative measurements such as cytoplasm roundness, cytoplasm elongation factor, nuclear elongation factor, ratio nuclear area to cytoplasm area ratio (AN/AC), nuclear dimension, and nuclear height, has been widely used in cancer diagnostics and hematology. Increasing evidence suggests that the extracted morphological features such as cell area and the length of major and minor axes, could also be used to analyze the dynamic changes of cells in diseases of the nervous system and cellular stress related phenomena. Furthermore, multivariate analyses of morphological data suggest that quantitative cytology may be a useful adjunct to conventional tests for the selection of new substances. Thus, understanding the interaction between microenvironment and cancer cells via cellular morphology is critical subject to tackle metastatic spread of cancer cells and its many associated issues. In this topic, the cellular morphological parameters and functional characteristics of cancer cells are summarized.
A Critical View on the Importance of Treating Spasticity and New Options to Improve Function in Patients with Cerebral Palsy GMFCS I-III
Authors: Brunner Reinald , Götz-Neumann Kirsten
Published: May 2023

Spasticity in patients with cerebral palsy is still an unclear concept which bases on the lesion of the upper motor neuron. The consequence is a loss of reflex control. The diagnosis is made during the static clinical exam and is transported into function. Spasticity is seen as an important factor which causes functional handicap as well as functional and later structural deformities. Because spasticity is considered a deteriorating factor for function, treatment of spasticity is one of the main columns in the treatment of children with spastic cerebral palsy. However, the diagnosis of spasticity during function is not possible up to now. Recent publications even raise doubts on the efficacy of spasticity treatment. On the other hand, spasticity is seen as a factor to compensate for weakness. New studies highlight the possibility of conditioning reflexes leading to an increase or decrease of reflex expression, hence spasticity. These facts query the treatment of spasticity and pave the way to new treatment concepts where experiencing successful movements can condition control of reflexes positively, without treating spasticity. This paper looks at the recent literature on new aspects of spasticity and describes the possible therapeutic consequences. The main shift in the treatment concept is to help patients cope with their spasticity and discover movement strategies in a large spectrum of movements. We describe possible modifications of the current treatment concepts. Movements should be carried out as an automatic muscle activity to reach the goal of an action which lets the patients experience success and joy. Dynamic orthotics help to keep the body segments in a functional adequate alignment, for an optimal movement experience under gravity, while the therapist intends to activate necessary but inactive muscles including eccentric muscle contractions. The patients discover new abilities and learn to move in a more efficient way. New feed-forward movement strategies are built up which help for activities in general. The need of spasticity compensating for weakness is reduced. These principles should be transported into daily life and sports. Sportive activities involve these therapeutic aims and the patients challenge themselves when they endeavour to improve.
Ventilator associated events:incidence, microbiological profile and outcome in the intensive care unit in a tertiary hospital of eastern Nepal
Authors: Jha Dharnish Kumar , Khanal Basudha , Sah Birendra Prasad , Baral Ratna
Published: May 2023

Ventilator associated events (VAE) refer to new surveillance definition developed by Centre for Disease Control and prevention (CDC)/ National Healthcare Safety Network (NHSN) is in use since the year 2013, switching the focus of surveillance from ventilator associated pneumonia (VAP) to ventilator associated events (VAE).

A number of studies have been conducted in the United States and other Western countries to evaluate its practicality. However, information on VAE in Asian countries is scarce. The purpose of this preliminary study was to illuminate the incidence and microbiological profile of VAEs in tertiary hospital in Nepal, as a first step in the effort to determine its practicality.

The objective of the study was to determine the incidence, etiological agent and mortality of VAE in patients on mechanical ventilation in medical Intensive care unit (ICU) of a tertiary hospital.

Patients admitted in ICU on Mechanical Ventilation were evaluated daily using the VAE surveillance criteria. At least 2 days of stable or decreasing ventilator settings followed by at least 2 days of increased ventilator settings was used as definition of VAE. Three tiered approach of VAE, namely Ventilator-Associated Condition (VAC), Infection-related Ventilator-Associated Complication (IVAC) and Possible VAP (PVAP) was used for the final classification of cases.

Of the 313 patients admitted to the ICU over the period of one year, 52 patients received MV for ≥2 days and met baseline criteria for VAEs Surveillance. Out of 52 patients, 14(27%) developed VAC only, 13(25%) developed IVAC only and 25(48%) patients developed PVAP. Endotracheal aspirate culture was positive in 25 patients (48%). The organisms isolated 14(53.84%), 7(26.92%), 4(15.38%), and 1(3.84%). Polymicrobial growth was observed in one Almost all the isolates 25 (96%) being multidrug resistant. Overall mortality rate in patients with VAE was 36.5% with highest mortality rate in PVAP (44%). Early onset PVAP was observed in 9 (36%) where as 16 (64%) had late‑ onset VAP.

VAE mostly being health care associated event and prevalence of multidrug resistance in as observed in this study warrant clinician to practices infection control measures and rationale use of antimicrobials as effective measures for infection control.
Use of antibiotics in surgical setup in tertiary healthcare hospital
Authors: Goswami Kanishka , Kumar Satish , Solanki Seema , Rana Jyoti
Published: May 2023

Surgical antimicrobial prophylaxis refers to brief course of an antimicrobial agent which is initiated just before surgery, to prevent any infections at the surgical site. It is one of the most widely accepted practices in surgery. However, despite the evidence of the effectiveness and the publication of guidelines for the antimicrobial prophylaxis, its use is often found to be suboptimal. However, between 30-90% of this prophylaxis is inappropriate.

Hence, this study was planned in order to examine the prevalent practices in the tertiary care hospital regarding the use of antimicrobials for surgical prophylaxis, with respect to the choice of the antimicrobial agent, the timing of its administration, the intraoperative reposing and the total duration of the prophylaxis, in order to detect any inappropriateness, so that corrective measures could be suggested.

A survey was conducted across the various departments undergoing surgery of 213 patients and was followed till their discharge. The age of patients varied from 5 to 85 years. Following risk factors were also included like anemia, smoking, alcohol, prolonged duration of surgery. All the cases in our study received prophylactic antimicrobials prior to surgery, even though prophylactic systemic antimicrobials are not typically indicated for the patients who underwent clean surgical site operations.

Though, this aspect was also the basis of forming two groups viz. group A and group B; this mode of treatment prior to surgery was found effective. Males are more prone to treatment failure, as suggested by the study. While recovery in females with the preliminary line of treatment continues in a positive way. A 75 cases out of 213 undergoing surgeries which are given planned regimes of antibiotic prophylaxis still end up with surgical site infection which is many a times not notified. To overcome this, change in antimicrobial regime is employed.
Prevalence and Its Related Factors of Undernutrition among Under 5-Year-Old Children, Fars, Iran 2017-2018
Authors: Derakhshandeh-Rishehri Seyedeh-Masomeh , Farmani Azam , Zarmehrparirouy Mina , Hemmati Abdolrasool , Faghih Shiva , Shenavar Razieh
Published: May 2023

Background: The present study aimed to investigate the prevalence and related factors of under-nutrition among under 5-year-old children in Fars province, Iran.
 Methods: This cross-sectional survey was conducted during 2017-2018 in Fars province of Iran. The study consisted of 606 children (0-59 months) from 13 regions of Fars province. A structured questionnaire collected the data, and under-nutrition indices, including stunting, wasting, and underweight, were investigated by the mixed-effects ordinal logistic regression model.
Results: The prevalence of stunting, underweight, and wasting were 2%, 4%, and 4.1%, respectively. Low birth weight was a risk factor for three undernutrition indices (P < 0.001; P < 0.001; and P = 0.004). Urban children were significantly more underweight and wasted than rural children (P = 0.001; and P = 0.002, respectively). Under-nutrition rates were impressed by the family size, mother's education, and father's occupation.
 Conclusion: The prevalence of undernutrition in children can be reduced by identifying and controlling significant factors, including birth weight, maternal education, type of settlement, family size, and father's occupation.
Cash Transfer versus Staple Food Subsidies: An Effective Factor on Food Security and Expenditure of Urban Households in Iran
Authors: Mohammadi-Nasrabadi Fatemeh , Omidvar Nasrin , Vedadhir AbuAli , Khoshfetrat Mohammad-Reza , Houshyar-Rad Anahita , Abdollahi Morteza , Zerafati-Shoae Nahid , Mehrabi Yadollah
Published: May 2023

Background: In 2010, food subsidy program implemented since 1979 was replaced by unconditional cash transfer (CT) in Iran. The present pre-and-post evaluation study aims to compare food security and expenditures of urban households during the implementation of food subsidy and CT programs.
Methods: Using a stratified cluster sampling method, 266 households were selected from Tehran city. Data were collected in two phases: before (2009) and after (2012) implementing CT program using questionnaires including demographics; household expenditure; locally validated Household Food Insecurity Access Scale (HFIAS); and three consecutive 24-hours diet recalls. Seven focus group discussions (FGDs) with women were also held.
Results: After implementing CT program, the households' food and total expenditures increased and their family size decreased. Mild, moderate, and severe food insecurity increased from 19.3%, 13.3%, and 11% to 28.4%, 15.5%, and 12.5%, respectively (P<0.001). There was a significant decrease in consumption of fat and oils and sugary food groups (time effect P<0.05). The consumption of fruits, meat, and dairy products was lower in the food insecure women than in the food secure ones (group effect P<0.05). However, the food secure and insecure households behaved differently in terms of only sugar consumption (time group effect P<0.05). Based on the FGDs, relative deprivation and social gaps increased.
Conclusion: Considering the reduction in welfare index, targeting poor/vulnerable groups, as well as conditional CT could be considered in Iran.
How Many Fenestrations Should I Make When Placing a Baerveldt Glaucoma Implant? A Laboratory Study
Authors: Yang Michael , Yang Christopher D. , Lin Ken
Published: May 2023

Purpose: This study investigates the effect of one versus two fenestrations on both fluid egress and opening pressure from a non-valved glaucoma implant.
Methods: In this laboratory study, we used an in vitro closed system comprised of ligated silicone tubing connected to a fluid reservoir and manometer to simulate the tubing found in a Baerveldt glaucoma drainage implant. Fenestrations were created using an 8-0 Vicryl TG140-8 suture needle. Main outcome measures included volume of fluid egress and fenestration opening pressures, which were measured via micropipette and increasing pressure until fluid egress was observed.
Results: No significant difference was observed in fluid egress between tubing with one versus two fenestrations at pressures ≤40 mmHg. At 50 mmHg, a statistically significant difference was observed in fluid egress between tubing with one versus two fenestrations (P < 0.05). The first fenestration opened at 10.5 ± 3.77 mmHg and the second fenestration opened at 28.83 ± 5.09 mmHg (average ± standard deviation).
Conclusion: Our in vitro findings suggest there may exist a critical pressure >40 mmHg at which the second fenestration starts to play a significant role in fluid drainage. There may be no difference in the amount of fluid egress and effect on intraocular pressure between one or two tube fenestrations when preoperative intraocular pressure is ≤40 mmHg.
Renal Function following Fluorescein Angiography in Diabetic Patients with Chronic Kidney Disease
Authors: Ebrahimiadib Nazanin , Hadavand Mirzaei Shaghayegh , Riazi-Esfahani Hamid , Amini Manouchehr
Published: May 2023

Purpose: To evaluate the effect of fluorescein dye usage on renal function in patients with diabetic retinopathy (DR) and chronic kidney disease (CKD).
Methods: Diabetic patients with retinopathy who were candidate for fundus fluorescein angiography (FA) were evaluated for serum creatinine and urea levels within five days prior to performing the FA. Serum creatinine levels of 1.5 mg/dl or more in males and 1.4 mg/dl or more in females were both identified as CKD and were included in the study. An increase of 0.5 mg/dl or 25% in creatinine after FA was considered as contrast-induced acute kidney injury (AKI). Estimated glomerular filtration rate (eGFR) was also calculated for all patients using a CKD-Epi formula. CKD grading was determined based on eGFR values.
Results: Forty-two patients agreed to participate, of which 23 (54.8%) were male. Seventeen patients were identified with grade 3a or lower CKD, 12 with grade 3b, 11 with grade 4, and two with grade 5 CKD. Considering all grades of CKD, the mean blood urea before and after angiography was 58.48 ± 26.7 and 57 ± 27.81 mg/dl, respectively (P = 0.475). The mean serum creatinine before and after the test was 1.89 ± 1.04 and 1.87±0.99 mg/dl, respectively (P = 0.993). The mean eGFR before and after the test was 44.024 ± 23.5447 and 43.850 ± 21.8581 mL/min/1.73 m2 (P = 0.875).
Conclusion: According to the findings of this study, FA does not seem to further deteriorate kidney function in patients with diabetic associated CKD.
A Survey on Orbital Space-occupying Lesions during a Twelve-year Period from a Referral Center in Iran
Authors: Bagheri Abbas , Ashtar-nakhaie Parisa , Aletaha Maryam , Kheiri Bahareh , Veisi Amirreza
Published: May 2023

Purpose: In this study, we describe different orbital space-occupying lesions (SOLs) from a referral center in Iran.
Methods: In this retrospective case series, all records of “orbital tumors” with a definite histopathologic diagnosis at a referral center in Iran were reviewed from April 2008 to May 2020.
Results: A total of 375 orbital SOLs were included. The study population consisted of 212 (56.5%) female and 163 (43.5%) male subjects with overall mean age of 31.09 ± 21.80 years. The most common clinical presentation was proptosis and the superotemporal quadrant was the most frequent site of involvement. Extraconal lesions (276 cases, 73.6%) outnumbered intraconal lesions (99 cases 26.4%). The great majority of SOLs (344, 91.7%) were primary, while 24 (6.4%) were secondary and 7 (1.9%) were metastatic. Benign lesions (309, 82.4%) were much more common than malignant SOLs (66, 17.6%). Overall, dermoid cysts and malignant lymphoma were the most prevalent benign and malignant orbital SOLs, respectively. The malignant to benign lesion ratio was 0.46 in children (≤18 years), 0.81 in middle-aged subjects (19–59 years), and 5.9 in older (≥60 years) cases. The most common type of malignancy was rhabdomyosarcoma in children, lymphoma in middle-aged subjects, and invasive basal cell carcinoma in older age group.
Conclusion: Over the 12-year study period, benign, primary, extraconal orbital SOLs were more frequent than malignant, secondary, and intraconal lesions. The ratio of malignant lesions increased with age in this cohort of patients.
Inverted ILM Flap Technique in Optic Disc Pit Maculopathy
Authors: Tavallali Ali , Sadeghi Yasaman , Abtahi Seyed-Hossein , Nouri Hosein , Samadikhadem Sanam , Rezaei Mitra , Mazloumi Mehdi
Published: May 2023

Purpose: To present the outcome of optic disc pit maculopathy (ODPM) managed successfullywith an inverted internal limiting membrane (ILM) flap over the optic disc. A narrative review ofODPM pathogenesis and surgical management techniques are also provided.
Case Report: This prospective interventional case series included three eyes of three adultpatients (25–39 years old) with unilateral ODPM and a mean duration of unilaterally decreasedvisual acuity of 7.33 ± 2.40 months (4–12 months). The pars plana vitrectomy with posteriorvitreous detachment induction was performed on eyes, followed by an inverted ILM flap insertionover the optic disc and gas tamponade. Patients were followed for 7–16 weeks postoperatively;best-corrected visual acuity (BCVA) improved dramatically in one patient from 2/200 to 20/25.BCVA in other patients improved two and three lines – to 20/50 and 20/30, respectively. Asignificant anatomical improvement was achieved in all three eyes, and no complication wasdetected throughout the follow-up period.
Conclusion: Vitrectomy with inverted ILM flap insertion over the optic disc is safe and can yieldfavorable anatomical improvement in patients with ODPM.
Congenital Retinal Macrovessel; Optical Coherence Tomography Angiography Features
Authors: Nourinia Ramin , Hassanpour Kiana
Published: May 2023

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