bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Fracture Detection in X-ray Images using Convolutional Neural Network
Authors:   Madhav Institute of Technology & Science, Gwalior, India, Bagaria Rinisha , Wadhwani Sulochana , Wadhwani A. K.
Published: April 2022

It is critical to design a fracture detection system to offer quick results and reduce diagnosing errors. Using X-ray images in growing artificial intelligence methodologies, especially the deep learning method, has become a practical choice for detecting bone fractures. This research paper suggests a deep learning method using X-ray images for early diagnosis of bone disorders and also detection of different bone fractures. The effectiveness of the convolutional neural network model for classifying bone fractures from normal bones is used. Several significant factors such as no. of epochs, batch size, type of optimizers and learning rate are considered to find the best-suited model. Hence, it is found that the convolutional neural network model has good performance using the specificity of 89.865%, accuracy of 90% approximately, and area under ROC curve of 0.8088.
Magnetic Resonance Diagnostics of Complications of Kidney and Ureteral Injury in Different Periods of Traumatic Disease: a Clinical Case
Authors: Magomedova Z. M. , Egorova E. A.
Published: April 2022

A clinical example is presented that demonstrates the capabilities of magnetic resonance imaging (MRI) in the diagnosis of kidney damage and their complications at different periods of traumatic disease. An optimized MRI protocol has been demonstrated, which allows for timely diagnosis of kidney damage and determines the treatment regimen.
The Role of high-resolution Magnetic Resonance Imaging at Different Stages of Subchondral Insufficiency Fracture in the Knee
Authors: Ivankov A. P. , Seliverstov P. V.
Published: April 2022

The  history of subchondral insufficiency fracture of knee is closely related to a pre-existing diagnosis of  spontaneous osteonecrosis (SONK). Previously,  it  was believed that  subchondral linear or lunate pathological changes on magnetic resonance imaging in elderly patients with osteoporosis are the result of spontaneous osteonecrosis that has occurred, but it was later found that a small proportion of patients with osteonecrosis of the femoral head initially  have a failure fracture, then complicated by secondary osteonecrosis. The main methods for diagnosing subchondral insufficiency fracture are radiography and magnetic resonance imaging. Magnetic  resonance imaging has demonstrated high information content in subchondral insufficiency fracture of knee.
Student Activity Sheets based on Scientific and Problem Based Learning (PBL) in the Introduction to Microeconomics course: How and Why?
Authors: Dewi Retno Mustika
Published: April 2022

Economics is the study of how humans choose and create wealth. Through economics, humans can think and make decisions in allocating their resources appropriately. The limited availability of the variety of questions used in microeconomics courses has encouraged researchers to compile scientific-based Student Activity Sheets (LKM) and Problem Based Learning (PBL). The purpose of this study is to describe (1) feasibility, (2) effectiveness, and (3) practicality of developing scientific-based Student Activity Sheets (LKM) and Problem Based Learning (PBL) in the Introduction to Microeconomic Theory course. This type of research is development research. using the Borg and Gall (1983) model. The trial subjects in this development research were students of the economic education study program. The results showed that the percentage of development feasibility was 94% in the very feasible category, the percentage of effectiveness showed that students obtained a learning mastery score above 75% in the effective and complete category, and the practicality percentage obtained a score of 99.5 in the practical category. It can be concluded that the development of the Student Activity Sheet is feasible to apply.
Pengaruh Pengetahuan, Pengawasan dan Motivasi Kerja terhadap Kepatuhan K3 Pekerjaan di Ketinggian PT IBP Proyek Electrical Maintenance PHR
Authors: Putra Rahmad Praya
Published: April 2022

Penelitian ini membahas mengenai bagaimana pengetahuan, pengawasan dan motivasi kerja berpengaruh terhadap kepatuhan K3 pekerjaan diketinggian PT IBP poryek electrical maintenance PHR. Tujuan penelitian ini adalah untuk mengetahui pengaruh pengetahuan, pengawasan dan motivasi kerja terhadap kepatuhan K3 pekerjaan diketinggian PT IBP proyek electrical maintenance PHR. Teknik pengambilan sampel menggunakan teknik sampling kuota dengan jumlah 59 responden yang berkaitan dengan penerapan K3 diketinggian. Alat uji analisis yang digunakan adalah SmartPLS v.3.3.5 dengan metode analisis SEM (Structural EquationModeling). Hasil penelitian ini menunjukkan bahwa pengetahuan berpengaruh positif dan signifikan terhadap kepatuhan K3, pengawasan berpengaruh positif dan tetapi tidak signifikan terhadap kepatuhan K3, motivasi berpengaruh positif dan signifikan terhadap kepatuhan K3, kinerja karyawan terbukti memediasi pengaruh kompensasi terhadap motivasi kerja. Variabel pengetahuan, pengawasan dan motivasi kerja berpengaruh sebesar 83.7% terhadap kepatuhan K3 pekerjaan diketinggian PT IBP proyek electricak maintenance PHR.Kata kunci:  Pengetahuan, pengawasan, motivasi kerja
Examining stability of machine learning methods for predicting dementia at early phases of the disease
Authors: Faouri Sinan , AlBashayreh Mahmood , Azzeh Mohammad
Published: April 2022

Dementia is a neuropsychiatric brain disorder that usually occurs when one or more brain cells stop working partially or at all. Diagnosis of this disorder in the early phases of the disease is a vital task to rescue patients’ lives from bad consequences and provide them with better healthcare. Machine learning methods have been proven to be accurate in predicting dementia in the early phases of the disease. The prediction of dementia depends heavily on the type of collected data which usually are gathered from Normalized Whole Brain Volume (nWBV) and Atlas Scaling Factor (ASF) which are normally measured and corrected from Magnetic Resonance Imaging (MRIs). Other biological features such as age and gender can also help in the diagnosis of dementia. Although many studies use machine learning for predicting dementia, we could not reach a conclusion on the stability of these methods for which one is more accurate under different experimental conditions. Therefore, this paper investigates the conclusion stability regarding the performance of machine learning algorithms for dementia prediction. To accomplish this, a large number of experiments were run using 7 machine learning algorithms and two feature reduction algorithms namely, Information Gain (IG) and Principal Component Analysis (PCA). To examine the stability of these algorithms, thresholds of feature selection were changed for the IG from 20% to 100% and the PCA dimension from 2 to 8. This has resulted in 7×9 + 7×7= 112 experiments. In each experiment, various classification evaluation data were recorded. The obtained results show that among seven algorithms the support vector machine and Naïve Bayes are the most stable algorithms while changing the selection threshold. Also, it was found that using IG would seem more efficient than using PCA for predicting Dementia. These promising results open the door to a new era of early prognosis of Alzheimer’s Disease and Related Dementias (ADRD).
An empirical study of the relationship between the busy outside directors and indicators of ESG performance
Authors: Tijani Amara , Ahmadi Ali
Published: April 2022

In this article, we analyse whether the management structure of a company plays a role in the sustainability of companies. More specifically, we study the impact of occupied outside directors, outside directors sitting on several boards of directors, on the environmental, social and governance (ESG) performance of the company. We collect information about board characteristics, information about the board and management from MSCI ESG Research and financial information from Compustat. The study collects data based on panel data, which ranges from 2014 to 2020. The final sample consists of 550 US companies over a five-year period and contains 3850 firm-year observations. The study finds a positive relationship between busy outside directors and ESG performance. Busy outside directors have a positive impact not only on the overall ESG score, but also on individual ESG components. The environmental score is most affected by busy external directors, while the governance score appears to be little affected. Contrary to the theory that busy outside directors are overly engaged and degrade the fixed value, the findings support the theory that busy outside directors improve a company's sustainability performance because of their engagement, experience and the ESG performance.
Determining the price elasticity of demand with and without memory effects using fractional order derivatives: A numerical simulation approach
Authors: Johansyah Muhamad Deni , Nahar Julita , Djauhari Eddy , Napitupulu Herlina , Saputra Jumadil
Published: April 2022

Demand elasticity is the sensitivity of changes in the number of goods demanded by consumers due to changes in the price of goods. This paper compares the price elasticity of demand with and without memory effect using fractional-order derivatives. This study is designed using the development theory of fractional derivatives for the economic field in determining the price elasticity of demand. The result of numerical simulation using the value of α and p indicated that the price elasticity of demand with memory effect is more accurate than without the memory effect. Furthermore, this study concluded that the price elasticity of demand does not only depend on the latest price (current price) but changes in all prices from a specific time interval. The findings of this study suggest future studies can examine the phenomenon of market equilibrium using fractional-order derivatives.
An investment decision-making model to predict the risk and return in stock market: An Application of ARIMA-GJR-GARCH
Authors: Hidayana Rizki Apriva , Napitupulu Herlina , Sukono Sukono
Published: April 2022

In deciding to invest in stocks traded in the capital market, investors need to predict which stocks provide the prospect of return and the risks to be faced. This paper aims to predict the return and risk of stock asymmetry using a time series model approach. Predicting stock returns and risk is based on the Autoregressive Integrated Moving Average-Glosten Jagannatan Runkle-Generalized Autoregressive Conditional Heteroscedasticity (ARIMA-GJR-GARCH) model. In contrast, the largest risk potential measurement is performed using the Value-at-Risk (VaR) model. The data analyzed are the best ten stocks according to the criteria that apply on the IDX, the period between 17 December 2018 to 14 December 2021, which includes the names of stock BBCA, BBNI, BBRI, BMRI, ASII, ICBP, PGAS, PTBA, TLKM, and UNVR. The analysis results show that of the best ten stocks, based on the ratio between the predicted values of the average return and Value-at-Risk, those with relatively better performance are PTBA, TLKM, UNVR and BBCA stocks. Based on the results of this analysis, it can be used as a reference in making investment decisions for investors, specifically investing in the ten stocks analyzed.
Ahmed Cevad Paşa ve Askeri Tarih Yazımı
Authors: DURGUN Bülent
Published: April 2022

Osmanlı Devleti’nde sadrazamlık görevinde de bulunmuş, okumayı-araştırmayı seven son derece münevver bir kişiliğe sahip olan Ahmed Cevad Paşa’nın (1850-1900) yayınları yayınlandığı andan itibaren geniş bir okuyucu kitlesine ulaşmıştır. Cevad Paşa’nın yazıları padişahlar tarafından da takdirle karşılanmış ve mesleki hayatına etki etmiştir. Kırım Harbi tecrübesi ve Girit valiliğini müteakip sadrazamlık görevinde bulunması Osmanlı Devleti’nin ve ordusunun içinde bulunduğu çöküşü gözlemlemesine imkân sağlamıştır. Elli yaşında, genç sayılabilecek bir yaşta vefat eden Ahmed Cevad Paşa hedeflediği yayınların hepsini tamamlayamamıştır; ancak ortaya koymuş olduğu eserler hem çeşitliği hem de niteliği açışında literatüre büyük katkılar sağlamıştır. Bu çalışmanın amacı; Osmanlı askerî tarihine yönelik yayınlarını politik-askeri değerlendirmeler ışığında geniş bir bakış açısı ile hazırlayan, modern anlamda Türk askerî tarihçilerinin ilk ve önemli yazarlarından birisi olan Ahmed Cevad Paşa’nın, en önemli ve bilinen eserlerinden birisi olan Tarih-i Askerî-î Osmânî isimli eseri incelenerek askeri tarih anlayışı ve yazımını ortaya koymaktır.
EATING DISORDERS, SELF-MANAGEMENT, AND ANXIETY DISORDERS IN DIABETICS DURING THE COVID-19 PANDEMIC: A CROSS-SECTIONAL STUDY
Authors: BAYINDIR ÇEVİK Ayfer , AKCAN Gizem
Published: April 2022

Objective: This study aimed to determine the frequency of eating disorders and symptoms, anxiety and self-care management status, and factors that have an impact on eating disorders in diabetics during the COVID-19 pandemic.
Method: This cross-sectional web-based study used a survey comprising a socio-demographic information form, the Bulimic Investigation Test of Edinburgh (BITE), Perceived Diabetes Self-Management Scale (PDSMS), and Generalized Anxiety Disorder Scale (GAD-7). Independent samples t Test, Mann Whitney U Test, Chi Square Test, Pearson correlation analysis, and Simple Regression Analysis were applied to the variables.
Results: Totally, 110 (52 Type 1, 58 Type 2) diabetics aged 18-65 participated in the study. BITE total score was determined as 20.92±7.99 (Min:8; Max:32). Eating disorder frequency was 29.1% while anxiety disorders frequency was 30.9%. Perceived Diabetes Self-Management Scale point is 24.80±3.85 (Min:8; Max:40). Married individuals and diabetics with anxiety disorder mostly had eating disorders (p<.005). There was no significant relationship between anxiety disorder, eating disorder and PDSMS scores of the participants and socio-demographics (p>.05). Anxiety was a significant predictor of eating disorders in diabetics (R=.45; R2 =.20; F (1.108)=28.61, p<.001).
Conclusion: Eating disorder symptoms and severity of diabetics, and their coping styles with anxiety should be determined during the pandemic by diabetes care and specialist. Family eating habits and the presence of anxiety disorders should be taken into account to reduce eating disorders. People with diabetes can be emotionally and self-management empowered through online training and counseling.
MERKEZİ DÜZEYDE PLANLAMA VE BÜTÇELEME İLİŞKİSİNİN SAĞLANMASI: ÇİN TECRÜBESİNİN TAHLİLİ
Authors: EROĞLU Abdulkerim
Published: April 2022

1978 yılından itibaren serbest piyasa ekonomisini benimsediğini ilan eden ve ademimerkeziyetçi bir yönetim sistemini gerçekleştirmeyi hedefleyen Çin’in bu amaçla uyguladığı politikalar, literatürde artan bir ilginin konusunu oluşturmaktadır. Bu politikaların temel araçlarının başında, planlama ve bütçeleme gelmektedir. Çin’de merkezi ve yerel yönetimler bağlamında planlama ve bütçeme ilişkisini inceleyen bu çalışmada Çin kamu maliyesi hakkındaki resmi belge ve veriler incelenerek mali kaynak ve sorumlulukların planlama çerçevesinde nasıl şekillendiği ortaya konulmaya çalışılmaktadır. Elde edilen verilerin resmi belge ve planlamalarda vurgulanan hususları desteklemediği, merkezi mali yapının terk edilmediği ve bazı durumlarda bunun güçlendirildiği, yerel hükümetlerin merkezi planlamaya uymak mecburiyetinde bırakıldığı, merkezi hükümetten yerel hükümetlere yapılan transferlerin merkeziyetçi yapıyı güçlendirdiği gibi sonuçlara varılmaktadır.
Examining Linkage Between Transactional Leadership, Organizational Culture, Commitment and Compensation on Work Satisfaction and Performance
Authors: Nurlina N.
Published: April 2022

The purpose of this study was to analyze the effect of transactional leadership, organizational culture, commitment, and compensation on job satisfaction. The research was conducted at the Agricultural Quarantine Center for the South Sulawesi Region with a population of 193 respondents. Data from the questionnaire were analyzed using the Structural Equation Model using the help of AMOS 18. The results found that transactional leadership directly had a positive and significant effect on employee job satisfaction. Organizational culture has a negative and significant effect on employee job satisfaction. organizational commitment has a significant effect on employee job satisfaction. Compensation has a significant effect on employee job satisfaction. Transactional leadership directly has a significant effect on employee performance. Organizational culture has insignificant effect on employee performance. Organizational commitment has significant effect on employee performance. Compensation has significant effect on employee performance. Job satisfaction has significant impacts employee performance. Indirectly, transactional leadership through job satisfaction positively and significantly affects employee performance. Indirectly, organizational culture through job satisfaction has a negative and insignificant effect on employee performance. Indirectly, organizational commitment through job satisfaction positively and significantly affects employee performance. Indirectly, compensation through job satisfaction has a positive and significant effect on employee performance.
Mirar a través de la zona de contacto: aproximaciones a las prácticas letradas vernáculas de un estudiante
Authors: Libreros-Galicia Eduardo Daniel
Published: April 2022

This paper presents an analysis of

the vernacular literacy practices that young

people share on social media through the case of

Esteban, a high school student whose activities

are negatively perceived by adults. This was done

through the perspective offered by the contact

zone, a theoretical construct that allowed us to

identify the social spaces where cultures interact,

often in contexts marred by asymmetrical relations

of power. Virtual ethnography was used to guide the

observation of Esteban’s social media, considering

mediated interaction as a social process, text as an

interaction, and the observer-observed relationship.

The method was broadened by an interview, to include the participant’s testimony about the creation of his vernacular literacy practices, as well as his experience on the contrasts between perceptions of his peers and those of the adults who

knew those practices. This case illustrates starting points to conduct pedagogical experiences based on the contact zone, to promote an approach to some students activities that are often stigmatized, helping to establish models of understanding them and the spaces where they take place.
Antiviral Activity of Extract of Neem (Azadirachta Indica) leaves: An in vivo study
Authors: Khurshid Rukhshan , Majeed Sadia , Saghir Sumera , Saad Maheen , Ashraf Huma , Fayyaz Iram
Published: April 2022

Background: HCV in mainly replicate in liver cell and cause liver damage. The replication of HCV may be inhibited by leaves extract of neem (Azadirachta Indica). Aim: To find the antiviral activity of extract of neem (Azadirachta Indica) leaves. Methods: Thirty five hepatitis C positive and disappointment of conservative treatment were studied. Effect of neem (Azadirachta indica) leaves was seen in serum of patient. Extract of Azadirachta indica leaves was prepared and given orally to patients. The seropositivity of hepatitis C was estimated prior and after the leave extract of neem by HCV- RNA quantitative analysis by Polymerase chain reaction. Level of ALT, AST and total protein were estimated by standard kit methods. Results: A high HCV seropositivity was observed in patients before taking neem extract. We observed that after using the leave extract of Azadirachta indica or neem, the HCV seropositivity was significantly decreased. Levels of enzymes ALT and AST were also significantly decreased after taking neem extract. However, the level of serum protein was not changed. Conclusion: Extracted leaves of Azadirachta indica may serve as valuable regimen against hepatitis C virus as it has an ability to inhibit the protease responsible for replication of virus. Keywords: HCV seropositivity, Azadirachta indica leaves, transaminases
Respiratory outcomes after 12 weeks in patients recovered from COVID-19 managed with non-invasive positive pressure ventilation
Authors: Ayub Baig Mirza Muhammad , Adnan Muhammad , Ramzan Zohaib , Baig Muhammad Usman , Sultan Faaiz
Published: April 2022

Aim: To assess the respiratory outcomes twelve weeks after the management with non-invasive positive pressure ventilation (NIPPV) in patients recovered from severe corona virus disease 2019 (COVID-19). Methodology: The cross-sectional analytical study was conducted in the Department of Pulmonology, Sir Ganga Ram Hospital Lahore between October 2020 and March 2021. Total 124 patients visiting the hospital twelve weeks after recovery from COVID-19 were enrolled using convenience sampling. After excluding patients with a history of previous respiratory symptoms before the development of COVID-19, data from 87 patients who required oxygen >15 L/minute and NIPPV support were subjected to final analysis. Results: The proportion of middle-aged adults was 52.9%, males 64.4% and smokers 49.4%. Twelve weeks after treatment with NIPPV, O2 saturation <97.0% at rest was found in 97.7% patients, PR >100 at rest in 16.1% patients, severe dyspnea in 65.5% patients, O2 dependency >5 L/min in 2.3% patients, severe CXR abnormalities in 20.7% patients and lung fibrosis in 27.6% patients. The distribution of SpO2, PR, and dyspnea status twelve weeks after recovery from severe COVID-19 were not significantly different between NIPPV duration groups (p-value >0.05). However, the number of patients with O2 dependency, severe CXR abnormality, and lung fibrosis were significantly different between NIPPV duration groups (all p-values <0.05). Conclusion: Oxygen desaturation, severe dyspnea and severe CXR abnormalities twelve weeks after the treatment with NIPPV were common among patients recovered from COVID-19. Severe CXR abnormality, lung fibrosis, and O2 dependency were significantly associated with prolonged duration of NIPPV. Keywords: COVID-19, Dyspnea, Pulmonary fibrosis, SARS-CoV-2, NIPPV.
High Sensitivity C-Reactive Protein Level and Ischemic Heart Disease
Authors: Ullah Himayat
Published: April 2022

Aim: To know the relation between serum hs CRP levels and IHD. Methods: This study was done in the Department of cardiology Hayatabad Medical Complex, Peshawar after approval from the hospital ethical committee. It was a cross-sectional descriptive study. The duration of the study was one and a half years, with a sample of 160 IHD patients.The sample size was calculated based on a universally validated calculator with a 95% confidence interval and a 5% margin of error. Results: Among the total 160 IHD patients included in this study, 102(63.7%) were male and 58(36.3%) females. Mean±SD age was 57.8±13.7. Among 160 patients, 32(20%) patients were having hs CRP below 1 mg/L, 45(28.1%) patients having between 1 to 3mg/L, and 83(51.9%) patients >3 mg/L. Mean±SD hs CRP level was 4.52±3.2mg/L. Conclusion: High sensitivity C-reactive proteins (hs CRP) is one of the important risk factors of IHD and its level is directly related to the frequency of IHD Keywords: Ischemic Heart Disease (IHD), cardiovascular disease (CVD), hs CRP
Study of Histopathological Pattern of Endometrial Curettings and Healthcare Burden due to Inadequate Samples
Authors: Ejaz Sameen , Ejaz Maryam , Kalsoom Umme , Kamran Maha , Ahsan Deeba , Qamar Samina
Published: April 2022

Aim: To determine the frequency of different histopathological findings of endometrial curettings presenting to a tertiary care hospital with a special focus on the frequency of inadequate samples which impose a major healthcare burden. Methods: The data of 975 female patients whose EC samples were received in the Pathology Lab of King Edward Medical University (KEMU), Lahore from August 2019- August 2021 was included in this retrospective, descriptive study. A statistical analysis of endometrial findings according to age and their association with histopathological findings was determined. Results: A total of 975 cases were analyzed (average age, 42.95 years). 34.9% had hormone induced change (n=340), 235 had secretory endometrium (24.1%). Next in the list were Chronic Endometritis, proliferative phase and endometrial polyps accounting for 68(7%), 57(5.8%) and 16(1.6%) of the biopsies respectively. 1.6% patients had Endometrioid Carcinoma 16 and 9(0.9%) had Squamous cell carcinoma. 201(20.6%) of the total were inadequate biopsy specimens. There were 28 cases of hyperplasia, half of which were associated with atypia and half were without atypia, i.e., 14(1.4%). Atrophic endometrium and granulomatous inflammation accounted for 3(0.3%) and 2(0.2%) cases respectively. Conclusion: A diverse spectrum of endometrial patterns was observed that included physiological as well as pathological patterns. The pathologies ranged from benign conditions to malignancies. There was a huge frequency of inadequate biopsies that were indicative of wastage of the limited resources of healthcare system. Keywords: Dilatation and curettage, Endometrial carcinoma, Uterine diseases
Correlation of Endometrial Thickness and Endometrial Histology in Post-Menopausal patients
Authors: Akhter Muhammad Kaleem , Khadija Syeda , Majid Nadia , Yousaf Humiara , Rehman Usman Ali , Iftikhar Anam , Manzoor Waqas
Published: April 2022

Background: Endometrial carcinoma is one of the commonest gynecological tumors occurring more commonly in post-menopausal women presenting with post-menopausal bleeding. TVUS is a screening tool to stratify patients as high or low risk on the basis of endometrial thickness. Aim: To know whether the finding of TVUS needs to be correlated with the histopathology of endometrial biopsy sample before making any definitive diagnosis or not. Method: We conducted a systematic search by using Google Scholar as search engines to retrieve all the relevant data published from 2019 to 2021 while following PRISMA Statement. Results: Out of 1039 articles retrieved, only 6 articles were found that met the preset inclusion and exclusion criteria and of which there were 4 were prospective studies and 2 were retrospective in nature. Conclusion: TVUS is an excellent screening tool for endometrial cancer but the findings of TVUS needs to be correlated with histopathological findings of endometrial biopsy samples to make a confirm diagnosis. Keywords: Correlation, Endometrial thickness, Transvaginal Ultrasonography, Histo-pathology
Clinical and Biochemical Factors of Portosystemic Encephalopathy in Cirrhosis
Authors: Ullah Himayat , Ashraf Muhammad , Ullah Raza , Na . Shahida , Ashraf Jawad
Published: April 2022

Aim: Responsible factors in patients with portosystemic encephalopathy and their relation with the severity of encephalopathy using “west haven scoring”. Methods: This cross-sectional study was done in the Gastroenterology Department, Hayatabad Medical Complex Peshawar. After ethical approval, a sample of 500 patients was calculated by universally accepted sample calculators. 95% confidence intervals and 5%margin of error. The sample was taken by a non-probability consecutive sampling technique. Results: Out of 500 patients, 307 were male and 193 females. The mean age was 57.36(±17.65 SD). Electrolyte imbalance (79.2%) was the most prevalent responsible factor, followed by infection (47.4%) and dehydration (24.4%). The number of patients with Grade 1, 2, 3 and 4 encephalopathy were 48, 187, 223, 42 respectively. In the majority of patients with encephalopathy, more than one responsible factor was present. Conclusion: Portosystemic encephalopathy is one of the most serious and life-threatening complications of liver failure and cirrhosis. Keywords: Portosystemic encephalopathy, responsible factors, gastrointestinal bleeding.
Complications of NA External Fixator in patients who Underwent Tibial Lengthening Surgery
Authors: Ali Muhammad , Ali Syed Asif , Iqbal Yasir , Dar Usman Zafar , Yousafzai Shandana , Shoaib Tayyab
Published: April 2022

Aim: To determine the spectrum of different complications during tibial lengthening procedure using NA external fixator in our patients at GMC, Gujranwala, and KEMU, Lahore, Pakistan. In addition, this study will also find significant factors associated with occurence of complications in NA fixator-assisted lengthening surgery. Methods: This was a cross-sectional study. The patients who underwent tibial lengthening procedure using NA external fixator were categorized into two categories: fixator complications group and no complications group. Statistical analysis was done using SPSS version 25. Independent sample T test and Chi-square test for independence were used for quantitative and qualitative variables respectively to determine their significant association with the occurrence of complications during tibial lengthening procedure. The p-values were taken statistically significant if < 0.05. Results: Out of a total of 100 patients, 26% suffered loosening of pin, 2% breaking of pin, 2% loosening of pin, 2% loosening of clamp, 2% breaking of clamp, while 66% had no complications. 52% got skin reaction to pins. The occurrence of complications of NA external fixator was significantly lower at younger age (p=0.022). It has positive association with the number of pins inserted during procedure (p=0.037) and negative association with the duration of hospitalization (p=0.003). The complications of NA external fixator occurred more after left leg surgery as compared to after right leg surgery (p=0.012) and were associated with post healing pain (p=0.042). Conclusion: Skin reaction to pins was the commonest complication of NA external fixator in our studied population. The risk of complications of NA fixator had positive correlation with increasing age and number of pins inserted during tibial lengthening procedure. The duration of hospitalization was less while post-healing pain was more among patients in which complications of NA fixator occurred. Complications occurred relatively more after left leg surgery in comparison to right leg surgery. Minimum number of pins should be inserted during lengthening procedure especially in aged people to reduce fixator related complications and post-healing discomfort Keywords: Tibial lengthening surgery, NA external fixator, Complications of fixator, SPSS
Impact of Continuous Positive Airway Pressure Therapy on Body Weight in patients with Obstructive Sleep Apnea
Authors: Moin Madiha , Rizvi Sameera Ali , Baig Mirza Saifullah , Asad Faisal , Rizvi Syeda Hina , Ullah Ubed
Published: April 2022

Aim: To determine the impact of Continuous Positive Airway Pressure therapy on body weight in Obstructive Sleep Apnea patients and assess the relationship between the weight change and other associated symptoms of Obstructive Sleep Apnea. Methods: From a Tertiary care Hospital, Karachi we enrolled 184 Obstructive Sleep Apnea patients of both gender with age more than 18 years of whom 92 patients were exposed to Continuous Positive Airway Pressure while 92 patients were not exposed. In a pre-and post-treatment, information on height, weight, Body mass Index, and neck circumference were recorded. Sleep score was evaluated through Epworth Sleepiness Scale. Results: Results revealed that CPAP effects on weight and BMI. 24% of participants exposed with CPAP gained weight (p=0.03) whereas 72% of participants reduced the weights (p=0.004). The paired t-test showed the mean difference of 3.53±7.5kg (mean±SD, p-value: 0.00). The multivariate analysis showed that CPAP lessens the poor concentration (OR: -4.852; p-value: <0.001), decreases daytime sleepiness (OR: -3.91; p-value: <0.001) and the persons who used dietary plan with CPAP therapy were 6.3 times (p-value: <0.001) more likely to change the weight. Conclusion: The weight of the patient changes with the treatment of OSA after taking a minimum of six months of CPAP therapy. The frequency of weight change in this study population was directed toward weight loss. Elimination of OSA symptoms is directly linked with weight reduction. Keywords: Obstructive sleep apnea, Continuous Positive Airway Pressure therapy, Bodyweight.
A Retrospective comparative Study of Endoscopic and Microscopic Tympanoplasty
Authors: Rasheed Tahir , Ayub Aamer , Ahmed Maqsood , Hassan Uzair , Naeem Hassan , Aslam Muhammad Salman
Published: April 2022

Aim: To investigate the outcomes of endoscopic vs. microscopic technique to tympanoplasty among patients. Methods: It was a retrospective study in which outcomes of sixty one ears of sixty patients (thirty three male and twenty seven female) who experienced type-1 tympanoplasty were assessed. Patients age range was between 20-50 years. Patients in Group-1 experienced tympanoplasty together with endoscopic procedure (n=32) while patients in Group-2 experienced tympanoplasty along with conservative microscopic approach (n=29). Among both groups patients, a rebound-shaped temporalis fascia was utilized. The results were studied regarding surgery time, success rate of graft and hearing gain. Results: Among both groups patients, postop ABG (air-bone gap) was considerably less than preop air-bone gap. Insignificant differences were found between pre- and post-op air-bone gap values (in decibel) in either cohort. Among Group-1 patients, mean surgery time was considerably less than Group-2 patients (51.37 versus 67.03 minutes)2. Among patients, this procedure was more frequently performed during current years3,4. Conclusion: Among patients experiencing type-1 tympanoplasty, particularly if external acoustic meatus is narrow and anterior canal wall is protuberant, endoscopic technique seems to offer results equivalent to microscopic technique for TM entire visualization while lack of additional interventions needed to assess the ossicular system. Keywords: Tympanoplasty, endoscopy, micsoscopy
Comparison of Unfavorable Outcome with and without Persistent Hyperglycemia in Patients with Acute Ischemic Stroke
Authors: Arain Safdar Hussain , Magsi Abdul Ghafoor , Soomro Fahim Ahmed , Ali Muhammad Munwar , Mugheri Ali Hyder , v Abrar
Published: April 2022

Aim: To compare the unfavorable outcome with and without persistent hyperglycemia in patients presenting with acute ischemic stroke. Study Design: Prospective observational study Place and duration of study: Department of Neurology, Chandka Medical College/Shaheed Mohtarma Benazir Bhutto Medical University, Larkana from 1st January 2021 to 30th September 2021. Methodology: Seventy ischemic stroke patients within the age group of 50-70 years were enrolled. There radiological imaging, clinical characteristics as well as sugar blood analysis was continuously monitored. The patients were divided into Group I and Group II (both having 35 patients each). Group I were those ischemic stroke patients with persistent hyperglycemia while Group II were those ischemic stroke patients who had no hyperglycemia. A comparison of primary and secondary outcomes of both groups was made and entered in a well structured questionnaire. Results: There was no significant variance among males and females of both groups. the mean rank of group I of ischemia and duration of hospitalization was much higher than group II. A significantly higher number of patients (74.2%) in group I with uncontrolled hyperglycemia lost their lives. The mechanical ventilation (82.8% vs 31.4%), vasopressin (85.7%vs 34.2%) and hemorrhagic transformation (31.4%vs 8.5%) was significantly higher in group I than group II respectively. Conclusion: There is a significant risk of unfavorable outcome in ischemic stroke patient with persistent hyperglycemia including a higher risk of mortality and mechanical ventilation requirement. Key words: Hyperglycemia, Ischemic Stroke, Diabetes, Complications
Rezension von: Bünz, Enno; Fouquet, Gerhard (Hrsg.), Die Pfarrei im späten Mittelalter
Authors: Popp Christian , Bünz Enno , Fouquet Gerhard
Published: April 2022

Die Pfarrei im späten Mittelalter, hg. von Enno Bünz und Gerhard Fouquet (Vorträge und Forschungen 77), Ostfildern: Thorbecke 2013. 472 S., 49 Abb. ISBN 978-3-7995-6877-7. € 64,–
Rezension von: Kaufmann, Dörte, Anton Friedrich Justus Thibaut
Authors: Elias Otto-Heinrich , Kaufmann Dörte
Published: April 2022

Dörte Kaufmann, Anton Friedrich Justus Thibaut (1772 – 1840), Ein Heidelberger Professor zwischen Wissenschaft und Politik (Veröffentlichungen der Kommission für geschichtliche Landeskunde in Baden-Württemberg Reihe B, Bd. 198), Stuttgart: Kohlhammer 2014. XXXV, 302 S. ISBN 978-3-17-024944-8. € 32,–
Rezension von: Westphal, Hans, Sehnsucht nach dem himmlischen Jerusalem
Authors: Bidlingmaier Rolf , Westphal Hans
Published: April 2022

Hans Westphal, Sehnsucht nach dem himmlischen Jerusalem. Das Emblemprogramm der Stettener Schlosskapelle (1682) (Veröffentlichungen der Kommission für geschichtliche Landeskunde in Baden-Württemberg), Stuttgart: Kohlhammer 2017. 400 S. mit 472 Abb. ISBN 978-3-17-033571-4. € 44,–
Rezension von: Fuchs, Franz; Litz, Gudrun (Hrsg.), Humanismus im deutschen Südwesten
Authors: Henkel Nikolaus , Fuchs Franz , Litz Gudrun
Published: April 2022

Humanismus im deutschen Südwesten. Akten des gemeinsam mit dem Verein für Kunst und Altertum in Ulm und Oberschwaben und dem Stadtarchiv-Haus der Stadtgeschichte Ulm am 25./26.10.2015 veranstalteten Symposions im Schwörhaus Ulm, hg. von Franz Fuchs und Gudrun Litz (Pirckheimer Jahrbuch, Bd. 29), Wiesbaden: Harrassowitz 2015. 171 S., 7 s/w Abb. ISBN 978-3-447-10344-2. € 41,80
Rezension von: Groothuis, Leo H.; Soreth, Johannes, Expositio paraenetica in Regulam Carmelitarum
Authors: Arras Yvonne , Groothuis Leo H. , Johannes Soreth
Published: April 2022

Johannes Soreth, Expositio paraenetica in Regulam Carmelitarum. Ein Kommentar zur Karmelregel. Übersetzt und erläutert von Leo Groothuis, mit Beiträgen von Bryan Deschamp und Edeltraud Klueting (Schriften des Forschungsinstituts der Deutschen Provinz der Karmeliten 1), Münster: Aschendorff Verlag 2018. XI, 199 S. ISBN 978-3-402-12135-1. Geb. € 29,90
Hepatic focal nodular hyperplasia in a five-year-old healthy boy: A case report and literature review
Authors: Alfayez Adel , Almodhaiberi Helayel , Al Hussaini Hussa , Alhasan Ibrahim , Algarni Abdullah , Takrouni Tharaa
Published: April 2022

Introduction: Focal nodular hyperplasia is unusually seen in a pediatric age group, with few reported cases in the literature. We report the case of a 5-year-old boy not known to have medical illnesses, who was found to have a liver mass, underwent right trisectionectomy. The purpose of this report is to familiarize the healthcare community with similar events, review the literature, and discuss recommendations for future similar cases. Case Report: A case of focal nodular hyperplasia (FNH) in a 5-year-old healthy boy who was found to have a huge liver lesion on ultrasound imaging due to a vague abdominal pain and distension. The patient underwent surgical excision of the mass due to abdominal pain, distension, and atypical features of FNH in radiological examinations. Histopathological analysis revealed a focal nodular hyperplasia. Conclusion: Focal nodular hyperplasia considered a benign lesion that has no malignant transformation. The presenting symptoms are variable, usually asymptomatic. Laboratory tests have of little significance. Imaging modalities mainly ultrasound scan initially then magnetic resonance imaging (MRI) are useful to obtain more accurate characteristic features of the lesion. Uncertain diagnostic lesion needs to be biopsied and examined under microscopy. Confirming the diagnosis will follow an acceptable conservative management approach. Surgical resection is the preferred method in uncertain, questionable, or atypical features observed in radiological imaging.
Estrategias metodológicas para mejorar la comprensión lectora de los estudiantes de cuarto grado básico
Authors: Arias Duque Luis Armando , Pardo Quiroz Kelly Pamela , Sáenz Rodríguez Janina Susana , Rodríguez Romero Shirley Giomar
Published: April 2022

El trabajo de esta tesis presenta como título: Estrategias metodológicas para la comprensión lectora de los estudiantes del 4to. Año de Educación Básica de la Unidad Educativa Salesiana Cristóbal Colón del cantón Guayaquil en el año lectivo 2014-2015. En la Institución se presenta la falta de innovaciones en estrategias apropiadas para mejorar la comprensión lectora afectando la enseñanza de lenguaje y comunicación y es por esto que se desprenden varios problemas como el no estar acostumbrados a leer y se aburren cuando lo hacen ya que desconocen como comprender lo leído y la falta de conocimiento de parte de los docentes acerca de estrategias metodológicas hacia la comprensión lectora. Este trabajo investigativo tiene el propósito de desarrollar una Guía de estrategias metodológicas para mejorar su comprensión lectora, cuya propuesta se justifica con la finalidad de incentivar al estudiante a comunicarse, interpretar ideas y que pueda comprenderlas para luego dar su apreciación de un tema dado, por lo que es necesario indicar que las Estrategias metodológicas son las encargadas de establecer lo que se necesita para resolver bien la tarea de estudio, determinan las técnicas más adecuadas que se han de utilizar, controlan su aplicación y toman las decisiones posteriores en función de los resultados, y la comprensión lectora es un proceso a través del cual el lector elabora un significado en su interacción con el texto. La metodología que se empleó fueron los métodos: empírico, científico, deductivo, inductivo, analítico –sintético ,empleando las técnicas de la encuesta, la entrevista, obteniendo los siguientes datos que los docentes no utilizan las estrategias metodológicas, a veces hay tiempo para actividades de creatividad y no realizan ejercicios de comprensión lectora, mientras tanto los estudiantes no son críticos no les gusta leer por cuanto no son motivados y los representantes manifiestan que necesitan ayuda para efectuar la comprensión lectora, por lo consiguiente es preciso aplicar las estrategias metodológicas con el fin de mejorar la Comprensión lectora, cuyo impacto será de gran beneficio para el desenvolvimiento del léxico y formar hábitos lectores.
Estudio del fenómeno migratorio Ecuador-Estados Unidos: implicaciones desde la política internacional en el periodo 2018-2020.
Authors: Castillo Bravo Cynthia Carolina
Published: April 2022

El presente trabajo de investigación estuvo dirigido a analizar el fenómeno migratorio Ecuador- Estados Unidos, considerando las implicaciones desde la política internacional en el periodo 2018-2020, con la finalidad de proponer un plan de acción que fortalezca la protección y asistencia de los inmigrantes irregulares ecuatorianos. Cada una de las acciones abordadas permitieron determinar la incidencia de la política migratoria de los Estados Unidos en los derechos fundamentales de los inmigrantes irregulares ecuatorianos. La metodología utilizada fue documental, descriptiva y se empleó el método Analítico-Sintético. Así mismo, la revisión de diversas fuentes bibliográficas permitió desarrollar un análisis exhaustivo de la temática de estudio ,considerando que tanto el enfoque neoclásico y socio crítico. Por lo tanto, en función del desarrollo documental y de las opiniones presentadas por los expertos entrevistados, se pudo concluir que en los últimos años se ha evidenciado a nivel internacional, un gran avance legislativo en el tratamiento de la inmigración, Sin embargo, las obligaciones de los estados para protección de estos derechos no han sido insuficientes para resolver los problemas migratorios que se presentan entre Ecuador y los Estados Unidos, reflejando deficiencias en la prestación de los servicios públicos u otros perjuicios bajo la condición de ingreso como irregulares. De esta manera, a través de esta investigación propusieron una serie de acciones internacionales dirigidas a propiciar la inclusión socio-económica de los inmigrantes de acuerdo con sus necesidades.
Reformas en la política local de ecuador, entorno al delito de femicidio
Authors: Briones Valverde Patricia Stephania
Published: April 2022

El objetivo principal de esta investigación se ha enfocado en determinar la tipificación del femicidio en Ecuador, considerando la relevancia de los convenios internacionales sobre los derechos de la mujer en el año 2020, lo cual permita proponer nuevas reformas para la prevención y erradicación de este tipo de delito. Se buscó, además identificar las dimensiones constitutivas que intervienen en la legislación ecuatoriana sobre el femicidio, incluyendo las controversias jurídicas y políticas cuya tipificación ha generado, desde el constructivismo social, determinando si procesos judiciales por femicidio desarrollados en Ecuador son coherentes con los planteamientos y compromisos incluidos en las Convenciones internacionales sobre los derechos de la mujer. Cada uno de los aspectos incluidos en este estudio se sustentó en el paradigma del constructivismo social, a partir de la construcción jurídica que engloba la legislación nacional, analizando la opinión de diversos expertos en esta área, lo que permitió profundizar sobre la problemática del femicidio desde su tipificación y penalización. Los resultados permitieron concluir que a pesar de la tipificación de este delito en la legislación ecuatoriana y las disposiciones que establecen los tratados internacionales, el tema del femicidio en Ecuador sigue siendo una problemática que devenga la actuación efectiva del Estado.
Who is Eligible for Voluntary Assisted Dying: Nine Medical Conditions Assessed against Five Legal Frameworks
Authors: White Ben P , Willmott Lindy , Del Villar Katrine , Hewitt Jayne , Close Eliana , Ley Greaves Laura , Cameron James , Meehan Rebecca , Downie Jocelyn
Published: April 2022

Eligibility criteria in voluntary assisted dying legislation determine access to assistance to die. This article undertakes the practical exercise of analysing whether each of the following nine medical conditions can provide an individual with access to voluntary assisted dying: cancer, motor neurone disease, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer’s disease, anorexia, frailty, spinal cord injury and Huntington’s disease. This analysis occurs across five legal frameworks: Victoria, Western Australia, a model Bill in Australia, Oregon and Canada. The article argues that it is critical to evaluate voluntary assisted dying legislation in relation to key medical conditions to determine the law’s boundaries and operation. A key finding is that some frameworks tended to grant the same access to voluntary assisted dying, despite having different eligibility criteria. The article concludes with broader regulatory insights for designing voluntary assisted dying frameworks both for jurisdictions considering reform and those reviewing existing legislation.