bluuebunny/crossref_metadata_2025 huggingface dataset:
Minyak Cengkeh (Syzygium aromaticum) Menginduksi Apoptosis pada Sel Kanker Servik HeLa melalui Peningkatan Kadar Protein p53
Authors: Permatasari Happy Kurnia , Kusuma Ihda Dian , Mayangsari Elly
Published: March 2019

Kanker serviks merupakan kanker yang paling sering dijumpai pada wanita setelah kanker payudara. Kanker ini terkait dengan infeksi persisten virus yaitu Human Papillomovirus (HPV). Virus ini mengekspresikan protein onkogenik virus yaitu protein E6 dan E7 yang terkait dengan proses karsinogenesis. Salah satu mekanisme onkogenik virus ini adalah pengikatan protein p53 yang menginduksi degradasi oleh protein E6, mengakibatkan efek anti-apoptosis dan proliferasi sel secara terus menerus. Minyak cengkeh yang mengandung senyawa aktif eugenol telah dilaporkan memiliki efek anti kanker pada beberapa kanker. Namun, mekanisme minyak cengkeh yang terkait dengan penghambatan kanker servik masih belum jelas. Penelitian ini, untuk mengkaji efek minyak cengkeh dari Syzygium aromaticum dalam efek pro-apoptosis sel kanker servik HeLa terkait dengan kadar protein p53. Tingkat apoptosis diamati dengan pewarnaan dengan Annexin-V dan PI dan dilakukan dengan metode flow-cytometry. Dilakukan pengecatan immunohistokima untuk melihat ekspresi caspase-3 aktif untuk mengonfirmasi sel yang apoptosis, sedangkan kadar protein p53 dievaluasi dari lisat sel menggunakan ELISA protein p53. Hasil studi menunjukkan bahwa minyak cengkeh memiliki efek pro-apoptosis, berkaitan dengan kadar protein p53, pada sel kanker serviks secara in vitro.
АНАЛІЗ ХІРУРГІЧНИХ МЕТОДИК ТА ПІДХОДІВ УСУНЕННЯ ДЕФЕКТІВ КІСТОК ЛИЦЕВОГО СКЕЛЕТУ
Authors: Пантус А. В. , Рожко М. М. , Ярмошук І. Р. , Когут В. Л. , Солоджук Ю. І.
Published: March 2019

Остеопластичний матеріал є золотим стандартом реконструкції кісткової тканини. Аутологічний матеріал може не давати імунологічної відповіді організму, даний матеріал також володіє не тільки остеокондуктивними, але й остеоіндуктивними властивостями.

Альтернативним рішенням аутотрансплантації є застосування алотранстплантів, які підлягають спеціальній обробці, при якій залишається як остеокондуктивна так і остеоіндуктивна властивість.

Було запропоновано методику закриття дефекту кісткової тканини нижньої щелепи за допомогою мікрохірургічних аутотрансплантантів.

При конструюванні біосумісних матеріалів потрібно застосовувати біоміметичний підхід. Кісткова тканина – це своєрідний композит, який поєднює два фізичні явища: твердість (за рахунок кристалів гідроксиапатиту) та еластичність (завдяки колагеновим волокнам).

Існує досвід застосування пористих кісткових блоків просочених кров’яним згустком хворого в комбінації гідроксиапатиту та трикальційфосфату. Такий тип біокераміки можна застосовувати для контурної пластики коміркової частини щелеп та заповнення дефектів кісток.

Отже, з наведених даних можна зробити висновок, що першим пріоритетним завданням регенеративної медицини, зокрема реконструктивної хірургії, є пошук методик та технологій створення стабільних пористих каркасів певної форми.
ШКІЛЬНА ДЕЗАДАПТАЦІЯ У ДІТЕЙ: ПЕРЕДУМОВИ РОЗВИТКУ, МЕХАНІЗМИ ВИНИКНЕННЯ ТА КЛІНІЧНІ ПРОЯВИ
Authors: Синоверська О. Б. , Осадець Н. Б.
Published: March 2019

Здоров'я дітей залишається пріоритетною проблемою сучасної медицини. В останні роки спостерігається негативна тенденція у стані здоров'я школярів, значно скоротилося число здорових і зросла чисельність хворих дітей. Безсумнівним є той факт, що діти більшу частину свого часу проводять у школі. Тому вплив шкільного навчання на стан здоров'я школярів є безумовним.
СИНДРОМ ДІАБЕТИЧНОЇ СТОПИ. ДІАБЕТИЧНА ПЕРИФЕРІЙНА НЕВРОПАТІЯ
Authors: Василюк С. М. , Шевчук А. Г. , Федорченко В. М. , Осадець В. С. , Кримець С. А. , Василюк А. С.
Published: March 2019

У статті розглянуті особливості діагностики і лікування діабетичної периферійної невропатії. Діабетична периферійна невропатія – це наявність симптомів та (або) ознак дисфункції периферійних нервів у пацієнтів з цукровим діабетом після виключення інших причин. Клінічна картина цього ускладнення цукрового діабету є варіабельною і залежить від переважання ураження того, чи іншого типу нервових волокон. Відмічається неспроможність виявляти зміни температури, вібрацію, глибоку чутливість, тиск та біль. З точки зору клінічного хірурга, при синдромі діабетичної стопи доцільно виділяти моторну, сенсорну і автономну діабетичну периферійну невропатію. Моторна діабетична периферійна невропатія діагностується об’єктивно, у пацієнта виявляють внутрішню мінусову стопу, яка має наступні діагностичні критерії: молотоподібні пальці, випинання голівок плюснових кісток на підошві, атрофію міжкісткових м’язів тилу стопи, посилену ротація дистальних відділів стопи, слабкість довгого розгинача великого пальця, виражене випинання на тилі стопи сухожилка довгого розгинача великого пальця, високе склепіння стопи, сухість і стоншення шкіри стопи. При сенсорній діабетичній периферійній невропатії пацієнт подає різноманітні скарги, серед яких найбільш небезпечним є відсутність больової чутливості. Автономна діабетична периферійна невропатія спричиняє зміни з боку шкіри стоп і порушення автономної регуляції судинного русла. Для діагностики використовують аналіз скарг пацієнта, монофіламентний тест, тест на вібраційну чутливість, тест на термічне відчуття, шкалу ідентифікації болю, тести на моторну діабетичну периферійну невропатію. Для проведення профілактичних заходів і медикаментозної корекції пацієнтів розподіляють на чотири категорії ризику з розвитку невропатичних виразок: низький ризик (категорія 0), помірний (категорія 1), високий (категорія 2) та дуже високий (категорія 3). Діабетична периферійна невропатія у даний час є одним з найважливіших факторів ризику втрати кінцівки у пацієнтів з цукровим діабетом. Сучасні підходи до медикаментозного лікування діабетичної периферійної невропатії і ортопедичної корекції анатомічних відхилень у пацієнтів з синдромом діабетичної стопи є достатньо добре напрацьовані і дозволяють значно знизити частоту ампутацій, пов’язаних з невропатичними змінами, однак у даний час ситуація все ще залишається критичною.
КОЖЕН ПАЦІЄНТ МАЄ ПРАВО НА МАКСИМАЛЬНО ЯКІСНІ ТА БЕЗБОЛІСНІ МЕДИЧНІ ПРОЦЕДУРИ
Authors: Готюр О. І. , Влашин Х. В.
Published: March 2019

Сучасна діагностика та новітні технологічні можливості сучасної медицини просто вражають. Комп’ютерна діагностика, магнітно-резонансна томографія із контрастуванням, онкологічні лабораторні показники та багато інших діагностичних тестів дозволяють професіоналам медичної практики своєчасно встановлювати діагнози та надавати кваліфіковану медичну допомогу пацієнтам.

Часто хвороби пацієнтів впливають на їх психологічний стан. Пацієнти які виснажилися від свого фізичного не задоволення, стають вередливими, вимагають гіперопіки до себе, особливо ті пацієнти, які спостерігають за можливостями сучасної медицини із телесеріалів, інтернету. Але, як виявляється, 20 % населення пострадянських країн та 10 % американців, не просто «капризують», а хворіють на – трипанофобію.

Згідно нашого дослідження, яке відбувалося на базі ЦМКЛ приймального відділення, на основі соціологічного опитування з 80 опитаних пацієнтів – 11 пацієнтів боялися ін’єкцій, 15 пацієнтів мали підвищений поріг больової чутливості, а 2 пацієнти навіть відмовилися від госпіталізації у стаціонар через синдром «білого халата». Це означає, що 35 % пацієнтів могли б отримати більш кваліфіковану медичну допомогу, якщо б попередньо знали про причину своїх фобій та були проінформованими про те, що мають право на безболісні процедури і правильну підготовку до медичних маніпуляцій.
Enhanced Safety Surveillance of Influenza Vaccines in General Practice, Winter 2015-16: Feasibility Study
Authors: de Lusignan Simon , Correa Ana , Dos Santos Gaël , Meyer Nadia , Haguinet François , Webb Rebecca , McGee Christopher , Byford Rachel , Yonova Ivelina , Pathirannehelage Sameera , Ferreira Filipa Matos , Jones Simon
Published: March 2019

Background

The European Medicines Agency (EMA) requires vaccine manufacturers to conduct enhanced real-time surveillance of seasonal influenza vaccination. The EMA has specified a list of adverse events of interest to be monitored. The EMA sets out 3 different ways to conduct such surveillance: (1) active surveillance, (2) enhanced passive surveillance, or (3) electronic health record data mining (EHR-DM). English general practice (GP) is a suitable setting to implement enhanced passive surveillance and EHR-DM.

Objective

This study aimed to test the feasibility of conducting enhanced passive surveillance in GP using the yellow card scheme (adverse events of interest reporting cards) to determine if it has any advantages over EHR-DM alone.

Methods

A total of 9 GPs in England participated, of which 3 tested the feasibility of enhanced passive surveillance and the other 6 EHR-DM alone. The 3 that tested EPS provided patients with yellow (adverse events) cards for patients to report any adverse events. Data were extracted from all 9 GPs’ EHRs between weeks 35 and 49 (08/24/2015 to 12/06/2015), the main period of influenza vaccination. We conducted weekly analysis and end-of-study analyses.

Results

Our GPs were largely distributed across England with a registered population of 81,040. In the week 49 report, 15,863/81,040 people (19.57% of the registered practice population) were vaccinated. In the EPS practices, staff managed to hand out the cards to 61.25% (4150/6776) of the vaccinees, and of these cards, 1.98% (82/4150) were returned to the GP offices. Adverse events of interests were reported by 113 /7223 people (1.56%) in the enhanced passive surveillance practices, compared with 322/8640 people (3.73%) in the EHR-DM practices.

Conclusions

Overall, we demonstrated that GPs EHR-DM was an appropriate method of enhanced surveillance. However, the use of yellow cards, in enhanced passive surveillance practices, did not enhance the collection of adverse events of interests as demonstrated in this study. Their return rate was poor, data entry from them was not straightforward, and there were issues with data reconciliation. We concluded that customized cards prespecifying the EMA’s adverse events of interests, combined with EHR-DM, were needed to maximize data collection.

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2016-015469
Tracking and Predicting Depressive Symptoms of Adolescents Using Smartphone-Based Self-Reports, Parental Evaluations, and Passive Phone Sensor Data: Development and Usability Study (Preprint)
Authors: Cao Jian , Truong Anh Lan , Banu Sophia , Shah Asim A , Sabharwal Ashutosh , Moukaddam Nidal
Published: March 2019

BACKGROUND

Depression carries significant financial, medical, and emotional burden on modern society. Various proof-of-concept studies have highlighted how apps can link dynamic mental health status changes to fluctuations in smartphone usage in adult patients with major depressive disorder (MDD). However, the use of such apps to monitor adolescents remains a challenge.

OBJECTIVE

This study aimed to investigate whether smartphone apps are useful in evaluating and monitoring depression symptoms in a clinically depressed adolescent population compared with the following gold-standard clinical psychometric instruments: Patient Health Questionnaire (PHQ-9), Hamilton Rating Scale for Depression (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A).

METHODS

We recruited 13 families with adolescent patients diagnosed with MDD with or without comorbid anxiety disorder. Over an 8-week period, daily self-reported moods and smartphone sensor data were collected by using the Smartphone- and OnLine usage–based eValuation for Depression (SOLVD) app. The evaluations from teens’ parents were also collected. Baseline depression and anxiety symptoms were measured biweekly using PHQ-9, HAM-D, and HAM-A.

RESULTS

We observed a significant correlation between the self-evaluated mood averaged over a 2-week period and the biweekly psychometric scores from PHQ-9, HAM-D, and HAM-A (0.45≤|r|≤0.63; P=.009, P=.01, and P=.003, respectively). The daily steps taken, SMS frequency, and average call duration were also highly correlated with clinical scores (0.44≤|r|≤0.72; all P<.05). By combining self-evaluations and smartphone sensor data of the teens, we could predict the PHQ-9 score with an accuracy of 88% (23.77/27). When adding the evaluations from the teens’ parents, the prediction accuracy was further increased to 90% (24.35/27).

CONCLUSIONS

Smartphone apps such as SOLVD represent a useful way to monitor depressive symptoms in clinically depressed adolescents, and these apps correlate well with current gold-standard psychometric instruments. This is a first study of its kind that was conducted on the adolescent population, and it included inputs from both teens and their parents as observers. The results are preliminary because of the small sample size, and we plan to expand the study to a larger population.
Differences in Perceptions of Health Information Between the Public and Health Care Professionals: Nonprobability Sampling Questionnaire Survey (Preprint)
Authors: Gesser-Edelsburg Anat , Abed Elhadi Shahbari Nour , Cohen Ricky , Mir Halavi Adva , Hijazi Rana , Paz-Yaakobovitch Galit , Birman Yael
Published: March 2019

BACKGROUND

In the new media age, the public searches for information both online and offline. Many studies have examined how the public reads and understands this information but very few investigate how people assess the quality of journalistic articles as opposed to information generated by health professionals.

OBJECTIVE

The aim of this study was to examine how public health care workers (HCWs) and the general public seek, read, and understand health information and to investigate the criteria by which they assess the quality of journalistic articles.

METHODS

A Web-based nonprobability sampling questionnaire survey was distributed to Israeli HCWs and members of the public via 3 social media outlets: Facebook, WhatsApp, and Instagram. A total of 979 respondents participated in the online survey via the Qualtrics XM platform.

RESULTS

The findings indicate that HCWs find academic articles more reliable than do members of the general public (44.4% and 28.4%, respectively, P<.001). Within each group, we found disparities between the places where people search for information and the sources they consider reliable. HCWs consider academic articles to be the most reliable, yet these are not their main information sources. In addition, HCWs often use social networks to search for information (18.2%, P<.001), despite considering them very unreliable (only 2.2% found them reliable, P<.001). The same paradoxes were found among the general public, where 37.5% (P<.001) seek information via social networks yet only 8.4% (P<.001) find them reliable. Out of 6 quality criteria, 4 were important both to HCWs and to the general public.

CONCLUSIONS

In the new media age where information is accessible to all, the quality of articles about health is of critical importance. It is important that the criteria examined in this research become the norm in health writing for all stakeholders who write about health, whether they are professional journalists or citizen journalists writing in the new media.
Implementasi Komunikasi Wifi dalam Perancangan Lengan Robot
Authors: Octavianto Aziz , Ramdani Muhammad , Mujirudin Mohammad , Ramza Harry , Dewanto Yohannes
Published: March 2019

Keberadaan teknologi robotika saat ini sangat membantu dalam aktivitas manusia untuk mempermudah melakukan perkerjaan. Salah satu teknologi robotika saat ini yaitu lengan robot. Lengan robot merupakan jenis robot yang menyerupai lengan manusia yang dapat memindahkan barang dari 0satu tempat menuju tempat lainnya. Namun ketika lengan robot ditempatkan pada area yang memiliki kondisi lingkungan yang ekstrim, maka lengan robot tersebut harus dilengkapi dengan sebuah sistem pengendali jarak jauh. Penelitian ini bertujuan untuk merancanglengan robot yang memiliki 4 derajat kebebasan dan mampu dikendalikan dari jarak jauh melalui komunikasi wifi dengan menentukan nilai waktu tunda. Lengan robot dirancang menggunakan mikrokontroler NodeMCU ESP-12E dimana mikrokontroler tersebut sudah memiliki fitur untuk terhubung kedalam jaringan WiFi. Lengan robot memiliki lima buah motor servo dan dapat bergerak berdasarkan empat bagian yaitu base, shoulder, elbow, dan wrist serta sebagai end-effectornya adalah gripper. Hasil penelitian menunjukkan bahwa lengan robot mampu dikendalikan dengan jarak jangkauan maksimum sejauh 16 meter dan memiliki rata-rata waktu tunda sebesar 66.6 ms.
Perancangan Pembangkit Listrik Tenaga Panas pada Knalpot Motor
Authors: Hadiansyah Hadied , Roza Emilia , Rosalina Rosalina
Published: March 2019

Handphone sebagai penunjang bisnis ojek on line tidak bisa kehabisan daya, sehingga dibutuhkan suatu pembangkit listrik yang bisa mengisi baterai tanpa harus berhenti terlebih dahulu. Metode yang dilakukan adalah merancang prototype pembangkit listrik tenaga panas pada knalpot yang merubah energi panas pada knalpot sepeda motor menjadi energi listrik. Apakah tegangan keluaran dari peltier bisa mencapai 2-3 volt. Mana yang lebih stabil antara menggunakan 1 peltier atau 2 peltier. Metode yang dilakukan adalah mengukur tegangan output pada 1 peltier dan tegangan keluaran 2 peltier yang dirangkai seri. Pengujian dilakukan pada perancangan pembangkit listrik tenaga panas saat knalpot motor yang dinyalakan selama 60 menit dengan mengukur tegangan output peltier dan modul chnager. Tegangan yang dihasilkan pada peltier saat menggunakan 1 peltier dan pada saat tegangan keluaran 2 peltier dirangkai seri > 2 volt yaitu 2.05 Volt dan 2.46 Volt. Tegangan keluaran pada 2 peltier yang dirangkai seri > 1 peltier tetapi pada modul charger tegangan yang dihasilkan lebih stabil pada saat menggunakan 1 peltier dari pada 2 peltier.
Maximum Likelihood Estimation for the Generalized Pareto Distribution and Goodness-of-Fit Test with Censored Data
Authors: Pham Minh H. , Tsokos Chris , Choi Bong-Jin
Published: March 2019

The generalized Pareto distribution (GPD) is a flexible parametric model commonly used in financial modeling. Maximum likelihood estimation (MLE) of the GPD was proposed by Grimshaw (1993). Maximum likelihood estimation of the GPD for censored data is developed, and a goodness-of-fit test is constructed to verify an MLE algorithm in R and to support the model-validation step. The algorithms were composed in R. Grimshaw’s algorithm outperforms functions available in the R package ‘gPdtest’. A simulation study showed the MLE method for censored data and the goodness-of-fit test are both reliable.
Moda sustentável: um estudo qualitativo com jovens empreendedores desse setor
Authors: Gammal Zeitune Leonardo Jacques
Published: March 2019

Ao notar que os recursos naturais são finitos e que o uso imoderado de bens naturais acarreta consequências devastadoras, o homem tem procurado novas formas de se desenvolver sem anular o meio ambiente. Diante disso, o presente trabalho tem como objetivo analisar como um setor especifico da Economia Criativa, o mercado da moda, funciona a partir da adoção de práticas sustentáveis sob a ótica de jovens empreendedores desse setor. Para isso, foi realizada uma pesquisa qualitativa por meio de entrevistas via redes sociais e Skype, acompanhado de um roteiro de perguntas pré-estruturado durante todo o mês de abril de 2018. O tratamento dos dados das entrevistas foi realizado por meio da análise de conteúdo, respeitando a identidade cada entrevistado.
The hype of risk-based management control: A phronetic approach
Authors: Mohamed Metwally Abdelmoneim Bahyeldin , Ali Hesham Ali Ahmed , Diab Ahmed Abdelnaby , Hussainey Khaled
Published: March 2019

This paper provides a phronetic review of Risk Management (RM), and its relationship to Management Accounting and Control (MAC). Building on Flyvbjerg’s (2012) phronetic approach, we study Risk-Based Management Control (RBMC) to answer the phronetic four main questions: (1) Where are we going? (2) Who gains and who loses? (3) Is this desirable? (4) What should we do? This review starts its lines of enquiry from the growing fears in the late modernity and risk society (Beck, 1992; Giddens, 1990), that led to heterogenic reactions and unintended consequences which need exploring and revealing. Hence, we will explore whether this is a right reaction or whether it would give rise to an “illusion of control” fortified with some unintended consequences. The paper concludes that the emergency of RBMC led to heterogenic practices and various unintended consequences. These unintended consequences need further research to unpack innovative solutions that can create real effective RBMC. Moreover, the RBMC best practices are still blurred and undefined, this plea for, more case studies to unpack the actual practices and its problems. The novelty of this research is deploying the phronetic approach to understand and criticise RBMC current studies by explaining the reasons and directions for future research. This work would also be of interest to practitioners interested in risk conception, risk management, and management control.
Agency Conflicts, Bank Capital Regulation, and Marking-to-Market
Authors: Lu Tong , Sapra Haresh , Subramanian Ajay
Published: March 2019

We show how shareholder-debtholder agency conflicts interact with strategic reporting under asymmetric information to influence bank regulation. Relative to a benchmark unregulated economy, higher capital requirements mitigate inefficient asset substitution, but potentially exacerbate underinvestment due to debt overhang. The optimal regulatory policy balances distortions created by agency conflicts and asymmetric information while incorporating the social benefit of bank debt. Asymmetric information and strategic reporting only impact regulation for intermediate social debt benefit levels. For lower social debt benefits in this interval, regulatory capital requirements are insensitive to accounting reports, so bank balance sheets need not be marked to market to implement the optimal regulatory policy. For higher social debt benefits, however, capital requirements are sensitive to accounting reports, thereby necessitating mark-to-market accounting to implement bank regulation. Mark-to-market accounting is essential when bank leverage levels are high, and is more likely to be necessary as banks' asset risk or specificity increases.
Does External Assurance Enhance the Credibility of CSR Reports? Evidence from CSR-Related Misconduct Events in Taiwan
Authors: Du Kai , Wu Shing-Jen
Published: March 2019

This study examines the credibility of corporate social responsibility (CSR) reports and the role of external assurance on CSR reports. Based on a sample of listed firms in Taiwan, we find that the issuance of CSR reports is not associated with a lower incidence, or frequency, of future CSR-related misconduct, unless accompanied by external assurance. In other words, external assurance can enhance the credibility of CSR reports. Moreover, the perceived credibility of CSR reports depends on whether firms genuinely fulfill their CSR commitments. For first-time offenders, prior CSR reports play a significant role in protecting firm value when misconduct does occur; however, for repeat offenders, such an insurance role does not exist, regardless of whether the CSR report is assured or not. Our findings attest to the benefits of CSR assurance and underscore the importance of understanding CSR practice in the context of country-specific institutions.

JEL Classifications: M14; M41; M42.

Data Availability: Data are available from sources identified in the paper. Manually collected data on CSR-related misconduct events will be provided upon request.
Anthropometric Assessment of Nutritional Status of Medical Students (Adolescents)
Authors: D. Godia Dr. Haresh , H Nikam Dr. Lalit
Published: March 2019

Aims: Anthropometric Assessment of Nutritional Status of Medical Students.

Material and Method: The present study is carried out on 100 1st M.B.B.S. students of GSMC and tertiary care hospital (50 males and 50 females) not suffering from any major illness. Weighing scale for weight measurement, A scale to measure height (stadiometer), Calipers to measure skin fold thickness.

Conclusion: According to BMI: 72% of females and 78% of males are well nourished; 8% of females and 6% of males are over nourished and 20% of females and 16% of males are under-nourished. Considering the consequences or morbidity and mortality associated with undernourishment; corrective steps in the form of improvement in dietary pattern should be undertaken and for over-nourishment; in addition to rectification of diet, more stress should also be laid on doing physical activity. Broca’s Index does not take build into consideration. It therefore gives high values for weight. On the other hand Metropolitan Life Insurance Tables give more accurate estimate of person’s nutritional status and they should be used as a reliable indicator for nutritional assessment. For Adolescent: BMI- Cutt off points as suggested by WHO should be followed rather than following the adult BMI values as the adult BMI value give a high estimate prevalence of malnutrition
Oral Anticoagulants in Orthopaedic Surgeries Comparison of Rivaroxaban and Standard-of-Care
Authors: Khot Dr. Sanjay , Kamra Dr. Sunil Kant
Published: March 2019

Background:  Venous thromboembolic (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE), cause significant morbidity, mortality and healthcare costs. Direct oral anticoagulant which has been demonstrated in clinical trials, anaesthetists need to be careful of how to minimize the risks of bleeding complications when treating patients who are taking an anticoagulant. Rivaroxaban, non-vitamin K antagonist direct oral anticoagulants (DOACs), was shown to be more effective regimens for the prevention of VTE after orthopaedic surgery. Aims and objectives: To look for the influence of timing of the first thromboprophylactic dose and clinical outcomes in patients undergoing orthopaedic surgery Method: Patients aged ≥18 years, with planned orthopaedic surgery or fracture-related orthopaedic surgery and in whom thromboprophylaxis has been indicated. Out of 324 patients selected for the study 164 received rivaroxaban 10 mg once daily and 160 received standard-of-care (SOC) pharmacological prophylaxis. Incidences of symptomatic thromboembolic events and bleeding events were analysed. Bleeding events and thromboembolic events recorded and calculated for the rivaroxaban and SOC groups.  Results: Overall major bleeding events observed in rivaroxaban group was  9 (5.49%) was much lower than the SOC group which was 13 (8.13%).The percentage of patients using mechanical methods alongside pharmacological thromboprophylaxis was slightly higher in   the rivaroxaban as compared to  SOC groups ( 64% and 55%). Overall thromboembolic effect was lower in rivaroxaban as compared to SOC group. Conclusion: Comparison of rivaroxaban & SOC shows the effectiveness and safety of rivaroxaban in patients undergoing major orthopedic surgery in clinical practice. Major bleeding events & thromboembolic with rivaroxaban were less as compared to SOC group.
Comparison of Dexmedetomidine Plus Ketamine Combination with Dexmedetomidine Plus Propofol for Awake Fiberoptic Nasotracheal Intubation: A Prospective Randomised and Controlled Clinical Trial
Authors: Kaur Balwinder , Garg Anubha , Kumar Parmod , Yadav Dr. Nisha
Published: March 2019

Background: Awake fibre optic intubation (AFOI) is a valuable technique in securing the airway in predicted difficult intubation scenario, compromised airway, airway pathology, when neck extension is to be avoided, vertebral artery insufficiency, Arnold Chiari malformation, limited mouth opening as in temporomandibular joint disease, mandibular-maxillary fixation and severe facial burns.[1] Fiberoptic intubation is the best, easiest and most successful method for awake intubation. Materials and Methods: A prospective, comparative and randomized study was conducted on 100 patients undergoing elective surgery under general anaesthesia. Patients were randomly divided into two groups of 50 each. Group-DK and group-DP patient received IV dexmedetomidine 1µg/kg over 10 mins. Upon completion of the dexmedetomidine bolus, preoxygenation was done with 100% oxygen via face mask with Bain’s circuit. Group-DK patients received ketamine 0.25 mg/kg IV and Group-DP patients received propofol 1mg/kg IV so as to achieve an adequate level of sedation i.e. Ramsay sedation scale=3. Haemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure), SpO2, EtCO2, total comfort scale and patient’s tolerance were assessed during preoxygenation, fiberscope insertion and endotracheal intubation. Results: Statistically significant difference (p<0.05) between two groups in terms of HR, SBP, DBP, MAP, total comfort score and patient tolerance was seen during fiberscope insertion and endotracheal intubation. Conclusion: Dexmedetomidine (1µg/kg) plus ketamine (0.25mg/kg) and dexmedetomidine (1µg/kg) plus propofol (1mg/kg) are safe and effective in patients undergoing fibre optic nasotracheal intubation offering conscious sedation. There is better tolerance and comfort while maintaining oxygen saturation without any hemodynamic alteration in dexmedetomidine (1µg/kg) plus ketamine (0.25mg/kg) group while on the other side use of dexmedetomidine (1µg/kg) and propofol(1mg/kg) during fibre optic intubation causing statistically significant decrease in heart rate, blood pressure, SpO2 and provides less tolerance and comfort.
Management of Otological Foreign Bodies Impaction in Tertiary Health Care Center
Authors: Adegbiji Waheed Atilade , Aremu Shuaib Kayode , Aluko AbdulAkeem A. , Olubi Olawale
Published: March 2019

Background: Otologic foreign body impaction are common ear disorder with an associated challenge due to high levels with of pre-hospital unskilled attempted removal.

Aim: This study aimed at determining the prevalence, socio-demographic features, etiology, clinical presentation, management and outcome in a tertiary health care center in Nigeria.

Materials and Methods: This is a prospective hospital-based study of all patients with an impacted otologic foreign body. Consented patients were studied between October 2015 and September 2017. The interviewer-assisted questionnaire was used to collect data. Analysis of obtained data was done SPSS version 16.0.

Results: Prevalence of otologic foreign body impaction was 4.5%. There were 58.5% males with a male to female ratio of 1.5:1.

The main type of ear foreign body impaction was 85.2% organic (living or dead) and 14.8% inorganic. Commonest otologic foreign body were a cotton bud, insects and seeds in 38.5%, 17.0% and 11.9% respectively.

The foreign body was unilateral in 97.0% and bilateral in 3.0%. Left ear in 42.2% and right ear in 54.8%. The foreign body was in the external canal in 97.8% and middle ear cleft in 2.2%.

Main sources of referral were self-reporting in 30.4% and general practitioners in 22.2%.

Commonest predisposing factors were 31.1% allergy, 23.7% otitis externa, 15.6% earwax and 3.0% mental disorders.

Conclusion: There are the different type of otology foreign body in all age group and associated predisposing factors. Pre-hospital attempt removal by unskilled sympathizers and untrained health workers leads to avoidable complications.
Peripheral Neuroblastic Tumours
Authors: Akbar Jasila , Saldanha Prema
Published: March 2019

Background: Peripheral neuroblastic tumours arise from the neural crest cells in the sympathetic nervous tissue. These are rare, but are the most common among the extracranial solid tumours occurring in children. Method: This was a retrospective study conducted on 15 cases of peripheral neuroblastic tumours. The demographic details were recorded and the slides were analysed for the microscopic features and classified according to International Neuroblastoma Pathology Classification (INPC). Results: Out of the 15 peripheral neuroblastic tumour cases, 8 were males and 7 females. Seven cases came under age group <1.5years, 5 were between 1.5 years to 5 years and 5 cases were over 5 years of age. Seven tumours were from the retroperitoneal region, 4 cases were from the adrenal gland, 2 from intracranium and one case each was from the neck and the mediastinal regions. There were 8 Neuroblastoma cases, 2 cases of Ganglioneuroblastoma and 5 cases of Ganglioneuroma. It was found that 8 tumours were in the favourable histology group and 7 tumours in the unfavourable histology group. Conclusion: Peripheral neuroblastic tumours are rare. It is important to classify them accurately according to the various categories which help to determine the prognosis.
EXPERIMENTAL STUDY OF BEACH SEINE MODELS IN TOWING CHANNEL OF “MARINPO” JSC
Authors: Korotkov Victor Konstantinovich , Golovin Evgeniy Romanovich , Nedostup Alexander Alekseevich , Sokolova Elena Valerievna
Published: March 2019

The experiment was conducted with three models of beach seines with different values оf continuity in the towing channel of “MariNPO” JSC. Experimental values of tension in the model wing and calculated values of hydrodynamic resistance coefficient depending on Reynolds number Re, continuity and shape of the models ( f / L ratio, blowing θ) have been obtained. The range of characteristic values made 123 ≤ Re ≤ 184; 0.168 ≤ F 0 ≤ 0.202; 0.15 ≤ f/L ≤ 0.77; 0.4 ≤ θ ≤ 0.8. There have been plotted the graphs of dependence of experimental values of force in seine wing on ratio f / L for different Re values. There have been built graphs of dependency of calculated values of hydrodynamic resistance coefficient on relations f / L for different Re values. Approximation of calculated values of hydrodynamic resistance coefficient has been made and the graphs of approximating functions of the dependence of hydrodynamic resistance coefficient on f / L ratio have been plotted for different Re values. Error of approximation of dependence сх = f (Re, F 0, f/L , θ) doesn’t exceed 10 %.
RESULTS OF EXPERIMENTAL HYDROACOUSTIC RESEARCHES ON EVALUATION OF SPATIAL DISTRIBUTION OF STURGEON UNDERYEARLINGS IN SHALLOW WATERS OF THE NORTHERN CASPIAN IN 2017
Authors: Balchenkov Igor Borisovich , Pomogaeva Tatiana Vasilievna
Published: March 2019

Since 2005, in the Russian part of the Northern Caspian, Caspian Research Institute of Fisheries has been conducting trawl-acoustic surveys to solve problems in determining the density, biomass and seasonal dynamics of commercial marine fish species. Recently, special attention has been paid to the estimation of the number of sturgeon fishes and their juveniles due to a sharp decrease in the concentrations of these fish in the areas of traditional trawl-acoustic surveys. Until 2015, sonar studies were carried out with the help of a fishfinder echosounder - a video plotter PEV-K, created in the Design Bureau of Marine Electronics “Vector” (Taganrog, Russia). Taking into account the shallow water of the Northern Caspian (depth 3-10 m), this echo sounder of the vertical location gave an insufficiently qualitative quantitative estimate of marine fish concentrations. According to the latest works in the field of acoustics on shallow water bodies, significant shortcomings in the use of vertical echolocation only have been identified, due to a significant underestimation of fish in the near-surface layer in shallow water conditions. It is proved that the most optimal alternative for conducting trawl-acoustic surveys is the simultaneous use of vertical and horizontal echolocation. Solving the actual problems of obtaining representative acoustic data, Caspian Research Institute of Fisheries acquired EY-60 hydroacoustic complex from “Simrad”, using the complex allows simultaneous horizontal and vertical echolocation. Within 2015-2017, with the help of this complex, a survey considering sturgeon yearlings was regularly conducted in the Northern Caspian.
Indicadores de crecimiento y de uso para las colecciones paleontológicas del IANIGLA-CCT CONICET Mendoza (Argentina)
Authors: Devincenzi Susana Mariel
Published: March 2019

La evaluación es una herramienta útil en la gestión de una colección de historia natural, que permitirá al curador o gestor conocer los atributos, las necesidades y los recursos necesarios para su manejo. La literatura ha reportado diferentes metodologías para definir el perfil de una colección de historia natural y realizar una evaluación. El objetivo del presente trabajo es analizar cuatro colecciones paleontológicas del IANIGLA-CCT CONICET Mendoza durante el periodo 2013-2017, a partir de la utilización de indicadores de crecimiento (cuantitativo y cualitativo) y de uso. Los parámetros analizados indican un incremento paulatino, pero constante, de las colecciones de Paleobotánica, Paleovertebrados y Paleoinvertebrados, y un estancamiento de la colección de Icnología. Los indicadores de uso muestran que las cuatro colecciones son utilizadas fundamentalmente para investigación científica, lo cual es consistente con el objetivo institucional. Ambos resultados justifican, a través de la utilización de un modelo de evaluación simple y confiable, una asignación racional de recursos para mejorar su manejo.
La Selva Marginal de Punta Lara, ¿relicto o colonización reciente?
Authors: Guerrero Elián , Deschamps Jorge , Tonni Eduardo
Published: March 2019

La asociación denominada selva marginal de Punta Lara está ubicada al sureste de la ciudad de La Plata, en el partido de Ensenada, a los 34° 47? 31?? Sur y 57° 59? 51?? Oeste. En esta asociación se destacan especies arbóreas como Blepharocalyx salicifolius, Allophylus edulis, Ocotea acutifolia, Pouteria salicifolia y Lonchocarpus nitidus, acompañadas de numerosas especies trepadoras, epífitas, hierbas y arbustos típicos de las selvas del sur de Brasil y noreste de Argentina. A fines de la primera mitad del siglo XX, los aportes de Cabrera & Dawson en 1944 y de Cabrera en 1949 constituyeron el marco teórico que siguió la comunidad científica para reconocer el estado ?primitivo? de área costera del Río de la Plata. Desde ese momento la calificación de ?relicto? para la selva marginal de Punta Lara quedó fuertemente arraigada en la literatura científica, técnica y de divulgación. El objetivo de este trabajo es poner a prueba ese marco teórico, sobre el cual se basan algunas de las principales prácticas conservacionistas de la provincia de Buenos Aires. Para ello, se utilizaron cinco fuentes de información: 1) cartografía de los siglos XVIII y XIX, 2) relatos de viajeros de esa época, obtenidas de diversas fuentes bibliográficas, 3) bases de datos de plantas vasculares herborizadas antes del siglo XX, 4) los hongos xilófilos herborizados a fines del siglo XIX en la costa platense y 5) el registro paleoclimático reciente. Como resultado del presente trabajo se propone una nueva hipótesis: la selva marginal de Punta Lara no constituye un relicto sino una asociación instalada recientemente, establecida a mediados del siglo XIX cuando el clima de la región del Río de la Plata manifestó un incremento en las precipitaciones y la temperatura mínima, tendencia que se mantiene hasta el presente.
La colección arqueológica ?Pedro Dade? del Museo de La Plata
Authors: Zilio Leandro , Buus Svend Aage , Hammond Heidi
Published: March 2019

En este trabajo se da a conocer el análisis de una colección de materiales arqueológicos provenientes de la costa norte de la provincia de Santa Cruz (Patagonia argentina) que se encuentra alojada en la División Arqueología del Museo de La Plata, Argentina. Las piezas que conforman la colección fueron recolectadas por el Señor Pedro Dade, capitán de navío alemán y agente secreto del gobierno de Alemania durante la Primera Guerra Mundial. P. Dade junto a su esposa vivieron en el territorio patagónico durante los años 1928 a 1932, y fueron ellos quienes realizaron las tareas de recolección de materiales arqueológicos en el sector costero de Santa Cruz gracias al financiamiento otorgado por el Museo de La Plata. En este trabajo se presenta una caracterización general de los materiales que componen la colección Pedro Dade, formada por 7366 artefactos. Además se lleva a cabo el análisis de los documentos archivísticos asociados que permitieron reconstruir diversos aspectos acerca de cómo se generó esta colección. Por otro lado, fue posible rastrear e identificar otros materiales precedentes de la misma área de Patagonia que fueron vendidos por P. Dade al Museo Nacional de Copenhague, en Dinamarca y al Museo Etnográfico de Berlín, en Alemania. Se realiza una breve descripción de estos objetos y se menciona la existencia de más piezas recolectadas por P. Dade alojadas en el Museo de Culturas del Mundo, en la ciudad de Gotemburgo, Suecia, y en el Museo Nacional en Viena, Austria. Se resalta el valor patrimonial y el potencial informativo de las colecciones arqueológicas para reconstruir aspectos de los grupos humanos que habitaron en el pasado.
Desejo da maternidade entre mulheres com insuficiência renal crônica dialítica
Authors: Majevski de Assis Bruno , Gomes de Souza Alvarenga Cristiane , Silveira Cardoso Lorena , Ribeiro Trindade Wânia
Published: March 2019

A Doença Renal Crônica consiste em uma lesão renal com perda progressiva e irreversível da função renal. Devido à gravidade da doença torna-se muito difícil a concepção e manutenção de uma gravidez. O objetivo foi verificar a percepção e desejo de engravidar em um grupo de mulheres com insuficiência renal crônica em terapia renal substitutiva dialítica. Trata-se de um estudo descritivo, com abordagem qualitativa realizado no Instituto Capixaba de Doenças Renais e Hipertensão LTDA, situado em Cariacica-ES. Os dados foram coletados em outubro de 2017, através de uma entrevista semiestruturada e 10 mulheres participaram da pesquisa. Análise de conteúdo, seguindo os momentos metodológicos propostos por Bardin. Constatou-se que mais de 50% das entrevistadas possuem o desejo de engravidar. Necessitam de um cuidado rigoroso da equipe multiprofissional abrangendo a mulher de forma holística e que o pré-natal seja iniciado o mais precoce possível.
O discurso institucional das entidades públicas de ATER
Authors: Franco Marcelo Horta Messias , Romarco Marcelo Leles , Borges Túlio Lima , Gomes Márcia Campos
Published: March 2019

A pesquisa apresenta uma análise exploratória dos discursos institucionais do serviço público de Assistência Técnica e Extensão Rural (Ater) no Brasil a partir de informações disponíveis nos sites institucionais das entidades públicas de Ater nacionais e à luz da Política Nacional de Assistência Técnica e Extensão Rural (Pnater) de 2010. Como recursos metodológicos foram utilizados procedimentos da análise de conteúdo e análise do discurso, os quais permitiram identificar coerências e incoerências entre os itens analisados, e destes com atual política nacional. Ficou evidenciada uma intencionada e nítida busca de sintonia da comunicação organizacional dessas entidades com o texto da lei da Pnater. Considerando o levantamento realizado e a discussão bibliográfica sobre o tema da Pnater, foi possível detectar, finalmente, a existência de disputas acerca das distintas visões sobre o desenvolvimento rural sustentável no Brasil.

Palavras Chave: Desenvolvimento Rural Sustentável. Extensão Rural. Pnater.
Hypokalemic periodic paralysis – the importance of patient education
Authors: Lewis Kristyn L. , Malouff Timothy D. , Kesler Alex M. , Harris Dana M.
Published: March 2019

Hypokalemic periodic paralysis (HOKPP) is a rare neuromuscular disorder caused by altered transport of cellular potassium that leads to significant muscle weakness of the extremities. Paralytic attacks are induced by a drop in the serum potassium level and they have been associated with specific triggers. This case describes a 21-year-old male who has had recurrent presentations of acute paralytic attacks following vigorous physical activity. At presentation, this patient exhibited flaccid paralysis of all skeletal muscles below the neck, but was alert and oriented with stable vital signs. The patient was found to have a potassium level of 2.1 mmol/L and an EKG demonstrating U waves (characteristic of hypokalemia). The patient was treated with potassium supplementation with resolution of symptoms. The mainstay of prevention of long term permanent muscle weakness is avoidance of triggers that can lead to hypokalemia. Through education on disease process and lifestyle modifications, we were able to end the cycle of recurrent hospital readmissions and the subsequent financial burden this generated for the patient and his family.
Ventricular tachycardia in a patient with cardiac haemochromatosis and normal left-ventricular ejection fraction
Authors: Revilla-Martí Pablo , Pelegrín-Díaz Juana , Rodrigo-Trallero Gonzalo , Linares-Vicente Jose Antonio , Ruiz-Arroyo Jose Ramón
Published: March 2019

We describe a rare case of ventricular arrhythmia in a patient with cardiac haemochromatosis related to iron overload in the myocardium and without evidence of systolic dysfunction or heart failure. This case stresses the utility of cardiac magnetic resonance imaging for the early identification of iron overload in the heart and starting appropriate treatment.
Modelo conceptual de la contaminación del suelo y agua subterránea por hidrocarburos
Authors: Azcuntar R. Omar , Izquierdo B. Jaime , Sánchez F. Paola A.
Published: March 2019

Se presenta un caso tipo de contaminación por hidrocarburos representado mediante un modelo conceptual. Para lograr el objetivo planteado se seleccionó como zona piloto Cavasa municipio de Candelaria, Valle del Cauca, y se desarrolló una metodología basada en el "Manual Técnico para la Ejecución de Análisis de Riesgos para Sitios de Distribución de Derivados de Hidrocarburos" expedido por el Ministerio de Ambiente, Vivienda y Desarrollo Territorial, 2007. La metodología se compone de dos fases: Antecedentes de la zona de estudio e Información característica. En la primera fase se recopiló la información histórica y actual del área de estudio, enfatizando en el uso del suelo; y en la segunda fase se describe la geología, tipo de suelo, nivel piezo métrico, características hidrogeológicas, topografía y dirección del flujo del área de estudio; así mismo, se identificaron los receptores sensibles a la contaminación. Mediante la construcción del modelo conceptual se identificó la información adicional que se debe recolectar para hacer una evaluación completa de la contaminación por hidrocarburos en el suelo y agua subterránea; a su vez, sirvió de herramienta para la entidad ambiental en proponer un plan de seguimiento, una evaluación y planteamiento de posteriores acciones correctivas para detener, eliminar o atenuar procesos de contaminación, teniendo como obligación proteger la calidad del recurso subterráneo que abastece en su totalidad a la población del corregimiento El Carmelo y en general al municipio de Candelaria.
Ý định và hành vi mua sắm trực tuyến của khách hàng: nghiên cứu mô hình lý thuyết thống nhất chấp nhận và sử dụng công nghệ, sự tin tưởng và hiệu ứng “cái đuôi dài”
Authors: Nguyen Thu Ha
Published: March 2019

Cùng với sự phổ biến của Internet cũng như công nghệ thông tin và truyền thông, mua sắm trực tuyến đang dần trở thành lựa chọn thay thế cho hình thức mua sắm truyền thống. Dựa trên mô hình mở rộng của lý thuyết thống nhất chấp nhận và sử dụng công nghệ (UTAUT2), bài viết này đề xuất khung lý thuyết phân tích các yếu tố tác động đến việc sử dụng hình thức mua sắm trực tuyến của khách hàng tại Việt Nam, trong đó bổ sung ảnh hưởng của hiệu ứng “cái đuôi dài” và sự tin tưởng của khách hàng. Bài viết đưa ra giả thuyết rằng bên cạnh bảy yếu tố của mô hình UTAUT2., hiệu ứng “cái đuôi dài” và sự tin tưởng của khách hàng có tác động tới ý định mua sắm trực tuyến và hành vi mua sắm trực tuyến của khách hàng. Dựa trên khung lý thuyết được đề xuất, bài viết đưa ra một số hàm ý đối với các doanh nghiệp thương mại điện tử nhằm thúc đẩy hành vi mua sắm trực tuyến của khách hàng. Đồng thời, bài viết cũng gợi ý một số hướng nghiên cứu trong tương lai nhằm phát triển và hoàn thiện mô hình cho phù hợp với bối cảnh thương mại điện tử tại Việt Nam.