bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Facilitators of Regaining Autonomy in People with Spinal Cord Injury
Authors: Farahani Moloud Farmahini , Khankeh Hamid Reza , Hosseini Mohammadali , Dalvandi Asghar , NorouziTabrizi Kian
Published: March 2021

Background:

One of the most important aims of rehabilitation in Spinal Cord Injuries (SCI) is regaining autonomy, which can affect individuals' Quality of Life (QOL). This study was conducted to understand the experiences of individuals with SCI in terms of regaining autonomy during transition from hospital to community.

Materials and Methods:

The present study was conducted using a qualitative research design. In this study, 15 semi-structured, in-depth interviews were conducted with individuals with SCI in Spinal Cord Injury (SCI) Association of Arak, Iran, from June 2018 to May 2019. The interviews were analyzed using the conventional content analysis method.

Results:

Data analysis emerged four core categories of “self-management” (adaptation to a new life, self-care, responsibility, and seeking information), “social support” (family and friends' support, health care providers' support, and peer support), “access to facilities and resources” (home modification, use of various rehabilitation techniques, and use of mobility equipment), and “spiritual and religious beliefs” (believing in divine destiny and performance of religious rites).

Conclusions:

The present study showed that several factors influenced the regaining of autonomy in individuals with SCI. It is important to consider the impact of these factors during transition from hospital to community. Health service providers can use the findings of this research to help these individuals regain their autonomy.
Designing Virtual Patients for Education of Nursing Students in Cancer Course
Authors: Bahrami Masoud , Hadadgar Arash , Fuladvandi Masoumeh
Published: March 2021

Background:

One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients.

Materials and Methods:

In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students.

Results:

Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity.

Conclusions:

This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.
Congenital Melanocytic Nevus with Scrotal Mass
Authors: Motiwala Tanmay , Rathod Kirtikumar J. , Jadhav Avinash , Shaikh Minhaj , Elhence Poonam , Paliwal Bharat , Sinha Arvind
Published: March 2021

Congenital melanocytic nevus is deposition of pigment producing cells of melanocytic lineage in the dermis. We present an extremely rare case of congenital melanocytic nevus with a scrotal mass associated with deposition of melanin in the brain. The mass may mimic like a testicular tumour on clinical presentation.
Awareness of Common Pediatric Surgical Entities among Practicing Indian Pediatricians
Authors: Mahalik Santosh Kumar , Pati Akash Bihari , Das Kanishka
Published: March 2021

Aim:

Common pediatric surgical entities often get a delayed referral to the pediatric surgeon in the average Indian scenario. This study was conducted to assess the awareness about management of select common pediatric surgical entities among practicing pediatricians.

Materials and Methods:

An online multiple-choice questionnaire consisting of twenty questions related to the diagnosis and management of common pediatric surgical entities encountered by pediatricians in their routine office practice was prepared, and the electronic link was circulated among the practicing pediatricians of India. Each question had one correct response.

Results:

One hundred and seventy-five responses were obtained, collated, grouped, and analyzed. Overall, 35% of all responses were correct. Individually, 56% of respondents marked 51%–75% of answers correctly; only 7% scored above 75%. Some clinical observations were disparate: 65% were unfamiliar with preputial adhesions and 51% would discharge a preterm neonate with inguinal hernia without a surgical consult. There is a tendency toward unnecessary imaging (60% – localization of undescended testis, 91% – wet umbilicus, and 51% – postanal dimple) and overzealous medical management (propranolol for the involuting hemangioma). However, 82%–88% concurred on the standard conservative or surgical management in index conditions such as hypospadias and umbilical problems.

Conclusion:

There was a concurrence in the principles of management of common pediatric surgical entities between pediatricians and pediatric surgeons in 35%. Misdiagnosis, unwarranted investigations, overzealous medical management, and delayed surgical consults figured in 65%. A systematic professional interaction between the physicians and surgeons would facilitate a coordinated management. A larger study would yield more meaningful data.
Coccygectomy for Chronic Refractory Coccygodynia in Pediatric and Adolescent Patients
Authors: Almetaher Hisham Almohamady , Mansour Mohamed Awad , Shehata Mohamed Ali
Published: March 2021

Aims:

Coccygodynia (also known as coccydynia and coccyalgia) described for the first time by Simpson in 1859. It is a disabling pain in the coccyx usually provoked by sitting or changing position from a sitting to a standing position. Treatment started with adjustment of ergonomics as specialized cushion for sitting, application of local heat, and oral analgesics. The aim of this study was to assess the results of total or partial coccygectomy for patients suffering from chronic refractory coccygodynia and not improving on conservative treatment in pediatrics and adolescents.

Methods:

The study included 22 patients, 8 of them with chronic refractory coccygodynia not responding to conservative management underwent partial or total coccygectomy using Key's surgical exposure after good preoperative preparation.

Results:

This study included 5 females (62.5%) and 3 males (37.5%), their ages ranged from 7 to 15 years. The results were excellent in 75% of patients and good in the remaining cases. The mean length of hospital stay was 1.43 ± 0.98 days. No significant intraoperative or postoperative complications were reported. The parents were satisfied in almost all cases in the long term follow up.

Conclusions:

Coccygodynia is a disabling problem, especially in pediatric patients. Coccygectomy is a feasible management option and has a favorable outcome when performed for an appropriate indication.
Anephric Neonate and Evolution of our Study on Intestinal Dialysis
Authors: Chatterjee Uday Sankar
Published: March 2021

Purpose:

Intestinal dialysis for end-stage renal disease (ESRD) is a proposed renal replacement therapy, and studies are going on worldwide to make it practicable. We are also doing the same study in our institution and would like to share our experience in managing an anephric neonate with intestinal dialysis in the perspective of our ongoing study of intestinal dialysis since 2010.

Patients and Methods:

We did double-ended jejunostomy in an isolated loop of the jejunum keeping the main tract intact with jejunojejunal anastomosis in this anephric neonate. Following that, we started irrigation with peritoneal dialysis fluid from the 3rd postoperative day (POD) in that jejunal loop through jejunostomy.

Results:

This patient had no uremic features since re-admission and showed better laboratory and clinical outcomes with combined jejunal loop and colonic dialysis for 7 days. However, the patient died on the 9th POD following severe hypoglycemia.

Conclusions:

From this study, it seems intestinal dialysis, with necessary modifications done in our subsequent patients, which might be recommended for ESRD in children as well as in adults.
Routine use of Circumferential ‘Doughnut’ Biopsy in Pull through Surgery for Hirschsprung's Disease
Authors: Murthi Govind V. S. , Townley Oliver G. , Lindley Richard M , Cohen Marta C.
Published: March 2021

Aims:

The aim of this study was to review the use of the on-table “doughnut” biopsy for frozen section assessment of bowel in the operative management of Hirschsprung's disease (HD).

Methods:

This was a single-center retrospective review of doughnut histopathology reports, operation notes, and slides from 2010 to 2017. Data were assessed for the presence of transition zone (TZ) features and the subsequent decision as to the level of pull-through.

Results:

Fifty-five patients had a doughnut biopsy taken as part of their intraoperative frozen section histopathology for pull-through for HD during the study period. Forty-eight required a single doughnut, six required a second more proximal doughnut, and one required a third doughnut. Of the 55 first doughnuts, 37 were identified as normal bowel, 17 were TZ, and not defined in the report in one case. Of the 17 TZ doughnuts, 8 were accepted for pull-through and 7 underwent second doughnuts (normal = 4 and TZ = 3). The third doughnut (one case) was normal. TZ was accepted for pull-through in 10/54 (18.5%) patients despite the use of a doughnut. However, TZ was avoided in six (11.1%), where the single-point biopsy was “normal.”

Conclusions:

The doughnut allows the entire circumference of pull-through level to be assessed, enabling TZ identification that can be missed by single seromuscular biopsies. This allows identification and avoidance of TZ pull-through, although sometimes, it is accepted for other reasons.
Numerical Simulation of the Electrostatic Coating Process: the Effect of Applied Voltage, Droplet Charge and Size on the Coating Efficiency
Authors: Pendar Mohammad Reza , Pascoa Jose
Published: March 2021

Electrostatic Rotary Bell Sprayers (ERBSs) have been widely used in the painting industry, especially in the automotive and aerospace industries, due to their superior performance. The effects of the applied voltage and paint droplet charge values on the spraying pattern and coating Transfer Efficiency (TE) in the ERBS, including a high-voltage ring for spray cloud control, have been studied numerically in a wide range of droplet size distribution. A 3D Eulerian-Lagrangian numerical analysis is implemented under the framework of the OpenFOAM package. The fluid dynamics of turbulence, primary and secondary breakup procedures are modeled using a large eddy simulation (LES) model, Rosin-Rammler distribution, and modified TAB approach, respectively. Compared to the conventional ERBSs, in the current work an exhaustive exhibition of the airflow dynamic and spray pattern characteristics around the ERBS with outer high-voltage control-ring field pattern, i.e., velocity, vorticity, electric potential field, overspray, film thickness are reported. Our findings indicate that the control-ring around the rotary bell rim improves the coating procedure TE and produces a more harmonized and narrower spray plume. Our in-depth investigation clearly shows the importance of the droplet charge values, voltage quantity, and considered droplet size range on the film thickness and its corresponding quality that is obtained from the workpiece.
Enhancing the Role of Public and Private Extension in Soil Conservation and Agricultural Productivity
Authors: Yahaya Mohammed Kuta
Published: March 2021

No Abstract.
Proximate and micronutrient compositions of four different cultivars of aubergine (Solanum melongena)
Authors: Ebiringa D. C.
Published: March 2021

Aubergine or Garden egg is a vegetable commonly chewed as such and served as kolanut within the southeast part of Nigeria. The aim of the study is to determine the proximate and micronutrient compositions of four different cultivars of aubergine (Solanum melongena). Four cultivars of aubergine, namely Solanum anguivi - A, Solanum aethiopicum (gilo group) - B, Solanum macrocarpon - C, and Solanum aethiopicum (kumba group) - D, were purchased from the Eke-ukwu market in Owerri, Imo State, Nigeria. Proximate compositions were determined using the standard AOAC methods. Mineral determination was carried out by using methods incorporating wet digestion while Vitamins were determined by using specific methods appropriate for each vitamin. The proximate analysis results of the samples showed that moisture content ranged from 80.29% for sample C to 90.63% for sample B; fat ranged from 1.40 (sample A) to 4.00 (sample C); Ash: 0.52 - 0.76 (C - A); Protein: 3.94 - 8.31 (A - C); Crude fibre: 2.02 - 2.86 (C - A); Carbohydrate: 0.47 - 4.86 (B - C). The micro-nutrient compositions showed that vitamin A ranged from 475.18i.u. (sample B) to 528.06i.u. (sample A); Vitamin C: 908.6 - 2929.65 mg/100g (A - C); Calcium: 97.95 - 586.02ppm (D - A); Magnesium: 80.63 - 106.31ppm (B - A); Iron: 10.14 - 14.97ppm (C - A). The four cultivars of aubergine contained fair amounts of macronutrients in addition to the substantial amounts of micronutrients. In all, Solanum anguivi cultivar was the richest of the four in nutrient compositions, and, therefore, the most preferred.
Analysis of net farm income and non-farm income of broiler farmers across different scale of production in Imo State, Nigeria
Authors: Anyaegbu C. N. , Ibekwe U. C. , Odii M.A.C.A. , Ehirim N.C , Chikezie C , Ogbonna S.E , Chukwurah V.C
Published: March 2021

This study analyzed net farm income and non-farm income of broiler farmers across different scale of production in Imo State, Nigeria. Capital accumulation for reinvestment and expansion remains a challenge among broiler farmers in the study area. A multi-stage sampling technique was adopted, and a total of 9 LGAs were purposively selected from the 3 zones (Orlu, Owerri and Okigwe zone). Stratified random sampling was used in selecting 26 small-scale and 9 medium-scale farmers from Owerri Agricultural zone for the study. In Orlu, 15 small-scale, 15 medium-scale and 6 large-scale of broiler farmers were selected, while 15 small-scale, 11 medium-scale and 3 large-scale broiler farmers were selected from Okigwe Zone. This gave a total of 113 broiler farmers selected from the chosen LGA's in the state. Out of 113 broiler farmers selected only a total of 100 responses were found useful for the study. Descriptive statistics, profitability ratio and net income model tools were employed for analyses in this study. The profitability result revealed that the large-scale broiler production has the highest return on naira used with 174% followed by medium-scale production with 47% return on naira used and the least was small-scale production with 33% return on naira expended. The result reveals that broiler farming in the study area is profitable and has the ability to offset its own cost, and still generate substantial return on naira used from every additional N1 spent no matter the scale of operation. The study also shows that net farm income of broiler farmers (N7,690,429.50 for small-scale, N 17,615,997.00 for medium-scale and N 142,674,200.00 for large-scale) is significantly greater than their non-farm income irrespective of scale ofoperation. In an attempt to raise the net-income of broiler farmers vis-a-vis more capital to scale-up broiler production, small and medium-scale operators are encouraged to diversify their productions with other livestock enterprises like layer production enterprise, turkey production enterprise and goat production enterprise.
Editor's note
Authors: Van Dyk Tobie
Published: March 2021

No Abstract.
How three high-fee independent secondary schools in the Western Cape currently conceptualise language support for international students with language barriers
Authors: Clift Mariana
Published: March 2021

A steadily increasing number of wealthy foreigners, mainly from other African countries, opt to send their teenage children to  independent secondary schools in South Africa to give their children what they perceive to be the “best education possible” (Spaull, 2015: 14). As is the case globally, international students entering the South African independent school system at secondary level may face major difficulties in acquiring academic English.International  students with language barriers tend to gravitate towards schools without rigorous entrance examinations in place. This article focusses on three high-fee independent secondary schools in the Western Cape, two boarding schools and one day school, whose websites in 2017 did not indicate that they had formal, exclusionary entrance examinations in place. Data subsequently provided by these schools showed that their student bodies did, in fact, include a substantialnumber of international students. For this study, the principal and two other senior members of staff at each of the three schools were interviewed to ascertain how they provided language support for international students with language barriers. After reporting backon these interviews, the discussion section of the article critically analyses current practices, with the conclusion of the article acting as a preamble for a follow-up article, in which aspects of the CLIL (content and language integrated literacy) model will be identified whichcould prove useful to these schools to further support students and staff.

Keywords: international students, language support,  independent schooling, challenges, secondary schools
Kepastian Hukum Dalam Kemudahan Berusaha Di Era Revolusi Industri 4.0 Terkait Dengan Profesi Notaris
Authors: Akbar Muhammad , Yazid Fadhil
Published: March 2021

ABSTRAKDimulainya Revolusi Industri 4.0 membawa banyak perubahan bagi dunia. Inilah era di mana praktik otomatisasi dan pertukaran data, pun penggunaan teknologi internet, cloud computing, serta cognitive computing akan mewarnai beragam sektor kehidupan manusia, termasuk ranah profesi. Semua perubahan, pasti membawa dua hal: tantangan dan peluang. Kendala yang didapati akibat perubahan yang terjadi melalui Revolusi Industri 4.0 bagi profesi notaris, notaris harus selalu update tentang peraturan perundang-undangan, dan paham tentang teknologi serta dapat memanfaatkan teknologi digital guna pembuatan akte otentik. Metode penelitian dalam penulisan ini adalah yuridis normatif dengan menganalisis bahan hukum berupa Undang-Undang Nomor 2 Tahun 2014 tentang Jabatan Notaris melalui studi pustaka. Bagi seorang notaris, inilah saatnya memandang dampak Revolusi Industri 4.0 sebagai tantangan dan peluang demi keberlanjutan profesi notaris.Kata Kunci : Kepastian Hukum, Industri 4.0, Notaris
De la contribution de l’ironie à la construction du monde inversé dans le roman de la diaspora africaine contemporaine
Authors: MANIRAMBONA FULGENCE , TUNGUHORE FÉLIX
Published: March 2021

Dans cet article, nous nous proposons d’analyser, dans quelques romans de la diaspora africaine contemporaine, les subversions qu’opère l’ironie pour créer des mondes fictionnels inversés. Nous entendons d’abord mettre en évidence la question du jeu paradoxal de l’ironie pour tenter de saisir son rôle dans la déconstruction du discours dominant et, par-delà, dans le renversement des univers de croyances. Cet axe de l’ironie permet de démystifier les pratiques en cours dans certains pays de destination des migrant·e·s et la civilisation qu’ils·elles incarnent, de critiquer certains maux de la société comme le racisme, la criminalité, etc. et de mettre en cause les faits et les situations jusque-là tenus pour appropriés. Nous analysons ensuite la satire qui déclenche une ironie qui attaque essentiellement les travers des humains et de la société, égratigne le pouvoir qui opprime ses concitoyen·ne·s et dénonce le système colonial qui contraint tout un peuple à l’adoption des valeurs contraires à ses convictions morales et à ses intérêts. Tout ce discours met à profit un trope dont le rôle est le retournement de situation, l’inversion des rôles et la représentation des antipodes que véhicule le monde contemporain.
Estudio relativo a los principios de la potestad sancionadora y a la tramitación del nuevo procedimiento sancionador común, a la vista de su regulación en las leyes 39/2015 y 40/2015 y de la jurisprudencia reciente
Authors: GAVIEIRO GONZÁLEZ Sonia
Published: March 2021

LABURPENA: Administrazio Publikoen Administrazio-prozedura Erkidearen 39/2015 eta Sektore Publikoaren Araubide Juridikoaren 40/2015 Legeak duela urte bat baino gehiago indarrean sartu dira. Ondorioz, Administrazio Publikoen lankidegoak bi arau horiek praktikara eramateko aukera izan du eta, horregatik, badirudi momentu egokia heldu dela analisi kritikoa egiteko. Hain zuzen, lan honen helburua zehapen-prozedura da (printzipioak, izapideak, …); baina, bereziki, balizko aldaketak, prozeduraren lege berri horiek indarrean sartu eta gero. Halaber, saiatuko gara ikuspuntu kritikoak eta irteera posibleak ematen, oraindik aplikagarriak diren epai-erabakiak behin aztertuta.

RESUMEN: Tras haber transcurrido más de un año desde la entrada en vigor de las Leyes 39/2015 de Procedimiento Administrativo Común de las Administraciones Públicas y 40/2015 de Régimen Jurídico del Sector Público, el personal de las Administraciones Públicas hemos tenido ocasión de poner en aplicación ambas normas y, por ello, parece que ha llegado un momento óptimo para realizar un análisis crítico. En concreto, es objeto de este trabajo el procedimiento sancionador (principios, trámites,…), destacando posibles cambios tras la entrada en vigor de estas nuevas leyes de procedimiento, pero intentando aportar un punto de vista crítico y posibles soluciones a la vista de pronunciamientos jurisprudenciales que siguen resultando aplicables.

ABSTRACT: After more than one year after the entry into force of the Laws 39/2015 of the common administrative procedure of the Public Administrations and 40/2015 of legal regime of the public sector, the personnel of the Public Administrations have had opportunity to implement both standards and, therefore, it seems that there has been an optimal time to conduct a critical analysis. In particular, the sanctioning procedure (principles, processes,...) is the subject of this work and, specially, we want to analyze possible changes after the entry into force of these new procedural laws, but trying to provide a critical point of view and possible solutions in sight of jurisprudential pronouncements that continue to be applicable.
An Investigation into the Correlation among Academic Staff’s E-journals Use, E-literacy Skills, Demographic variables and Research Productivity
Authors: Arshad Alia , Ameen Kanwal
Published: March 2021

The study aimed to investigate relationship of academic staff's use of e-journals with demographic and profession related variables. The quantitative survey method was used to achieve the objectives of the study. The population of the study included academic staff of 12 faculties of the University of the Punjab. Self-administered questionnaire was distributed to 841 regular and contractual academic staff members with a response rate of 54 %. The results of the study found that the respondents' frequency of e-journals use was significantly related to their discipline, age, education, internet use, e-literacy skills and research output. However, e-journals use was not significantly related to their official position and gender. It is a valuable study as it comprehensively investigated correlation of certain variables with academic staff's use of e-journals in Pakistani perspective.
A Review of Detection of Pest Problem in Rice Farming by using Blockchain and IoT Technologies
Authors: Hidayat Taufik , Mahardiko Rahutomo
Published: March 2021

Pest can be a serious topic in agricultural areas especially rice plantations. The pest destroys the plants before harvesting time. Because of the presence of the pest, the yield of agricultural products is decreasing. From a technical point of view, an agricultural professional should identify not only the type of pest that destroys rice plants but also overcome the pest. This research proposes a paper review on pest detection systems by using Blockchain technology and the Internet of Things involving all parties involved. The use of the review is to have a broad overview regarding the functional combination between IoT and Blockchain technologies to reduce the pest problems. Smart contract technology Blockchain may be held to determine automatic alert in the system and know how to resolve the problem accurately and all information is verified by blockchain system without a human interception. IoT devices can be attached to rice plantations to monitor, determine and send the information of the pests. Our paper explains the combination of IoT and Blockchain technologies in order to improve any possibility of success rate by getting the pests. Thus, IoT replaces human manual checking in pest identification to reduce human error. So that, the harvesting time can be increased and the agriculture yields are good. The search comparison results show that ScienceDirect has the highest search value
Effects on the Wound Healing Process Using Ozonated Oils (Sesame, Nigella sativa, Hypericum perforatum) in Rats
Authors: CANPOLAT İbrahim , ERÖKSÜZ Yesari , RIZAOĞLU Tamara
Published: March 2021

Objective: In this study, the effects of three different ozonated oils (Sesame, Nigella sativa, and Hypericum perforatum) on wound closure rate, healing process, and possible complications were examined macroscopically and microscopically. Materials and Methods: Twenty-one adult Wistar albino female rats were used in the study. Subjects were divided into three groups, early wound healing, (7 days), medium wound healing, (14 days), and late wound healing (21 days). Four full-thickness skin wounds of equal size (10 mm in diameter) were formed on the back regions of all rats. This region was chosen for preventing self-inflicted injuries and reducing external irritation. The wound was left open during the healing process. While the first wound (control) received no treatment in the second wound, ozonated Sesame oil, in the third wound ozonated Nigella sativa oil, and in the fourth wound ozonated Hypericum perforatum oil were used. No group obtained parenteral drug administration. The first, second, and third main groups were euthanized on days 7, 14, and 21, respectively. The wound healing was assessed macroscopically daily. Wound sizes of individual rats were measured with a caliper and digitally photographed every day from the day of injury. After euthanasia, all wound sites of the subjects were evaluated histopathologically. Results: There were no significant differences in wound healing between treatments on the first day 7. On the 14, it was found that the healing was better in the group that applied Nigella sativa and Sesame oils (p≤0.05). On day 21 wound healing was completed in all subjects with a resultant of better outcome in Nigella sativa oil treatment compared with others (p≤0.01). Conclusion: In this study, the best wound healing outcome was achieved with Nigella sativa oil and Sesame oil where three different minced oils were used.
Role of global longitudinal strain diastolic index in assessment of patients with suspected obstructive coronary artery disease and normal or mildly reduced ejection fraction
Authors: Bolog Mihaela , Dumitrescu Mihaela , Romanoschi Florentina , Pacuraru Elena , Rapa Alina
Published: March 2021

Objective – To examine the utility of global longitudinal strain imaging diastolic index (SI-DI) in the assessment of patients with suspected obstructive coronary artery disease (CAD). Methods – We performed rest 2D standard echocardiography and strain imaging in 30 healthy subjects and in 148 patients with normal or mildly reduced ejection fraction and indication for coronarography for suspected obstructive CAD. Standard echocardiographic and strain parameters were analysed. Results – Global SI-DI was signifi cantly lower in the selected vs control group (p <0.001). After coronarography patients were divided in three subgroups: 74 patients with more than 50% obstruction in any major artery, 26 patients with previous revascularisation but no significant obstructive lesions at present and 48 patients without obstructive artery disease. Average global SI-DI was significantly lower in the subgroup with obstructive CAD vs the other two subgroups (p<0.05). Global SI-DI lower than 0.5 had a good sensitivity (84%) and a reasonable positive predictive value (52%) for detection of obstructive CAD. Conclusions – Global SI-DI is significantly lower in patients with obstructive CAD and normal or mildly reduced ejection fraction compared with normal subjects. A cut off value lower than 0.5 selects patients with a higher probability of obstructive CAD.
Effects of reaction conditions on the degree of substitution in acetylated nanocellulose
Authors: Doan Van Hong Thien , Tran Thao Nhu , Do Thi Kieu Trang , Nguyen Chanh-Nghiem , Pham Van Toan , Van-Pham Dan-Thuy
Published: March 2021

In this study, cellulose nanocrystals (CNC) were chemically extracted from the waste newspapers and acetylated by reacting CNC with acetic anhydride, using sulfuric acid as a catalyst. Response Surface Methodology based on a three-factor factorial design was applied to analyze the interaction effects of reaction temperature, time, and the ratio of nanocellulose and acetic acid (wt/v) on the degree of substitution (DS) which was calculated and compared. Various experimental conditions as reaction temperature (50-70 °C), reaction time (90-150 min), and the ratio of nanocellulose and acetic acid (wt/v) (1:15-1:25) were under investigation. It was found that reaction temperature and its interaction effects have the most significant effects on DS. The acetylated CNC was characterized by FTIR and 1H-NMR spectroscopy. The highest DS (2.997) was obtained in 90 min and the CNC/acetic acid ratio of 1:15 at 70 °C.
Utilidad de la mediastinoscopia: Resultados de 140 procedimientos
Authors: Hidalgo José A. Mainieri , Hidalgo Ernesto Artavia , Breedy Marcelo J. Mainieri
Published: March 2021

Determinar la sensibilidad y especificidad de la mediastinoscopia para diagnóstico y estadiaje de enfermedades del tórax.
La implementación del abordaje colaborativo en Costa Rica: hacia una integración entre la psiquiatría
Authors: González Ricardo Millán
Published: March 2021

La Organización Mundial de la Salud ha postulado que para reducir la brecha de tratamiento, la inversión en salud mental debe centrarse en la atención primaria. El abordaje colaborativo es una metodología estandarizada que cuenta con evidencia científica de efectividad y costo - efectividad en estas poblaciones.
Enfermedades: raras, un verdadero reto
Authors: Vargas Carlos Salazar
Published: March 2021

En estos días se ha dado a conocer en la prensa nacional el caso de unas pacientes con enfermedad de Pompe y la necesidad que tienen que la CCSS, les provea un medicamento que supuestamente puede paliar dicha patología. El medicamento no solo es caro, sino que su eficacia no está completamente demostrada, según la publicación periodística. Esta situación debe hacernos reflexionar sobre el tema de las enfermedades raras (ER), de pacientes que las padecen y de sus familiares.
Efectividad del alendronato más calcio y vitamina D, comparado con calcio y vitamina D para la prevención de la fractura de cadera
Authors: Costarricense Acta Médica
Published: March 2021

Este artículo de Monge-Vargas y cols publicado en Acta méd. costarric. 58(4):155, describe un estudio observacional, analítico de todos los pacientes atendidos en la Caja de Seguro Social que recibieron alendronato 70 mg semanales calcio y vitamina D (Grupo A) o con calcio y vitamina D indicado como grupo control (Grupo C). Existen varios puntos discutibles en cuanto a la metodología y resultados del mismo
Intolerancia a la lactosa
Authors: De Céspedes Montealegre Carlos
Published: March 2021

La lactasa es una disacaridasa que desdobla específicamente la lactosa de la leche en sus monosacáridos componentes, la glucosa y la galactosa que consecuentemente son absorbidos a nivel del yeyuno. La lactosa que pasa al colon es desdoblada por la ß -galactosidasa, una enzima de la flora bacteriana normal, y al carecer el colon de los sistemas de transporte para la glucosa y la galactosa, estas son metabolizadas por las bacterias de la misma flora a ácidos orgánicos de cadena corta (3-4 carbonos), con la producción concomitante de gas hidrógeno (H2), con la consecuente diarrea osmótica y sus signos acompañantes de dolor abdominal, borborigmos y flatulencia, lo cual conforma el cuadro clínico de la intolerancia a la lactosa. Variaciones en la composición del microbioma intestinal, pueden explicar en parte las diferencias individuales en las manifestaciones clínicas ante ingestas de cantidades similares de lactosa.

La intolerancia a la lactosa se debe en principio a una disminución o ausencia de la actividad de la lactasa. La enzima se encuentra integrada a la membrana del enterocito en el borde en cepillo del epitelio del yeyuno, lo cual dificulta la medición directa de su actividad en la práctica ante la necesidad de obtener una biopsia. De hecho, la medición del H2 en el aire espirado es la forma más práctica hasta ahora, de estimar la actividad de la lactasa en la clínica. La adición de una prueba de tolerancia a la lactosa con medición de la glucosa sanguínea aumenta significativamente la confiabilidad de los resultados.

En medicina, usualmente se clasifica la deficiencia de lactasa en primaria y secundaria. Se considera deficiencia secundaria de la lactasa a la actividad decreciente de la enzima que resulta del daño en el epitelio intestinal provocado por trastornos inflamatorios como la enfermedad de Crohn, por diarreas de origen infeccioso o por desnutrición. En el presente editorial no nos referimos a la deficiencia secundaria de la lactasa.
Barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica
Authors: Rivera Chavarría Ana , Sánchez Hernández Germana , Espinoza Aguirre Azálea
Published: March 2021

Objetivo: analizar barreras y facilitadores relacionados con el diagnóstico de la lepra en Costa Rica, desde la perspectiva de la persona con la enfermedad y en el contexto de la vida cotidiana.

Métodos: se llevó a cabo un estudio cualitativo de carácter exploratorio a partir de 25 entrevistas semiestructuradas, a personas con lepra o con antecedente de haberla padecido, de entre 23 y 88 años, atendidos en el sistema de salud público costarricense. A partir del análisis de los datos cualitativos, las barreras y facilitadores se agruparon en factores personales, culturales y la oferta de los servicios de salud.

Resultados: en relación con los factores personales, la mayoría de los participantes reportó no poseer conocimiento ni conciencia previa a la enfermedad. El temor a ser estigmatizado, la sintomatología intermitente, sentirse bien, compromisos laborales y familiares, fueron percibidos como barreras. Entre los factores culturales, algunas creencias religiosas fueron percibidas como barreras, y la historia familiar de lepra como facilitador en términos de la búsqueda de atención y diagnóstico. Con respecto a los servicios de salud, el acceso oportuno a citas con personal de salud informado, la telemedicina y médicos de la familia, fueron citados como facilitadores.

Conclusiones: las principales barreras y facilitadores descritos en los resultados del estudio deben ser tomados en cuenta a fin de contribuir a la detección y tratamiento oportuno de la lepra, para curar la enfermedad, evitar la discapacidad y eliminar la transmisión.

Descriptores: lepra, barreras de acceso a los servicios de salud, diagnóstico precoz, análisis cualitativo, Costa Rica.
DETERMINANTS OF THE PERFORMANCE OF DEVELOPMENT PROJECTS IN DEVELOPING COUNTRIES
Authors: Nanéma Dr. Mahamadi , Nassè Dr. Théophile Bindeouè , Ouédraogo Prof .  Alidou
Published: March 2021

This article aims to analyze the determinants of the performance of development projects in developing countries in general and in particular in the Burkinabé context. This involves identifying the internal and external factors that explain the performance of development projects in the Burkinabé context. The methodology used is essentially based on the hypothetico-deductive approach which led to the definition of a sample of 44 respondents on the quantitative aspect of the study. The results of the study show that two explanatory variables positively and significantly influence the performance of development projects in Burkina Faso. This concerns in particular the technical organization of projects and the environment or the project intervention area. Notwithstanding these results, recommendations are formulated for more efficiency in the implementation of development projects.
Keywords: Performance, Project Management, World Bank, Project Management.
Contributions to Positive Sexuality from the Zen Peacemakers
Authors: Pliskin Eli
Published: March 2021

Inspired by a lineage of Zen Buddhism, Zen Peacemakers provides a transformational path that integrates theory and practices, including meditation, Nonviolent Communication (NVC), the Way of Council, Bearing Witness Retreats, activism, and social enterprise. As an ordained Minister in the lineage who personally apprenticed with co-founder Bernie Glassman, I have seen these principles and practices provide great benefit. This article will highlight some of the many possible theoretical and practical points of resonance between Zen Peacemaking and the Eight Dimension Model of the Center for Positive Sexuality (CPS) (Williams, Thomas, Prior, & Walters, 2015) by suggesting how this rich and cohesive peacemaking methodology might help actualize each of the eight dimensions of positive sexuality, one dimension at a time. The eight dimensions are: (a) peacemaking, (b) multiple ways of knowing, (c) open, honest communication, (d) ethics, (e) application across all levels of social structure, (f) strengths, wellbeing, and happiness, (g) the recognition that individual sexuality is unique and multifaceted, and (h) humanization.
List of 2021 Health Technology Trends to Watch
Authors: Horizon Scanning Service CADTH
Published: March 2021

The CADTH Horizon Scanning Service identifies and monitors new and emerging health technologies likely to have a significant impact on health care in Canada. This Watch List focuses on those categories of medical devices, clinical interventions, or other health technologies that are, or may become, important or disruptive to Canadian health care or decision-making in the next few years.
Among others, the trends and technologies featured in this Watch List include:

developments of artificial intelligence within imaging technologies
greater integration and connectedness of wearables to improving patient monitoring systems
proliferation of transcatheter valve devices driving innovations for interventional cardiology
increasing interest and development of non-pharmacological solutions for pain management
rapid growth in technologies and digital services enabling virtual care
Gravity Drainage Versus Forced Suction Drainage for Patients With Excess Fluid in Pleural or Peritoneal Spaces
Authors: Li Yan , Argáez Charlene
Published: March 2021

The evidence for chest drainage with gravity compared with forced suction was mixed. Two randomized controlled trials included in 2 systematic reviews with meta-analysis suggested that there is no difference between chest drainage with gravity versus forced suction regarding the risk of prolonged air leak, or post-operative pneumothorax and the duration of chest tube drainage, or hospital stay, following lung cancer surgery. However, 1 randomized controlled trial included in a systematic review with meta-analysis suggested that chest drainage with gravity resulted in a shorter duration of chest tube drainage and hospital stay compared to forced suction following lung cancer surgery.

One guideline suggests that chest drainage with forced suction does not provide additional benefits for patients undergoing lung surgery compared to gravity drainage.

There is a lack of relevant literature and guidelines on the clinical effectiveness or use of abdominal space drainage with gravity or forced suction.
Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment
Authors: Wells Charlotte , Severn Melissa
Published: March 2021

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment.

Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment.

The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high.

The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.
Rapid Testing for the Diagnosis of Pulmonary Tuberculosis and Rifampicin Resistance: A Review of Cost-Effectiveness
Authors: Subramonian Anusree , Severn Melissa
Published: March 2021

The evidence regarding the cost-effectiveness of the Xpert Mycobacterium tuberculosis complex and resistance to rifampicin (Xpert MTB/RIF) test compared with smear microscopy in diagnosing tuberculosis is summarized in this report.

Results from the included 6 studies showed that Xpert MTB/RIF testing is a cost-effective option compared with sputum smear microscopy. However, the generalizability of the results to the Canadian setting are unclear because of the clinical data source populations, willingness-to-pay thresholds, and assumptions used in the analyses.

There is a lack of evidence regarding the cost-effectiveness of Xpert MTB/RIF testing compared with mycobacterial cultures or culture-based susceptibility testing.
Método experiencial e avaliação em profundidade: novas perspectivas em políticas públicas
Authors: Carvalho Rodrigues Lea
Published: March 2021

O artigo apresenta duas propostas de avaliação de políticas públicas que se interconectam. A desenvolvida por Raul Lejano (2012), centrada na noção de experiência, e a desenvolvida por Lea Rodrigues (2008, 2011a) com foco em análise de categorias do entendimento, noções de tempo (percursos e trajetória) e espaço (territorialidade). Apresenta-se as duas propostas e, em seguida, de forma esquematizada, seus pontos de conexão e diferenciação. Por fim, se tomará um setor específico das políticas públicas, o turismo como estratégia de desenvolvimento, e se apresentarão alguns aportes analíticos com base nas referidas propostas.
Intransigência, falácia e ilusão: a reação conservadora contra a previdência e seguridade social no Brasil
Authors: Godinho Delgado Ignacio
Published: March 2021

O artigo analisa a reforma da previdência impulsionada pelo presidente Bolsonaro. Seu primeiro propósito é identificar os elementos comuns à retórica conservadora e reacionária que acompanha, no Ocidente e no Brasil, todas as medidas que envolveram o progresso social e a expansão da cidadania, agora dirigida contra a seguridade social brasileira, instituída na Carta de 1988. Também são apresentados dados e argumentos produzidos pela Associação Nacional dos Auditores Fiscais da Receita Federal do Brasil (ANFIP), principalmente, e autores que têm se dedicado ao tema, que afirmam a falácia do diagnóstico sobre a crise da previdência. Além disso, aponta que tal diagnóstico não considera outras possibilidades de lidar com os possíveis dilemas atuariais da previdência social, por estar eivado de um certo malthusianismo, que negligencia o impacto do desenvolvimento tecnológico sobre o mercado de trabalho e o nível de renda global da economia
O novo marco legal de ciência, tecnologia e inovação no Brasil: desafios para a universidade
Authors: Nunes Gimenes Ana Maria , Machado Bonacelli Maria Beatriz , Delpino Bambini Marta
Published: March 2021

Este artigo promove uma reflexão sobre a evolução da legislação brasileira relacionada à Ciência, Tecnologia e Inovação (CT&I), do ponto de vista das Universidades inseridas em um Sistema Nacional de Inovação. O estudo teve características empírico-teóricas e natureza qualitativa, buscando identificar os principais desafios que se colocam às Universidades para a assimilação do novo Marco Legal de CT&I (MLCTI). Os resultados indicam que apenas a promulgação de novas leis não leva a uma mudança substancial no posicionamento dos atores envolvidos, incluindo as Universidades. Há que se compreender, para isso, as possibilidades abertas pelo MLCTI e desenvolver uma cultura e um ambiente institucional mais adequados ao novo contexto, estabelecendo pontes com o setor produtivo, a partir de diferentes estratégias e políticas.
Neo-Liberalism and the Rise of Right-Wing Conservatism in India
Authors: Mazumdar Surajit
Published: March 2021

This paper assesses the origins and the consequences of the decisive right wing shift in Indian politics ushered in by the 2014 elections. Tracing this to long-term but not linearly developing tendencies in Indian politics, the paper relates these with the distinctive nature and history of capitalist development in India, particularly the sharply polarizing growth and accumulation regime of the neo-liberal era and the crisis it now confronts. Asserting that the electoral success of the Narendra Modi-led BJP was based on it being the political agent of not change but of a reassertion by India’s economic elite, the paper explains the challenge of managing sharply contradictory interests that this places in the path of the consolidation of the new regime.