bluuebunny/crossref_metadata_2025 huggingface dataset:
First-pass Success Rate and Number of Attempts Required for Intubation in Anticipated Difficult Airway
Authors: Raja Rameez , Gupta Sunana , Mehta Nandita , Attal Prerna
Published: October 2022

Background and Aims:

Video laryngoscopy has been shown to improvise Cormack–Lehane grading and rate of successful tracheal intubation and is now incorporated in most of the difficult airway guidelines. Since there is scarce literature regarding the use of channeled blade of King Vision video laryngoscope (KVVL) in anticipated difficult intubation, we planned to undertake this randomized control trial to assess the performance of channeled blade of KVVL and Macintosh laryngoscope in patients with anticipated difficult intubation.

Design and Setting:

This prospective randomized study was conducted in a tertiary care hospital.

Materials and Methods:

Patients fulfilling the inclusion criteria were randomly assigned equally to the KVVL group or Macintosh group. The primary outcome of the study was intubation success in the first attempt and number of attempts required for intubation, and the secondary outcomes were Cormack–Lehane grading and time required to intubate in both the groups.

Results:

The first-pass success of intubation was 88.6% in the KVVL group and 76.5% in the Macintosh group (P = 0.035). The second attempt of intubation was required in 11.4% and 20.6% of patients in the KVVL and Macintosh groups, respectively. Cormack Lehane Grade I was achieved in 100% of patients of the KVVL group as compared to 29.4% of patients in the Macintosh group. Moreover, the difference was statistically significant (P = 0.035). The mean duration of intubation was prolonged in the KVVL group as compared to the Macintosh group, and the difference was statistically significant (P = 0.04).

Conclusion:

The channeled blade of KVVL had a higher first-pass success rate and required fewer attempts to intubate when used in patients with anticipated difficult intubation. Further, the KVVL was found to be significantly better than the Macintosh laryngoscope in terms of Cormack–Lehane grading, but the time taken to intubate the trachea was more in the KVVL group.
Secondary communicating hydrocephalus management by implantation of external ventricular shunt and minimal gradual increase of cerebrospinal fluid pressure
Authors: Mostofi Keyvan , Samii Madjid
Published: October 2022

Background: This paper presents a new management strategy explaining the process used by implantation of external ventricular drainage (EVD) and very gradual increase of intracranial pressure for treatment of acute hydrocephalus. During the last 30 years' experience in professional practice, the senior author (M.S.) discovered that there are some options of regulations between cerebral spinal fluid (CSF) production and resorption. This theory shows that minimal continuous increase of the CSF pressure as long as the patient general neurological condition is unchanged and appears as normal can lead to definitive treatment of hydrocephalus without needing to set a shunt. Gradual weaning from EVD is used in some neurosurgical centers related to aneurismal subarachnoid hemorrhage only in a way to treat hydrocephalus in the acute phase, but not as an alternative curative treatment for hydrocephalus, and as far as we know this
procedure has not been presented to date in medical literature in this form and this purpose. Materials and Methods: Between July 2000 and November 2012, 16 patients suffering from acute secondary hydrocephalus were treated by the method described in the International Neurosciences Institute in Hannover (Germany). Results: The causes of hydrocephalus were brain tumors (12), arteriovenous malformations (2), one cavernoma, and one polytrauma. In 11 patients (68.75%), the procedure led to a complete cure and surgical treatment has been excluded after EVD removal without any risk to the patients. Conclusions: Minimal gradual increase of CSF pressure by EVD implantation for the treatment of secondary acute communicating hydrocephalus used by senior author as an option is a safe alternative treatment of hydrocephalus and may obviate the need for surgical procedures.
Central Venous Pressure as End-Point Fluid Removal in Drowning Patients
Authors: Lantang Eka Yudha , George Yohanes , Sugiarto Adhrie , Diana Arifah
Published: October 2022

Central venous pressure (CVP) is used as a guidance to control hemodynamics and to achieve the efficacy of hemodynamic balance. The drowning patient experienced a laryngeal spasm, which caused water passively enter the respiratory tract and accumulated in the lungs. Excess fluid in the lungs leads to pulmonary hypertension, venous congestion, and increased CVP. The use of diuretics guided by CVP values is the best way to achieve hemodynamic balance. Two drowning patients in different water had an increased CVP up to 12 mmHg in the sea, with serum creatinine (sCr) of 0.5 mg/dL and cumulative fluid balance (CFB) of −250 cc, and others in the lake CVP up to 14 mmHg with sCr of 0.7 mg/dL and CFB of −320 cc. Both were given furosemide at a dose of 5 mg from the first day of treatment until day 5 when both patients’ CVP returned to normal values, CVP of 5 mmHg, sCr of 0.6 mg/dL, and CFB of −1105 cc, and the others with CVP of 1 mmHg, sCr of 0.6, and CFB of −1170, then furosemide was discontinued. The use of furosemide with CVP guidance shows effective results in reducing fluids and venous congestion and is safe for the kidney, which is marked by normal values of sCr and CFB.
A proposed five-step simplified algorithm for the management of hepatocellular carcinoma in India
Authors: Arora Anil , Singal Ashwani K. , Sharma Praveen , Kumar Ashish
Published: October 2022

Hepatocellular carcinoma (HCC) is the eighth-most frequent cause of cancer mortality in India. The staging system most often used for treatment decisions in India is the Barcelona clinic liver cancer (BCLC) system. However, this staging system is often criticised for several reasons, such as heterogeneity of patient prognosis in each BCLC stage, limited guidance on expanding the role of liver transplantation (LT), no recommendation on combination therapies, no guidance on downstaging and limited treatment options for late presenters (stages C or D). Hence, we propose a simplified five-step algorithm for making treatment decisions for HCC patients in India. This algorithm incorporates evidence-based treatment allocations based on the step-by-step assessment of major prognostic and treatment-related parameters. The five steps of the algorithm are – Step 1: assessment of performance status, Step 2: assessment of extrahepatic spread and macrovascular invasion, Step 3: assessment for living donor LT, Step 4: assessment for the eligibility of liver resection and Step 5: assessment for appropriate locoregional therapy. Each of these steps does not require any separate investigations, and the initial workup for the diagnosis of HCC (dynamic computed tomography/magnetic resonance imaging and routine laboratory tests) would suffice in this five-step algorithm. We hope that this algorithm will not only simplify the management approach to HCC patients in India, but also it will bring uniformity in the treatment protocol for HCC in India.
Evaluation of Inhaler Technique and Asthma Control Among Children in a Low-Resource Setting
Authors: Prasad Harit , Ghosh Sohini , Das Sai Chandan , Manasa R. V.
Published: October 2022

Background:

Inhalation has become the preferred route of drug administration compared to oral medication in managing Asthma due to its direct delivery to the airways, thus producing a faster onset of action and fewer systemic side effects at lower doses than would be required for other routes of administration.

Aims and Objectives:

This study aimed to evaluate the inhaler technique among children with asthma and its association with the level of asthma control and to identify factors associated with improper use of inhaler devices.

Materials and Methods:

This is a prospective cross-sectional study conducted at the Department of Pediatrics at B. P Koirala Institute of Health Science, university teaching Hospital in Nepal. The children with asthma were asked to use their inhaler device as usual and inhalational technique was assessed using inhaler device assessment tool and control of asthma level was assessed using the Childhood Asthma Control Test score.

Results:

One hundred and three asthmatic children of the age range of 4–11 years were enrolled in the study. The mean age of surveyed children was 6.3 ± 2.2 years and over half of the participants were boys (68.9%). Around 60% had moderate asthma. Among them, 50% had symptoms for <3 years; only 50% of children with asthma demonstrated good technique of inhaler medication. Forty-five percent of them showed optimal asthma control. Near about a quarter of the participants showed mistakes in one step and about a fifth of the children showed mistakes at more than one step. Almost 30% of children with asthma have not obtained inhaler technique education. Factors associated with poor inhaler technique and poor asthma control were younger age and irregular follow-ups. The most common errors in the proper use of inhalers were not shaking the inhaler before use (30%) and wrong breathing techniques (30%).

Conclusions:

Improper inhaler technique is common among children with asthma. Children with asthma should have their inhaler technique routinely checked, during visits and should be given detailed education on proper inhalation techniques. Health education programs on asthma control are recommended in countries like Nepal to improve proper asthma inhaler device use and treatment outcomes in children with asthma.
Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism
Authors: Rathi Manisha , Dahiya Monika , Dabas Ruchi , Rustagi Inder Mohan , Sachdeva Sumit , Dhania Sweety
Published: October 2022

Purpose:

To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications.

Methods:

A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ≥ grade 4, “with the rule” astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with “against the rule” astigmatism, keratoconus, pre-existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded.

Results:

The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications.

Conclusion:

SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture.
Evaluation of cautery in manual small-incision cataract surgery
Authors: Bahl Vishwa Jyoti , Malik Krishan Pal Singh , Guliani Braham Prakash
Published: October 2022

Purpose:

Manual small-incision cataract surgery (MSICS) has a major role in tackling cataract blindness in our country. Cauterization of sclera is one of the important steps performed in MSICS to have bloodless field during surgery. Only few studies have addressed the effect of cautery on post-operative astigmatism. The present study is designed to evaluate the effect of cautery on surgically induced astigmatism in Indian patients.

Methods:

The study was designed as a prospective randomized trial conducted in a tertiary health care institution over a period of 2 years. A total of 150 eyes were randomized into two groups. The study group (Group 1, n = 75) underwent MSICS with cauterization using wetfield bipolar cautery with 4 amperes power. In the control group (Group 2, n = 75), no cauterization was performed. Surgically induced astigmatism was calculated using Naesers polar value method and compared between these two groups up to 60 days post-operatively.

Results:

Data from 150 eyes were available for evaluation. The net post-operative astigmatic value was 1.01 ± 0.21, 1.04 ± 0.19, and 1.03 ± 0.22 D on the 1st, 7th, and 30th post-operative days, respectively, showing a stable trend in patients undergoing cauterization. In Group 2, the net post-operative astigmatic values observed were 0.47 ± 0.11 D, 0.54 ± 0.10, and 0.54 ± 0.09 D on the 1st, 7th, and 30th post-operative days, respectively. The mean value of surgically induced astigmatism at 2 months post-operatively with and without cautery was 0.60 ± 0.20 D at 90° and 0.47 ± 0.10 D at 90°. The difference was not statistically significant (P = 0.08).

Conclusion:

The results of this study show that the use of cautery in MSICS is not associated with a higher surgically induced post-operative astigmatism. The magnitude of surgically induced astigmatism decreases with time.
Safety and efficacy of manual small-incision cataract surgery in patients with brunescent and black cataracts and other ocular comorbidities
Authors: Gajraj Manju , Mohan Amit
Published: October 2022

Purpose:

To determine the safety and efficacy of manual small-incision cataract surgery (MSICS) for brunescent and black cataracts in patients with other ocular comorbidities.

Methods:

Medical records of patients with hard cataracts (grade 4 nuclear opalescence and above) with other ocular comorbidities such as spheroidal degeneration of the cornea (SDC), pseudoexfoliation (PXF), non-dilating pupil, and high myopia who underwent MSICS were retrieved retrospectively. Intraoperative and postoperative complications were noted. Preoperative and postoperative visual outcome comparisons were performed using paired t-tests. Statistical significance was set at P < 0.05.

Results:

A total of 124 cataract patients with brunescent or black cataracts and other ocular comorbidities underwent surgery during the study period. They ranged in age from 56 to 89 years (mean: 68.9 + 11.9 years), with 55.66% (n = 69) of the patients being female and 44.35% (n = 55) male. Of the 124 cases, 45.16% (n = 56) had SDC, 31.45% (n = 39) had PXF, 14.51% (n = 18) had non-dilating pupils, and 8.87% (n = 11) had high myopia. Preoperatively all patients had visual acuity <6/60. At 1 month postoperatively 77.4% of patients achieved good vision >6/18, 16.9% had a borderline vision (6/18–6/60), and 5.6% had a poor vision (<6/60). No serious complications were observed. One patient had posterior capsular rent in a case of high myopia, and two cases had zonular dialysis for pseudoexfoliation.

Conclusion:

MSICS with intraocular lens implantation is safe and effective in eyes with brunescent/black cataracts if associated with SDC, PXF, high myopia, and non-dilating pupils and provides good visual outcomes with minimal complications.
Endoexpression technique of nucleus delivery in manual small-incision cataract surgery
Authors: Boramani Jagannath , Bali Jatinder , Boramani Priyanka , Bali Ojasvini
Published: October 2022

Manual small-incision cataract surgery (MSICS) is a cost-effective alternative to phacoemulsification and extracapsular cataract extraction (ECCE) for cataract surgery. The surgical technique in MSICS is heterogeneous, and the maximum variation exists in incision and nucleus delivery techniques. Many studies on various incisions are available, and most of them are dedicated to surgically induced astigmatism (SIA), utility, and visual outcomes. The nucleus delivery techniques have less-extensive literature available. They can be divided into “pulling” techniques like phacosandwich technique, fish hook technique, and vectis delivery and “pushing” techniques like viscoexpression or hydroexpression with irrigating vectis/Blumenthal’s MiniNuc technique. Postoperative surgical-induced astigmatism is comparable in all techniques. The authors describe a pushing technique which does not raise the pressure of the anterior chamber and can be utilized with variable-sized and irregularly shaped nuclear fragments. It has universal application, especially when the size of the incision is getting smaller in MSICS and phacofragmentation is being used as an adjunct to reduce the incision size. It can be used in situations like posterior polar cataracts, where pressure variations in the anterior chamber can be dangerous.
Comparative study of anatomical and functional recovery of eye along with patient satisfaction score after small-incision cataract surgery and phacoemulsification cataract surgery
Authors: Dole Kuldeep , Baheti Neha , Deshpande Rahul , Kulkarni Sucheta , Shetty Rakesh , Deshpande Madan
Published: October 2022

Purpose:

Functional recovery after cataract surgery depends on the anatomical recovery of the eye. This study compared the improvement in visual function parameters after uniocular manual small-incision cataract surgery (MSICS) and phacoemulsification cataract surgery.

Methods:

This study included 310 patients divided randomly into two groups: 155 who received MSICS (MSICS group) and 155 who underwent phacoemulsification (phaco group) for cataract treatment. Outcome measures assessed included vertical and horizontal keratometry reading. The mean corneal astigmatism tear function measured using Schirmer 1 test results were recorded preoperatively, and on postoperative day 1, day 7, and day 30. Optical coherence tomography (OCT) was done to record the average central macular thickness (μm) on day 7 and day 30.

Results:

The mean corneal astigmatism and anterior chamber inflammation were more in the MSICS group than in the phaco group immediately postoperatively. However, no statistically significant difference was found between the groups with respect to corneal sensation, mean corneal astigmatism, tear film function, and visual outcomes on postoperative day 30. Uncorrected visual acuity was better in the phacoemulsification group than in the manual SICS group on postoperative day 1, day 7, and day 30 (P < 0.001).

Conclusion:

Both phacoemulsification cataract surgery and manual small-incision sutureless cataract surgery (MSICS) are safe and effective for visual rehabilitation. Phacoemulsification is the preferred technique where resources are available with the advantages of less mean corneal astigmatism, less anterior chamber inflammation, and better uncorrected visual acuity (UCVA) in the immediate postoperative period.
Modified small-incision cataract surgery for combined extraction – A comparative study of two techniques
Authors: Khan Lubna , Verma Sonam
Published: October 2022

Purpose:

To explore straight incision technique in terms of efficacy for intraocular pressure (IOP) lowering by small-incision cataract surgery (SICS) trab versus modified “frown” incision with triangular scleral flap technique.

Methods:

This study was done at a tertiary health center. It included 44 eyes diagnosed with cataract and coexisting primary glaucoma that underwent SICS with trabeculectomy using modified “frown” incision with triangular scleral flap technique and straight incision in group A (n = 22) and B (n = 22), respectively. Postoperative evaluation was done at first postoperative day, then at the end of first week, third week, and 6 weeks; at the end of third month and finally at the end of sixth months. Data were entered and analyzed via Microsoft Excel sheet and SPSS software using Mann–Whitney U test for averages and Chi-square test for categorical values.

Results:

Mean preoperative IOP in groups A and B were 38.6 and 29.1 mm Hg respectively, by applanation tonometry. After 6-month follow-up, mean of difference in IOP (preoperative – postoperative) for group A was 20.8 ± 8.3 mm Hg and that for group B was 17.2 ± 13.5 mm Hg.

Conclusion:

Capacity of IOP reduction of both techniques was found to be comparable and did not show much difference up to the end of 6 months. Mastering technique of group A (modified “frown” incision with triangular scleral flap technique) requires more expertise; the simpler straight incision technique provided in group B may be effectively used by the novice and current era Ophthalmologists to combat glaucoma coexistant with cataract.
Role of single-ring oval disposable wound protecting device in preventing surgical site infection in laparoscopic colorectal resections
Authors: Kurumboor Prakash , Chacko Sidharth , Vipin I. S. , Prakash Rohan , Pal Ashna S.
Published: October 2022

Context:

Surgical site infections (SSI) continue to be a major cause of morbidity, mortality, prolonged hospital stays and a major reason of financial burden to health-care providers and patients after major abdominal surgeries. Along with infection control practices and care bundles, additional use of devices which protect the wound from contamination is believed to decrease the burden of SSI.

Aims:

This study aims to assess the benefit of single-ring disposable wound protector in preventing SSI, overall complications, hospitals stay and morbidity data in laparoscopic colorectal resection.

Settings and Design:

The study design involves case–control study, retrospective.

Subjects and Methods:

A case–control study comparing single ring oval wound protector versus conventional wound protectors retrospectively between August 2019 and December 2021. The ease of use of the device, rate of SSI, overall complications, hospitals stay and morbidity data were analysed.

Statistical Analysis Used:

The statistical analysis was performed by IBM SPSS Statistics 20 version. All Categorical Variables will be described as frequency and percentage. Continuous variables will be described as mean ± standard deviation. Continuous variables were analysed using t-test and categorical parameters using Fisher’s exact test.

Results:

Of the 110 patients studied, wound Protecting devices were used in 58 patients Wound Protector Group (WPG group) and 62 patients did not use such devices (no WPG). The groups were comparable in demographic features, risk features, systemic illness, type of surgeries undertaken and the specimen extraction wound used. There was a significant decrease in the incidence of SSI (1.7% vs. 16% P ≤ 0.008) and the hospital stay (P ≤ 0.03) when WPG was used compared to the group in which it was not used.

Conclusions:

Apart from the use of infection control practices and care bundles, the use of oval-shaped single-ring wound protector is likely to reduce SSI.
Laparoscopic management of symptomatic urachus remnants in adults: A retrospective study
Authors: Bawahab Mohammed A.
Published: October 2022

Aim:

To report our experience in the laparoscopic management of symptomatic urachal remnants (URs) in adults.

Patients and Methods:

A retrospective study included all patients who underwent laparoscopic excision of URs during the period January 2015–January 2020. The following data were retrieved from the files of the patients: demographic data, clinical presentations, intra-operative findings, the procedure performed, operative details, intraoperative or post-operative complications and follow-up period mentioned in the files for those patients.

Results:

The study included 10 patients (four males and six females) with a mean age of 27.8 ± 11.0 years. URs were discovered preoperatively in all patients except one patient who was diagnosed intraoperatively. URs were associated with other pathologies in four patients (40%) that required two simultaneous surgical procedures. Eight patients (80%) presented with simple umbilical discharge and were diagnosed easily by ultrasonography. All patients were managed successfully with laparoscopic excision and umbilical sparing technique. Excision of the dome of the bladder was done on the selective approach to one patient. No patients showed early post-operative complications. Only one patient had stitch sinus 6 months postoperatively due to a concomitant hernia repair rather than due to the excision of the URs.

Conclusions:

Laparoscopic excision of symptomatic urachus is a feasible procedure even when the excision of the bladder is required. It could be performed successfully with other pathologies. It is associated with a low incidence of complications. Laparoscopy allows good visualisation and complete excision that leads to almost no recurrence rate.
Comparison of pulmonary computed tomography scan findings and clinical symptoms of COVID-19 in three outbreak peaks in Isfahan, Iran
Authors: Soufi Ghazaleh Jamalipour , Hekmatnia Ali , Zarei Andrew Parviz , Hekmatnia Farzaneh , Shafieyoon Shamim
Published: October 2022

Background:

The aim of the present study was to investigate and compare the relationship between the anatomical distribution of pulmonary lesions in computed tomography scan of patients with COVID-19.

Materials and Methods:

This is a cross-sectional study that was performed in 2020–2021 in Isfahan on 300 patients infected with COVID-19 pneumonia. We collected data on the age, gender, and comorbidities of patients. In addition, we gathered data on the clinical manifestations of the patients from their medical records.

Results:

We noted a significant decline in symptoms such as fever and sputum production in the second and third peak in comparison to the first peak (P < 0.05). Moreover, cough and muscular pain were higher in the second and third peaks compared to the first peak (P < 0.05). Cough was the most common clinical manifestation related to the peripheral distribution of the involvements, bilateral lung disease, and right lower lobe (RLL) involvements in the first peak. In the second COVID-19 peak, fever and cough were the most common clinical findings, respectively, that were mostly associated with peripheral distribution and left lower lobe involvement.

Conclusion:

Cough was the most common clinical manifestation related to the peripheral distribution of the involvements, bilateral lung disease, and RLL involvements in the first peak. In the second COVID-19 peak, fever and cough were the most common clinical findings.
Do Pharmacists Have a Compelling Vision for the Future?
Authors: Alderman Chris
Published: October 2022

In some parts of the pharmacy sector, the gains made over the past decades have not filtered down to those directly working with patients. Though pharmacy students in-training can look forward to emerging from their studies into a place to work, many would argue that in some parts of the profession those workplaces are not especially attractive to younger practitioners.
Looking Forward: Disruptive Shifts in Population Health Present Opportunities for Pharmacy
Authors: Antimisiaris Demetra
Published: October 2022

The US Bureau of Labor Statistics current pharmacist's job prediction of negative growth is a snapshot, based on information known at the time of publication (2021-2022). It reflects the employment bandwidth of the current pharmacy ecosystem, in the aftermath of the once-in-a-lifetime, acute COVID-19 pandemic, and current economic turmoil. This report ignores the evolving and yet to be defined future âœnew normalâ of health care as the turmoil of today settles, and the impact of population growth and an aging population take full effect, driving an abrupt shift toward population health approaches to care.
Assessing the Impact of the Consultant Pharmacist on Pneumococcal Vaccine Administration in a Long-term Care Facility
Authors: Dauz Aileen , O’Neil Christine K. , Stewart-Lynch Autumn
Published: October 2022

Objective To describe the impact of consultant pharmacist recommendations on the frequency of pneumococcal vaccines administered to older people admitted to a long-term care facility (LTCF). Design: Retrospective observational study. Setting: LTCF with skilled
and intermediate level care. Participants: Adult patients newly admitted to a LTCF in Southwestern Pennsylvania between December 1, 2016, and November 30, 2017, and between January 1, 2018, and December 31, 2019, were included. Interventions The intervention in the
study was a consultant pharmacist-driven immunization screening service that was implemented as part of the admission medication review process in January 2018. To assess the impact of the service, the pneumococcal immunization rates of patients who were candidates for pneumococcal vaccination
were compared between two patient cohorts who were defined by exposure to the immunization needs assessment and subsequent recommendations by a consultant pharmacist. Results A total of 468 patient admissions were included, with 68 in Cohort 1 and 400 in Cohort 2. Pneumococcal
immunization rate, calculated as number of pneumococcal vaccinations administered over the number of admissions eligible for pneumococcal vaccination, had a statistically significant increase (1.9%-20.2%; P < 0.05). Conclusion The recommendations from a consultant
pharmacist as a result of an immunization needs assessment upon admission to a LTCF significantly contributed to an increased rate of pneumococcal immunizations. Further investigation is warranted to evaluate future strategies to reduce vaccination refusals.
Pharmacists as Health Care Providers: Where Are We Now?
Authors: Baldwin Paul
Published: October 2022

The pharmacy profession is an outlier in the ranks of health care professionals because they are not considered health care providers under the rules of the Medicare program. Other professions, including physical and occupational therapists and dieticians can be directly reimbursed for their services-but not pharmacists. The author discusses the policy and advocacy work that ASCP has been undertaking on the 1135 waiver.
О голоморфных накрытиях плоских областей
Authors: Dubinin Vladimir Nikolaevich
Published: October 2022

Ранее нами было показано, что $p$-листное голоморфное накрытие
областей комплексной плоскости является
экстремальным в принципе мажорации для $p$-листных функций и
квадратичных форм, ассоциированных с функциями Грина этих областей.
В настоящей заметке устанавливаются двойственные принципы мажорации
с участием как функций Грина, так и функций Неймана,
в которых $p$-листное накрытие вновь является экстремальным.
В качестве примеров даны некоторые приложения указанных принципов
в геометрической теории функций.
Библиография: 15 названий.
Эта-инварианты для операторов с параметром,
ассоциированных с действием дискретной группы
Authors: Zhuikov Konstantin Nikolaevich , Savin Anton Yurievich
Published: October 2022

Исследуются $\eta$-инварианты для класса нелокальных операторов
с параметром, ассоциированных с изометрическим действием
дискретной группы степенного роста
на гладком замкнутом многообразии. $\eta$-инвариант определяется
как регуляризация числа вращения. Получена формула для вариации
$\eta$-инварианта при изменении оператора. Результаты основаны
на исследовании асимптотических разложений следов
нелокальных операторов с параметром.
Библиография: 29 названий.
Решения, выраженные через матрицы Коши, для некоторых локальных и нелокальных комплексных уравнений
Authors: Xu Haijing , Zhao Songlin
Published: October 2022

Разработана редукционная техника, основанная на матрице Коши, которая позволяет получать решения редуцированных локальных и нелокальных комплексных уравнений из решений, выраженных через матрицы Коши, для исходных систем до редукции. Путем введения локальных и нелокальных комплексных редукций уравнений типа Абловица-Каупа-Ньюэлла-Сигура изучаются некоторые локальные и нелокальные комплексные уравнения, такие как модифицированное уравнение Кортевега-де Фриза, уравнение синус-Гордона, потенциальное нелинейное уравнение Шредингера и потенциальное модифицированное уравнение Кортевега-де Фриза. Представлены решения этих уравнений, выраженные через матрицы Коши, - солитонные решения и решения, в которых определяющая матрица имеет жорданову форму. Динамическое поведение некоторых полученных решений проанализировано с помощью графиков.
Оператор Шредингера в полуплоскости с условием Неймана на границе и сингулярным $\delta$-потенциалом, сосредоточенным на двух лучах, и системы функционально-разностных уравнений
Authors: Lyalinov Mikhail Anatol'evich
Published: October 2022

Изучается асимптотика по расстоянию для собственной функции оператора Шредингера в полуплоскости с сингулярным $\delta$-потенциалом с носителем, сосредоточенным на двух лучах. Оператор такого типа встречается в задачах рассеяния трех одномерных квантовых частиц с точечным парным взаимодействием при некоторых дополнительных ограничениях, а также в задачах дифракции волн в клиновидных и конусовидных областях. С помощью представления Конторовича-Лебедева задача построения собственной функции оператора сводится к изучению системы однородных функционально-разностных уравнений с характеристическим (спектральным) параметром. Изучены свойства решений такой системы однородных функционально-разностных уравнений второго порядка с потенциалом из специального класса. В зависимости от значений характеристического параметра в уравнениях описаны их нетривиальные решения, собственные функции уравнения. Исследование этих решений основано на сведении системы к интегральным уравнениям с самосопряженным ограниченным оператором, который является вполне непрерывным возмущением матричного оператора Мeлера. Предложены достаточные условия существования дискретного спектра правее существенного для возмущенного оператора Мeлера. Изучены условия конечности дискретного спектра. Эти результаты применяются в рассматриваемой задаче в полуплоскости. С помощью перехода от представления Конторовича-Лебедева к интегральному представлению Зоммерфельда построена асимптотика по расстоянию собственной функции рассматриваемого оператора Шредингера.
Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis
Authors: de Oliveira Jeronymo Neves Ana Carolina , Gomes dos Santos Ana Paula , de Medeiros Regielle Luiza , de Oliveira Jeronymo Ana Júlia , Coelho Neves Guilherme , de Almeida Isabela Neves , Carvalho de Queiroz Mello Fernanda , Lineu Kritski Afrânio
Published: October 2022

Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.
Gençlik Kamplarına Katılan Gençlerin Yeşil Tüketim Profili ile İlgili Farkındalık Tutum ve Davranışlarının İncelenmesi
Authors: ERBAŞ Akın , ŞİRİN Erkan Faruk
Published: October 2022

Bu çalışmanın amacı gençlik kamplarına katılan gençlerin yeşil tüketime yönelik tutumları, subjektif normları, algıladıkları davranışsal kontrolleri, algılanan tüketici etkililikleri, çevresel bilgi ve kaygıları, davranışa yönelik niyetleri ve gerçek satın alma davranışlarını tespit etmek ve bu değişkenler arasındaki ilişkiyi incelemektir. Araştırmada, nicel paradigma kapsamında betimsel model ve korelasyonel model kullanılmıştır. Araştırmanın verileri Gençlik ve Spor Bakanlığına bağlı Çamkoru Gençlik Kampı (Ankara), Yol Konak Gençlik Kampı (Kastamonu) ve Ondokuz Mayıs Gençlik Kampına (Samsun) katılan ve tesadüfi örneklem yoluyla seçilen gençlerden oluşan gönüllü 100 katılımcıdan elde edilmiştir. Araştırmada veri toplama aracı olarak “Kişisel Bilgi Formu” ve “Yeşil Tüketim Davranış Ölçeği” kullanılmıştır. Verilerin analizinde, ilk olarak normallik sınaması yapılmış ve yeşil tüketim davranışına yönelik tutum, subjektif normlar, niyet, algılanan davranışsal kontrol, algılanan tüketici etkililiği, yeşil satın alma davranışı, çevresel bilgi ve çevresel kaygı boyutlarının gençlik kamplarına katılan gençlerin kişisel özelliklerine göre farklılıklarını belirleyebilmek için uygun testler kullanılmıştır. Yapılan analizler sonucunda yeşil tüketim davranışı ölçeği alt boyutlarından tutum, niyet, algılanan tüketici etkililiği ve çevresel kaygı ile cinsiyet değişkeni arasında, çevresel kaygı ile yaş değişkeni arasında, algılanan davranışsal kontrol ile gençlik merkezine üye olma, eğitim ve anne eğitim durumu arasında, tutum ile baba eğitim durumu arasında farklılık belirlenirken diğer değişkenler arasında bir farklılaşma belirlenmemiştir. Son olarak gençlik kamplarına katılan gençlerin Yeşil Tüketim Davranışı Ölçeği alt boyutlarının hem yeşil satın alma davranışı ile hem de genel yeşil tüketim davranışı ile arasında pozitif ve doğrusal anlamlı bir ilişki olduğu belirlenmiştir.
Ampute Futbol Hakemlerinin İş Tatmini ve İş Performansı İlişkisinin İncelenmesi
Authors: EROL Yusuf , YÜKSEL Mehmet Fatih
Published: October 2022

Bu araştırmanın amacı, ampute futbol hakemlerinin bazı demografik değişkenlere göre iş tatmini ile iş performansları düzeylerini incelemek ve aralarındaki ilişki durumunu araştırmaktır. Araştırmanın modeli, genel tarama modellerinden ilişkisel tarama modelidir. Araştırmanın evrenini, 2020-2021 yıllarında Ampute Futbol Liglerinde aktif olarak görev yapan ampute futbol hakemleri oluşturmaktadır. Ulaşılan örneklem grubu (n=86) evrenin %96’sını oluşturmaktadır. Araştırmada veri toplama araçları olarak, Chang ve Chang’ın (2007) geliştirdiği ve Koca ve Yıldız (2018) tarafından Türkçe’ye uyarlanan “İş tatmini ölçeği”, Koca ve Yıldız (2018) tarafından geliştirilen “İş Performansı Ölçeği” kullanılmıştır. Elde edilen veriler SPSS 20.0 programı kullanılarak analiz edilmiştir. Elde edilen verilerin analizinde, ilk olarak betimleyici istatistiksel metotlar (sayı, yüzde, ortalama, standart sapma) kullanılmıştır. Verilerin normal dağılım gösterip göstermediğini tespit etmek amacıyla Kolmogorov-Smirnov test sonuçlarına bakılmış olup verilerin normal dağılmadığı saptanmıştır. Normal dağılım göstermediği için ikili grup karşılaştırmalarında Mann Whitney U Testi, ikiden fazla grup karşılaştırmaları içinse Kruskal Wallis H Testi kullanılmıştır. Ayrıca iş performansı ve iş tatmini arasındaki ilişkiyi ortaya çıkarmak amacıyla da nonparametrik testlerden olan Spearman Sıra Farkları Korelasyon Testi kullanılmıştır. Anlamlılık düzeyi olarak p<0.05 kabul edilmiştir. Araştırma sonucunda; ampute futbol hakemlerinin iş tatmini ve iş performansı düzeylerinde yaş, medeni durum, mesleki kıdem, meslek değişkenlerine göre anlamlı farklılık görülmezken; eğitim düzeyi değişkenine göre ise anlamlı farklılık (p<0.05) olduğu tespit edilmiştir. Ayrıca ampute futbol hakemlerinin iş tatmini ve iş performansı düzeyleri arasında pozitif yönlü ve anlamlı bir ilişki olduğu belirlenmiştir.
Sekiz Haftalık Düzenlenmiş Pliometrik Antrenmanın Müsabık Kadın Taekwondocularda Seçilen Fiziksel ve Fizyolojik Parametrelere Etkisi
Authors: SARISOY Fatih , LÖK Sefa
Published: October 2022

Bu araştırmada kadın taekwondocular da 8 haftalık pliometrik antrenmanın seçilen fiziksel ve fizyolojik parametreler üzerine etkisi incelenmiştir. Araştırmaya Bartın Üniversitesi Beden Eğitimi ve Spor Yüksek Okulu’nda öğrenim gören müsabık 12 deney ve 12 kontrol olmak üzere toplamda 24 kadın sporcu alınmıştır. Deney grubuna pliometrik egzersizler haftada 3 gün olmak üzere toplamda 8 hafta süresince yaptırılmıştır. Kontrol grubu ise normal Taekwondo antrenmanına devam etmiştir. Ölçümler araştırmaya başlamadan önce ve araştırma bittikten sonra yapılmıştır. Verilerin istatistiksel değerlendirilmesi SPSS 16.0 paket programında yapılmış olup, deney ve kontrol gruplarının ön test son test puan ortalamalarının karşılaştırılması için bağımsız gruplarda t testi kullanılmıştır. Deney ve kontrol gruplarının kendi içindeki öntest ve sontest verilerinin değerlendirilmesinde ise eşleştirilmiş örneklemlerde t testi kullanılmıştır. Deney grubu için; anaerobik dayanıklılık testi, esneklik testi, bacak kuvveti testi, sırt kuvveti testi, dikey sıçrama testi, durarak uzun atlama testi, kavrama kuvveti testi ön test ve son test karşılaştırıldığında istatistiksel olarak anlamlı farklılıklar bulunmuştur (p<0,05). Kontrol grubunun öntest ve sontest karşılaştırılmasında ise dayanıklılık, bacak kuvveti ve sırt kuvvetinde istatistiksel olarak anlamlılık saptanmıştır (p<0,05). Sonuç olarak, 8 haftalık pliometrik antrenmanı uygulayan müsabık kadın taekwondocularda fiziksel ve fizyolojik özelliklerinin gelişimine katkı sağladığı ve pliometrik çalışmaların taekwondo sporuna uygun olduğu görülmüştür.
Türkiye İşitme Engelli Erkek Milli Basketbolcularda Dinlenme ve Yorgunluk Görsel-Motor Reaksiyon Sürelerinin Karşılaştırılması
Authors: TATLICI Ali , ÖZER Ömer
Published: October 2022

Basketbolun oyun hızı düşünüldüğünde reaksiyon süresi çok önemli bir yere sahiptir. Ancak işitme engelli olimpik basketbolcuların reaksiyon sürelerine ilişkin sınırlı sayıda çalışma bulunmaktadır. Yorgunlukta reaksiyon süreleri üzerine yapılan çalışmalar ise daha da azdır. Bu çalışmanın amacı, Türkiye işitme engelli erkek milli basketbolcuların dinlenme ve yorgunluk halindeki görsel-motor reaksiyon sürelerinin araştırılmasıdır. Çalışmaya 13 basketbolcu (Olimpiyat düzeyinde işitme engelli sporcular) (yaş 25.92±4.9 yıl, boy 184.15± 10.22 cm; vücut ağırlığı 88.53± 20.29 kg) katılmıştır. Deneklere standart bir ısınma uygulanmış ve ardından baskın elde ve diğer ele 3 kez fit-light reaksiyon cihazında (Fitlight Sports Corp., Kanada) görsel-motor reaksiyon testi uygulanmıştır ve en iyi süreleri kaydedilmiştir. Ardından, yorgunluk yaratmak için deneklere yo-yo aralıklı toparlanma testi seviye1 (Yo-Yo IR1) uygulanmıştır. Katılımcılar Yo-Yo IR1'i tamamladıklarında hemen sonra görsel-motor reaksiyon testine başlamışlardır. Ortalama reaksiyon süresi fitlight cihazı tarafından otomatik olarak kaydedilmiştir. Verilerin analizinde SPSS paket programı kullanılmış ve eşli karşılaştırmalarda paired sample t-testi kullanılmıştır. Baskın ve baskın olmayan ellerin ön test ve son test süreleri karşılaştırıldığında (dinlenme ve yorgunluk arasında) anlamlı bir farka rastlanmamıştır. Ayrıca, dinlenme ve yorgunlukta baskın ve baskın olmayan eller arasında anlamlı bir fark bulunamamıştır. Elde edilen sonuçlara göre işitme engelli oyuncuların görsel tepki sürelerinin bireysel özelliklerine ve antrenman seviyelerine göre değişiklik gösterebileceği söylenebilir.
Implementasi ISPS Code Terkait Dengan Pelaksanaan Drill dan Exercise di Pelabuhan Tanjung Emas
Authors: Kensiwi Fitri , Maharani Atria , Riyanto Riyanto
Published: October 2022

Indonesia has ratified the International Convention for the Safety of Life at Sea (SOLAS Convention) and is now making plans for the security of port facilities, building facilities, installing equipment for security, training security officers, and so on based on the ISPS Code. However, there are still problems that arise, such as the lack of facilities and equipment for security and the performance of the security system which is still considered inadequate. This study aims to determine the need for the implementation of ISPS Code drill and exercise, as well as to determine the effect of the ISPS Code implementation related to the implementation of the drill and exercise on security at Tanjung Emas Port. Qualitative descriptive method that describes the implementation of the ISPS Code related to implementation of drill and exercise at the Port of Tanjung Emas Semarang. The data then analyzed using interactive analysis techniques from Miles and Huberman. The results of the study indicate that the drill and exercise activities need to be implemented at the Port of Tanjung Emas Semarang, as well as drill and exercise activities in accordance with the requirements. that have an effect on the ability to implement the ISPS Code.
Motivasi Kunjungan Konseling Taruna ke Unit Psikologi (Studi Kasus di Politeknik Ilmu Pelayaran Semarang)
Authors: Purwantono Purwantono , Susanti Eka
Published: October 2022

Shipping cadets are intellectuals who enter a period of development as early adults so that the problems they face are quite a lot, such as study problems, future problems, conflicts with family and fellow cadets, therefore the psychology unit is a unit that is very much needed for its existence. The purpose of this study was to analyze the dominant factors that support cadets visiting the psychology unit and the extent to which these factors affect the cadets' visits to the psychology unit. The research method used is quantitative with the research instrument in the form of a questionnaire. The independent variables consist of: (X1) infrastructure facilities with indicators of physical evidence (tangibles); (X2) human resources with indicators of reliability (reliability), responsiveness (responsiveness), assurance (assurance) and attention (empathy); (X3) services with indicators of consultation, film screenings, discussions, book collections, and (Y) as the dependent variable, namely the interest of student visits. The sample used was 60 people from a population of 600 cadets taken by stratified random sampling. The analysis used in this study are: validity, reliability, product moment correlation and chi square. The results of this study indicate that there is a strong relationship between the quality of infrastructure and service quality on the interest of cadets visiting the psychology unit.
The Effect of Adding Concrete Wastes to Iraqi Ordinary Portland Cement
Authors:   Northen Cement Company, Mosul, Iraq, Al-Jiboory Younus , Al-Hazaa Sawsan ,   Department of Applied Geology, College of Science, University of Tikrit, Tikrit, Iraq.
Published: October 2022

The research relied on taking five samples: The first sample is the Iraqi Ordinary Portland Cement. Physical tests were carried out for the purpose of comparison with other samples, as the rank of the Ordinary Portland Cement sample under study was 52.5R, according to the Iraqi specification No. 5, 2019. The second sample is concrete waste that was crushed then added water to it in known proportions according to the Iraqi specification and making a paste for concrete wastes only, but it failed to compressive strength and soundness. Three other samples of concrete waste 25%, 30%, and 35% with Ordinary Portland Cement as the addition of concrete wastes, were a partial substitute for the Ordinary Portland Cement. The results of the physical tests including fineness, setting time soundness, and compressive strength that were conducted on the third and fourth samples 25% and 30% were good results within the Iraqi specification No. 5, 2019. The result of physical tests at 35% of concrete wastes failed to test compressive strength. The results of mixing the concrete wastes with the Ordinary Portland Cement under consideration, showed that they can be mixed in various ratios and obtain different results. The more the concrete wastes mixed with the cement, the less the quality of the mixed cement was reaching the highest ratio that led to the failure of the mixture with the concrete wastes in terms of the physical properties. Basically, the mixture ratio of concrete wastes with the cement depends on the quality of the cement and its class in accordance with the compressive strength, and concrete waste quality.