bluuebunny/crossref_metadata_2025 huggingface dataset:
DOENÇAS INFLAMATÓRIAS INTESTINAIS: PRINCIPAIS ALTERNATIVAS TERAPÊUTICAS
Authors: Penno João Vítor Estivalete , Lanzini Felipe Severo , Pereira Mateus Sebben , Bonacina Patrick , Bigolin Pedro Henrique Gomes
Published: July 2021

Introdução: A doença de Crohn (DC) e a retocolite ulcerativa idiopática (RCUI) são as formas mais comuns de doenças inflamatórias intestinais (DII) e resultam da resposta imune inadequada em indivíduos suscetíveis, aliada a interações com fatores ambientais, microbianos e do sistema imune entérico. Caracterizam-se por inflamação crônica do intestino de etiologia não completamente esclarecida. As opções terapêuticas promovem remissão, mas não curam a doença. Objetivo: Apresentar as principais terapêuticas utilizadas no manejo das DII. Materiais e Métodos: Realizou-se revisão sistemática de literatura sobre as alternativas terapêuticas no manejo das DII. Pesquisou-se no SCIELO e PUBMED o descritor “Doença inflamatória intestinal". Além dos Protocolos Clínicos e Diretrizes Terapêuticas sobre DII fornecidos pelo Ministério da Saúde. Resultados: O manejo das DII é feito combinando medidas comportamentais e farmacológicas e depende da etiologia, local acometido, gravidade e extensão da doença. As DII leves a moderadas têm tratamento baseado nos derivados do ácido 5-aminossalicílico (5-ASA). Na DC não colônica, os derivados 5-ASA ligados aos radicais sulfa são ineficazes. Quando não responsivas ao tratamento inicial, a escolha são os glicocorticoides. Na RCUI, caso a terapia dupla não seja eficaz ou seja impossível fazer o desmame do glicocorticoide, opta-se por imunomoduladores. Na DC moderada a grave, faz-se manejo com glicocorticoides, imunomoduladores e terapia biológica, inexistindo consenso quanto ao mais eficaz. Em casos de DII grave a fulminante, as medidas englobam reposição hidroeletrolítica, jejum e tratamento cirúrgico. Na DC fistulosa e no pós operatório de colectomia em RCUI, o tratamento inclui antibioticoterapia, acompanhada ou não de terapia biológica e/ou imunomoduladores. Caso ineficiente (na DC fistulosa) prossegue-se para correção cirúrgica. Em ambas patologias se administra glicocorticoide endovenoso. Caso haja refratariedade ao glicocorticoide, na RCUI, opta-se por imunobiológicos, ciclosporinas ou tratamento cirúrgico. A manutenção é feita com imunomoduladores ou terapia biológica. Na RCUI podem ser utilizados, também, análogos 5-ASA. Conclusão: Embora as DII não possuam etiologia completamente esclarecida, é imprescindível uma abordagem ampla e individualizada de cada paciente. Ademais, é necessário caracterizar o acometimento para que seja realizada a conduta correta, pois mesmo sem possibilidade de cura, a remissão das crises melhora a qualidade de vida dos pacientes.
Abstraction of Object Diagram from Input Java Program
Authors:   Dept of C.S.E, BITM, Ballari, Karnataka, India., Kulkarni Dr. R.N. , Rama Prasad Mr. P. Pani ,   Dept of C.S.E, BITM, Ballari, Karnataka, India.
Published: July 2021

The Unified Modelling Language (UML) is a design tool used to design the software applications or software systems. It comprises thirteen different diagrams which represent the static behavior and dynamic behavior of the software systems. This paper presents an automated methodology to abstract the UML object diagram features from the input restructured java program. The methodology proposed here takes the restructured java program as an input and then abstracts the class name, attributes, operations, visibility, relationships and stores in the form a table. Further by using the restructured java program and the class table, the relevant details of the object diagram is abstracted and is stored in the form a table for further processing FULL TEXT PDF
A representação por mapas mentais para trabalhar a violência nas aulas de Geografia
Authors: Pereira Henrique Sabino da Silva , Melo Josandra Araújo Barreto de
Published: July 2021

A partir da compreensão da importância dos mapas mentais para o ensino-aprendizagem espacial, foi desenvolvida pesquisa durante as aulas de Geografia, com discentes do 6o ano do Ensino Fundamental de uma escola pública localizada na Zona Leste de Campina Grande, PB. Tomando como referência o método fenomenológico e as técnicas da pesquisa colaborativa, o projeto foi realizado através da criação de situações de ensino-aprendizagem pautadas na representação, estudo e compreensão do lugar de vivência, buscando resgatar, por meio dos mapas mentais, as percepções descritas pelos discentes nas representações espaciais. Foi possível verificar que, apesar da Zona Leste ser conhecida como violenta, situação agravada pela forma como os meios de comunicação social noticiam os fatos ocorridos nessa região da cidade, os discentes não vivenciam esse fenômeno sócio-espacial da forma como é apresentada pela imprensa, a minoria identificou algum tipo de violência no lugar ou mesmo na escola, apesar de em suas casas serem colocados dispositivos de segurança, como grades e cercas elétricas. Por fim, a pesquisa disponibiliza informações sobre o trabalho com mapas mentais e suas contribuições no ensino-aprendizagem, aludindo à representação/leitura espacial e à construção de valores cidadãos, competências que sintetizam os objetivos do ensino de Geografia na escola básica.
The use of PAM fluorometry to assess microalgal physiological stress for the production of biodiesel
Authors:   , White Sarah Anne
Published: July 2021

Under environmental stress, most microalgae produce intracellular neutral lipids as a storage mechanism. In the biotechnology industry, these lipids are extracted and converted to microalgal biodiesel; however the extent of the stress is not measured for optimum lipid accumulation. In the series of studies undertaken, Pulse Amplitude Modulated (PAM) fluorometry was used to measure three types of physiological stress on Chlorella sp., a freshwater microalgal species. Biomass and lipid yields were also used as indicators of the induced stress conditions. Firstly, nutrient induced physiological stress and the subsequent synthesis of cellular neutral lipids was investigated.
Partial characterization of toxigenic Fusarium
Authors:   , Govender Leroosha
Published: July 2021

Various methods have been developed for the analysis of Fusarium and its toxins. Advances in molecular biology can lead to efficient characterization of this group of fungi. This study was undertaken to examine random amplified polymorphic DNA, volatile compound production and hydrolytic enzyme production by 19 Fusarial isolates. These techniques were employed to assess their abilities in differentiating Fusarium species and F. verticillioides strains and extending the analysis to discriminate toxin producing capabilities amongst these fungi
Investigations on aerobic thermophilic treatment of pulp mill effluent
Authors:   , Reddy Prenaven
Published: July 2021

Thermophilic treatment of wastewaters increases in importance as industries shift from end-of-pipe treatment towards integrated process water treatment. The need for treatment of process water becomes evident, as the levels of pollutants in industrial water circuits need to be controlled whereas the intake of fresh water generally diminishes. In the paper and pulp industry, high process water temperatures prevail and thus wastewater treatment needs to take place under thermophilic conditions. This thesis describes research in which the aerobic treatment of paper and pulp mill effluent was investigated under thermophilic conditions. The objectives of this study were, firstly, to identify a suitable inoculum for thermophilic degradation of pulp mill effluent and this was achieved by screening from various sources i.e., activated sludge, heating water, soil and compost. The second objective was to determine the feasibility of aerobic thermophilic degradation of pulp mill effluent using temperatures of 40°C, 50°C and 60°C. Batch, fed-batch and continuous experiments would enable the feasibility of degradation of pulp mill effluent. Prior to fed-batch systems, batch systems were optimised by determining the following parameters: 1) Effect of temperature on degradation of pulp mill effluent, 2) Effect of biomass concentration on degradation of pulp mill effluent, 3) Effect of aeration on degradation of pulp mill effluent, and 4) the effect of nutrient supplementation. I I I I I I I I I I I I I I I I I I I I I Once batch systems were optimised, the fed-batch systems came into play, and this system demonstrated much potential for thermophilic degradation of pulp mill effluent, which finally led to developing a continuous system, were degradation was optimal.
Incidence and characterization of Fusarium species from mycotic keratitis infections
Authors:   , Naiker Shamantha
Published: July 2021

Mycotic keratitis has been found to account for 6% to 50% of all cases of ulcerated keratitis. Fusarium species, and in particular Fusarium so/ani, is the most frequent cause of mycotic infections of the cornea. These infections lead to a marked loss of vision and eventually a complete perforation of the cornea if not correctly diagnosed and treated. Fusarium species produce toxic mycotoxins that are known to exert adverse health effects in humans and animals. However, very few attempts have been made to establish the mycotoxin-producing capabilities of clinical isolates of Fusarium species from keratitis infections or any other human infections for that matter.
Rubber selection in the automotive filtration industry
Authors:   ,   Durban University of Technology, Naidoo Sherese
Published: July 2021

Filters have seals to prevent leakage and to attain service intervals at required temperatures. There are various materials and the correct material must be chosen for the filter to operate efficiently and effectively. Material selection is vital as it can effectively reduce cost and if one material is selected but is more expensive and of higher quality the price can be reduced because of purchasing in large volumes. The overall aim of this study was to produce a process to follow for rubber selection for seals and grommets that would eliminate material identification testing at the automotive filter company, make the best choice based on the design of experiments (DOE) software, and to save costs by eliminating the use of over-engineered products. The objectives were to identify current rubber material types used on oil filters, conduct lab tests to determine the limits of parameters that rubber material can withstand, identify trends of testing, and lastly, determine the rubber that could possibly be used across a range of filters by using the DOE software. Materials tested included nitrile-butadiene 321 (NBR 321), nitrile-butadiene 322 (NBR 322), methyl vinyl silicone 332 (VMQ 332), nitrile-butadiene 333 (NBR 333), polyacrylate 334 (ACM 334), Viton 337, hydrogenated nitrile butadiene 338 (HNBR) and ethylene acrylic 336 (AEM 336). These materials were exposed to mineral oil and synthetic oil at operating conditions ranging from 120 °C to 150 °C and 168 h to 500 h which equated to 10 000 km to 30 000 km service intervals. The DOE software was used to develop the models in order to determine the best fit material for the required service interval and temperature. The conclusions drawn from this thesis indicate that when all these materials are exposed to mineral oil, ACM 334, Viton 337 and AEM 336 have the highest resistance to temperature and longest service intervals which is 120 °C to 150 °C at 30 000 km and, when exposed to synthetic oil, Viton 337 has the highest resistance to temperature and longest service intervals which is 130 °C at 30 000 km and 150 °C at 20 000 km. Further conclusions show that synthetic oil is a stronger fluid as it degrades all materials to a greater extent than mineral oil. It was evident from the DOE software that ACM 334 and Viton 337 were found to be the best solutions. The desired solution is closest to material ACM 334 at a temperature of 124 °C and service interval of 172 h (refer to table E.15). The trends observed were an increase of hardness and change in volume as temperature and exposure periods increased and a decrease of tensile strength and elongation as temperature and exposure periods increased. This is an agreement with findings in the literature (Refer chapter 2, section 2.1.6) which validates these trends.
China’s CyberAI Talent Pipeline
Authors:   Center for Security and Emerging Technology, Cary Dakota
Published: July 2021

To what extent does China’s cultivation of talent in cybersecurity and AI matter in terms of competitiveness with other countries? Right now, it seems to have an edge: China’s 11 World-Class Cybersecurity Schools offer more classes on artificial intelligence and machine learning than do the 20 U.S. universities certified as Centers of Academic Excellence in Cyber Operations. This policy brief recommends tracking 13 research grants from the National Science Foundation that attempt to integrate AI into cybersecurity curricula.
Ending Innovation Tourism: Rethinking the U.S. Military’s Approach to Emerging Technology Adoption
Authors:   Center for Security and Emerging Technology, Flagg Melissa , Corrigan Jack
Published: July 2021

As dual-use technologies transform the national security landscape, the U.S. Department of Defense has established a variety of offices and programs dedicated to bringing private sector innovation into the military. However, these efforts have largely failed to drive cutting-edge commercial technology into major military platforms and systems. This report examines the shortcomings of the DOD’s current approach to defense innovation and offers recommendations for a more effective strategy.
Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure
Authors: Bayram Zubeyde , Efe Süleyman Cagan , Karagoz Ali , Dogan Cem , Guvendi Busra , Uysal Samet , Acar Rezzan Deniz , Akbal Ozgur Yasar , Yilmaz Fatih , Tokgoz Hacer Ceren , Kirali Mehmet Kaan , Kaymaz Cihangir , Ozdemir Nihal
Published: July 2021

Objectives: The aim of this study was to investigate the effect of heart failure (HF) etiology on clinical, echocardiographic, and hemodynamic findings, right ventricular (RV) function, and outcomes in patients with end-stage HF.

Patients and Methods: A total of 470 end-stage HF patients who undergoing evaluation for heart transplantation (HT) were divided into two groups: ischemic cardiomyopathy (ICMP, n=249) and nonischemic cardiomyopathy (NICMP, n=221). RV dysfunction was defined as tricuspid annular plane systolic excursion (TAPSE) ≤1.5 cm (TAPSE-defined RV dysfunction) and right ventricular stroke work index (RVSWI) <5 g/m/beat/m2 (RVSWI-defined RV dysfunction). The primary outcome was defined as left ventricular assist device implantation, urgent HT, or death.

Results: Patients with ICMP had higher pulmonary vascular resistance, systolic and mean pulmonary artery pressures (PAPs and PAPm) than those with NICMP [3.0 (1.1-6.0) vs. 2.0 (1.0-5.0),P=0.013; 53.5 (42.0-68.0) vs. 46.0 (32.5-64.5),P <0.001 and 35.512.9 vs. 31.812.3,P=0.002]. RVSWI levels were lower in NICMP patients than in ICMP patients [5.4 (3.7-7.6) vs. 6.5 (4.6-9.6),P <0.001]. While TAPSE-defined RV dysfunction was comparable between NICMP and ICMP, RVSWI-defined RV dysfunction was higher in NICMP (44.3% vs. 55.0%,P=0.069 and 45.2% vs. 31.3%,P=0.012). NICMP was an independent predictor for RVSWI-defined RV dysfunction, but not for TAPSE-defined RV dysfunction, according to multivariate analyses (OR:1.79, 95% CI:1.13-2.82,P=0.012 and OR:0.63, 95% CI:0.28-1.39,P=0.254). Over a median follow-up of 503.5 days, it was demonstrated that HF etiology was not a predictor of primary outcome according to unadjusted and adjusted models (OR:0.99, 95% CI:0.80-1.23,P=0.936 ve OR:0.89, 95% CI:0.60-1.31,P=0.542).

Conclusion: We that demonstrated patients with end-stage HF, ICMP had greater RV afterload and RVSWI value than NICMP and HF etiology was not predictor of primary outcome. However, we couldn't say for sure whether HF etiology has an effect on RV function because of the conflicting results in TAPSE-defined RV dysfunction and RVSWI-defined RV dysfunction.
Impact of Bi-ventricular systolic function on mortality in patients with sepsis and septic shock
Authors: Tükenmez Tigen Elif , Kepez Alper , Sünbül Murat , Özben Beste , Ertürk Şengel Buket , Bilgili Beliz , Olgun Yıldızeli Şehnaz , Tigen Kürşat
Published: July 2021

Objectives: We aimed to evaluate left ventricular (LV) and right ventricular (RV) systolic performance in patients with sepsis or septic shock and possible functional alteration on in-hospital mortality.

Patients and Methods: Thirty-seven consecutive patients with the diagnosis of sepsis or septic shock were included in the study. All patients underwent comprehensive transthoracic echocardiographic examination. Data of patients discharged from the intensive care unit was compared with data of patients who died in the hospital.

Results: Fifteen patients (40.5%) survived, while 22 patients were died in the hospital (59.5%). A significant difference was detected between survivor and non-survivor groups regarding before discharge or death level of inflammatory markers such as CRP (p=0.05) and procalcitonin (p=0.03) besides BNP (p=0.01) and SOFA (p=0.009) score. There were two patients (5.4%) with EF value less than %50 in the study population. Eight patients (21.6%) displayed hypokinesia on the apical segment, and four patients (10.8%) had TAPSE values below 17 mm. One patient (6.6%) in the survivor group, but seven patients (31.8%) in the non-survivor group had apical hypokinesia with a trend towards significance (p=0.068). One patient in the survivor group (6.6%) and three patients (13.6%) in the non-survivor group had RV systolic dysfunction (p: 0.51).

Conclusion: We found a much lower rate of LV and RV systolic dysfunction in patients with sepsis or septic shock compared with previous studies. None of the myocardial dysfunction types was associated with in-hospital mortality. Apical hypokinesia was also more prevalent in non-survivors despite borderline significance.
Isolated right ventricular noncompaction in an adult woman with severe pulmonary hypertension following at the intensive care unit
Authors: Yildiz Mustafa , Ozsahin Yasemin , Yilmaz Ak Hulya , Oksen Dogac
Published: July 2021

Pulmonary hypertension is defined by a mean pulmonary artery pressure ≥25 mmHg at rest, measured during right heart catheterization. Ventricular noncompaction is a genetic cardiomyopathy which mostly effects left ventricle. It is related with deterioration of myocardial embryogenesis and commonly together with other cardiac diseases (1).
Isolated ventricular non-compaction is characterized by modified morphology of myocardial wall, increased trabeculation in ventricular cavity and deep intertrabecular recesses.
A 43-year-old woman presented exercise induced dyspnea and atypical chest pain. She has not any medical history prior. On admission, her 12 lead ECG showed complete righ bundle branch block, her blood pressure was 120/80 and pulse rate 80 per minutes. Transthoracic 2D echocardiogram and magnetic resonance imaging showed dilated and hypertrophied right ventricle with non-compaction of the right ventricular apex. The systolic pulmonary arterial pressure was 80 mmHg on the Doppler echocardiography. The coronary angiography revealed normal coronary arteries. The catheterization was showed pulmonary hypertension, right ventricle non-compaction and negative pulmonary vasoreactivity testing.
Ventricular noncompaction, especially right ventricular noncompaction, complicated by severe pulmonary hypertension is exceptional. Only a few isolated right ventricular noncompaction has been reported but inclusion of pulmonary hypertesion cases are rare subsets .
Diagnosis of pulmonary hypertension may be a consequence of increased pulmonary venous pressures caused by systolic and diastolic ventricular dysfunction secondary to right ventricular noncompaction. Widespread usage of cardiac magnetic resonance imaging, may enhance visual quality and evaluation of ventricular morphology, probably this will provide prevalance increment and clinical outcome improvements. Early diagnosis would bring better results.
Characteristic Features of SARS CoV-2
Authors: Bakhat Shaista , Taj Yasmeen
Published: July 2021

Corona-virus arose from China, spread globally and has become a great challenge for health care workers and Governments of several countries. This virus is transmitted predominately through respiratory droplets by symptomatic and asymptomatic carriers. The disease manifests itself with fever, dry cough and shortness of breath, these symptoms may be mild or have fatal outcomes. This virus attaches to the angiotensin converting enzyme (ACE) receptor, in the lung. This assessment, recapitulates the existing awareness of host features and the paths that are activated with HCOV (Human Corona virus) infection highlighting the infection derived stress response, autophagy, apoptosis and natural defense mechanism. The interaction of virulence tactics utilized by HCOV is also reviewed. This virus can be detected in the laboratory with help of reverse transcription polymerase chain reaction (RT-PCR), with up to 50%-69% false negative results. Treatment agenda is supportive therapy including supplemental oxygen, antipyretic, dexamethasone and ventilators.
Diagnostic Pathology in the Era of Precision Medicine
Authors:   Bahria University Medical and Dental College, Karachi, Shawanna Summaya , Taj Yasmeen
Published: July 2021

The ever-increasing importance of targeted therapy in the management of cancerous and non-neoplastic diseases calls for novel, advanced techniques of diagnostic pathology. The past decade has witnessed substantial changes in how cancer patients are managed, with a pronounced focus on precision medicine based on genomic profiles and gene expression analysis, thus discarding the “one-size-fits-all” approach1.
Comparison of Early Versus Delayed Showering on Post-Operative Wound Infections
Authors: Abbasi Salman Habib , Basit Abdul , Farooq Muhammad , Shah Fazal Hussain
Published: July 2021

Objectives: To compare frequency of SSIs with and without early showering after clean and clean contaminated surgical wounds. Study Design and Setting: Randomized controlled trial was conducted at Department of Surgery. HIT Hospital, Taxila from June 2020 to December 2020. Methodology: A total of 130 participants were recruited after taking informed consent. After clean and clean-contaminated surgery, first group was subjected to early showering (48 hours after surgery) while second group was not allowed showering until removal of stiches. Both groups were compared in terms of SSIs. Data was entered into SPSS version 25. The mean and standard deviation were used for the expression of continuous variables while frequency and proportion were used for qualitative variables. Both groups were compared by independent sample t test and chi square test. A p value of <0.05 was considered statistically significant. Results: The mean age of the patients was 39.92 ± 11.42 years and there was male gender dominancy i.e. 74 (56.9%) were males while 56 (43.1%) were females. Clean surgeries were 81 (62.3%) and clean-contaminated proportion was 49 (37.7%). Collectively, 12 (9.2%) patients developed SSIs during clinical followup. There was no difference between groups in terms of age, gender, and wound types (p values 0.680, 0.157 and 0.587 respectively). In shower group, 3 (4.6%) and in nonshower group, 9 (13.8%) patients developed SSIs (p value 0.069). Conclusion: Early postoperative showering can be implemented safely in clean and clean contaminated surgical wounds to minimize SSIs. The results should be evaluated in large RCTs
Effects of Intravenous Versus Inhalational Anesthesia on Red Cell Distribution Width and Mean Platelet Volume in Patients Undergoing Coronary Artery Surgery
Authors: Yiğit Özay Hülya , Demir Zeliha Aslı , Balcı Eda , Kaya Bahçecitapar Melike
Published: July 2021

INTRODUCTION: The effects of midazolam-based intravenous anesthesia (TIVA) and sevoflurane-based inhalation anesthesia (SEVO) maintenance on postoperative hematological parameters were compared in patients undergoing coronary artery surgery. METHODS: The 100 patients included in the study were divided into two groups according to the anesthesia management: All patients' anesthesia inductions were performed with 10 μgkg-1 fentanyl, 0.15 mgkg-1 midazolam, and 0.8 mgkg-1 rocuronium. Anesthesia was maintained with total intravenous anesthesia in the TIVA group patients, while sevoflurane was used in the SEVO group patients. Demographic, clinical, operative data, red cell distribution width (RDW), and mean platelet volume (MPV) values were recorded. RESULTS: Except that the extubation time was shorter in the SEVO group, no difference was observed between the groups in terms of all these variables. There was a significant increase in postoperative RDW and MPV measurements in both groups. Postoperative RDW value was lower in the inhalation anesthesia group compared to the TIVA group (p=0.013). DISCUSSION AND CONCLUSION: In our study, RDW was found to be lower in the inhalation anesthesia group, indicating less inflammation. There was no difference in terms of postoperative complications and mortality.
The Effect of Two Different Doses Protocol of Bupivacaine for Femoral Block on Postoperative Analgesia: A Retrospective Analysis of Single Center Data
Authors: Selvi Adem , Yılıdız Gökhan , Türksal Erbil , Özbek Rıdvan , Okkaoğlu Mustafa Caner , Özayar Esra
Published: July 2021

INTRODUCTION: In our study, we aimed to compare the analgesic efficacy, side effect profile and its effect on opioid consumption of the femoral nerve block applied with different concentrations of local anesthetic agents (%0.5 bupivacaine and %0.25 bupivacaine) in the same volume (20 mL) after total knee replacement (TKR) operation. METHODS: The files of patients who underwent unilateral TKR surgery under spinal anesthesia between August 2018 and June 2019 were retrospectively reviewed. A total of 163 patients were included in the study, 81 patients in group 1 who received %0.25 bupivacaine, and 82 patients in group 2 who received %0.50 bupivacaine for femoral block. The highest visual analogue pain scale (VAS) scores in the postoperative 24 hours, the amount of tramadol requested and consumed with intravenous patient-controlled analgesia (PCA) devices, and whether there was a significant difference in terms of side effects (nausea, vomiting, motor and sensory deficit) were analyzed. RESULTS: The highest VAS score in group 1 was 2.95 ± 1.31, in group 2 it was 2.84 ± 1.06, and there was no significant difference between them. The mean consumption of tramadol was 197.04 ± 92.03 mg in group 1 and 208.05 ± 85.06 mg in group 2. There was no difference between the demand and consumption of tramadol and side effects. DISCUSSION AND CONCLUSION: 20 mL %0.25 bupivacaine for the femoral block provided the equivalent analgesic efficacy to the same volume of %0.50 bupivacaine. We think that the use of % 0.25 bupivacaine is a more reliable option to reduce systemic side effects, motor block risk and complications.
The Effect Of Intraoperative Restrictive Fluid Therapy On Postoperative Outcomes In Patients Undergoing Hyperthermic Intraperitoneal Chemotherapy
Authors: Yiğit Özay Hülya , Salman Nevriye , Bölükbaşı Demet , Kemerci Perihan , demirci Aslı , Karadeniz Ümit
Published: July 2021

INTRODUCTION: Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRC) are effective multimodal treatment options in patients with peritoneal carcinomatosis. Procedures are long-lasting operations with excessive blood and fluid loss. Intraoperative fluid management is very important because of major hemodynamic, respiratory and metabolic changes. This study aims to investigate the effect of intraoperative restrictive fluid therapy on postoperative outcome in patients undergoing HIPEC and SRS. METHODS: Patients who underwent HIPEC and SRS in our clinic between 2014-2018 were included in the study. The demographic, intraoperative and postoperative data of all patients were retrospectively analyzed. The patients who underwent restrictive fluid replacement were named Group R, and the group with liberal fluid replacement was named Group L. RESULTS: It was observed that the mean age was 54.6 ± 11.4 years, the female gender was 60.5% and the malignancy originating from the gastrointestinal system was 76.3%. There was no effect of liberal and restrictive fluid treatments on postoperative minor and major complications, length of stay in hospital and intensive care, and mortality. DISCUSSION AND CONCLUSION: We concluded that intraoperative restrictive fluid therapy did not affect postoperative complications and mortality in HIPEC and SRS surgeries.
COVID-19 Vaccines and Anesthesia
Authors: Gümüş Demirbilek Semra , Sezgin Çiğdem , Gürsoy Canan
Published: July 2021

The immunization campaigns launched at the national and global level have been a hope to end the COVID-19 pandemic, which has threatened the whole world since December 2019 and left health systems in despair. However, adult vaccination campaigns, which were developed in a short time using new technologies and started with emergency use approval, confronted anesthesiologists with an obscurity. In this review; in general, the interactions of vaccination and anesthesia applications were reviewed, suggestions were made for anesthesia applications after COVID-19 vaccination in adult patients.
Silencios, etnicidades y VIH: visibilizando algunas problemáticas en la incidencia y prevalencia de la epidemia en los pueblos originarios de Latinoamérica
Authors: Ponce Patricia , Muñoz Martínez Rubén , Stival Matías
Published: July 2021

Se presentan los resultados de una investigación cuyo objetivo gene- ral fue describir y analizar la situación de prevalencia epidemiológica, prevención y tratamiento del VIH en los pueblos indígenas en Latinoa- mérica. Para ello, se revisaron un total de 304 materiales provenientes de 16 países de Latinoamérica. En este artículo se analizan algunas de las razones de la invisibilización del impacto de la epidemia del VIH en los pueblos indígenas de Latinoamérica, y se presenta la situación de 9 países de la región en los que se dispone de evidencia sobre la preva- lencia/incidencia de VIH en ciertas poblaciones indígenas. A partir del análisis del escaso material cuantitativo y cualitativo existente en la ac- tualidad, se evidencian determinantes multinivel que deben de ser es- tudiados detalladamente considerando, como eje exploratorio nodal, la vulnerabilidad diferencial asociada a la condición étnica.
Oportunidades ganadas en vacunación de los adultos. Implementación de una estrategia combinada para superar barreras
Authors: Obed Mora , García María Cecilia , Chaparro Gustavo , Palaoro Analía Edith , Alcorta María Belén , Ávila María de los Ángeles , Alzogaray María Fernanda , González Ayala Silvia E. , Mykietiuk Analía
Published: July 2021

El Programa Nacional de Inmunizaciones en Argentina es- tablece la administración universal y obligatoria de las vacunas doble adultos (dT) y hepatitis B (HB) y las vacunas antigripal y antineumocó- cica para poblaciones especiales y mayores de 65 años. Son gratuitas y, excepto las vacunas antigripal y antineumocócica en personas en- tre 2-64 años, no requieren prescripción para su administración. Sin embargo, las tasas de vacunación en los adultos son bajas. Mejorar las coberturas vacunales en adultos es un desafío. Realizamos un estu- dio prospectivo de corte transversal para evaluar la implementación de una estrategia de vacunación combinada para aumentar la vacunación de los adultos de una institución. Esta se basó en el requerimiento obli- gatorio de dT en las cirugías programadas junto con el consejo médico en el vacunatorio y el acceso inmediato a la vacunación. Como resulta- do de esta estrategia se administraron 2.946 dosis extra que represen- tan un aumento de 312% sobre las dosis sin intervención. Esta estrate- gia simple podría ser replicada fácilmente en otros centros
Relación entre desarrollo de los programas para la gestión del uso de antimicrobianos, apropiabilidad y consumo de antibióticos en hospitales de Argentina
Authors: Quirós Rodolfo , Vila Andrea , Manzur Adriana , Calani Liliana , Decima Milton , Falco Adriana , Cuello Alejandra , Olivo Luz M. , Acosta Claudia M. , Sastre Guadalupe , Maurizi Diego , Riera Fernando , Blanch Marcela V. , Bangher María del Carmen , Camerano Cecilia , Grupo del Proyecto PROA
Published: July 2021

Introducción: La implementación de Programas para la Optimización de Uso de Antimicrobianos (PROAs) ha resultado una estrategia útil para mejorar los resultados asistenciales, de manera segura y costo-efectiva, reduciendo el desarrollo de la resistencia a los antimicrobianos.

Objetivo: Estimar la relación entre nivel de desarrollo de los PROAs, apropiabilidad y consumo de antimicrobianos en hospitales ArgentinosMaterial y métodos: Entre Jul-2016 y Ene-2017, 111 hospitales condujeron una autoevaluación del nivel de desarrollo de sus PROAs usando un instrumento basado en los lineamientos del CDC (0 a 100 puntos), además de un corte de prevalencia para evaluar la apropiabilidad de las prescripciones de antimicrobianos y su consumo mensual [Dosis Diarias Definidas (DDD) c/100 días-paciente]. Para la comparación de estos indicadores, los centros fueron dicotomizados tomando como punto de corte el percentilo 75 (p75) de la autoevaluación.

Resultados: La comparación entre hospitales con puntaje ≥p75 vs. <p75 mostró diferencias significativas en todos los indicadores analizados (autoevalua- ción: 51,6 vs.. 25,4; dif. 26,2; IC95% 30,3 a 22,0, p<0,000; profilaxis quirúrgica: ≤24 hs 64,8 % vs. 52,3 %; dif. 12,5 %; IC95 % 5,1 % a 20,0 %, p<0,002; adherencia a guías clínicas: 77,6% vs. 47,0%; dif. 30,6%; IC95% 28,1% a 33,0%, p<0,000; revisión de la indicación: 69,4% vs. 46,8%; dif. 22,6%; IC95 % 20,0 % a 25,2 %, p<0,000; consumo de antimicrobianos: 114,8 DDDs vs. 259,2 DDDs; dif. –144,4 IC95% –140,6 a –148,2, p<0,000). Conclusiones: Aquellas instituciones con mayor puntaje en la autoevaluación presentaron mejores indicadores de apropiabilidad y consumo de antimicrobianos, reforzando la importancia de una implementación efectiva de los PROAs.
THE IMPACT OF THE PANDEMIC ON THE TOURISM BUSINESS
Authors: Shanidze Goderdzi
Published: July 2021

If Pandemic has had an impact on any business it’s primarily a tourism business. Other businesses have a very close relation with this business and therefore they have been affected as well. As you know, the world travel and tourism market is expected to have lost more than 75.2 million jobs by 2020. According to the UNWTO, small and medium-sized enterprises were most affected. Their share in the tourism sector is 80%. Coronavirus will have a special impact on the countries whose economy accounts for a large share of tourism and whose economic growth is largely due to the tourism sector, and Georgia is also among them.
According to the Georgian government, Georgia will develop the tourism sector in the near future, of course, in compliance with the safety standard and taking into account the recommendations. Tourism is the sector that has received the hardest and first blow due to the crisis and which, in addition to being one of the most important driving forces of the country's economy in recent years, the sector has a competitive advantage that can contribute to the economic development of Georgia in the post-crisis pandemic economy.
Tourism is one of the largest spheres in the world, and its development is conditioned by the safe environment of the country, economic and political stability. It creates jobs and helps increase incomes for the population. International tourism contributes to the inflow of foreign currency into the country and affects the social and cultural environment of the country. That is why it is important to bring the tourism business out of the crisis.
Pratiques RH, culture et performance des organisations Revue de littérature théorique et empirique
Authors: RAJÂA Omar
Published: July 2021

Cette revue de littérature théorique et empirique nous a permis de mieux appréhender les différentes approches qui ont abordé le rôle des pratiques RH dans la performance des organisations et d’exposer les principaux résultats des études effectuées partout dans le monde aussi bien dans la perspective unidimensionnelle que pluridimensionnelle. En premier lieu, nous avons présenté, l’approche économique, l’approche financière, l’approche stratégique et l’approche psychologique et de plus spécifiquement l’approche universaliste, l’approche de contingence et l’approche configurationnelle. En second lieu, après avoir exposé une synthèse quantitative de 235 résultats des 241 études empiriques et recherches effectuées entre 1978 et 2003 répertoriées en 2004 par Allouche et al., nous avons présenté quelques 123 confirmations empiriques du lien pratiques RH, dont 7 traitant le cas marocain, et la performance des organisations effectuées partout dans le monde depuis 2004 et quelques 31 études illustrant la variable culturelle comme élément contingent et médiateur dans la relation pratiques RH et performance des organisations.
Facteurs explicatifs de l’adoption des services du mobile money par les clients des opérateurs de téléphonie mobile à Dakar
Authors: SOSSOU Maurel Loïs Ahlonko , GAYE Abdoulaye , WADE Mohamed El Bachir
Published: July 2021

Le mobile money représente, pour les entreprises de services en l’occurrence les opérateurs de télécommunication, une innovation incrémentale de service accessible à tous les individus via le téléphone portable. Ressortir les facteurs explicatifs de son adoption par les clients répond aux préoccupations des offreurs de services financiers mobiles, en particulier celles des opérateurs de téléphonie mobile qui ambitionnent de développer leur portefeuille clients. Au plan individuel la théorie unifiée d’acceptation et d’utilisation de la technologie a été mobilisée dans différents contextes pour prédire le comportement d’adoption d’une innovation. Grâce à une approche méthodologique mixte et à l’échantillonnage de commodité, une étude qualitative de type semi-structuré suivant une analyse de contenu thématique a été effectuée d’une part et d’autre part un questionnaire conçu à base de Likert à 5 points a été réalisé sur un échantillon de 251clients utilisateurs. Les résultats révèlent que l’intention des clients à utiliser les services s’explique par la testabilité et l’utilité perçue. Quant à l’analyse de régression logistique, les résultats dévoilent d’une part que l’offre des services du mobile money est à faible coût et d’autre part que l’intention d’utilisation et la commodité constituent les réels facteurs expliquant l’adoption des services du mobile money.
Effet de la crise de Covid sur la persistance et l’asymétrie de la volatilité du marché boursier marocain
Authors: NABOUK Mohamed
Published: July 2021

La volatilité a été toujours la matière première des activités du marché boursier dont il faut toujours appréhender, analyser et prévoir. Son évolution dépend à la fois des facteurs macro-économiques (inflation, taux de chômage, etc…) et des facteurs spécifiques (résultats des entreprises cotées). Mais parfois des événements improbables : par exemple crise des sub-primes 2008 ou récemment la pandémie de Covid créent des turbulences et des incertitudes et qui conduisent le niveau de la volatilité à des pics très élevés suite aux fluctuations des valorisations des actifs financiers cotés à la bourse. Cette pandémie, et qui a affecté l’ensemble des marchés mondiaux, n’a pas épargné la bourse des valeurs de Casablanca. L’objet de ce papier est d’une part d’analyser l’impact de cette pandémie sur le comportement de la volatilité et son degré de persistance malgré l’optimisme apporté par les nouveaux vaccins et d’autres de voir dans quelle mesure la crise a créé ou amplifié l’effet d’asymétrie suite aux chocs dus aux événements négatifs. Les conclusions de ce travail ont abouti d’une part à la confirmation de l’augmentation de la persistance de la volatilité pour l’ensemble du marché et d’autres part à l’apparition d’un effet d’asymétrie dans le comportement de la volatilité.
Liquidity Management Practices of Small and Medium-Scale Enterprises in Lagos State, Nigeria
Authors: O.J. Abiola , F. Oluwatuyi , B.H. Mustapha , B. Funmilayo
Published: July 2021

The study investigated the extent of liquidity management practices among Small and Medium-Scale Enterprises in Lagos State, Nigeria. The study made use of primary data and the population of the study comprised of 4,460 registered Small and Medium-Scale Enterprises in Lagos State based on the Nigerian government contacts database (2015). Using Taro Yamane’s formula, a sample size of 367 Small and Medium-Scale Enterprises was computed for questionnaire administration. In each Small and Medium Enterprises that was randomly sampled, questionnaires were administered to the respondents; Owner, Supervisor or Financial Manager who provided the necessary information on liquidity management practices of their firms. Data collected from the study were analysed with the use of appropriate descriptive statistics. The result of the study revealed that SMEs engaged in liquidity management practices such as cash budget (97%), bank account operation (77%), investment in current assets (67%), and making current assets available for immediate conversion into cash (71%). Use of mechanisms in the realisation of sundry debtors (64%) and collection of debts due (64%). The study, therefore, recommended that regulatory authorities should put in place an appropriate policy with compliance measures to check high volume cash transactions and cash hoarding prevalent in the economy.
DIAGNOSTIC ACCURACY OF ELECTROCARDIOGRAPHY (ECG) FOR THE DIAGNOSIS OF LEFT VENTRICULAR HYPERTROPHY, TAKING ECHOCARDIOGRAPHY AS GOLD STANDARD
Authors: Fahad Muhammad , Nawaz Ayesha , Mehmood Khalid , Hussain Rameesha , Ahmad Raza
Published: July 2021

ABSTRACT

OBJECTIVE: To determine the diagnostic accuracy of Electrocardiography (ECG) of Left Ventricular Hypertrophy, taking echocardiography as a gold standard.

SUBJECTS & METHODS: It was a Cross-Sectional Study. The study was conducted in the Medicine Department, Services Hospital, Lahore from February 19, 2018, to August 19, 2018. A total of 300 cases were enrolled. Standardized a 12-lead ECG was used in subjects by Cardiofax electrocardiograph paper speed at 25mm/sec. Two dimensionally (2D) guided M Mode echocardiographic measurements were taken and the presence/absence of LVH was recorded. The collected data was entered and analyzed in computer software SPSS software v25.0. A 2x2 table was drawn to calculate the Sn, Sp, PPV, NPV and diagnostic accuracy of ECG for LVH taking Echocardiographic findings as a gold standard.

RESULTS: Out of 300 cases, 172(57.33%) were male and 128(42.67%) as females. The mean age was 38.72±5.64 years. Accuracy of electrocardiography (ECG) for LVH diagnosis taking echocardiography as the gold standard was calculated as 85.21%, 84.18%, 82.88%, 86.36% and 84.67% as Sn, Sp, PPV, NPV, and diagnostic accuracy respectively.

CONCLUSION: Diagnostic accuracy of Electrocardiography (ECG) for LVH diagnosis is higher and this diagnostic modality can be used in areas where echocardiography is not available.

KEYWORDS: Electrocardiography (ECG), Diagnostic Accuracy, Echocardiography, Left Ventricular Hypertrophy.
PREVALENCE OF ALUMINUM PHOSPHIDE INTOXICATION AMONGST VICTIMS OF POISONING – FORENSIC MEDICINE AND TOXICOLOGY REGISTRY DATA
Authors: Malik Beenish , Saleem Khalid , Afridi Hakim Khan , Khan Rabia , Zaman Masud Uz
Published: July 2021

Objectives: To study the prevalence of aluminum phosphide intoxication, depending on the manner of ingestion whether accidental or intentional at Forensic Medicine and Toxicology department, Khyber Medical College, Peshawar.

Methodology: Retrospective study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar, from January 2019 to December 2019.

Results:  A total of 99 cases were received, out of which 70 were females and 29 were males. The most commonly affected age group is 11-20 years among females and 21-30 years among males. More common is rural than in urban areas.

Conclusion: Aluminum phosphide (wheat pills) is the most commonly used substance for poisoning among young people. The reasons are Pakistan being an agricultural country, due to lower income and easy availability of wheat pills.

Keywords: Prevalence, Accidental, suicidal, poisoning.
GAMBARAN TINGKAT KECEMASAN MAHASISWA AKPER DHARMA WACANA METRO ANGKATAN XXII SAAT PERTAMA TINGGAL DIASRAMA AKPER DHARMA WACANA METRO
Authors: Purwono Janu
Published: July 2021

Kecemasan adalah gangguan alam perasaan ketakutan / kehawatiran yang mendalam dan berkelanjutan, perilaku dapat terganggu tetapi masih dalam batas-batas normal. Kecemasan banyak ditemui pada mahasiswa saat menghadapi lingkungan baru. Tujuan penelitian  adalah untuk mengetahui gambaran Akper Dharma wacana Metro Angkatan XXII saat pertama tinggal di asrama Akper Dharma wacana dengan mengukur tingkat kecemasan mahasiswa. Desain penelitian ini adalah deskriptif kuantitatif, yaitu mengetahui gambaran tingkat kecemasan pada mahasiswa Akper Dharma wacana Metro Angkatan XXII saat pertama tinggal di asrama Akper Dharma wacana. Sedangkan teknik sampling yang digunakan adalah total sampling. Jumlah sampel dalam penelitian ini sebanyak 108 responden. Upaya mengukur tingkat kecemasan dengan menggunakan ZSAS yang telah diadaptasi terdiri dari 38 item pernyataan. Hasil penelitian ini menunjukan bahwa didapatkan 95 orang ( 87 %)  mengalami kecemasan ringan, ada sebanyak 13 orang (  12 %) mengalami kecemasan sedang dan ada 1 orang (1%) yang mengalami tingkat kecemasan berat. Hal ini memberikan arti bahwa kecemasan pada mahasiswa Akper Dharma wacana Metro Angkatan XXII saat pertama tinggal di asrama Akper Dharma wacana secara umum adalah  kecemasan ringan. Saran yang disampaikan antara lain dilakukan secara khusus kepada pihak akper dharma wacana Metro khususnya pengelola asrama perlunya pengarahan, penguatan mental serta bimbingan dan arahan di asrama. Bagi mahasiswa baru yang tinggal pertama di asrama perlu melakukan teknik relaksasi dengan cara mengendurkan otot pada tangan, lengan, kaki, perut, punggung, bahu, leher, dahi hingga mencapai relaksasi kemudian  berkonsentrasi sambil berdoa sebelum saat terjadi kecemasan.
HUBUNGAN PENGETAHUAN IBU DENGAN KEJADIAN KARIES GIGI PADA ANAK DI DESA BANJAR NEGERI KECAMATAN WAY LIMA KABUPATEN PESAWARAN
Authors: Sari Rita
Published: July 2021

Karies gigi atau gigi berlubang merupakan salah satu masalah kesehatan gigi dan mulut yang sering kita jumpai di masyarakat saat ini, penyakit ini dapat terjadi pada semua usia, baik balita, anak-anak, remaja, maupun orang dewasa. Karies gigi merupakan suatu penyakit yang terjadi pada jaringan keras gigi (email dan dentin) dan di awali dengan demineraliasasi komponen anorganik gigi dan kemudian di ikuti dengan hancurnya matriks organik gigi. Salah satu penyebab tingginya angka kejadian karies adalah kurangnya pengetahuan orang tua  akan kesehatan gigi anak mereka. Tujuan penelitian ini adalah untuk mengetahui hubungan pengetahuan ibu tentang kesehatan gigi dengan kejadian karies gigi pada anak usia sekolah. Variabel penelitian adalah pengetahuan Ibu dengan kejadian karies gigi pada anak, dengan menggunakan metode pendekatan crossectional jumlah populasi sebanyak 126 dengan sampel 56 ibu yang memiliki anak yang berumur 6-11 tahun di Desa Banjar Negeri Kecamatan Way Lima Kabupaten Pesawaran dengan tehnik yang digunakan random sampling. Data penelitian ini diambil dengan menggunakan kuisioner dan lembar observasi. Setelah di tabulasi, data yang ada di analisis dengan menggunakan Uji chi-aquere dengan program SPSS dengan tingkat kemaknaan 0,05. Hasil yang diperoleh p value 0,029. Kesimpulan ada hubungan antara pengetahuan ibu tentang kesehatan gigi dengan kejadian karies gigi pada anak di Desa Banjar Negeri Kecamatan Way Lima Kabupaten pesawaran tahun 2014.