bluuebunny/crossref_metadata_2025 huggingface dataset:
What Makes Metaphors Manipulative Tools?
Authors: Jamet Denis , Terry Adeline
Published: March 2021

Manipulation implies a conscious choice from speakers to trigger a change of opinion in the interlocutors and to make them accept their own point of view, i.e. their own vision of the world. As pointed out by Goatly [2007], Charteris-Black [2005, 2014] or Van Dijk [1998], metaphors can be used as manipulative tools. Metaphors have traditionally been considered as figures of speech used by rhetoricians to convince crowds; cognitivists have demonstrated that they are figures of thought as well, which partly accounts for their manipulative potential. The three underlying reasons to this are, among others, the highlighting-hiding process, the existence of asymmetrical metaphors, and the multivalency of metaphors. The manipulative potential of metaphors is examined in twelve speeches from pro-life supporters, ranging from 2006 to 2019. One of the main ideological debates going on in the US has been on abortion, as the pro-life movement has grown stronger in recent years and has been threatening the right to abortion guaranteed by Roe v. Wade. The study of the metaphors in those speeches has enabled us to highlight how pro-lifers manipulate people regarding the apprehension of reality by systematically using a limited number of conceptualizations.
PENGOLESAN EXTRA VIRGIN OLIVE OIL PADA STRIAE GRAVIDARUM
Authors: Ramadhanti Indah Putri , Amy Gita Ruthika
Published: March 2021

Latar Belakang: Pada masa kehamilan, terjadi perubahan pada kulit yang berbeda antara satu wanita dengan wanita lain dikarenakan adanya pertambahan darah yang mengalir ke kulit yang menyebabkan perubahan kulit wanita hamil yaitu striae gravidarum. Hampir 90% ibu Hamil di Indonesia mengalaminya. Kandungan Extra Virgin Olive Oil (EVOO) dapat mengurangi permasalahan kulit tersebut yang masih jarang digunakan di Indonesia.Tujuan: Penelitian ini bertujuan mengetahui pengaruh pengolesan EVOO terhadap perubahan striae gravidarum pada ibu hamil Trimester II di Klinik Bina Kasih Sarolangun.Metode: Metode penelitian adalah Quasy Eksperimen dengan pendekatan one group pre and post test design. Populasi sebanyak 14 orang ibu hamil, sampel 8 responden dengan Teknik purposive samplingHasil: Dari hasil uji normalitas saphiro wilc, didapati data berdistribusi normal sehingga uji bivariat menggunakan paired t-test. Hasil Analisa univariat didapati rerata striae gravidarum pretest adalah 2,38 dengan kategori II (warna merah tua) dan III (warna ungu), rerata striae gravidarum posttest adalah 1,25 dengan kategori I (warna merah muda). hasil Analisa bivariat dengan p-value ­0,012Simpulan: Dapat disimpulkan bahwa ada pengaruh pengolesan EVOO terhadap perubahan striae gravidarum pada ibu hamil Trimester II. Disarankan bahwa ibu hamil dapat menjaga dan memelihara kulit dari awal kehamilan sehingga dapat mengurangi perluasan striae gravidarum selama kehamilan yang dapat mengganggu kenyamanan selama kehamilan.
A Hybrid Security System for Unmanned Aerial Vehicles
Authors: Al-Abrez Shahad Mahdi , Alheeti Khattab M. Ali , Alaloosy Abdul Kareem A. Najem
Published: March 2021

Autonomous unmanned aerial vehicles are one of the most important applications in modern technology. Otherwise known drones, these vehicles perform a lot of vital missions and sensitive tasks in scientific discoveries and agricultural and military applications. Drones that are in a network possess the freedom to roam in various directions. The security system of drones plays an important role in performing services. In this paper, a hybrid security system is proposed for drones to protect their data. This detection system is designed to protect autonomous drones from any attack. The proposed approach is implemented in a highway environment scenario. Our experimental results for the security system demonstrate that the proposed approach possesses an outstandingly accurate rate for intrusion detection.
The Impact of Neural Network Techniques in the Optimization of the Image Processing
Authors: Anwer Dalya Abdullah
Published: March 2021

Nowadays, image processing is widely utilized in many applications and for various purposes. Scholars proposed and suggested various techniques of image processing. The neural network is one of the main processing techniques, which is a state-of-art method. This paper aims to investigate neural network techniques in the field of image processing. Moreover, medical imaging, as well as increasing trends of utilizing digital medical imaging, has gained huge attention in the health sectors. In this regard, this paper focuses on the effect of neural networks in optimizing medical image processing. In this context, the early diagnosis and detection of the eye have an important role in the avoidance of visual impairment, because of the fact that around 45 million people have visual impairments all over the world, according to the World Health Organization. For this reason, the current paper introduces a new method based on image processing for vascular segmentation based on a morphological active contour. Then, segmentation carried out based on morphological operations, fuzzy c-means, and watershed transform. The output of such segmentation methods was given to conventional neural network. The optimized feature values are then extracted. The threshold value is set to compare these optimized feature values. From this, the best segmentation methods will be obtained.
Black Oil Leakage Influence on the Physical and Engineering Properties of Faw Soil
Authors: Al-Qaisee Ghusoon S. , Aymen  , Mohammed R. , Mahdi Elaaf Mahmod
Published: March 2021

Various regions of the world experience oil pollution for many reasons, including oil spills due to transport accidents or during oil exploration. These oil spills will have a negative impact on the environment and can change the geotechnical properties of the soil. The soil in Faw city, in the southeast of Basra Governorate, is frequently polluted due to the presence of many pipes and wells; oil leakage has been encountered as a result of damage to these pipes. The aim of this article is to study the effects of black oil on the physical and engineering characteristics of Faw soil. The analyses include two parts: (a) Natural soil properties and (b) Contaminated soil properties with oil percentages of 2.0, 5.0, 10.0, 15.0, and 20.0 % of the weight of the dry samples. Various tests were carried out. The results show an increase in soil compressibility and reduction in permeability due to the addition of black oil. In addition, the results show that using a layer of soil-oil-water under the foundation is advisable. This layer must be isolated from living creatures.
Business Intelligence of Indonesian Telematics Human Resource: Optimization of Customer and Internal Balanced Scorecards
Authors: Tosida Eneng Tita , Wahyudin Irfan , Andria Fredi , Djatna Taufik , Ningsih Winda Kartika , Lestari Desti Dina
Published: March 2021

This study aims to build an Indonesian telematics human resources business intelligence based on the optimization of the balanced scorecard of the customer and internal aspects. The balanced scorecard for customer aspects is done through the concept of the data lake and needs of the telematics workforce, which refers to the largest job vacancy site in Indonesia. The internal aspect of the balanced scorecard is carried out through vocational high school clustering as a telematics workforce producer. Business intelligence applications are able to describe in real-time the needs of the telematics workforce. Moreover, this application is also made in a mobile version, so that the conditions make it easier for vocational high schools to find out trends in telematics workforce needs nationally. This business intelligence is integrated with the balanced scorecard in the internal aspects of vocational telematics high school. The results show that Indonesian vocational telematics high schools still have major constraints on laboratory facilities, but most vocational telematics high schools show optimism through the development of technopreneurial programs. This is in line with the government's program, which continues to launch a telematics-based start-up ecosystem growth program to be highly competitive in facing the Asian Economic Community and industrial revolution 4.0. The government needs to provide more intensive workshop program incentives to vocational high school teachers because this shows a significant effect on the absorption capacity of vocational high school graduates.
Software Engineering Methods to Improve the Design of Software Reliability Systems: Roadmap
Authors: Kocher Idrees S.
Published: March 2021

The reliability of software is founded on the development, testing, evaluation and maintenance of software systems. In recent years, researchers have been come to see software reliability as a major focus. This is due to the fact that reliability is central to all software quality concepts. System Reliability Engineering is the study of the processes and results of software systems in relation to the basic requirements of users. This paper provides an overview (roadmap) of current developments in software reliability metrics, modeling and operational profiles. It outlines several software engineering methods to achieve reasonable system reliability. Finally, failure metrics are considered based on feedback collected from users after releasing the software and case studies of detected failures. Consequently, numbers and types of failures will be recorded from the users feedback.
A Risk Assessment Proposal through System Dynamics
Authors: Di Nardo M. , Madonna M. , Gallo Mosè , Murino Teresa
Published: March 2021

The issues about legislation of safety management, as well as main techniques of "risk analysis and evaluation", are widely integrated in complex production environment. From an organizational and technological point of view, it’s not easy to implement these techniques in Small and Medium Enterprises. In fact, each technique does not permit a complete and exhaustive analysis and quantification of risks. Application of aforementioned methods does allow for achievement of a wide number of benefits. The aim of this paper is to critically analyse both analysis and risk assessment processes. In this paper, integration between System Dynamics and Layers of Protection Analysis technique is provided in order to enhance results of risk management. System Dynamics shows to be very effective in evaluating interaction effect of different incidental scenarios properly identified through risk analysis technique used. System Dynamics modelling permits simulation through changes in time and feedback mechanism. This approach has been validated via testing in a plastic molding plant with a scenario of risk of a massive fire.
Integrated CCTV Surveillance System for Public Transportation
Authors:   Department of Information Technology, Shree L.R. Tiwari College of Engineering, Thane, India., Vibhakar Dhaval , Jha Suraj ,   Department of Information Technology, Shree L.R. Tiwari College of Engineering, Thane, India., Kamble Aditya ,   Department of Information Technology, Shree L.R. Tiwari College of Engineering, Thane, India, Suman Saurabh ,   Information Technology, Shree L.R. Tiwari College of Engineering, Thane, India
Published: March 2021

The urban center residential district Railway is one in every of the busiest railway stations in Bharat and carries over seven.5 million commuters daily. The railways spreads over 123.78 km (76.91 mi).The Railways encompass thirty-nine stations. Trains typically begin from and terminate at necessary stations. in line with a survey ,the total stats given by the RPF(Railway Police Force) & GRP(GOVERNMENT RAILWAY POLICE), 2,700 railway commuters killed, over 1,400 whereas crossing tracks up until last and this variety has been increasing daily. This is creating railways a dangerous possibility for travel and transportation. The video closed-circuit television used is irving to be not useful and not updated. To overcome this drawback we tend to area unit creating associate integrated video closed-circuit television for detection of crimes and missed objects and explains during this paper.We area unit exploitation high resolution cameras which might focus and might be simply accustomed establish someone and can also be helpful in dark.
Aproximación metodológica al consumo ambulatorio de antibióticos
Authors:   Universidad Santiago de Cali, Castro Espinosa Jobany
Published: March 2021

En este libro se plasma el proyecto de investigación titulado Analisis Espacial y Temporal del Consumo de Antibióticos. Este consistió en la estimación del consumo de antibióticos a partir de las ventas en droguerías en Santiago de Cali, empleando para ello la metodología de la Dosis Diaria Definida por 1000 habitantes día. Esta es una metodología estandarizada y empleada a nivel mundial para estimar el consumo de medicamentos de una forma poblacional. Esto permite entonces, realizazar comparaciones con los resultados de otros estudios a nivel mundial, con datos de población, periodos de tiempo o áreas diferentes. Este trabajo muestra un analisis geoespacial del consumo, identificando de forma diferencial el consumo por comunas en Santiago de Cali, lo cual permite identificar cuales de estas tienen un consumo superior a las demás. También muestra un analisis temporal en el que se describe el patrón de consumo en distintas unidades de tiempo, desde cada mes del periodo de estudio, cada mes del año y de forma anual; ello permitió identificar meses del año de mayor o de menor consumo durante un determinado periodo del estudio.
La ciudad de las palabras
Authors:   Universidad Santiago de Cali, Caro Gamboa Miguel Fernando
Published: March 2021

Citando a Daniel Penac, celebró esta iniciativa de la Universidad Santiago de Cali, cuyo propósito –para que no se diluya en la nube– es contribuir a la construcción de una memoria impresa de las múltiples y cambiantes expresiones artísticas y culturales que eclosionan en las calles, laderas, parques, muros, sitios abiertos, recintos cerrados, caminos verdales... que forman ese crisol llamado Santiago de Cali, donde se funde la presencia de seres humanos nacidos en este “sueño atravesado por un río”, en el mar Pacífico, en las montañas del sur o en cualquier punto de nuestra geografía colombiana. Seres, que al incorporarse a este terruño, comparten sus raíces y acogen lo existente, para dar paso a ese caleidoscopio espléndido del que hacemos parte en medio de las angustias, alegrías, odios, amores, indiferencia, compromiso, intolerancia, solidaridad, fraternidad... y todo lo que es inherente a esta experiencia alucinante que significa ser ciudadano de Santiago de Cali.
A Prospective Evaluation of Complications
of 10,000 Fluoroscopically Directed Epidural
Injections
Authors: Manchikanti Laxmaiah
Published: March 2021

Background: Among the multiple modalities of treatments available in managing chronic spinal
pain, including surgery and multiple interventional techniques, epidural injections by various routes,
such as interlaminar epidural injections, caudal epidural injections, transforaminal epidural injections,
and percutaneous adhesiolysis are common.
Even though the complications of fluoroscopically directed epidural injections are fewer than blind
epidural injections, and have better effectiveness, multiple complications have been reported in
scattered case reports, with only minor complications in randomized or non-randomized studies and
systematic reviews. Thus, prospective studies with large patient series are essential to determine the
types and incidences of complications.
Study Design: A prospective, non-randomized study of patients undergoing interventional
techniques from May 2008 to December 2009.
Setting: A private interventional pain management practice, a specialty referral center in the
United States.
Objectives: To assess the complication rate of fluoroscopically directed epidural injections.
Methods: This study was carried out over a period of 20 months and included over 10,000
procedures: 39% caudal epidurals, 23% cervical interlaminar epidurals, 14% lumbar interlaminar
epidurals, 13% lumbar transforaminal epidurals, 8% percutaneous adhesiolysis, and 3% thoracic
interlaminar epidural procedures. All of the interventions were performed under fluoroscopic
guidance in an ambulatory surgery center by one of 3 physicians. The complications encountered
during the procedure and postoperatively were prospectively evaluated.
Outcomes Assessment: Measurable outcomes employed were intravascular entry of the needle,
profuse bleeding, local hematoma, bruising, dural puncture and headache, nerve root or spinal cord
irritation with resultant injury, infectious complications, vasovagal reactions, and facial flushing.
Results: Intravascular entry was higher for adhesiolysis (11.6%) and lumbar transforaminal (7.9%)
procedures compared to other epidurals which ranged from 0.5% for lumbar, 3.1% for caudal,
4% for thoracic, and 4.1% for cervical epidurals. Dural puncture was observed in a total of 0.5%
of the procedures with 1% in the cervical region, 1.3% in the thoracic region, 0.8% with lumbar
interlaminar epidurals, and 1.8% with adhesiolysis.
Limitations: Limitations of this study include a single-center study even though it included a large
number of patients.
Conclusion: This study illustrates that major complications are rare and minor side effects are
common.
Key words: Spinal pain, epidural injections, caudal epidural, interlaminar epidural, transforaminal
epidural, percutaneous adhesiolysis, complications, and steroids.
Feasibility, Safety and Cement Leakage in
Vertebroplasty of Osteoporotic and Malignant
Compression Fractures Using Ultra-Viscous
Cement and Hydraulic Delivery System
Authors: Georgy Bassem A
Published: March 2021

Background: The major complications arising from vertebroplasty or kyphoplasty are related
to leakage of cement beyond the confines of the collapsed vertebral body. Traditionally, a liquid
(low viscosity) cement is used in most vertebroplasty systems available on the market, coupled
with mechanical injection devices or one mL syringes.
Objectives: The purpose of this study is to evaluate the feasibility and safety, as well as
study cement leakage patterns, in vertebroplasty performed for both osteoporotic and
malignant vertebral compression fractures using ultraviscous cement injected by the hydraulic
CONFIDENCE Vertebral Augmentation System.
Study Design: Retrospective evaluation of postoperative images.
Setting: Single center inpatient and outpatient population.
Methods: A retrospective evaluation of clinical charts and postoperative X-ray imaging was
performed in 122 cases; a total of 214 levels were treated. The study group comprised a total
of 163 levels of benign osteoporotic fractures and 51 levels of various malignant lesions. The
degree of leakage, seen in postoperative films, was assessed at each treated level using a strict
4-point scale (none, mild, moderate, severe).
Results: For benign lesions, there was no leakage in 82 levels (50%), mild venous leakage
in 38 levels (23%), moderate venous leakage in 4 levels (2%), mild disc leakage in 28 levels
(17%), moderate disc leakage in 7 levels (4%), mild paravertebral leakage in 2 levels (1%), and
moderate paravertebral leakage in 2 levels (1%). No severe leakage or epidural leakage were
seen. For malignant lesions, there was no leakage in 25 levels (49%), mild venous leakage in
12 levels (24%), moderate venous leakage in 4 levels (8%), mild disc leakage in 7 levels (14%),
moderate disc leakage in one level (2%), mild paravertebral leakage in one level (2%), and one
level showed a mild epidural leakage (2%).
Limitations: Retrospective study, single center.
Conclusion: Percutaneous cement augmentation in osteoporotic and malignant compression
fractures using a highly viscous cement that can be safely controlled and injected via a hydraulic
system can be performed safely without significant complications. The leakage rate and patterns
were similar in both benign and malignant compression fractures. The use of highly viscous
cement may decrease the complication rate in malignant lesions that has been traditionally
described to exhibit more cement leakage with low viscosity cement.
Institutional Review: This study was approved by the Institutional Review Board
Key words: Vertebroplasty, high viscosity cement, CONFIDENCE system, hydraulic injection.
Occipital Nerve Stimulation for Chronic
Migraine: A Randomized Trial
Authors: Serra Dr. Gerardo
Published: March 2021

Background: Chronic migraine (CM) and medication overuse headache (MOH) are disabling
conditions that may be only partially managed with conservative treatments. Occipital nerve
stimulation (ONS) is an innovative treatment for headache disorders.
Objectives: To investigate the safety and efficacy of ONS for CM and MOH patients and to
evaluate changes in disability, quality of life, and drug intake in implanted patients.
Study Design: Prospective, randomized cross-over study.
Methods: Eligible patients who responded to a stimulation trial underwent device implantation
and were randomized to “Stimulation On” and “Stimulation Off” arms. Patients crossed over
after one month, or when their headaches worsened. Stimulation was then switched On for all
patients. Disability as measured by the Migraine Disability Assessment (MIDAS), quality of life
(SF-36), and drug intake (patient’s diary) were assessed over a one-year follow-up.
Results: Thirty-four patients (76% women, 34% men, mean age: 46 ± 11 years) were
enrolled; 30 were randomized and 29 completed the study. Headache intensity and frequency
were significantly lower in the On arm than in the Off arm (P < 0.05) and decreased from
the baseline to each follow-up visit in all patients with Stimulation On (median MIDAS A and
B scores: baseline = 70 and 8; one-year follow-up = 14 and 5, P < 0.001). Quality of life
significantly improved (P < 0.05) during the study. Triptans and nonsteroidal anti-inflammatory
drug use fell dramatically from the baseline (20 and 25.5 doses/month) to each follow-up visit
(3 and 2 doses/month at one year, P < 0.001). A total of 5 adverse events occurred: 2 infections
and 3 lead migrations.
Limitations: Single-centre study, relatively small number of patients, absence of a control
group.
Conclusions: According to the results obtained, ONS appears to be a safe and effective
treatment for carefully selected CM and MOH patients.
Key words: Occipital nerve stimulation, chronic migraine, headache attacks, quality of life,
cross-over
The Neurological Safety of Intrathecal
Acyclovir in Rats
Authors: Choi Sang Sik
Published: March 2021

Background: Effective early antiviral treatments reduce both acute zoster pain and
the risk of postherpetic neuralgia. The authors hypothesized that the direct neuraxial
administration of acyclovir could provide superior drug application to the spinal neural
structures with a higher viral burden and have various advantages over the other routes of
drug administration in terms of required doses, side effects, and efficacy.
Objective To know whether intrathecal acyclovir injection is neurologically and
histopathologically safe or not.
Study Design: Randomized, experimental trial in rats.
Setting: Associated experiment center.
Methods: A total of 40 rats weighing between 250-300g were used. The rats were
randomly divided into 2 groups of 20 each using a random number table: normal saline
group (Group N) and acyclovir group (Group A). Rats in Group N were administered 20 µl
of normal saline and Group A were administered the same volume of 700 µg/mL acyclovir
into the intrathecal space via an intrathecal catheter. Saline or acyclovir was administered
daily for 5 consecutive days. The changes in behavior and sensory-motor function were
checked and histopathological findings of the spinal cords were observed by light and
electron microscopy.
Results: No rats in Group N or Group A showed any behavioral change or sensorymotor dysfunction during the 5-day observation period. Furthermore, no histopathological
abnormalities of the spinal cord were observed in the 6th day after the last intrathecal
administration of the drug.
Limitations: There is a need to perform studies to evaluate long-term safety by observing
cumulative neurotoxic effects with continual injection during a long-term period.
Conclusions: There was no evidence of neurological and histopathological abnormalities
following intrathecal acyclovir injection.
Key words: acyclovir, safety, spinal,intrathecal, acute zoster pain, post herpetic neuralgia
Does Long-Term Opioid Therapy Reduce Pain
Sensitivity of Patients with Chronic Low Back
Pain? Evidence from Quantitative Sensory
Testing
Authors: Wang Haili
Published: March 2021

Background: Long-term opioid treatment has been used extensively in treatment of
chronic low back pain (cLBP) in the last decades. However, there are serious limitations to the
long-term efficacy of opioids and related side effects.
Objectives: In this study we investigated whether long-term opioid treatment changes
pain sensitivity of patients with cLBP.
Study Design: A prospective, nonrandomized, cross-sectional study.
Setting: Multidisciplinary pain management clinic, specialty referral center, university
hospital in Germany.
Methods: Using quantitative sensory testing (QST), we compared the pain sensitivity of the
low back bilaterally among 3 groups: 35 patients with cLBP undergoing a long-term opioid
therapy (OP); 35 patients with cLBP administered no opioids (ON), and 28 subjects with
neither pain nor opioid intake (HC).
Results: OP patients showed significantly higher bilateral thermal detection thresholds to
warm stimuli on the back as compared to both ON (P = 0.009 for left low back, P = 0.008
for right low back) and HC subjects (P = 0.004 for left low back, P = 0.003 for right low
back). Pain thresholds for cold and heat on the hand were similar in OP and ON groups;
both showed, however, significantly reduced heat pain thresholds in comparison with HC
participants (P = 0.012 for OP, P = 0.001 for ON). Factors such as age, sex, duration and
dose of opioid intake, and self-reported pain intensity, but not depression and pain duration,
correlated significantly with QST results.
Limitations: Limitations include small numbers of patients with heterogeneous opioid
therapy and the nonrandomized observational nature of the study.
Conclusions: The current study demonstrated that chronic opioid intake may only reduce
the temperature sensitivity but not pain sensitivity measured by QST which is a useful tool in
detecting characteristic changes in pain perception of patients with chronic low back pain
after long-term opioid intake.
Key words: Pain sensitivity, opioid treatment, chronic low back pain (cLBP), quantitative
sensory testing (QST)
Consumer/Patient Encounters with Prescription
Drug Monitoring Programs: Evidence from a
Medicaid Population
Authors: Goodin Amie
Published: March 2021

Background: Prescription drug monitoring programs issue reports about a patient’s
controlled substance prescription history upon request to physicians, law enforcement
officials, and pharmacists. The dual purposes of these programs are to reduce the abuse
and diversion of controlled substances while not preventing access to these medications for
legitimate medical need.
Objective: The purpose of this study was to examine the experiences of Medicaid patients
with Kentucky’s Prescription Drug Monitoring Program (PDMP).
Study Design: A random sample of Medicaid patients was surveyed in 2010; respondents
were matched with patient retrospective claims data from 6 months prior to the survey’s
administration.
Study Setting: Kentucky Medicaid patients from across the state.
Methods: A combination of patient surveys and Medicaid claims data was used to test the
relationship between patient characteristics and patient-reported interactions with physicians
regarding their PDMP reports and whether they experienced difficulty obtaining or filling a
prescription for a controlled substance due to a PDMP report.
Results: Most Medicaid patients are unaffected by the PDMP; however, patients diagnosed
with chronic non-cancer pain conditions and patients reporting a Hispanic ethnicity are
significantly more likely to have a physician discuss their PDMP report with them. Patients
diagnosed with chronic non-cancer pain conditions are also significantly more likely to report
difficulty obtaining a prescription for a controlled substance than patients that have not
been diagnosed with chronic non-cancer pain conditions. Patients living in rural areas are
significantly less likely than patients in urban areas to report difficulty obtaining a prescription
for a controlled substance.
Limitations: The utilization of controlled substance prescriptions by respondents was
not measured or monitored. The Medicaid population examined in this study may not be
representative of the population as a whole.
Conclusions: These results suggest that more attention to the consumer/patient perspective
is warranted in maintaining a balanced approach to decreasing drug abuse and diversion
while not limiting access to controlled substances in cases of legitimate medical need
Key words: Prescription Drug Monitoring Program, Medicaid, controlled substances,
chronic pain patients, patient experiences, KASPER
A Systematic Review of Randomized Trials on
the Effectiveness of Opioids for Cancer Pain
Authors: Koyyalagunta Lakshmi
Published: March 2021

Background: In all recommended guidelines put forth for the treatment of cancer
pain, opioids continue to be an important part of a physician’s armamentarium.
Though opioids are used regularly for cancer pain, there is a paucity of literature
proving efficacy for long-term use. Cancer is no longer considered a “terminal
disease”; 50% to 65% of patients survive for at least 2 years, and there are about
12 million cancer survivors in the United States. There is a concern about side effects,
tolerance, abuse and addiction with long-term opioid use and a need to evaluate the
effectiveness of opioids for cancer pain.
Objective: The objective of this systematic review was to look at the effectiveness of
opioids for cancer pain.
Study Design: A systematic review of randomized trials of opioids for cancer pain.
Methods: A comprehensive review of the current literature for randomized controlled
trials (RCTs) of opioids for cancer pain was done. The literature search was done using
PubMed, EMBASE, Cochrane library, clinical trials, national clearing house, Web of
Science, previous narrative systematic reviews, and cross references. The studies were
assessed using the modified Cochrane and Jadad criteria. Analysis of evidence was
done utilizing the modified quality of evidence developed by United States Preventive
Services Task Force (USPSTF).
Outcome Measures: Pain relief was the primary outcome measure. Secondary
outcome measures are quality of life (QoL) and side effects including tolerance and
addiction.
Results: The level of evidence for pain relief based on the USPSTF criteria was fair
for transdermal fentanyl and poor for morphine, tramadol, oxycodone, methadone,
and codeine.
Limitations: Randomized trials in a cancer setting are difficult to perform and justify.
There is a paucity of long-term trials and this review included a follow-up period of
only 4 weeks.
Conclusion: This systematic review of RCTs of opioids for cancer pain showed fair
evidence for the efficacy of transdermal fentanyl and poor evidence for morphine,
tramadol, oxycodone, methadone, and codeine.
Key words: Opioids, pain relief, cancer pain, morphine, hydromorphone, methadone,
fentanyl, oxymorphone, hydrocodone, oxycodone, buprenorphine.
Assessment of Neuropathic Pain in Patients
with Cancer: The Interobserver Reliability.
An Observational Study in Daily Practice
Authors: Timmerman Hans
Published: March 2021

Background: Neuropathic pain (NeP) is a burdensome problem in all stages of cancer.
Although clinical judgment is accepted as a surrogate for an objective gold standard in
diagnosing NeP, no publications were found about its reliability.
Objectives: Therefore, levels of agreement on the clinical examination of NeP were
estimated by calculating kappa-value (Κ) and percentage of pair wise agreement (PA) to
determine the interobserver reliability of diagnosing NeP.
Setting: The outpatient clinic of medical oncology of the Radboud University Nijmegen
Medical Centre.
Methods: Patients with cancer with potential NeP complaints were recruited from the
outpatient clinic of medical oncology. Physicians were recruited from the department of
pain and palliative medicine. Physicians and patients were recruited for participation in an
observational study in daily practice. Each patient (N = 34) was examined by 2 specialists
via independent clinical assessment. All consultations were video recorded. After each
assessment, physicians were asked to indicate the most adequate characterization of the
pain: pure NeP, pure nociceptive pain (NoP), mixed pain (MiP), or no pain (NP).
Results: Kappa (Κ) for the diagnosis of the most adequate pain characterization was 0.50,
PA 64.7%. For diagnosing pure NeP k was 0.78 (PA 91.2%), for the NeP component (NeP
+ MiP) and NoP component (NoP + MiP), it was respectively 0.52 (PA 76.5%) and 0.61 (PA
82.4%). For the diagnosis on the basis of the grading system between physicians, Κ was
0.34 (PA 52.9%). The intrarater reliability for the diagnosis of an NeP component on the basis
of clinical assessment and the NeP component on the basis of the grading system, for pain
specialists Κ was 0.69 (PA 85.3%) and for palliative care specialists Κ was 0.61 (PA 79.4%).
Limitations: The values of Κ and the PA for the existence of an NeP component are not
satisfying and the clinical agreement between physicians around findings from physical
examination should encourage a better standardization of the clinical assessment and
classification of pain in patients with cancer in respect with the identification of NeP.
Conclusions: A substantial level of agreement was found for the diagnosis of pure NeP and
a moderate level of agreement for the diagnosis of the NeP component was found, both with
a PA ≥ 70%. There was only a fair agreement between the physicians regarding the grading
system. However, there was a substantial level of (interrater) agreement for the diagnosis of
an NeP component and the outcome of the grading system. The findings in this study also
suggest that a better standardization of the clinical assessment and classification of pain in
patients with cancer with respect to the identification of neuropathic pain is necessary.
Key words: Neuropathic pain, diagnosis, interobserver reliability, agreement, cancer
observational study, pain, clinical assessment, diagnostic test
Antioxidant Therapy for Pain Relief in Patients
with Chronic Pancreatitis: Systematic Review
and Meta-analysis
Authors: Wu Sheng-Xi
Published: March 2021

Background: Currently, there is no specific therapy for chronic pancreatitis (CP). The treatment
of micronutrient antioxidant therapy for painful CP has been sporadically used for more than 30
years, however, its efficacy are still poorly understood.
Objective: The purpose of this meta-analysis is to investigate the safety and efficacy of
antioxidant therapy for pain relief in patients with CP.
Setting: University Hospital in China
Study Design: Systematic review and meta-analysis
Methods: Two authors independently reviewed the search results and extracted data and
disagreements were resolved by discussion. Effects were summarized using standardized mean
differences (SMDs), weighted mean differences, or odds ratio (OR) according to the suitable effect
model. MEDLINE, PsycINFO, Scopus, EMBASE, and the Cochrane Central Register of Controlled
Trials were searched from 1980 through December 2012. Randomized controlled trials (RCTs)
that studied antioxidant supplementation for pain relief in patients with CP were analyzed.
Results: Nine randomized controlled trials (RCTs) involving 390 patients were included. Overall,
there was no association of antioxidant therapy with pain reduction in CP patients (SMD, −0.55;
95% CI, −1.22 to 0.12; P = 0.67). However, antioxidant therapy significantly increased blood
levels of antioxidants in CP patients versus the placebo group (SMD, 1.08; 95% CI, 0.74 to 1.43;
P < 0.00001). Interestingly, combined antioxidant (selenium, β-carotene, vitamin C, vitamin E,
methionine) therapy was found to be associated with pain relief (SMD, -0.93; 95% CI, -1.72 to
-0.14; P = 0.02), while the trials in which a single antioxidant was used revealed no significant
pain relief (SMD, -0.12; 95% CI, -1.23 to 0.99; P = 0.83) in CP patients. Strong evidence was
obtained that the antioxidants increased adverse effects (OR, 6.09; 95% CI, 2.29 to 16.17, P <
0.01); nevertheless, none was serious.
Limitations: Because of the small sample, a consolidated conclusion cannot be reached based
on current RCTs. Large-sample RCTs are needed to clarify the analgesic effect of antioxidants in
CP patients.
Conclusions: Combined antioxidant therapy seems to be a safe and effective therapy for pain
relief in CP patients. Measures of total antioxidant status may not help to monitor the efficacy of
antioxidant therapy for patients with CP.
Key words: Antioxidant, pain, chronic pancreatitis, meta-analysis
Needle Echogenicity in Ultrasound-Guided
Lumbar Spine Injections: A Cadaveric Study
Authors: Gofeld Michael
Published: March 2021

Background: Echogenicity of regional anesthesia needles has been tested on different preclinical
models; however, previous studies were done in an ideal experimental setting utilizing highfrequency insonation and superficially located targets. Because steep-angle deep injections are
typically required for spinal and other chronic pain procedures, and low-frequency transducers are
used, further feasibility study is warranted.
Objectives: To determine effectiveness of steep-angle deep injections, typically required for spinal
and other chronic pain procedures.
Study Design: Experimental laboratory study.
Setting: Willed Body Program, University of Washington.
Methods: In-plane lumbar spine procedures with 50° and 70° angles were performed on a human
cadaver. The images and video clips of a non-echogenic (Quincke-type) and echogenic (SonoPlex,
StimuQuick, and EchoStim) needle placements were presented to 3 blinded assessors who rated the
needle visibility on a 4-point scale.
The data was statistically analyzed to determine the differences in visibility between the needles with
and without the digital image enhancement, and to compare the video clips to captured images.
Results: ANOVA analysis demonstrated that overall SonoPlex was significantly better (P = 0.02) than
other needles. SonoPlex maintained its superiority in the subset of facet joint injections (P = 0.02),
followed by Quincke-type, then the StimuQuik, and EchoStim needles. In deep procedures, EchoStim
was comparable with SonoPlex (P = 0.03), and they both were better than the other 2 needles. The
enhanced images received higher rates, with a 0.6 point mean improved rating (P = 0).
Limitations: This study is limited by choice of needles, number of experiments performed, and
potential postmortem changes of echogenicity.
Conclusions: The SonoPlex needle appeared to have better echogenicity in this study. While nonechogenic Quincke-type needle visibility was adequate in superficial placements, it was limited in
deep injections. An imaging enhancement is effective in improving needle visibility and should be
used whenever possible.
Key words: Spinal injections, ultrasound, echogenic needle
Effectiveness Of Blended Learning In Human Anatomy Courses
Authors: I Nyoman Gede Wardana
Published: March 2021

It is very demanding to teach anatomy in the present curriculum of medical education. The amount of time allotted to teach and learn human anatomy is diminishing. The traditional teaching method is no longer effective in being able to provide vast amounts of human anatomy learning material. Besides, this method is also passive, which is not liked by the current generation of students. Various disciplines have widely used the learning approach with the blended learning method. This study aims to compare the effectiveness of the blended learning method (BL) with the traditional teaching (TT) method on the student's final grades and the percentage of graduation rates for the gross human anatomy courses. A total of 217 final student grades from Batch 2016 (69 students), Batch 2017 (69 students), and Batch 2018 (79 students) were collected and analyzed. Students in Batch 2018 received the blended learning (BL) method while the Batch 2016 and Batch 2017 received the traditional teaching (TT) method. The mean final scores between the BL and TT methods were compared, also the percentage of graduation rates between the two methods. There was a significant mean difference in the student's final grade (P <0.001) between the BL method (66.77) versus the TT method (47.84). The percentage of students who passed with the BL method (65.82%) is higher than the TT method (10.14%). The result concluded blended learning method is more effective in increasing the final grade and percentage of graduating students than the traditional teaching method for gross human anatomy courses.
Penggunaan Bahasa Indonesia Berdasarkan Pedoman EYD Pada Media Sosial Facebook
Authors: Hendrawan Ari Yunus , Riang Hati Waruwu
Published: March 2021

Tujuan dari penelitian ini adalah untuk mengetahui gangguan yang muncul akibat hadirnya bahasa alay terhadap komunikasi di jejaring sosial, khususnya media Facebook. Data dikumpulkan dengan menginventarisasi penggunaan bahasa alay di media Facebook. Kemudian data yang telah dikumpulkan akan diklasifikasikan menurut gangguan semantik yang terjadi terhadap unsur unsur komunikasi. Metode penelitiaan menggunakan metode deskriptif kualtitatif. Penulis akan mendeskripsikan dengan cara kualitatif satu persatu data yang diperoleh dengan cara mendeskripsikan gangguan-gangguan semantik terhadap unsur-unsur komunikasi tersebut. Berdasarkan hasil penelitian yaitu seiring majunya perkembangan zaman, semakin banyak pula pilihan cara berkomunikasi. Perkembangan teknologi yang begitu cepat menyebabkan para pelaku komunikasi selalu berupaya mencari cara berkomunikasi dengan cepat, murah, dan praktis.Bahasa alay menjadi sebuah variasi bahasa yang marak di kalangan remaja. Diarik kesimpulannya yaiu dalam media sosial facebook ini semakin berkembangnya zaman akan semakin banyak orang-orang yang menggunakannya apalagi dizaman yang maju setiap orang sudah memerlukan handphone untuk memenuhi kebutuhannya termasuk untuk mencari hiburan agar dapat membantu merefreskan otak disaat orang lelah. Pemakaain huruf kapital, pemakaian tanda titik, dan pemakaian tanda koma.Banyaknya kata alay yang digunakan banyak berdampak pada anak-anak yang belum mengerti dan akhirnya anak tersebut mengikuti apa yang dilihat dan didengar, dan itu bisa menjadi dampak buruk bagi anak-anak dan orang yang belum mengerti.
PERFIL DOS PACIENTES COM DOENÇAS OSTEOMIOARTICULARES ATENDIDOS EM UM AMBULATÓRIO DE FISIOTERAPIA DE UM SERVIÇO PÚBLICO DO MUNICÍPIO DE BELÉM
Authors: Bossini Erielson dos Santos , Esteves Tiago Costa , Pinheiro Vanessa do Nascimento
Published: March 2021

Introdução: Atualmente as doenças osteomioarticulares estão entre as patologias que mais acometem a população, gerando um elevado custo a saúde pública e impacto socioeconômico. Objetivo: Traçar o perfil epidemiológico de pacientes atendidos no ambulatório de Fisioterapia de um serviço público. Métodos: Trata-se de um estudo de caráter retrospectivo, observacional e de delineamento longitudinal, para quantificar o perfil epidemiológico de pacientes atendidos no ambulatório de Fisioterapia de 2015 a 2019, através da analise de dados dos prontuários. Resultados: Foram analisados 680 prontuários, no qual foi identificado a prevalência mais frequente da faixa etária, do gênero, da distribuição geográfica, dos segmentos anatômicos acometidos e das patologias. Conclusão: Conclui-se que o perfil dos pacientes atendidos no setor público, foi do gênero feminino, com a faixa etária entre 46 anos a 55 anos, com a coluna vertebral sendo o segmento mais acometido e a hérnia de disco lombar a patologia mais incidente.
The role of antioxidants in the treatment of diabetes
Authors:   Azərbaycan Tibb Universiteti, Ulduz Kazimova Afag , Musa Musayeva Elnura ,   Azərbaycan Tibb Universiteti, Asif Huseynova Gulbaniz ,   Azərbaycan Tibb Universiteti, Musa Abdullayeva Rashida ,   Azərbaycan Tibb Universiteti
Published: March 2021

Oxidative stress is a major cause of various types of tissue damage, especially endothelial dysfunction, which occurs in diabetes mellitus. In a healthy organism the formation of ROS occurs under the strict control of the biological system, on the contrary, under severe stress, many diseases, as well as diabetes, the production of ROS increases curtly. Due to its high reactivity, an increase in the amount of SOR leads to oxidative stress, which disturb the balance between the antioxidant and prooxidant systems. The main prin-ciple of the therapeutic strategy to reduce oxidative stress in diabetes mellitus is to inhibit the formation of free radicals. The results of clinical and experimental experiments demonstrate the administration of antioxidants, especially vitamin E, insulin resistance and therapeutic effect in diabetic conditions. Recently, the use of synthetic, as well as herbal antioxidants, along with other drugs in the pharmacotherapeutic correction of a number of pathologies in medical practice has become widespread. The development of a more effective pharmacotherapeutic strategy for diabetes with antioxidants and the synthesis of potent agents are promising for further research. Key words: diabetes mellitus, antioxidant, oxidative stress, reactive oxygen species (ROS), free radicals
İMMUNPROFILAKTIKANIN TƏŞKILININ ƏSASLARI, ONUN EFFEKTIVLIYININ VƏ TƏHLÜKƏSIZLIYININ QIYMƏTLƏNDIRILMƏSI
Authors:   Gəncə Dövlət Universiteti, Isfandiyar Sadigov Gunay , Alihuseyin Azizova Gulustan ,   Gəncə Dövlət Universiteti
Published: March 2021

The purpose of this article is to investigate the growing number of viral diseases, to gather information on what measures should be taken against them and to educate the population. The immunological structure of the population is formed due to increased insensitivity to pathogenic microorganisms, which occurs through the formation of natural immunity (inherited or acquired as a result of an infectious process) and artificial immunity (created through immunoprophylaxis). The level of the immunological structure of the population affects the direction (trend) of the epidemic process. The higher the AID for a particular infectious disease, the lower the incidence, as well as the risk of group illnesses or outbreaks Key words: immunology, prophylaxis, natural immunity, artificial immunity, vaccination, vaccine, acquired immunity, serum, foreign antigen, organism, hereditary, physiological feature, anatomical feature
Study of the effect of physical mutagens on the elements of cotton varieties Summary
Authors:   Bitki Mühafizə və Texniki Bitkilər Elmi-Tədqiqat İnstitutu, Ibrahim Rzayeva Ilhama
Published: March 2021

The effect of different doses of gamma rays of the Co60 isotope on the seeds of cotton varieties AzNIXI-104 and AzNIXI-195 before sowing caused changes in the growing season, plant height, sympodial branches and the number of bolls on the bush. At low doses of gamma rays (500 r, 5000 r) the vegetation period was shortened, the number of sympodial branches and bolls in the branch increased, and at high doses of mutagen a decrease in biomorphological features was observed. Key words: cotton, sort, gamma ray, mutagen, sympodial branch, vegetation period.