bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival and Long-term Outcomes Following in-hospital Cardiac Arrest in a Swiss University Hospital: a Prospective Observational Study
Authors: Fuchs Alexander , Käser Dominic , Theiler Lorenz , Greif Robert , Knapp Jürgen , Berger-Estilita Joana
Published: March 2021

Background: Incidence of in-hospital cardiac arrest is reported to be 0.8 to 4.6 per 1,000 patient admissions. Patient survival to hospital discharge with favourable functional and neurological status is around 21%. The Bern University Hospital is a tertiary medical centre in Switzerland with a cardiac arrest team from the Department of Anaesthesiology and Pain Medicine that is available 24 h per day, 7 days per week. Due to lack of central documentation of cardiac arrest team interventions, the incidence, outcomes and survival rates of cardiac arrests are unknown. The aim was thus to record all cardiac arrest team interventions over 1 year, and to analyse the outcome and survival rates of adult patients after in-hospital cardiac arrests.Methods: We conducted a prospective single-centre observational study that recorded all adult in-hospital cardiac arrest team interventions over 1 year, using an Utstein-style case report form. The primary outcome was 30-day survival after in-hospital cardiac arrest. Secondary outcomes were return of spontaneous circulation, neurological status (after return of spontaneous circulation, after 24 h, after 30 days and 1 year), according to the Glasgow Outcomes Scale, and functional status at 30 days and 1 year, according to the Short-form-12 Health Survey.Results: The cardiac arrest team had 146 interventions over the study year, which included 60 non-life-threatening alarms (41.1%). The remaining 86 (58.9%) acute life-threatening situations included 68 (79.1%) as patients with cardiac arrest. The mean age of these cardiac arrest patients was 68 ±13 years, with a male predominance (51/68; 75.0%). Return of spontaneous circulation was recorded in 49 patients (72.1%). Over one-third of the cardiac arrest patients (27/68) were alive after 30 days with favourable neurological outcome. The patients who survived to 1 year after the event showed favourable neurological and functional status. Conclusions: The in-hospital cardiac arrest incidence on a large tertiary Swiss university hospital was 1.56 per 1,000 patient admissions. After a cardiac arrest, about a third of the patients survived to 1 year with favourable neurological and functional status. Early recognition and high-quality cardiopulmonary resuscitation provided by a well-organised team is crucial for patient survival.Trial Registration: The trial was registered in clinicaltrials.gov (NCT02746640).
Development of a Europium Nanoparticles Lateral Flow Immunoassay for NGAL Detection in Urine and Diagnosis of Acute Kidney Injury
Authors: Yin Moli , Nie Yuanwang , Liu Hao , Liu Lei , Tang Lu , Dong Yuan , Hu Chuanmin , Wang Huiyan
Published: March 2021

Background:AKI is related to severe adverse outcomes and mortality with Coronavirus Infection Disease 2019 (COVID-19) patients, that early diagnosed and intervened is imperative. Neutrophil gelatinase-associated lipocalin (NGAL) is one of the most promising biomarkers for detection of acute kidney injury (AKI), but current detection methods are inadequacy, so more rapid, convenient and accuracy methods are needed to detect NGAL for early diagnosis of AKI. Herein, we established a rapid, reliable and accuracy lateral flow immunoassay based on europium nanoparticles (Eu-NPS-LFIA) for the detection of NGAL in human urine specimens. Methods:A double-antibody sandwich immunofluorescent assay using europium doped nanoparticles was employed and the NGAL monoclonal antibodies conjugate as labels were generated by optimizing electric fusion parameters. Eighty-three urine samples were used to evaluate the clinical application efficiency of this method. Results:The quantitative detection range of NGAL in AKI was 1-3000 ng/mL, and the detection sensitization was 0.36 ng/mL. The CV of intra-assay and inter-assay were 2.57%-4.98% and 4.11%-7.83%, respectively. Meanwhile, the correlation coefficient between Eu-NPS-LFIA and ARCHITECT analyzer was significant (R2=0.9829, n=83, p<0.01). Conclusions:Thus, a faster and easier operation quantitative assay of NGAL for AKI has been established, which is very important and meaningful to diagnose the early AKI, suggesting that the assay can provide an early warning of final outcome of disease.
Profiling analysis of circular RNA and mRNA in human temporal lobe epilepsy with hippocampal sclerosis ILAE type 1
Authors: Gu Yifei , Wu Hongmei , Wang Tianyu , Yu Shengkun , Han Zhibin , Zhang Wang
Published: March 2021

Hippocampal sclerosis (HS) is the most common surgical pathology associated with temporal lobe epilepsy (TLE). However, the cause of TLE with or without HS remains unknown. Our current study aimed to illustrate the essential molecular mechanism that are potentially involved in the pathogenesis of TLE-HS and to shed light on the transcriptional changes associated with hippocampal sclerosis. RNA-seq analysis was performed to evaluate profiling of circRNAs and mRNAs in hippocampal tissues of HS IALE-type 1 and no-HS patients. Systematic bioinformatic analysis of expression levels was utilized in circRNAs and mRNAs. Altered expression of selected circRNAs and mRNAs levels was confirmed by RT-PCR. In this study, we explored transcriptomic profiling of circRNAs and mRNAs expression in 3 ILAE type 1 and 3 no-HS hippocampal tissues. Compared to no-HS group, 341 mRNA transcripts and 133 circRNA transcripts were differentially expressed in ILAE type 1 group. Gene Ontology analysis demonstrated that the dysregulated genes were associated with the biological processes of vesicle-mediated transport. Enrichment analysis demonstrated that dysregulated genes were involved mainly in the mitogen-activated protein kinase (MAPK) signal pathway. Subsequently, A total of 441 known or predicted interactions were formed among DEGs, and the most important module was detected in the PPI network using the MCODE plug-in. There were mainly four functional modules enriched: ER to Golgi transport vesicle membrane, Basal transcription factors, GABA-gated chloride ion channel activity, CENP-A containing nucleosome assembly. A circRNA-mRNA co-expression network was constructed including 5 circRNAs(hsa_circ_0025349, hsa_circ_0002405, hsa_circ_0004805, hsa_circ_0032254, and hsa_circ_0032875) and three mRNAs (FYN, SELENBP1, and GRIPAP1) based on the normalized mRNA signal intensities. This is the first to report the circRNAs and mRNAs expression profile of surgically resected hippocampal tissues from TLE patients of ILAE-1 and no-HS, and these results may provide new insight on the transcriptional changes associated with this pathology.
Influenza- and COVID-19-associated pulmonary aspergillosis: are the pictures different?
Authors: reizine florian , Pinceaux Kieran , Lederlin Mathieu , Autier Brice , Guegan Hélène , Gacouin Arnaud , Luque-Paz David , Boglione-Kerrien Christelle , Bacle Astrid , Dare Brendan Le , Launey Yoann , Lesouhaitier Mathieu , Painvin Benoit , Camus Christophe , Mansour Alexandre , Robert-Gangneux Florence , Belaz Sorya , Tulzo Yves Le , Tadié Jean-Marc , Maamar Adel , Gangneux Jean-Pierre
Published: March 2021

BackgroundInvasive pulmonary aspergillosis (IPA) in intensive care unit patients is a major concern, in particular for those with acute respiratory distress syndrome (ARDS). As observed previously for influenza-associated ARDS, the SARS-CoV-2 pandemic has shown a high proportion of COVID-19 patients with ARDS to be at risk of developing invasive fungal diseases.MethodsWe used the new international definitions of influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA) to compare the demographic, clinical, biological and radiological aspects of IAPA and CAPA in a monocentric retrospective study.ResultsAmong the 120 ARDS patients included, we observed equivalent prevalence of IPA in Influenza and COVID-19 populations: 17 IAPA (23.9%) and 10 CAPA (20.4%). There were no significant differences in demographic or admission characteristics between patients with and without IPA. Kaplan-Meier curves showed significantly higher 90-day mortality for IPA patients overall (p = 0.032), whereas mortality did not differ between CAPA and IAPA. The duration of mechanical ventilation was higher for IPA patients (23 days [IQR 17–40] than those without (17 days [IQR 9–25], p = 0.038). Patients with COVID-19 and influenza associated ARDS treated with corticosteroids were more likely to develop IPA. Radiological findings of IPA in both populations using the new criteria increased sensitivity but with still poor specificity. Nonetheless, they also showed interesting differences between IAPA and CAPA with a higher proportion of features suggestive of IPA in IAPA patients. Lastly, therapeutic drug monitoring also appeared challenging since a wide proportion of IPA patients had low plasma voriconazole concentrations, with a significant higher delay to reach voriconazole concentrations > 2mg/L in CAPA versus IAPA patients (p = 0.045).ConclusionsICU patients presenting with ARDS during COVID-19 are very similar to those with severe influenza pneumonia in terms of prevalence of IPA and outcome, while CAPA is mainly favored by advanced age irrespective of the background. The dramatic consequences on the patients' prognosis emphasize the need for a better awareness in these particular populations. Larger prospective studies may help in designing the most well-adapted personalized management to prevent IPA, which represents a high burden of death in severe COVID-19 and Influenza pneumonia.
Three different genetic risk scores based on Fatty Liver Index, Magnetic Resonance Imaging and lipidomic for a nutrigenetic personalized management of NAFLD: the Fatty Liver in Obesity study
Authors: Pérez-Díaz-del-Campo Nuria , Riezu-Boj Jose I. , Marin-Alejandre Bertha Araceli , Monreal J. Ignacio , Elorz Mariana , Herrero José Ignacio , Benito-Boillos Alberto , Milagro Fermín I. , Tur Josep A. , Abete Itziar , Zulet M. Angeles , Martinez J. Alfredo
Published: March 2021

Background
Non-alcoholic fatty liver disease (NAFLD) affects 25% of the global population. The pathogenesis of NAFLD is complex where available data unveils that genetics and ascribed interactions with environmental factors may play an important role in the development of this morbid condition. The purpose of this investigation was to assess genetic and non-genetic determinants putatively involved in the onset and progression of NAFLD after a 6-months weight-loss nutritional treatment.
Methods
A group of 86 overweight/obese subjects with NAFLD from the Fatty Liver in Obesity (FLiO) study were enrolled and metabolically evaluated at baseline and after 6-months. Also, a total of 95 single nucleotide polymorphisms (SNPs) related to obesity and weight loss were analyzed by a targeted next-generation sequencing system. Three genetic risk scores (GRS) concerning the improvement on hepatic health evaluated by minimally invasive methods such as the Fatty Liver Index (FLI) (GRSFLI), lipidomic-OWLiver®-test (GRSOWL) and Magnetic Resonance Imaging (MRI) (GRSMRI), were derived by adding the risk alleles genotypes. Body composition, liver injury-related markers and dietary intake were also monitored.
Results
Overall, 26 SNPs were independently associated with the change on FLI, 16 SNPs with OWLiver®-test and 8 SNPs with MRI, which were specific for every diagnosis tool. After adjusting for gender, age and other related predictors (insulin resistance, inflammatory biomarkers and dietary intake at baseline) the calculated GRSFLI, GRSOWL and GRSMRI were major contributors of the improvement on hepatic status. Thus, fitted linear regression models showed a variance of 53% (adj. R2 = 0.53) in hepatic functionality (FLI), 16% (adj. R2 = 0.16) in lipidomic metabolism (OWLiver®-test) and 34% (adj. R2 = 0.34) in liver fat content (MRI).
Conclusion
These results demonstrate that three different genetic scores can be useful for the personalized management of NAFLD, whose treatment must rely on specific dietary recommendations guided by the measurement of specific genetic biomarkers.
Trial registration:
The FLiO study: Fatty Liver in Obesity study, NCT03183193. Registered 12 June 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03183193
Political Polarization in the Media Landscape: The Case of Indonesian Elections
Authors: maulana ardian , Situngkir Hokky
Published: March 2021

Political polarization has long been a central topic for political science. This study investigate the phenomenon of political polarization in Indonesian news media landscape during the 2019 Presidential Election. We represent the media landscape as a network of news media based on their shared audience, and implement community detection algorithms to extract media clusters. We also construct a time series of media network and explore the dynamics of polarization during the observation period. The study confirms the existence of political polarization in the global and temporal networks of Indonesian news media, and shows that Twitter users' news consumption behavior is highly polarized. We also reveal periods with higher and lower polarization throughout the observation period, namely the degree of polarization in the media landscape is already high from the start of the observation, relaxes quickly after the election, and then reaches its maximum prior to the announcement of the official results.
Disassembly sequence planning based on a modified grey wolf optimizer
Authors: Xie Jin , Li Xinyu , Gao Liang
Published: March 2021

Disassembly sequence planning (DSP) can effectively increase the disassembly efficiency, shorten the disassembly cycle, reduce disassembly costs and reduce environmental hazards of end-of-life (EOL) products, playing an important role in manufacturing industries. Thus, it is urgent to propose an approach to solve the DSP problem. DSP is a famous NP-hard combinatorial optimization problem. As the size of components increases, exact algorithms can hardly obtain the optimal disassembly sequence. Therefore, we proposes a promising intelligence algorithm, modified grey wolf optimizer (MGWO), for solving the DSP problem. MGWO inherits the main idea of the hierarchy and hunting mechanism of the original grey wolf optimizer (GWO). Three new operators are designed in MGWO to ensure the feasibility of solutions under the complex constraint of disassembly precedence. The feasible solution generator (FSG) is designed to obtain feasible disassembly sequences, the neighborhood search operator (NSO) is developed to make wolves (solutions) self-evolving, and the guided search operator (GSO) is used to make the wolf group guided by three leaders of wolves. Two engineering cases are applied to validate the effectiveness of the proposed operators. Then, they and one real-world application are used to compare the MGWO with other reported methods. The results demonstrate that MGWO can solve the DSP problem effectively.
Telemedical Second Opinions in Germany – a Customer Survey of an Online Portal
Authors: Könsgen Nadja , Prediger Barbara , Schlimbach Anna , Bora Ana-Mihaela , Weißflog Victoria , Loh Jan-Christoph , Bruch Dunja , Pieper Dawid
Published: March 2021

BackgroundSecond medical opinions (SOs) can strengthen patients’ certainty in decision-making. Since 2019, statutory health insured German residents have the right to obtain an SO for selected indications according to the SO Directive. Additionally, several health insurers offer SO programs often in cooperation with telemedical SO providers. Telemedical SO programs are mostly based on documents only. Our aim was to analyze the characteristics of people who obtained telemedical SOs, their experiences made during the SO process, and their assessment of SOs in general and of the different routes of SO delivery (personally/by phone/documents only).MethodsGerman residents who obtained an SO via an online portal between January 2016 and February 2019 (n=1247) were contacted by post between August and November 2019 up to three times. The results were analyzed descriptively.ResultsThe 368 participants (response rate 30%) were 54% male, 95% statutory health insured and 61 years old (median; interquartile range 51-72). Most participants reported having an orthopedic condition (87%) or had been recommended surgery (78%). The most common reason for seeking an SO in general was the need for more information on further treatment recommendations (64%). A telemedical SO was mainly chosen because it was offered by the health insurer (82%). Disagreements between first opinions and SOs occurred in 55% of the participants. Approximately 60% of the participants with disagreements followed the treatment recommendation of the SO. For 67% of the participants, the SO (rather) enhanced the certainty in decision-making. Approximately 75% were (rather) satisfied with obtaining the SO via the online portal, and 95% would seek another SO (irrespective of the online portal). The most preferred route of SO delivery was a personally delivered SO, which 80% would (rather) consider, followed by 70% (rather) considering SOs based on documents only and 48% (rather) considering SOs by phone.ConclusionSOs were generally appreciated. Although our results show that SOs (based on documents only) support patients and that patient satisfaction was high, personally delivered SOs were still preferred. Future research on the use of SOs based on documents only (in which patient population and in what situations) is needed.
Numerical Integration of Multibody Dynamic Systems Involving Nonholonomic Equality Constraints
Authors: Natsiavas Sotirios , Passas Panagiotis , Paraskevopoulos Elias
Published: March 2021

This work considers a class of multibody dynamic systems involving bilateral nonholonomic constraints. An appropriate set of equations of motion is employed first. This set is derived by application of Newton’s second law and appears as a coupled system of strongly nonlinear second order ordinary differential equations in both the generalized coordinates and the Lagrange multipliers associated to the motion constraints. Next, these equations are manipulated properly and converted to a weak form. Furthermore, the position, velocity and momentum type quantities are subsequently treated as independent. This yields a three-field set of equations of motion, which is then used as a basis for performing a suitable temporal discretization, leading to a complete time integration scheme. In order to test and validate its accuracy and numerical efficiency, this scheme is applied next to challenging mechanical examples, exhibiting rich dynamics. In all cases, the emphasis is put on highlighting the advantages of the new method by direct comparison with existing analytical solutions as well as with results of current state of the art numerical methods. Finally, a comparison is also performed with results available for a benchmark problem.
The German Research Consortium for the Study of Bipolar Disorder (BipoLife): A Magnetic Resonance Imaging Study Protocol
Authors: Vogelbacher Christoph , Sommer Jens , Schuster Verena , Bopp Miriam H. A. , Falkenberg Irina , Ritter Philipp S. , Bermpohl Felix , Attar Catherine Hindi , Rauer Lisa , Einenkel Karolin E. , Teutlein Jens , Gruber Oliver , Juckel Georg , Flasbeck Vera , Mulert Christoph , Hautzinger Martin , Pfennig Andrea , Matura Silke , Reif Andreas , Grotegerd Dominik , Danlowski Udo , Kircher Tilo , Bauer Michael , Jansen Andreas
Published: March 2021

Background: Bipolar disorder is one of the most severe mental disorders. Its chronic course is associated with high rates of morbidity and mortality, a high risk of suicide and poor social and occupational outcomes. Despite the great advances over the last decades in understanding mental disorders, the mechanisms underlying bipolar disorder at the neural network level still remain elusive. This has severe consequences for clinical practice, for instance by inadequate diagnoses or delayed treatments. The German research consortium BipoLife aims to shed light on the mechanisms underlying bipolar disorders. It was established in 2015 and incorporates ten university hospitals across Germany. Its research projects focus in particular on individuals at high risk of bipolar disorder, young patients in the early stages of the disease and patients with an unstable highly relapsing course and/or with acute suicidal ideation. Methods: Functional and structural magnetic resonance imaging (MRI) data was acquired across nine sites within three different studies. Obtaining neuroimaging data in a multicenter setting requires among others the harmonization of the acquisition protocol, the standardization of paradigms and the implementation of regular quality control procedures. The present article outlines the MRI imaging protocols, the acquisition parameters, the imaging paradigms, the neuroimaging quality assessment procedures and the number of recruited subjects.Discussion: The careful implementation of a MRI study protocol as well as the adherence to well-defined quality assessment procedures is one key benchmark in the evaluation of the overall quality of large-scale multicenter imaging studies. This article contributes to the BipoLife project by outlining the rationale and the design of the MRI study protocol. It helps to set the necessary standards for follow-up analyses and provides the technical details for an in-depth understanding of follow-up publications.
Predicting the Ultimate Tensile Strength of AISI 1045 steel and 2017-T4 aluminum alloy joints in a laser-assisted rotary friction welding process using Machine learning: a comparison with Response surface methodology
Authors: Barrionuevo Germán Omar , Mullo José Luis , Ramos-Grez Jorge Andrés
Published: March 2021

Welding metal alloys with dissimilar melting points make conventional welding processes not feasible to be used. Friction welding, on the other hand, has proven to be a promising technology. However, obtaining the welded joint's mechanical properties with characteristics similar to the base materials remains a challenge. In the development of this work, several of the machine learning (ML) regressors (e.g., Gaussian process, decision tree, random forest, gradient boosting, and multi-layer perceptron) were evaluated for the prediction of the ultimate tensile strength (UTS) in joints of AISI 1045 steel and 2017-T4 aluminum alloy produced by rotary friction welding with laser assistance. A mixed design of experiments was employed to assess the effect of the rotation speed, friction pressure, and laser power over the UTS. Furthermore, the response surface methodology (RSM) was employed to determine an empirical equation for predicting the UTS, and contours maps determine the main interactions. A total of 48 specimens were employed to train the regressors; the 5-fold cross-validation methodology was used to find the algorithm with greater precision. The gradient boosting regressor (GBR) and Gaussian processes regressors present the highest precision with a less than 3% percentage error for the laser-assisted rotary friction welding process. The capability of the GBR exceeds the accuracy of the RSM with a coefficient of determination (R2) of 90.90 versus 83.24 %, respectively.
Interfacial strength and microstructure of AlN/Cu joints produced by a novel brazing method facilitated by porous-copper layer and Ag foil
Authors: Huang Yilian , Fu Renli , Chen Xudong , Cheng Bo , Agathopoulos Simeon
Published: March 2021

The reliability of wide-bandgap (WBG) semiconductors used as power electronics is closely related to the high thermal conductivity of AlN-metalized substrates. Thus, the bonding of AlN ceramics with metals is a key issue for the production of reliable AlN-metalized substrates. This paper reports on a new method for producing AlN/Cu joints by employing a novel film-metallization production process, which involves a porous network of Cu layer and Ag foil. The microstructure and the phases formed at the interface of the AlN/Cu joints produced at various brazing temperatures and times, were analyzed by scanning electron microscopy and X-ray diffraction analysis. Strong joints with shear strength of 48.5 MPa were produced after brazing at 850 °C for 10 min. The typical microstructure at the interfacial reaction zone was Cu / Ag(s) + Cu(s) / CuAlO2 + Al2O3 + Cu(s) / AlN. The experimental results manifest the crucial role of the Ag-Cu eutectic liquid phase, formed by the reaction between the Cu layer and the Ag foil, and of the porous network of the Cu layer deposited on the surface of the AlN ceramic substrate, since both of them effectively favor the reduction of the residual thermal stresses in the joint and result in strong ceramic/metal joins.
Presymptomatic viral shedding and infective ability of SARS-CoV-2; a case report.
Authors: Nissen Karolina , Hagbom Marie , Krambrich Janina , Akaberi Dario , Sharma Sumit , Ling Jiaxin , Hoffman Tove , Bondeson Kåre , Svensson Lennart , Salaneck Erik
Published: March 2021

Reports of possible pre- or asymptomatic transmission have been reported, both from SARS-CoV and from MERS-CoV outbreaks, although this appears to be uncommon. In contrast, during the COVID-19 pandemic, an increasing number of studies and case reports indicate that pre- or asymptomatic transmission of SARS-CoV-2 is not only possible but also occurs frequently. We report repeated rRT-PCR detection of SARS-CoV-2 in a health care worker and demonstrate infective ability up to three days prior to mild COVID-19 symptoms. rRT-PCR indicated high viral levels approximately three days after exposure. Viral samples collected one and three days prior to symptoms exhibited infectivity on Vero E6 cells, confirmed by detection of double-stranded RNA by immunofluorescence, assessment of cytopathic effect (CPE) and rRT-PCR. SARS-CoV-2 specific IgM and IgG antibodies were detected by day 9 and 15, respectively, after symptom onset. We propose that this provides evidence for potential early presymptomatic transmission of SARS-CoV-2 and that infectivity may be manifest shortly after exposure.
THE CURRENT SITUATION OF TEACHING FUNDAMENTAL PHYSICFOLLOWING CDIO APPROACH
Authors:   Ho Chi Minh University of Food Industry., Thi Kim Tuyen Ta
Published: March 2021

The article presents the surveying of the teaching situation of Fundamental Physics to meet the output standards in university which use the CDIO approach to teach students of engineering major, as well as information on the application of methods, form of evaluation in the teaching process of Fundamental Physics.
WOMAN SEXUALITYMOROCCANS WOMAN KNOWLEDGE
Authors:   Professeur Assistant De Psychiatrie a lhopital Psychiatrique Universitaire Arrazi, Sale., Belbachir S. , Houmiri A. ,   Psychiatre Sante Publique., Ouanas A. ,   Professeur De Psychiatrie a lhopital Psychiatrique Universitaire Arrazi, Sale.
Published: March 2021

The sexuality has an important impact on the mental health, the social functioning and the quality of life of the woman. A good knowledge of its own body and the importance of the preliminary allow an awareness of erogenous zones, and to know all the resources which lead to the pleasure, to reach a satisfaction of the emotional, psychological and physical needs Objectives: estimate the theoretical knowledge concerning the feminine sexuality in a population of Moroccan women, to emphasize their perception and their knowledge in this domain. Methodology: a investigation with 100 women of 20 and more years old, all socioeconomic and educational levels. Use of anheteroquestionnary containing items relative to the anatomy of the body of the woman, to the preliminary, to the attitude of the woman during the sexual intercourse, and to the feminine orgasm Results: in Morocco, country of Arab culture -berbero-Muslim- the sexuality is submitted toCultural, ethical, psychological and social, biological factor. In our study 88% of the women considered that the knowledge of the feminine genital anatomy is essential for the sexual self-fulfillment. Erogenous zones could be not genital parts of the body for 82%. In our study 48% of women know the role of the clitoris in the sexual pleasure, 20% have already heard about the G point, and only 8% were able to know how to placeit.Concerning the erogenous character of the G-spot, meadows of 87% of our investigated ignore this role. 46% think that the woman must be active during the sexual intercourse. In our study only 7% declared to know that there are 2 types of orgasms at the woman clitoral and vaginal. Conclusion: it is very clear that the taboo remains heavy, the lack of information, and a sex education focusing on the hashouma (mixture of shame and prohibition), however, the majority of the investigated are for a sex education while respecting the cultural and religious values of our country.
SYSTEM THAT INTERFERES WITH THE FIRST LAW OF THERMODYNAMICS
Authors: Hazeleger Hendrik
Published: March 2021

The first law of thermodynamics, also known as Law of Conservation of Energy, states that work cannot be created or destroyed in an isolated system. Here-in presented is a system, tested and with calculations that interferes with the first law of thermodynamics. The proposed and tested system shows that it takes less work to pump air underwater than the work that is produced by the quantity of water lifted above the water level with that underwater air pressure that lifts the system, in addition to the work that accumulated in the air stored underwater. Unfortunately it is however it is not possible to utilize this work to generate a perpentual motion machine. It generates free energy, free energy is subject to irreversible loss in the course of such work.
PESANTEURS SOCIOCULTURELLES ET LEURS IMPACTS SUR LES ACTIVITES DE DEVELOPPEMENT DANS LA REGION DE MARADI AU NIGER
Authors:   UMR : Developpement Durable, Societes et Adaptation aux Changements climatiques, Faculte dAgronomie et des Sciences de lEnvironnement, Universite Dan Dicko Dankoulodo de Maradi, Niger., Lawali Sitou , Amadou Issoufou ,   Laboratoire des Sciences et Technologies Alimentaires, Faculte dAgronomie et des Sciences de lEnvironnement, Universite Dan Dicko Dankoulodo de Maradi, Niger., Djamila Gambo Mahaman Nana ,   UMR : Developpement Durable, Societes et Adaptation aux Changements climatiques, Faculte dAgronomie et des Sciences de lEnvironnement, Universite Dan Dicko Dankoulodo de Maradi, Niger., Saley Maman ,   Programme Alimentaire Mondial, Sous Bureau Maradi, Niger.
Published: March 2021

The study is part of an agreement between the World Food Program (WFP) and the University Dan DickoDankoulodo of Maradi. Its objective is to analyze the socio-cultural factors related to the development activities undertaken by WFP. It was carried out in three WFP intervention areas, namely: GuidanYaro located in the rural commune of Baoudeta (local government of Tessaoua), Tambaraoua Amani located in the rural commune of Chadakori (local government of GuidanRoumdji), and the village of Maya da rojiya located in the urban commune of Mayahi (local government of Mayahi). The results indicated that the package of activities undertaken by WFP and its partners (rural development, education and nutrition) improved the living conditions of assisted house hold in all the villages. However, several gravities have been identified by this study. That is ignorance which has an impact on the education of children, illiteracy which limits the ability to obtain and understand information, the lack of regular attendance at health centers which causes illness to persist. Also, the lack of accountability of men in household expenses coupled with the rural exodus increase the vulnerability of women and children, followed by a lack of labor for development activities. On the other hand, it shows the overload of womens work limiting their participation in development activities and the spirit of the population to be always assisted which impacts the management of natural resources with a lack of personal initiative. On the other hand, it shows the overload of womens work limiting their participation in development activities and the spirit of the population to be always assisted which impacts the management of natural resources with a lack of personal initiative. In addition, the results highlight certain cultural ceremonies which seriously impact the level of education of children and the debt of parents. other forms of ceremony limit womens participation in development activities.
SMART SOLUTIONS FOR ENHANCING ROAD SAFETY AND BETTER RIDING EXPERIENCE USING IOT
Authors:   Department of Computer Engineering AISSMS CoE Pune, India., Vinay Kulkarni Aashay , Krishna Baroorkar Abhinav ,   Mechanical Engineering Department, Sinhgad College of Engineering Pune, India., Sandeep Lele Sumedh ,   Department of Electronic Science DES Fergusson College Pune, India .
Published: March 2021

This paper aims at providing solutions that would improve safety and riding experience. To ensure that the rider uses a helmet, the bike wont start unless the rider is wearing the helmet. The paper also proposes a solution to get the live location of the rider as well as using this location to disable the horn in no honking zones. With the help of different sensors mounted on the bike and helmet, the proposed system can detect an accident and inform emergency contact numbers. To further improve the efficiency of the entire system, solar power can be used.
ROLE OF NOVEL ORAL ANTICOAGULANTS (NOACS)IN PATIENTS WITH ATRIAL FIBRILLATION CARDIOVERSION- AN EXECUTIVE SUMMARY
Authors: Jing Wang , Sophearith Phav
Published: March 2021

In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is necessary for prevention of stroke and systemic embolism especially during cardioversion. While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with requirements for frequent monitoring (INR) and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban). These medications have been shown to be at least as effective as warfarin for stroke prevention in NVAF with more favorable safety profiles. However, their advantages are underscored by a lack of specific antidotes and assays quantifying their anticoagulant effects. This review addresses how well do the Rivaroxaban prevents stroke and systemic embolism compare to VKAs in patients with NVAF, with a special focus on high-risk populations, including the elderly, those with renal disease, diabetes mellitus, coronary artery disease, and previous stroke.
THE 1986 LAKENYOSGAS DISASTER IN CAMEROON:CHALLENGES AND IMPLICATIONS ON SURVIVORS AND THE LIVESTOCK ECONOMY
Authors:   Department of History and Archaeology The University of Bamenda., Comfort Sjinkwe Kimah
Published: March 2021

This paper seeks to examine how the Lake Nyos gas disaster of 21 August 1986 affectedlivestock production and cattle rearing within the environment of Subum, Cha and Nyos. It brings to the forefront, the post-disaster effects onthe pastoral cattle rearing community. Thepolicies and strategies put forth by the various stakeholdersat the national and international levels have partially addressed some of the worries posed by this disaster, even thoughthe area is still in dire need of government and humanitarian support to improve onthe sector.The paper argues that, the resettlement of these livestock breeders could improvethis sector and render the environment sustainable for human habitation. Gleaned from a wide range of primary and secondary sources, the paper concludes that there isabsolute need for the government of Cameroon to tackle these long-term difficulties faced by these communities and to develop an effective livestock policy geared towards improving the livelihoods of the people around Lake Nyos.
DIGITAL IMPLANT PLANNING: A BRIEF NARRATIVE REVIEW
Authors:   Mohammed V University., Khourani W.El , Yamani A.El ,   Mohammed V University.
Published: March 2021

Recently, the development of radiology, and software engineering, has led to the development of a new protocol called computer-assisted implantology (CAI) or guided implantology. CT / CBCT scanners allow the dentist to visualize a patients anatomy in 3 dimensions. Define the precise measurement of bone for implant placement, soft tissue thickness, proximity and adjacent root anatomy. The exact location of the maxillary sinuses, and other relevant vital structures such as mandibular canal, mental and incisal foramen canal. Once the images are imported, to the software the clinician can then virtually begin treatment planning. The type and size of the planned implant, its position in the bone, its relationship to the restoration and adjacent teeth and/or implants, and its proximity to vital structures can be determined prior to surgery. Computer-generated surgical drill guides can then be manufactured from the virtual treatment plan.
COMPARATIVE STUDY OF FENTANYL, TRAMADOL AND NALBUPHINE IN ATTENUATION OF HAEMODYNAMIC RESPONSES IN LAPAROSCOPIC CHOLECYSTECTOMY
Authors:   HOD, Department of Anaesthesia AND ICU, Amar Hospital, Patiala, Punjab., Singh Hp , Kumar Jindal Naveen ,   Consultant, Department of Anaesthesia and ICU, Amar Hospital, Patiala, Punjab., Singh Jaspreet ,   Consultant, Department of Anaesthesia and ICU, Amar Hospital, Patiala, Punjab.
Published: March 2021

Background:-Numerous attempts have been made in the past to attenuate the haemodynamic responses occurring during laparoscopic cholecystectomy. The present study compared the effect of three opioids namely TRAMADOL, Fentanyl and Nalbuphine in obtundation of haemodynamic responses in laparoscopic cholecystectomy in terms of Heart rate, BP (SBP, DBP and MAP) and secondary aim was to calculate duration of analgesia and sedation score. Materials And Methods:-This was a randomised study comparing three opioid drugs- nalbuphine, fentanyl and TRAMADOL. It was carried out on 75 patients of either sex aged 18 - 60 years scheduled for elective laparoscopic cholecystectomy under GA. Subjects were enrolled into three groups- Group B (n= 25) patients received inj. TRAMADOL 2 mcg/kg IV, Group F (n= 25) received inj. Fentanyl 2 mcg/kg IV and Group N (n= 25) patients received inj. Nalbuphine 0.2 mg/kg 5 minutes before the induction. Result:-At the time of extubation, mean MAP in Group B, F and N was 99.88, 95.32 and 97.24 respectively. This difference is highly significant when compared statistically (p value is 0.005). Conclusion:-With this study, we conclude that the administration of intravenous fentanyl and nalbuphine five minutes prior to induction of anaesthesia helps in better obtundation of haemodynamic responses to laparoscopic cholecystectomy than TRAMADOL.
EFFECTS OF TECAR THERAPY ASSOCIATED WITH MANUAL THERAPY ON GLUTEAL SKIN FLACCIDITY
Authors:   Federal Universityof Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil., Rego Maia Rafaella , Froes Meyer Patricia ,   Rio Grande do Norte University Center (UNIRN), Natal, Brazil., Marcel Valentim Da Silva Rodrigo ,   Estacio College, Natal, Rio Grande do Norte, Brazil Mauricio de Nassau College, Natal, Rio Grande do Norte, Brazil., M. Soares Elayne ,   Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil., Cristina F Da Silva Isabela ,   Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil., Santos De Vasconcellos Liliane ,   Federal Universityof Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil., Davi Costa E. Silva Julio ,   Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil., De Morais Carreiro Eneida ,   Rio Grande do Norte University Center (UNIRN), Natal, Brazil., Gonzaga De Araujo Neto Luis ,   Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil., Rosa V. Marques Ana ,   Potiguar University (UnP), Natal, Rio Grande do Norte, Brazil., Tavora Pinho Rosado Ventura Antonia ,   Product Specialist Manager in BTL, Brazil.
Published: March 2021

Background: A new technology called Tecar therapy, widely used in the orthopaedic area, has been studied in aesthetics in order to treat skin flaccidity. The equipment allows the association of radiofrequency with manual therapy. This study is an experimental research that aims to analyse the effects of the Tecar therapy associated with manual therapy on skin flaccidity of the gluteal region. Methods:Volunteers were individuals aged between 21 and 54, who presented skin flaccidity in the gluteal region. The sessions/applicationsoccurred once a week, totalling four applications with the TR THERAPY ELITE-6000 BTLTMdevice pre-set underthe following parameters: 500 KHz frequency, 100% duty cycle and 80% power, capacitive mode, in an area corresponding to twelve quarters measuring 7 cmÂ² each, during60 minutes. Results:The evaluations were carried out in all the sessionsand included metric verification, photographic recording with subsequent photo submission to the AutoCAD software, and photogrammetric analysis. At the end of treatment, the volunteers answered anadaptedquestionnaire of satisfaction and a global aesthetic improvement scale form (GAIS). The results regarding AutoCAD, metric measurement, and photogrammetry did not present significant statistical differences. Conclusion:Although the statistical results were not satisfactorydespite its limitations regarding sample size,and possiblydue to the subjective analysis of the resources used as the evaluation methods. Still, the volunteers reported improvement in the texture and firmness of the skin in the treated region, indicating their satisfaction with the performed treatment.
LIMPACT DES THERAPIES TRADITIONNELLES SUR LA PRISE EN CHARGE DES MALADES MENTAUX
Authors:   Professeur Assistant de Psychiatrie a lhopital Psychiatrique Universitaire Arrazi, Sale., Belbachir S. , Benzineb A. ,   Psychiatre liberal a Rabat., Ouanass A. ,   Professeur de Psychiatrie a lhopital Psychiatrique Universitaire Arrazi, Sale.
Published: March 2021

In spite of the development of the psychiatry in Morocco, the traditional therapy is another current phenomenon always using to treat mental disorder. The surnatural was dominating in the representation of the mental disorder, and it as well at the level of its origin as of its treatment.The objective of this work is to describe the cultural perception of the first psychiatric symptoms by the families of the mental sick, to determine the first approach of care.It is about a descriptive forward-looking study using a heteroquestionnary including a sample of 184 families of hospitalized or consultant patient to the Ar-razipsychiatric hospital in Sale (Morocco) over a period of three months of the current year.We counted 184 families who have a member consulted or hospitalized at the Arrazi hospital. 38% represent mother of patient. All the socioeconomic and educational levels were represented. Almost all the diseases were founded with a big ascendancy of the psychotic disorders. The appeal to Fkihs in front of first symptoms was almost important the conversifs disorders and anxious seem to be the preference illness of this kind of practice but you should not forget that the psychoses also represent a not insignificant rate with 66%. The cultural interpretations of the mental illness are represented by the charm in 35 % of the cases, the Toukal (deliberate poisoning) in 29% and the ownership by devils in 21 %. The bad eye is reported in 20%. More than 63% of families turned to the traditional therapy in front of the first psychiatric symptoms, while only 36 % returned the patients at a general doctor or a psychiatrist. 62 % of families continue to turn to the traditional therapies in spite of the psychiatric follow-up, in this case they tend to stop the medical treatment in 30 % of the cases. There is a significant link between the first orientation and the interpretation of the disease. Traditherapeutes was more requested at the patients of whom families think that their disease is of surnatural origin (p = 0,001). The appeal to the traditional therapy and the residence in rural areas and not schooling are also strongly correlated. (P = 0,011 and p = 0,001). The Moroccan psychiatry was able to realize a lot of progress during the last two decades, in spite of the insufficiency of the human resources and the infrastructures. Additional efforts are necessary, especially with the high request of care, for it all the community should participate in the promotion of the mental health to reduce the stigmatization of this discipline and offer a better management of patients. The family is at the heart of the care of the mental disorders. Simple interventions with family can largely improve the quality of life of the sick person and that of the whole family.
SCLERITES ET EPISCLERITES EN MEDECINE INTERNE UNE SERIE DE 40 OBSERVATIONS
Authors:   Service de Medecine Interne, Centre Hospitalier Universitaire Mohammed VI Marrakech., Yousfi Jaouad , Elouakhoumi Amal ,   Service de Medecine Interne, Centre Hospitalier Universitaire Mohammed VI Marrakech., Zahlane Mouna ,   Service de Medecine Interne, Centre Hospitalier Universitaire Mohammed VI Marrakech., Essaadouni Lamiaa ,   Service de Medecine Interne, Centre Hospitalier Universitaire Mohammed VI Marrakech.
Published: March 2021

Purpose :To evaluate demographic characteristics, clinical features, systemic disease associations, visual outcomes, and treatment modalities of patients with episcleritis and scleritis in an internal medicine departement Methods :Data from 17 patients with episcleritis and from 23 patients with scleritis followed from 2010 to 2019 were retrospectively evaluated. The main outcome measures were demographics, ocular disease characteristics, presence of systemic associated disease, and treatment regimen. Results :Episcleritis and scleritis were found bilaterally in 62.5 % patients.The episcleritis was diffuse in 11 and focal in 06 patients, while the scleritis was diffuse in 5, nodular in 10, necrotizing in 1, and posterior in 7 patients. An associated systemic disease was found in 27.5%. Conclusion :The importance of differentiating scleritis from episcleritis is remarkable given the significant difference in the degree of ocular complications and associated systemic diseases between these ocular conditions.