bluuebunny/crossref_metadata_2025 huggingface dataset:
The Core Internal Medicine Training: Evolving beyond the Clinical Teaching Unit
Authors: Panju Mohamed , Whitehead Lori , Martin Leslie
Published: May 2020

AbstractOver the past 50 years, the CTU has remained a core part of training for residents within internal medicine training programs. At the same time, the needs of society have changed significantly over the years, and current training needs to reflect this change. This is not a novel idea, but one that we feel requires greater attention to adequately address the needs of academic teaching hospitals across the country.

ResumeAu cours des 50 dernières années, la CTU est restée un élément essentiel de la formation des résidents dans le cadre des programmes de formation en médecine interne. Dans le même temps, les besoins de la société ont considérablement évolué au fil des ans, et la formation actuelle doit refléter ce changement. Il ne s’agit pas d’une idée nouvelle, mais d’une idée qui, selon nous, nécessite une plus grande attention afin de répondre adéquatement aux besoins des hôpitaux universitaires d’enseignement à travers le pays.
Knowledge Translation in Heart Failure
Authors: Brahmbhatt Darshan H. , Kobulnik Jeremy
Published: May 2020

The treatment of heart failure has expanded over the past three decades with large numbers of new medications and healthcare innovations available for these patients. At the same time, the prevalence of heart failure continues to increase across Canada and these patients are managed by a variety of clinicians from differing backgrounds in both primary care and hospital settings. Despite national recommendations advocating uptake of these new therapies, their utilization remains limited and inconsistent across the country. This review discusses the importance of knowledge translation in heart failure and examines the barriers to implementation of new therapies and models of care, providing a range of solutions to facilitate the delivery of guideline-directed care for heart failure patients.
Paternal Perinatal Depression: A Narrative Review
Authors: Philpott Lloyd Frank , Savage Eileen , Leahy-Warren Patricia , FitzGerald Serena
Published: May 2020

The perinatal period, which covers the time when a man’s partner becomes pregnant through to the first year after birth can be a time of great excitement, happiness, and joy. However, it can also be a time of great disruption and change. Despite the positive and protective long-term effect that fatherhood has on men’s health, a significant proportion of fathers’ experience depressive symptoms during the perinatal period. This paper aims to review studies that assessed symptoms of depression in fathers during the perinatal period and to describe the prevalence estimates, identify the risk factors and impact of depression, and establish if there are interventions that effectively reduce depression among fathers. A systematic search of relevant electronic databases including Medline, CINAHL, Cochrane Library, PsycARTICLES, PsycINFO, and Psychology and Behavioural Sciences Collection were searched using keywords related to paternal perinatal depression. Prevalence estimates of paternal perinatal depression varied widely between studies, ranging from 1 to 46%. Several sociodemographic variables that contribute to depression in fathers in the perinatal period were reported and these include paternal age, lower education levels, parity, an unplanned pregnancy, and maternal depression. Paternal perinatal depression is associated with morbidity within the father’s family, including depression in his partner, maladjustment to parenthood and future psychological problems in his children. In conclusion, evidence from this review adds further support for the need to review how we plan, provide and resource our health services, to recognize the influence that pregnancy, birth, and fatherhood in the perinatal period can have on men’s mental health.
Sugar and Stones
Authors: Elhadi M , D’Costa J , De Vogel C , Devarajan R , Otite U
Published: May 2020

Introduction

Urolithiasis is a common urological problem in the United Kingdom. 6% of the adult population were diag-nosed with diabetes in England in 2013. Researchers suggest the association of diabetes with stone forma-tion, recurrence, and morbidity. This study aimed to compare the prevalence of risk factors like metabolic syndrome, urinary tract infections, age, gender and ethnicity among diabetics versus non-diabetics and to determine how diabetes affects the biochemical and surgical outcomes of urolithiasis.

Methods

There were182 patients treated surgically for urolithiasis between January 2010 and December 2012 were retrospectively analyzed. Information was cross-referenced with electronic notes to produce biochemical and surgical data.

Results

A total of 31 (17%) patients had type 2 diabetes. The mean age of diabetics was significantly higher than non-diabetics by nearly 12 years (p-value < 0.001). Hypertension, hyperlipidaemia, obesity and UTIs were more prevalent among diabetics (p-value < 0.001, < 0.001, 0.01, 0.009 respectively). Diabetics had signifi-cantly bigger mean stones size (p-value=0.008) and are at higher risk of stone recurrence at 1 year (p-value =0.04) than non-diabetics. Stone recurrence was not significant at 3 and 5 years between the two groups. Diabetics significantly had higher urinary oxalate, and nearly statistically significant lower phosphate levels (p-value=0.007, 0.076 respectively).

Conclusions

Diabetics were significantly older and associated with metabolic syndrome. UTIs were more prevalent among diabetics which put them at risk of postoperative complications. Diabetics are at higher risk of stone recurrence at 1 year compare to non-diabetics. Biochemical urinary findings are important as they can guide the management of recurrent stone formers.
The Burden on a Urologist of Percutaneous Nephrostomies and Antegrade Ureteric Stents: Should Trainee Urologists Learn to Perform these Procedures?
Authors: Donati-Bourne J Jack , Nour Shahd Seifeldin , Siddiqui Zain , Viney RP Richard P.
Published: May 2020

Background and Objective

Renal obstruction is a common urological emergency potentially requiring urgent decompression by percutaneous nephrostomy (PCN) or antegrade ureteric stent (AUrS), procedures performed by interventional radiologists, or retrograde stenting in theatre by a urologist.

The study aimed to assess the burden of PCN / AUrS on the overall workload of a urology department and evaluate impact of procedural delays in terms of bed-occupancy and cost.

The findings serve to explore whether formal PCN / AUrS training would be desirable for UK trainees in urology.

Material and Methods

Prospective study of all patients admitted under urology at Queen Elizabeth Hospital Birmingham (QEHB) between 20thOctober - 18thNovember 2018.

Electronic records to retrieve data pertaining to admission, treatment provided, length of in-patient stay and delay awaiting PCN / AUrS.

Results

n=148 patients identified. n=22 (14.8% of total) primary admission reason and/or main treatment provided related to PCN / AUrS. 601 urology in-patient days occupied for all causes, 166 (27.6%) related to PCN / AUrS and 66 (10.9%) awaiting PCN / AUrS (delays cost �11,361 / month).

Conclusion

PCN / AUrS constituted a noteworthy proportion of all admissions and in-patient bed days in QEHB urology. Clinically non-urgent patients experienced notable cumulative delays whilst awaiting PCN / AUrS which adversely impacted bed occupancy. A suitably trained urologist competent at PCN / AUrS may positively address these issues. The findings merit consideration of a call for UK urology trainees to be trained in PCN / AUrS as part of CCT requirements.
Trends in Renal Stone Clearance after Ureteroscopy: A Review
Authors: Subramonian Subiksha , Gopalakrishnan Somasundari , Smith Yuko
Published: May 2020

Background and Objectives

Stone clearance rate in ureteroscopy has varied over the years. This study aims to review the stone clear-ance rate over the last 25 years and assess the change over time. We have analyzed the reasons for the peaks and troughs in stone clearance rate to see if it correlates with any factors such as the introduction of new technology like the holmium laser, flexible ureteroscopy, access sheaths, and digital ureteroscopy.

Material and Methods

We performed a PubMed search (August 2019) for papers including the terms “lithiasis”, “stone clear-ance”, “calculi”, “kidney stone”, “ureteric stone”, “ureteroscopy”, “holmium laser”, “retrorenal surgery” in their title and published between the years 1994 and 2019. The stone size, stone clearance rate and mode of imaging to determine clearance rates were recorded. For data analysis, only prospective studies with a minimum of 50 patients and ureteroscopy arm of prospective randomized controlled trials were included.

Results

We reviewed 16 papers with a total of 1,689 patients with renal stones. Average stone clearance was 80% and the median stone size was 11.0mm. Stone clearance was determined by either: Computed tomography (CT) scan (8 studies), x-ray alone (3 studies), x-ray and ultrasound (3 studies) or not mentioned (2 studies). CT scan yielded lower stone clearance rates than x-ray due to the increased detail shown on CT. For studies that used absolute clearance with no residual stones, average clearance was 52%, and this stone clearance rate increased as the cut-off size used to determine the stone-free rate was increased.

Conclusion

This study highlights that stone clearance rate after ureteroscopy varies significantly amongst different pa-pers because of the stone size used to define ‘stone-free rate’ and the method of imaging used to determine stone clearance. The study also shows that stone clearance rates have not improved significantly over time, despite the introduction of advances in technology.
Day Case Mini Percutaneous Nephrolithotomy (PCN): First UK Experience
Authors: Auer A , Abdelqader B , Glassey A , Rowbotham C , Ismail M
Published: May 2020

Background and Objective

To investigate the safety, efficacy, and feasibility of performing mini PCN (MIP-M Karl Storz) as a day case procedure. We report our experience and outcomes from our case series which to our knowledge is the first reported in the UK.

Material and Methods

Ten patients appropriate for mini PCN and day-case surgery were selected prospectively. All 10 patients underwent a mini PCN procedure in a prone position. Access was achieved by the operating surgeon under fluoroscopic guidance in 9 cases and by a consultant uroradiologist under ultrasound guidance in 1 patient with a ureterosigmoidostomy using a Kellet needle and the MIP-M system (Karl Storz, Germany). Stones were fragmented with a 550um laser fibre and retrieved by both the Vortex effect and a grasper. Drainage was achieved with a 6 Fr antegrade stent in 9 cases and a 10 Fr nephrostomy tube in one patient. Stone related outcomes, duration of surgery, length of stay and complications were recorded.

Results

All cases were completed as planned. The mean operating time was 93 minutes. A day case rate of 80% was achieved. Two patients were admitted overnight for social reasons; one lived on a nearby island and was not ready for discharge in time to catch the last ferry and another no longer had a responsible adult at home to monitor him overnight. All patients were deemed radiologically stone free. No readmissions, transfusion, infections or other complications were recorded at 90 days postoperatively.

Conclusion

We have shown that day-case mini PCN is a feasible and safe procedure in selected patients. A larger number of cases are needed to establish our patient selection criteria and corroborate our early outcomes.
Metabolic Stone Screening – Can Education Improve Adherence to National Guidelines?
Authors: Ravindraanandan Manoj , Jayawardena Panduka
Published: May 2020

Nephrolithiasis is a common urological disease affecting approximately 13% of the global population. Identifying a preventable cause during follow-up for stone formation is a necessary factor in reducing recurrence.

The majority of kidney stones are comprised of calcium, with oxalate and phosphate compounds account-ing for approximately 80% of stone formers. Serum analysis can be used to identify the levels of calcium in the blood, excluding metabolic causes for stones. Current NICE guidelines recommend performing a metabolic screen during an acute admission. Adherence to these guidelines from clinicians can be poor. We aim to see whether education can improve serum metabolic requests from clinicians in the UK.

Method

A case-control study was performed in a single rural district general hospital in the UK. Patients who pre-sented with renal colic were analyzed retrospectively for four months, looking at serum metabolic screen requests. Two months of education was then delivered to acute departments, with a further prospective study performed following this for six months. Outcomes were then compared between both groups to see if there was an improvement in serum requests following the delivery of local education.

Results

A total of 124 patients were included in our study. 50 patients were analyzed in cohort A over a 4-month period. Complete serum analysis was performed on 22% (n=11) of patients. Incomplete serum analysis was performed on 58% (n-29) of patients with uric acid being missed on all of them. 10 patients had no metabolic serum analysis performed at all, with 1 patient having a previous history of stones.

A total of 74 patients were analyzed in cohort B over a 6-month period. This was following the 2 months of departmental education given by urologists. Complete serum analysis was performed on 24% (n=18) of patients. Incomplete serum analysis was performed on 55% (n=41) of patients with uric acid being missed from all of them. The remaining 21% of patients (n=15) had no metabolic serum screen performed at all.

There was no significant difference seen between both cohorts after comparing metabolic serum requests before and after department education for 2 months (p=0.7287).

Conclusion

Improving adherence to clinical guidelines for metabolic screening has proved difficult with departmental teaching alone, with very little improvement achieved. Nevertheless, formal face-to-face education is ad-vocated to reinforce knowledge in junior doctors managing renal stones.
Female Urinary Retention: Observations from a Retrospective Case Note Review
Authors: Khela Aman , Olateju Ayooluwa , Gunendran Thiruendran , Montague Richard J
Published: May 2020

Background and Objective

There are no current guidelines to manage female retention patients. We aimed to see if a standardized approach could be used to manage these patients.

Methods

Between October 2014 and September 2016, all female patients with urinary retention admitted under a urology consultant were reviewed.

Results

A total of 46 females had a single episode of urinary retention whilst 19 females had recurrent episodes. The commonest cause for a single episode of retention was attributed to anesthesia (general/spinal) (n=9), constipation (n=9) and medication use (n=4). Most of these women (95%) voided on the first attempt fol-lowing catheter removal. In the absence of any neurological symptoms, pelvic ultrasound was the only investigation that revealed any underlying pathology in female retention patients. A pelvic mass was identi-fied in 3 (4.5%) patients.

Conclusion

Females with an isolated episode of retention, with an obvious precipitating cause identified during full history and examination, could proceed directly to a nurse-led trial of catheter removal without the need for any further urology review. Others should undergo a pelvic ultrasound and review by a urologist. In our opinion, females with recurrent unexplained episodes of urinary retention should be referred for a trial of sacral neuromodulation if considered appropriate.
Estados Falidos: Da origem às intervenções das Nações Unidas no pós Guerra Fria
Authors: Rodrigues Anselmo de Oliveira
Published: May 2020

O presente artigo tem por finalidade aprofundar o conhecimento sobre os Estados Falidos, analisando esse tema desde a sua origem até a sua utilização nos dias atuais. Para tanto, este artigo está estruturado da seguinte forma: inicialmente é realizada uma breve ambientação sobre esse assunto, seguida da exposição do objetivo de pesquisa. Na sequência, são apresentadas as correntes de pensamento contrárias e favoráveis sobre os Estados Falidos. Posteriormente, é realizado um breve histórico sobre a evolução desse tema na sociedade. Em seguida, é feito um debate sobre o conceito de Estados Falidos e sua respectiva utilização. A próxima seção expõe as metodologias adotadas por alguns Think Tanks que se propuseram a mensurar a falência estatal. Na seção seguinte, discorre-se sobre a tentativa da comunidade internacional na reconstrução dedeterminados Estados a partir da queda do muro de Berlim. Na parte final, realizam-se reflexões sobre a utilidade e a importância dessa teoria atualmente.
Manejo de pacientes con enfermedad inflamatoria intestinal durante la pandemia de COVID-19d-19
Authors: Juliao Baños Fabian
Published: May 2020

La pandemia causada por el virus SARS-CoV-2, originada en Wuhan, capital de la provincia de Hubei (China), se ha convertido en un desafío para la humanidad. Es un virus altamente contagioso; hasta el momento, la enfermedad por coronavirus (COVID-19) presenta una mortalidad global alrededor del 6 %, que es mayor en pacientes con comorbilidades. La enfermedad inflamatoria intestinal (EII) es una patología discapacitante, con daño tisular y alteración en la respuesta inmunológica, lo cual, asociado a los medicamentos inmunosupresores que se utilizan frecuentemente para su tratamiento, pone al paciente en riesgo de desarrollar infecciones y complicaciones. En esta revisión consideramos la interacción del virus SARS-CoV-2 con el tracto gastrointestinal y los potenciales mecanismos por los cuales un paciente con EII podría tener un riesgo incrementado de la infección por COVID-19. Adicionalmente, y a pesar de que no hay estudios clínicos publicados en pacientes con EII y COVID-19, damos recomendaciones basadas en opinión de expertos sobre el cuidado de pacientes con EII, con énfasis en su tratamiento y la realización segura de procedimientos endoscópicos, tanto para el paciente como para el personal de salud.
Inducción de “tormenta de citocinas” en pacientes infectados con SARS- CoV-2 y desarrollo de COVID-19. ¿Tiene el tracto gastrointestinal alguna relación en la gravedad?
Authors: Parra Izquierdo Viviana , Florez-Sarmiento Cristian , Romero-Sanchez Maria Consuelo
Published: May 2020

Los coronavirus son una extensa familia de virus; algunos pueden ser causa de diversas enfermedades humanas, que van desde el resfriado común hasta el síndrome respiratorio agudo severo. La enfermedad por coronavirus (COVID-19) es causada por el coronavirus zoonótico SARS-CoV-2, y comenzó en China en diciembre de 2019. En marzo de 2020, la Organización Mundial de la Salud (OMS) lo declaró una pandemia mundial. Esta enfermedad tiene un gran espectro de signos y síntomas, predominantemente se presenta con tos y fiebre, lo que resulta en una proporción de pacientes que desarrollan síndrome de dificultad respiratoria aguda (SDRA). Se ha planteado que la afectación pulmonar grave por el virus puede ser causada también por hiperinflamación y un cuadro similar a la linfohistiocitosis hemofagocítica (HLH), el cual es un síndrome clínico provocado por una respuesta inadecuada del sistema inmunológico a un desencadenante, sea infeccioso, neoplásico, metabólico o reumatológico, que resulta en una reacción inflamatoria desproporcionada. Esta respuesta inmune altamente activada causa una liberación exagerada o tormenta de citocinas responsable del cuadro clínico. De allí la importancia de revisar el concepto actual y su desenlace en COVID-19. Recientemente se han publicado artículos en los que se sugiere que la presencia de síntomas gastrointestinales se ha asociado a COVID 19 con mayores indicadores de gravedad, lo que motiva al gastroenterólogo a explorar cómo el sistema digestivo podría impactar en esta hiperinflamación.
Teleconsulta en la pandemia por Coronavirus: desafíos para la telemedicina pos-COVID-19
Authors: Márquez Velásquez Juan Ricardo
Published: May 2020

Con el objetivo de detener la transmisión del coronavirus (declarado como pandemia por la Organización Mundial de la Salud [OMS]), y prevenir la propagación de la enfermedad COVID-19, el Gobierno de Colombia decretó un período de aislamiento social y confinamiento obligatorio en el territorio nacional a partir del 24 de marzo de 2020. El Instituto de Coloproctología (ICO) diseñó un programa de teleconsulta, junto con la entidad prestadora de los servicios de salud (EPS) SURA, apoyado en las tecnologías de la información disponibles. Se buscó mantener las actividades propias de la coloproctología y la fisioterapia del piso pélvico para garantizar a los pacientes la atención y el acceso ininterrumpido. Luego de 25 días, se programaron 626 consultas (coloproctología 62 % y fisioterapia del piso pélvico 38 %) con un porcentaje de ejecución del 94 % y una resolutividad del 78 %. Estas cifras demuestran que la telemedicina, al igual que otras actividades basadas en el teletrabajo, llegó para quedarse y trae consigo altos niveles de satisfacción para médicos, pacientes y entidades prestadoras de los servicios de salud. En este campo, también, el mundo nunca será el mismo.
The effects of intracerebroventricularly applied ghrelin on thymocytes and thymic architecture in rats of different ages
Authors: Todorovic Jovana , Terzic-Supic Zorica , Mazic Sanja , Suzic-Lazic Jelena , Zikic Dejan , Nesic Dejan
Published: May 2020

Ghrelin positively influences the total number of thymocytes and size of the thymus in 14-, 20- and 24-month-old rats. We examined the effect of centrally-applied ghrelin on thymus weight and structure in Wistar rats of different ages. The study included 30 male Wistar rats of three age groups: peripubertal (5-week-old rats), young (2 months) and adult (6 months). The animals of each age group were divided into control and experimental groups that were administered intracerebroventricularly (ICV) 1 ?g ghrelin/5 ?L saline daily for five consecutive days. Following treatment, the thymuses were isolated, weighed and processed for stereological analysis by the point-counting method. The average weights of the thymuses were significantly higher in the ghrelin groups with respect to control rats (5 weeks: 444.90?18.03 vs 365.00?18.63; 2 months: 354.30?13.77 vs 257.00?9.60; 6 months: 365.00?15.90 vs 225.00?7.03, p<0.01). The absolute volume of lymphoid tissue was significantly higher in the ghrelin groups (5 weeks: 392.85?16.94 vs 294.48?33.37; 2 months: 309.30?12.10 vs 216.62?10.72; 6 months: 222.70?11.41 vs. 114.33?16.48, p<0.01). Ghrelin treatment restored thymic structure by increasing medullary cellularity, improving thymic medullary architecture and providing a clearer delineation between the cortex and medulla. This study shows the positive effects of centrally applied ghrelin on suppression of thymus atrophy, its weight and architecture.
Drowning-out crystallization of sodium molybdate in aqueous-ethanol solutions
Authors: Casas Jesús , Lagos Josué
Published: May 2020

The drowning-out crystallization process of sodium molybdate (Na2MoO4) was studied in water-ethanol solutions at room temperature. Sodium molybdate was separated from the solution in well-crystalline particles using less water and energy compared with the industrial processes that use evaporative crystallization. Results showed that crystallization of sodium molybdate di-hydrate was achieved after 20 or 40 min in one or two operating stages for super-saturation control with the addition of 25 or 50 vol.% ethanol, respectively. Crystallization with ethanol could reduce the operating costs for about 32% with respect to the conventional evaporative crystallization method, and the exhausted ethanol in the aqueous solution could be recovered by distillation and then recycled into the process.
A computational study of the chemical reactivity of isoxaflutole herbicide and its active metabolite using global and local descriptors
Authors: Mendoza-Huizar Luis , Rios-Reyes Clara , Zuñiga-Trejo Hector
Published: May 2020

In this work, the chemical reactivity of isoxaflutole (ISOX) and diketonitrile (DKN) was analyzed at the X/6-311++G(2d,2p) (where X = = B3LYP, M06, M06L and ?B97XD) level of theory, in the gas and aqueous phases. The results indicate that DKN, the active metabolite of ISOX, is more stable than isoxaflutole in both phases. ISOX is susceptible to electrophilic and free radical reactions through the isoxazole ring; while the carbonyl group is attacked by nucleophiles. For DKN nucleophilic and free radical attacks are expected on the aromatic ring, while electrophilic attacks are favored on the oxygen atom of the carbonyl groups. The results suggest that the cleavage of the N?O bond in the isoxazole ring is possible through electrophilic and free radical attacks, while electrophilic and free radical attacks will favor substitutions on the carbonyl groups of DKN.
Analysis of the interaction process during laser transmission welding of multilayer polymer films with adapted laser wavelength by numerical simulation and thermography
Authors: Brosda Maximilian , Nguyen Phong , Olowinsky Alexander , Gillner Arnold
Published: May 2020

The field of application of multilayer polymer films ranges from the packaging of food and other goods to medical technology and the encapsulation of organic electronics. The layer structure of the polymer films is adapted to the respective areas of application. Usually, polymer film systems contain several individual layers. A trend toward more flexible production and batch sizes down to one can be identified in all the above-mentioned areas of application. This requires new production processes. Laser transmission welding with adapted laser beam sources represents a promising approach for this. It is characterized by a contactless and a locally limited energy position. A very high degree of format flexibility is also possible, thanks to a purely numerical adjustment of the welding contour. In many applications, it is desired to keep the polymer film as it is available on the market. If two multilayer polymer films should be welded with laser radiation in an overlapping arrangement, sufficient absorption of the laser radiation in the material is required. Each individual polymer layer has wavelength-dependent material-specific optical properties. Due to the vibrations of polymer chains, polymers have absorption peaks in the near infrared range. If a suitable laser beam source is now used for the welding process, the energy can be deposited directly in the material without modifying it beforehand. The energy input should be the highest at the point of contact or in the sealing layers of the two polymer films so that it is locally heated and melted. The surrounding film layers are also thermally influenced by heat conduction processes. In addition, the optical properties of the other layers influence the propagation of the laser radiation through the multilayer polymer film. For a comprehensive understanding of the process, it is imperative to examine these processes in detail. Therefore, the interaction process is considered in depth and, especially, the propagation of the temperature field within the material, which is not directly accessible for real measurements, is analyzed exactly. For this purpose, on the one hand, a numerical temperature model is set up, which depicts the real experimental setup and takes into account the optical properties and heat conduction variables of the individual layers. The numerical model allows the temporal resolution of interaction processes within the multilayer polymer film to be viewed from different angles. On the other hand, thermographic images of the real samples are taken during the welding process. For this purpose, the emitted heat radiation of the polymer films is measured off-axis. The data obtained are evaluated and compared with each other. For the final discussion of the results, additional analyses of the weld specimens microscopy and thin sections are used.
Penerapan Model Pembelajran Kooperatif Tipe STAD dengan Metode Bimbingan Individu dan Kelompok untuk Meningkatkan Prestasi Belajar Matematika
Authors: Balik I Wayan
Published: May 2020

Penelitian tindakan kelas ini dilaksanakan di SMP Negeri 1 Gianyar tahun pelajaran 2018/2019 semester II dengan tujuan untuk meningkatkan prestasi belajar Matematika siswa kelas IX A SMP Negeri 1 Gianyar melalui penerapan model pembelajaran Kooperatif tipe STAD dengan metode bimbingan individu dan kelompok. Subjek penelitian ini adalah siswa kelas IX A SMP Negeri 1 Gianyar yang berjumlah 36 orang dalam mata pelajaran Matematika. Data tentang prestasi belajar siswa diperoleh dengan menggunakan metode tes dengan instrumanya yaitu berupa tes prestasi belajar. Data tersebut kemudian dianalisis dengan menggunakan teknik analisis deskriptif kuantitatif. Hasil penelitian ini adalah Penerapan model pembelajaran Kooperatif Tipe STAD dengan metode bimbingan individu dan kelompok dapat meningkatkan prestasi belajar Matematika siswa kelas IX A SMP Negeri 1 Gianyar pada semester II tahun pelajaran 2018/2019. Skor rata-rata prestasi belajar siswa menunjukkan adanya peningkatan dari siklus I ke siklus II. Rata-rata kelas prestasi belajar pada awal pembelajaran hanya mencapai 67,22, siklus I meningkat menjadi 75,00 pada siklus II menjadi 83,33. Ketuntasan klaksikal awal hanya mencapai 19,44%, pada siklus I meningkat menjadi 52,77% dan pada siklus II menjadi 94,44%.
Factors Influencing the Improvement of Students’ Writing Skill Through Peer Editing Technique
Authors: Merina Yola , Autila Rani , Yelliza Yelliza
Published: May 2020

This research investigated the students’ writing skill on recount text at session at session 2016 A English Department of STKIP West Sumatera. Some of them had difficulties in organization, content, grammar, mechanic, and vocabulary. Then, they really need lecturers’ correction in every step of their writing process. Therefore, the researcher applied peer editing technique as the focus of research to solve this problem. The purposes were to find whether peer editing technique can improve students’ writing skill on Recount Text and some factors influence the improvement. The methodology of research is a classroom action research (CAR). Researcher used writing test and questionnaire as the instruments. The finding of the research showed that the students’ writing skill of recount text improves through Peer Editing technique and there are four factors influenced the improvement.
HEAVY METAL CADMIUM (Cd) AND LEAD (Pb) IN VANAME SHRIMP (Litopenaeus vannamei) COLLECTED FROM TRADITIONAL MARKETS IN MEDAN CITY, INDONESIA
Authors: Yusni Eri , Setiani Tri Pardiana
Published: May 2020

The presence of heavy metals in the aquatic environment must be monitored continuously. This study aims to determine the amount of heavy metal content of Cadmium (Cd) and Lead (Pb) on Vaname Shrimp (Litopenaeus vannamei). Determining the value of Cadmium (Cd) and Lead (Pb) using an AAS (Atomic Absorption Spectrophotometer) device. It is known that the highest Cd content in the sample 4 (market pancing) which is worth 0.011 mg/kg, and the lowest is in the sample 6 (market sei kambing) which is worth 0.004 mg/kg. The value of the highest Pb value is found in the sample 3 (market merah) worth 0.019 and the lowest value is the sample 5 (market petisah) worth 0.008. So that the results of these tests can be concluded, that the content of heavy metals Cd and Pb in each sample of vaname shrimp is classified as low according to the World Health Organization (WHO), namely the maximum limit of Cd is 5.0 and the maximum limit of Pb is 2.0 while according to EUROPEAN UNION the limit of calcium Cd is 0.2 and the maximum limit of Pb is 0.5 because the vaname shrimp sample is still safe for consumption and can be an export commodity.
DETERMINATION OF WATER QUALITY IN PHYSIC AND CHEMICAL USE STORET INDEX AND POLLUTION INDEX IN COASTAL WATERS DUMAI RIAU PROVINCE
Authors: Arifin Nur , Siregar Sofyan Husein , Nasution Syafrudin
Published: May 2020

The condition of good water quality is essential to support the survival of organisms that live in it. Determination of the status of water quality needs to be done as a reference in monitoring the water quality pollution.The purpose of this study to analyze and determine the status of water quality physically and chemically in the coastal waters Dumai. The method used in this research is survey method was conducted in December 2018 - April 2019 in the Coastal Water Dumai in Riau province. Sampling sites physical and chemical parameters determined by purposive sampling. Based on consideration of environmental conditions and Dumai City Regulation No. 11 In 2002, it was determined sampling consisted of four stations, with each station there are 5 sampling points were used as replicates. Determining the status of water quality using storet index and the index of pollution. Water quality measurement results About Coastal Dumai use Storet index and the pollution index shows that the coastal waters of Dumai categorized as Heavy Polluted waters.
Tres niveles de análisis sobre la movilidad académica de argentinos hacia Estados Unidos
Authors: Moreno María Verónica
Published: May 2020

En este artículo la autora se propone identificar los motivos, incentivos, mecanismos y condiciones habilitantes para movilizarse a Estados Unidos a fin de realizar un doctorado o posdoctorado en ciencias exactas y naturales. Se utilizó una estrategia cualitativa, menos predominante en estos estudios, para favorecer su comprensión. La técnica de recolección fue la entrevista semi-estructurada, y se trabajó con una muestra intencional, integrada por cuarenta casos. Los capítulos analíticos discuten la evidencia empírica y sistematizan los hallazgos en términos macro, micro y meso. Se destaca la importancia de: i) la asimetría internacional y la coyuntura nacional; ii) los incentivos académicos, y iii) los entramados heterogéneos de sociabilidad. Las conclusiones presentan una tipología de los movimientos según la estructura de oportunidades de los sujetos.
Improvement of Mathematics Teacher Performance Through Academic Supervision With Collaborative Approaches
Authors: Anshori Isa , . Suwidiyanti
Published: May 2020

This study aims to understand the improvement of mathematics teacher performance in
learning through academic supervision with a collaborative approach. Using school action
research; two cycles are carried out, with 4 stages, namely: Planning, Implementation,
Observation, and Reflection. The research subjects were determined purposively, consisting
of six mathematics teachers class Ten, Eleven, and Twelve in a well-known high school in
Indonesia. Data collection is done through focused observation, in-depth interviews and
documentaries, and using academic supervision instruments. The results showed that the use
of collaborative approaches in effective academic supervision could improve the performance
of mathematics teachers in high schools. This increase in performance was seen in all the
tasks and responsibilities of teachers, starting from preparing and developing learning plans
(19.40%), implementing the learning process (22.40%), evaluating the process and learning
outcomes (4.55%), implementing the follow-up activities of student assessment results
(33.00%), to complete the administration of learning (5.84%). This improvement occurred
because the supervision carried out in schools was carried out collaboratively, with full peer,
involving various components of the school.
Difficulties in the treatment of recurrent juvenile laryngeal papillomatosis associated with pemphigus vulgaris
Authors: Sarafoleanu Codrut , Lapicus Gheorghe , Lupu Ana Isabela , Budu Vlad
Published: May 2020

Recurrent laryngeal papillomatosis is a disease caused by human papillomaviruses (HPVs), which currently does not benefit from a curative treatment. Due to the fact that HPV has the action of modifying cellular DNA, with changes in the expression of interleukins and interferon, with insufficient maturation of T cells and intracellular overpopulation of immunosuppressive cells, the association of RRP (Recurrent Respiratory Papillomatosis) with an autoimmune disease may cause particular difficulties in the therapeutic management of patients diagnosed with RRP.

Immunosuppressive medication negatively influences the development of papillomatosis, increasing the number of local relapses and, respectively, the need for surgical intervention due to the increased viral multiplication and the proliferation of papillomatous lesions. In order to exemplify the difficulties encountered in treating RRP associated with an autoimmune disorder, the authors present the case of a 21-year-old patient diagnosed with juvenile recurrent laryngeal papillomatosis genotype 6, with multiple antecedent surgeries, who was diagnosed with pemphigus vulgaris at the age of 19. The peculiarity of the case lies in the difficulty of managing the RRP associated with an immunosuppressive disorder whose therapeutic indication is cortisone and immunosuppressive treatment, which led to exacerbation of viral multiplication and proliferation of papillomatous lesions.
Extramedullary plasmacytoma with intranasal localization
Authors: Pirvu Alexandru , Sarafoleanu Codrut , Musat Gabriela
Published: May 2020

Plasmacytoma is a rare, non-epithelial, malignant tumor, affecting soft or bony tissues, which can have a unique location (solitary or extramedullary solitary plasmacytoma), or multiple (multiple myeloma). In the ENT sphere, it is most commonly encountered in its extramedullary form, which develops in the region of the head and neck, at the level of the submucosa. Most commonly, it affects the elderly, who have cardinal symptoms such as unilateral nasal obstruction, nasal or facial swelling, tissue necrosis or mucosal ulcerations, perforation of the nasal septum with dysmorphia of the nasal pyramid, recurrent unilateral epistaxis. Radiotherapy is the treatment of choice for extramedullary plasmacytoma. The prognosis is a reserved one, the risk of recurrence or conversion to multiple myeloma also existing 15 years after treatment.
A shift in the classic management of parotidectomy - the facelift approach
Authors: Ciofu Mihai-Liviu , Cobzeanu Mihail Dan , Boisteanu Otilia , Sulea Daniela , Giuvara Razvan , Carp Alexandra , Popescu Eugenia , Costan Victor-Vlad
Published: May 2020

BACKGROUND. Improving the aesthetic and functional outcomes of parotidectomy is a constant concern of recent studies. We describe our experience on this topic by employing techniques inspired from rhytidectomy.

MATERIAL AND METHODS. We performed a retrospective study including patients that underwent parotidectomy through a facelift approach and we documented the details of the technique and the postoperative care and outcomes.

RESULTS. A total of 247 patients with parotid gland tumors were operated using the facelift approach. A superficial or quasi-total parotidectomy was performed, followed by a superficial musculoaponeurotic system-plasty. The postoperative outcomes were favourable regarding both the appearance and function, with minimal complications. The advantages of the employed technique are discussed.

CONCLUSION. It is possible to decrease the sequelae, simplify the postoperative care and improve the aesthetic outcome of parotidectomy cases by employing the facelift approach and the superficial musculoaponeurotic system (SMAS) reconstruction of the post-parotidectomy defect.
The role of 3D reconstruction in surgical training for the ENT young surgeon
Authors: Passali Francesco Maria , Flora Barbara , Fuccillo Emanuela , Di Girolamo Stefano
Published: May 2020

BACKGROUND. Nose and paranasal sinus surgery requires an accurate anatomical knowledge and a fine systematic learning. Surgical practice on cadaveric specimens is very important for the ENT resident to allow for a step-by-step learning, but it is not easy in all countries to have access to this compound.

MATERIAL AND METHODS. We propose 3D-printed anatomical bone model exercitations as an alternative method for anatomical study, morphological research and surgical learning

RESULTS. We have achieved very satisfactory morphological results both for the colours and shapes.

CONCLUSION. The use of 3D modelling simulation allows the young surgeon to improve their technical skills and to the expert surgeon to plan the preoperative strategy in complex situations.
Giant schwannoma of the left maxillary sinus - a rare case report
Authors: Musa Muhammad Adzha , Affandi Ahmad Nordin , Narayanan Prepageran , Nee Tan Shi
Published: May 2020

BACKGROUND. Polyps, cysts and mucocele are the commonest sinonasal tumors present unilaterally, as well as invasive tumors, such as inverted papillomas and squamous cell carcinomas. On the contrary, Schwannomas are rare lesions found in this area.

MATERIAL AND METHODS. We present a case of a 48-year-old female who presented with a 2-year progressive history of left nasal obstruction, cranio-facial fullness sensation and pain, with intermittent epistaxis. The CT scan of the nose and paranasal sinuses showed complete opacification of the entire left nasal cavity and maxillary sinus, causing a deviated nasal septum to the right side.

RESULTS. The tumor was completely excised endoscopically without any complication. Histopathology was consistent with that of a schwannoma.

CONCLUSION. The diagnosis of sinonasal Schwannomas remains challenging, as it is a rare tumor and sometimes its clinical behaviour and imaging may be misleading. The treatment of choice for paranasal sinus schwannoma is complete excision of the tumor with good prognosis.
Laolita nTo Pamona (Ceritera Rakyat Orang Pamona)
Authors: Adriani N.
Published: May 2020

Ceritera Rakyat To Pamona dari Sulawesi Tengah, sebagaimana ditranskripsi oleh N. Adriani (Bare'e Verhalen 1932); dicetak ulang dengan Ejaan Yang Disempurnakan.

Folktales of the To Pamona of Central Sulawesi, as transcribed by N. Adriani (Bare'e Verhalen 1932); reprinted in the new Indonesian orthography (Ejaan Yang Disempurnakan).
IMPLEMENTASI PERPAJAKAN DALAM PENGELOLAAN DANA DESA (STUDI KASUS DI DESA BUNGAEJAYA KECAMATAN PALLANGGA KABUPATEN GOWA)
Authors: Wahyu Sakina Dwi , Burhan Imron , Akrim Djusdil
Published: May 2020

Penelitian ini bertujuan untuk mengetahui implementasi perpajakan dalam pengelolaan Dana Desa di Desa Bungaejaya Kecamatan Pallangga Kabupaten Gowa. Metode penelitian yang digunakan adalah   kualitatif   dengan   sumber   data   primer   dan sekunder dengan prosedur pengambilan data   dalam penelitian ini yaitu wawancara dan dokumentasi. Teknik analisis data adalah deskriptif kualitatif. Hasil penelitian menunjukkan bahwa implementasi perpajakan dalam pengelolaan Dana Desa Tahun 2018 belum sepenuhnya dilaksanakan di Desa Bungaejaya Kecamatan Pallangga Kabupaten Gowa.
Kadın Sporcuya Özgü Yaralanmadan Korunma Stratejileri
Authors: ERCAN Sabriye
Published: May 2020

Kadın sporcuların spora katılımının artması, kadın sporculara özgü yaralanma spektrumunu daha iyi anlamamıza neden olmaktadır. Cinsiyete özgü morfolojik, fizyolojik, anatomik ve biyomekanik dizayn farklılıkları kadınlardaki yaralanma paternlerinin benzersizliğini açıklayabilmektedir.
Epidemiyolojik çalışmalar, kadın sporcuların erkek sporculara göre özellikle artmış alt ekstremite kas-iskelet sistemi yaralanma riski taşıdığını bildirmektedir. Kadınlarda riski artan yaralanma tiplerinin; nonkontakt ön çapraz bağ rüptürü, patellofemoral ağrı ve instabilite, alt ekstremite stres fraktürü, kadın sporcu üçlemesi, omuz instabilitesi, femoroasetabular impingement ve konküzyon olduğu belirlenmiştir.
Kadın sporculardaki yaralanma etiyolojilerinin farklılığı konusunda ilgili birimlerin farkındalığın artması ve koruyucu programların günlük pratiğe sokulması gerekmektedir. Bu derlemede, kadın sporcuya özgü yaralanmalar ve bu yaralanmalardan korunma yöntemleri sunulacaktır.
Crystal Structure of Urotropine Under High Pressure and Non-Hydrostatic Stress-Induced Phase Transitions in Cage Compounds
Authors: Gunka Piotr , Olejniczak Anna , Fanetti Samuele , Bini Roberto , Collings Ines E. , Svitlyk Volodymyr , Dziubek Kamil F.
Published: May 2020

High-pressure behavior of hexamthyleneteramine (urotropine) was studied in situ using angle-dispersive single-crystal synchrotron X-ray diffraction (XRD) and Fourier transform infrared absorption (FTIR) spectroscopy. Experiments were conducted in various pressure transmitting media (helium and neon for XRD, nitrogen and KBr for FTIR experiments) to study the effect of deviatoric stress on phase transformations. Contrary to As4O6 arsenolite, a material of similar cage-like molecular structure, no pressure-induced helium penetration into the crystal structure was observed. Instead, two pressure-induced structural changes are observed. The first one is suggested by the following occurrences: (i) gradual quenching of the magnitudes of atomic displacement parameters, (ii) diminishing libration contribution to the experimental C−N bond length, (iii) discontinuity in calculated IR-active vibrational modes and (iv) asymptotically vanishing discrepancy between the experimental and DFT‑calculated unit cell volume. All these features reach a plateau at ~4 GPa and can be attributed to a damping of molecular librations and atomic thermal motion, pointing to the existence of a second-order isostructural phase transition. The second transformation, with an onset at ~12.5 GPa is a first-order phase transition to a tetragonal structure, characterized by sluggish kinetics and considerable hysteresis upon decompression. However, it occurs only in non-hydrostatic conditions, induced by a deviatoric stress in the sample. This behavior finds analogies in similar cubic crystals built of highly symmetric cage-like molecules and may be considered a common feature of such systems. Last but not least, it is worth noting successful Hirshfeld atom refinements, carried out for the incomplete high-pressure diffraction data up to 14 GPa, yielded more realistic C−H bond lengths than the independent atom model.
Listening to Voices of the Future
Authors: Coleman Andrew , Karacaoglu Girol
Published: May 2020

The six articles that follow are contributions from eight people born after 1985. They represent a response to the invitation we published in the August 2019 issue of Policy Quarterly (Coleman and Karacaoglu, 2019). We hope that what follows is a valuable contribution to various intergenerational conversations that are taking place in New Zealand and around the world.