bluuebunny/crossref_metadata_2025 huggingface dataset:
KEPATUHAN MINUM OBAT PADA PASIEN SKIZOFRENIA DENGAN GANGGUAN PERSEPSI SENSORI HALUSINASI PENDENGARAN
Authors: Amaliah Siti Lia , Wungu Aprilla Dewi Kencana
Published: June 2024

Introduction: Hallucinations are a false stimulus that can only be felt by the sufferer and cannot be felt by other people. The purpose of writing this scientific paper is to describe the implementation of nursing in implementing medication adherence in schizophrenic patients with auditory hallucination sensory perception disorders. Method: The type of research used is descriptive type. In collecting scientific writing data using interview and observation methods. In this writing, one of the respondents who was diagnosed with hallucinatory sensory perception disorder was taken. The research instrument used nursing care sheets and observation sheets. The research results obtained at the time of assessment, obtained nursing problems sensory perception disorders auditory hallucinations. Result: Result in this study after implementing the implementation of taking medication for 3 days, clients can control hallucinations and there is a decrease in signs and symptoms of hallucinations. Conclusion: The conclusion of the action of implementing medication adherence is proven to be effective in reducing signs and symptoms of hallucinations.
REVIEW ARTICLE: AKTIVITAS FARMAKOLOGI DAN SENYAWA KIMIA PADA BEKATUL
Authors: Azzahra Ayu Jasmine , Budiyanti Lia Eka , Amelia Azzahra , Saputra Monica Yashna Kusuma Adi , Hidayah Himyatul
Published: June 2024

Pendahuluan: Beras (Oryza sativa L.) adalah sumber makanan utama manusia di seluruh dunia. Bekatul, produk sampingan dari penggilingan padi, adalah sumber penting antosianin, tokoferol, sterol, gamma-orizanol, asam ferulic, dan asam protocatechuic yang meningkatkan kesehatan. Ada bukti bahwa ekstrak bekatul memiliki efek farmakologis terhadap hiperaktif enzim pengubah angiotensin, resistensi insulin, dislipidemia, stres oksidatif, peradangan, dan peradangan. Metode: Metode penelitian ini menggunakan jenis penelitian Literatur Review Article dengan hasil database yang diambil dari berbagai artikel melalui ScienceDirect, Google Scholar, Semantic Scholar, PubMed. Hasil: Hasil dari berbagai penelitian menujukkan bahwa Bekatul memiliki nutrisi dan dapat digunakan untuk mengobati diabetes, alopecia, hiperkolesterolemia, hepatitis C, herpes, TB alergi, dan kanker payudara. Simpulan: Kesimpulan yang dapat diambil mengenai bekatul adalah, bekatul mengandung zat-zat peningkat kekebalan tubuh seperti fitosterol, polisakarida, mineral, dan trace mineral seperti magnesium, selenium, seng, vitamin E, omega-3, asam lemak, dan beberapa fitonutrien lainnya.
PERLINDUNGAN HUKUM BAGI BIDAN DALAM PEMBERIAN TERAPI KOMPLEMENTER SENAM HAMIL TERHADAP KUANTITAS TIDUR IBU HAMIL TRIMESTER III DI WILAYAH KERJA PUSKESMAS SAWAN II
Authors: Lutfiana Indrie , Widiastini Putu Monna Frisca , Ningrum Kadek Agustina Puspa
Published: June 2024

Tenaga Kesehatan memiliki peran penting untuk meningkatkan kualitas
pelayanan kesehatan yang maksimal kepada masyarakat agar masyarakat mampu
meningkatkan kesadaran, kemauan, dan kemampuan hidup sehat sehingga akan
terwujud derajat kesehatan yang setinggi-tingginya sebagai investasi bagi
pembangunan sumber daya manusia yang produktif secara social dan ekonomi serta
sebagai salah satu unsur kesejahteraan umum sebagaimana dimaksud dalam UUD
Republik Indonesia Tahun 1945.
Selama kehamilan kebanyakan wanita mengalami perubahan fisik dan emosional. Perubahan fisik dan emosional, memerlukan adaptasi terhadap penyesuaian pola hidup dengan proses kehamilan yang terjadi (Mansur, 2009). Keluhan - keluhan yang muncul pada ibu hamil trimester ke III diantaranya nyeri punggung bawah, sesak napas, varises, haemoroid, gangguan tidur, diastasis recti, nyeri pelvis dan lain - lain. Salah satu keluhan yang sering muncul yaitu gangguan tidur. Gangguan tidur yang sering dialami wanita hamil, khususnya pada trimester III lebih tinggi, karena adanya ketidaknyamanan seperti nyeri pinggang banyak buang air kecil, dan spontan bangun dari tidur.
Tujuan penelitian ini yaitu Mengetahui Perlindungan Hukum Bagi Bidan Dalam Pemberian Terapi Komplementer Senam Hamil Terhadap Kuantitas Tidur Ibu Hamil Trimester Iii Di Wilayah Kerja Puskesmas Sawan II. Desain penelitian ini menggunakan Jenis penelitian Quasi Experimen dan rancangan penelitianya pre test dan post test yaitu peneliti menguji adanya perubahan yang terjadi pada kuantitas tidur ibu hamil trimester III setelah dilakukan senam hamil yang dilakukan pada 1 kelompok tanpa adanya pembanding. Sampel dalam penelitian ini sebanyak 22 responden. Variabel independennya adalah Senam Hamil dan variabel dependennya adalah Kuantitas tidur. Data dalam penelitian ini diambil dengan penggunaan lembar observasi
Berdasarkan hasil penelitian dapat diketahui bahwa bahwa skor rata-rata kualitas tidur ibu hamil tirmester III sebelum diberikan Senam Hamil di Wilayah Puskesmas Sawan II sebesar 1,27 skor rata-rata kualitas tidur ibu hamil setelah diberikan Senam Hamil di Wilayah Puskesmas Sawan II 1,82. Diperoleh pula nilai t hitung sebesar -5,020 dan nilai p value sebesar 0,000 < α (0,05) sehingga dapat disimpulkan bahwa terdapat Pengaruh Kualitas Tidur Ibu Hamil Trimester III Sebelum dan Sesudah Diberikan Senam Hamil di Wilayah Puskesmas Sawan II
Senam hamil merupakan suatu bentuk terapi komplementer dalam olah raga atau latihan yang terstruktur. Dengan dilakukannya senam hamil maka akan memberikan rasa nyaman pada ibu hamil. ibu hamil trimester III yang melakukan senam hamil akan merasa nyaman dan rileks sehingga dapat meningkatkan kuantitas atau durari tidur ibu hamil.
HUBUNGAN SELF EFFICACY DENGAN KEPATUHAN MINUM OBAT HIPERTENSI DI PUSKESMAS KERAMBITAN I
Authors: Kusuma A.A. Ngurah Nara , Prihandini Claudia Wuri , Gandari Ni Komang Matalia , Suryadewi Ida Ayu Gde
Published: June 2024

Hipertensi merupakan penyakit yang tidak dapat disembuhkan, sehingga diperlukan kepatuhan dalam minum obat agar dapat meminimalisir komplikasi akibat tekanan darah tinggi. Kepatuhan minum obat pada pasien hipertensi dipengaruhi oleh kepercayaan diri dalam berperilaku dalam pengobatan hipertensi atau yang disebut dengan self efikasi. Penelitian ini bertujuan untuk mengetahui hubungan antara efikasi diri dengan kepatuhan minum obat hipertensi di Puskesmas Kerambitan I. Penelitian dilakukan dengan desain observasional analitik dengan pendekatan cross sectional yang dilaksanakan pada bulan September sampai Oktober 2023 dengan jumlah sampel sebanyak 41 responden yang dipilih dengan teknik konsekutif sampling. Data dikumpulkan dengan menggunakan kuesioner efikasi diri secara umum dan kuesioner kepatuhan minum obat. Data dianalisis menggunakan uji spearman’s rho. Hasil penelitian menunjukkan bahwa sebagian besar pasien hipertensi mempunyai self eficacy yang tinggi yaitu sebanyak 30 orang dengan persentase 65,2%, dan sebagian besar mempunyai kepatuhan minum obat yang tinggi yaitu sebanyak 21 orang dengan persentase 45,7%. Analisis hubungan antara efikasi diri dengan kepatuhan minum obat hipertensi diperoleh nilai p <0,001 sehingga dapat dikatakan ada hubungan antara efikasi diri dengan kepatuhan minum obat hipertensi di Puskesmas Kerambitan I. Rekomendasi penelitian ini diharapkan dapat menjadi masukan bagi perawat untuk selalu memberikan peningkatan self efikasi pasien sehingga kepatuhan dalam minum obat.
Kata Kunci : Self Efficacy, Kepatuhan, Hipertensi
PENGETAHUAN IBU HAMIL PRIMIGRAVIDA TENTANG PROGRAM PERENCANAAN PERSALINAN DAN PENCEGAHAN KOMPLIKASI (P4K) DI WILAYAH KERJA PUSKESMAS KUBUTAMBAHAN 1
Authors: Sandy Putu Wahyu Sri J , Pratama Aditha Angga
Published: June 2024

Pendahuluan: Tingkat kematian ibu saat melahirkan di Indonesia masih tinggi. Saat ini semakin diperparah dengan adanya pandemic yang menyebabkan ibu hamil tidak bisa dengan mudah untuk mendapatkan perlakuan atau Tindakan medis. Salah satu upaya untuk menurunkannya yaitu dengan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K). Tujuan penelitian ini adalah untuk mengetahui gambaran pengetahuan ibu hamil tentang P4K berdasarkan karakteristik di Puskesmas Kubutambahan I. Metode penelitian ini adalah deskriptif. Populasi dalam penelitian ini adalah seluruh ibu hamil di Puskesmas Kubutambahan I Tahun 2024, teknik pengambilan sampel dalam penelitian ini adalah total sampling dengan jumlah sampel sebanyak 53 responden. Hasil penelitian menunjukkan bahwa sebagian besar responden mempunyai tingkat pengetahuan yang baik tentang P4K. Karakteristik yang memiliki pengetahuan baik Sebagian besar memiliki Pendidikan terkahir SMA/SMK sebanyak 43,4% dan memiliki pekerjaan sebagai IRT (67,9%). Pengetahuan ibu hamil yang baik tentang program P4K dikarenakan teraksesnya informasi P4K yang diterima oleh ibu. Peningkatan pengetahuan ibu hamil dan keluarga tentang P4K sangat diperlukan untuk mencegah kematian ibu hamil dan persalinan, usaha ini dapat dilakukan melalui sosialisasi kader-kader posyandu, tokoh-tokoh masyarakat kepada ibu hamil dan keluarga.
PREDIKTOR UNMET NEED KONTRASEPSI IBU DENGAN HIV/AIDS DI KABUPATEN BULELENG
Authors: Meriyani Dewi Aprelia , Megaputri Putu Sukma , Widiarta Made Bayu Oka , Sari Cindy Meilinda
Published: June 2024

Pencegahan penularan HIV/AIDS dari ibu ke anak merupakan satu hal penting yang dilakukan agar insiden HIV/AIDS menurun. Selain itu perlu adanya persiapan kehamilan yang baik dan merencanakan kehamilan yang baik agar nantinya tidak terjadi penularan dari ibu ke bayinya. Banyaknya ibu dengan HIV/AIDS yang tidak menggunakan kontrasepsi dengan tujuan menjarangkan kehamilan serta mengatur kehamilan dengan baik belum tercapai. Tujuan dari penelitian ini adalah untuk menilai predictor dari unmet need kontrasepsi pada ibu dengan HIV/AIDS di Kabupaten Buleleng. Metode penelitian ini secara kuantitatif dengan sumber datanya adalah data sekunder di Puskesmas di Kabupaten Buleleng. Sampel yang diambil sebanyak 105 sampel dengan menilai rekam medis penggunaan kontrasepsinya. Kemudian data dianalisis secara univariat dan multivariat menggunakan regresi logistic. Hasil penelitian menemukan bahwa predictor terjadinya unmet need adalah status pernikahan AOR 3,17 dan nilai p <0,05. Kesimpulannya bahwa status pernikahan meningkatkan terjadinya unmet need kontrasepsi pada ibu dengan HIV/AIDS di Kabupaten Buleleng.
Analysis Forms of Political Communication in Campaign Strategies to Increase Voter Participation in the 2024 Sumut Regional Elections
Authors: Jannah Nurul Ainun , Sampurna Ahmad , Hasibuan Manita Rahma , Ardianti Indah , Barry Ahlan Adib AL
Published: June 2024

This research examines the forms of political communication in the campaign strategy to increase voter participation in the 2024 North Sumatra regional elections. This research aims to identify and analyze the forms of political communication used in the 2024 North Sumatra regional election campaign strategy and evaluate their effectiveness in increasing voter participation. This research uses a qualitative approach using the case study method. Data collection techniques in this research are observation, interviews and documentation. The research results reveal that various forms of political communication have an important role in increasing voter participation in the 2024 North Sumatra regional elections. Interpersonal communication through door-to-door campaigns and community meetings increases voter confidence. Mass media such as television, radio and newspapers help shape public opinion. Social media is effective in reaching young and urban voters. Political debates and speeches provide an opportunity for candidates to present their work programs. Door-to-door campaigns remain effective in rural areas. This combination of various forms of political communication has proven effective in increasing voter participation.
Analýza variant vlastní činnosti v plánovacím a rozhodovacím procesu s využitím válečné hry
Authors:   Univerzita obrany, Brno, Černý Jiří , Pitaš Jaromír ,   Univerzita obrany, Brno
Published: June 2024

Decision-making is one of the basic activities of commanders in combat. Commanders' decision-making is a process of choosing between at least two possible options for the actions of their own units. The creation of variants of one's own activity is characterized by the effort of the staff to develop the widest possible set of conceptually different variants, which are selected at a certain stage of the process and inadmissible variants are subsequentlyexcluded. The content of the article is a description of the principles and ways of using the war game with the application of selected methods (systematic-analytical methods of the probability tree, supplemented by the scenario method) and managerial decision-making methodology (Kepner Tregoe methodology).
Analýza aktuálnych trendov výdavkov na obranu v Európskej únii pod vplyvom konfliktu na Ukrajine
Authors:   Akadémia ozbrojených síl generála Milana Rastislava Štefánika, Liptovský Mikuláš, Harantová Petra
Published: June 2024

The security situation in Europe changed dramatically after the military invasion of Ukraine by the Russian Federation on February 24, 2022. The unexpected return of the conflict to the European continent requires the adoption of measures in several areas, including an increase in defence funding. Sufficient defence abilities and capabilities are key for the member states of the European Union to be able to face current security challenges and threats. The European Union is asked to become a stronger and more reliable guarantor of security, which can also be achieved through the growth of defence spending and its effective use to procure the required capabilities, and capacities. Therefore, the aim of the article is to analyse the current development of defence spending in the European Union, for which we use relevant scientific methods of analysis, synthesis, and comparison.
Rozhodovanie v strategickom prostredí
Authors:   Akadémia ozbrojených síl generála Milana Rastislava Štefánika, Liptovský Mikuláš, Liška Richard
Published: June 2024

Decision-making in a strategic environment is linked to security factors1, whether external or internal, which contribute to the overall security of the object in our understanding of the state. If we want to discuss security factors, it is necessary to know the processes of building and maintaining state security, their structure and approaches to setting strategic goals. From the security environment, we will focus on the state defense system, where we will learn about 4 planning disciplines2 in the Slovak Armed Forces environment. This is also why planning and decision-making are and will be demanding standards or systemic steps as well as requirements for individual officials who will have to make final decisions to fulfill the overall task. Making decisions in a strategic environment is very difficult. A basic prerequisite for a correct decision is timely and reliable intelligence information.
Promowanie przez pisanie. Rola publikacji i krytyki w kształtowaniu projektowania graficznego
Authors:   Academy of Fine Arts in Katowice, Mrowczyk Jacek
Published: June 2024

This article attempts to analyse and critically discuss the evolution of graphic design promotion with emphasis on the influence of theory, professional criticism and publications on the development and perception of the discipline. It analyses the history of design from the epoch of mechanised production and invention of typographic print, through the development of theory and practice of typography, to the contemporary discourses and practices of design. Particular attention is paid to key figures and publications, which have had significant influence on the development of graphic design, such as the works of Joseph Moxon, Pierre Simon Fournier, Jan Tschichold, Beatrice Warde, as well as the later periodicals – “Graphis”, “Neue Graphik” and “Projekt”. Moreover, the text presents how the development of design theories and practices have been accompanied by the need for criticism and reflection over the role a applied graphics in the society, as apparent from such manifestos as Ken Garland’s First Things First and the activity of magazines, e.g. “Emigre” and “Eye”. There is emphasis on the meaning of attitudes and areas of designer’s operations, as well as their influence on contemporary design practices. The analysis highlights that the promotion of graphic design is not limited to visual aspects, but also includes a broad cultural, educational and social context, underlying its diversity and complexity. As the results of the analysis demonstrate, the discipline constantly evolves, responding to changeable social and technological needs, which contributes to its dynamic development and adaptation. Keywords: design promotion, history of typography, design criticism, graphic design theory, design practices evolution
The Genetics of Alzheimer’s Disease and the role of non-long coding RNAs in disease
pathogenesis
Authors:   Department of Biochemistry and
            Biophysics, University of Kalyani, Kalyani, Nadia, West Bengal, India, Roy Sreekanya , Biswas Sima ,   Department of Biochemistry
            and Biophysics, University of Kalyani, Kalyani, Nadia, West Bengal, India, Guha Dipanjan ,   BIF Centre, University of
            Kalyani, Kalyani, Nadia, West Bengal, India., Dasgupta Rakhi ,   Department of Biochemistry
            and Biophysics, University of Kalyani, Kalyani, Nadia, West Bengal, India, Bagchi Angshuman ,   Department of Biochemistry
            and Biophysics, University of Kalyani, Kalyani, Nadia, West Bengal, India
Published: June 2024

The advancements in medical research and public health have led to a recent
relative increase in the global population of elderly persons that is leading to an
increase in age-related, non-communicable neurological diseases. Neurodegenerative
diseases cause progressive loss of neuron function that tends to the rapid death of
neurons. One such neurodegenerative condition is Alzheimer’s disease (AD), which is a
result of accumulation of misfolded proteins. AD is distinguished into two forms
Sporadic Alzheimer’s Disease (sAD) and Familial Alzheimer’s Disease (fAD). sAD is marked
by late onset of the disease, whereas, fAD is characterized as the early onset with
Mendellian inheritance. A number of hypotheses were proposed to explain the disease. The
widely accepted ones are: Amyloid plaque Hypothesis and Tau pathology Hypothesis.
Amyloid plaque hypothesis states that amyloid β (Aβ) peptide accumulates and deposits in
the brain, either as oligomers or fibrils, and thus regarded as the main cause of
Alzheimer’s disease (AD); whereas Tau pathology hypothesis states that the main factor
causing neurodegeneration in AD is tau phosphorylation and aggregation. The most
significant genes include APP, APOE, PSEN1, PSEN2, etc. The clinical hallmarks are
amyloid plaques and neurofibrilary tangles (NFTs). In the recent decade scientists have
also seen significant relation between non-coding RNAs and Alzheimer’s disease
(AD).
Green Solvents in Organic Synthesis: A Futuristic Approach
Authors:   Department of Chemistry, The
            ICFAI University Tripura,Kamalghat, Mohanpur, Agartala, Pin 799210, Tripura,
            India, Chakraborty Ankita
Published: June 2024

The field of Green or Sustainable Chemistry has gained recognition as a
significant scientific topic, gathering immense interest from the scientific community.
The research conducted in this field relies significantly on the “Twelve Principles of
Green Chemistry,” which serve as the fundamental framework for all chemical processes.
Researchers are highly interested in developing chemical processes that might mitigate
the environmental harm caused by toxic solvents, taking into consideration environmental
concerns. Extended exposure to hazardous solvents has a detrimental impact on living
beings, causing significant harm to the majority of human organs. Volatile organic
molecules derived from petrochemicals, commonly referred to as conventional organic
solvents, provide a significant peril to terrestrial, atmospheric, and aquatic
organisms. The concept of utilizing water, ionic liquids, organic carbonates,
supercritical carbon dioxide, deep eutectic solvents, and non-toxic liquid polymers as
catalysts or reaction mediums has gathered significant interest due to their potential
to remove environmental hazards. These diverse combinations of solvents fall under the
category of green solvents, which are distinguished by their low toxicity, easy handling
and reusability. However, the total substitution of traditional solvents with
environmentally friendly solvents has a negative effect on industrial production and
chemical synthesis. Despite this, some effective alternatives have demonstrated their
chemical efficiency and widespread utilization. This chapter will provide a concise
overview of ecologically friendly solvent alternatives to traditional solvents, focusing
on their application in chemical processes with a green matrix.
The Importance of the Three-Tier Panchayat System in Promoting Education in Rural
West Bengal
Authors:   Department of Geography,
            Assistant Professor, Chakdaha College., Alam Dr. Iftikar
Published: June 2024

Though it took another fifty years, a major breakthrough in the history of India’s
education took place when the Lok Sabha, on November 28, 2001, passed the 93rd
Constitutional Amendment Bill, making education a fundamental right. This bill, while
emphasizing quality and accessible education, also calls for the sharing of
responsibilities between different levels of government. Education being a basic right
of citizens, the need for community participation in ensuring adequate and quality
education for all (irrespective of class or caste) cannot be over-emphasized. It is our
firm conviction that Panchayati Raj Institutions (PRI) has a major role to play in this
regard. This study examines the role of Panchayati Raj Institutions in overseeing
education in collaboration with the Education Department in West Bengal. It is based on
a field study of recent trends in educational administration in West Bengal. The aim was
to thoroughly analyse the connections and collaboration between the development
administration and the Panchayati Raj Department in West Bengal. Additionally, it also
seeks to evaluate the obstacles in promoting public participation and democratic
governance.
Alergia a la proteína de leche de vaca que simula enfermedad de Hirschsprung por los hallazgos en el enema de bario. Reporte de un caso
Authors: Higuera Carrillo Juanita , Higuera Michelle
Published: June 2024

Introducción. La alergia a la proteína de la leche de vaca puede tener múltiples manifestaciones clínicas. Algunos casos presentan inflamación del colon rectosigmoide con dismotilidad colónica secundaria, similar a la enfermedad de Hirschsprung. Estudios previos han destacado que la proporción de alergia a la proteína de leche de vaca en recién nacidos que presentan síntomas similares a los de la enfermedad de Hirschsprung es alta. 
Objetivo. Describir el caso clínico de una paciente con alergia a la proteína de leche de vaca, con síntomas e imagen en el enema de bario sugestiva de enfermedad de Hirschsprung. 
Caso clínico. Paciente nacida a término, previamente sana, que desde las dos semanas de vida presenta episodios de regurgitación y a los tres meses empeoramiento de los síntomas con vómitos e irritabilidad. Al examen físico presenta hallazgos compatibles con alergia a la proteína de leche de vaca. Recibía lactancia materna exclusiva y se indica continuarla con dieta de exclusión a leche de vaca. A los tres días de iniciada, el cuadro empeora con emesis, por lo que se amplían los estudios por imágenes, con hallazgos que podrían haberse relacionado con enfermedad de Hirschsprung. Se realizó una biopsia endorrectal que descartó enfermedad de Hirschsprung. Se indicó suspender la lactancia y continuar con la fórmula a base de aminoácidos, con adecuada tolerancia, progresión de peso y talla, resolución de la xerodermia y de la distensión abdominal. 
Conclusión. En pacientes con distensión abdominal severa o hallazgos que simulan enfermedad de Hirschsprung, como diagnóstico diferencial debe evaluarse la alergia a la proteína de leche de vaca, siendo una entidad cada vez más frecuente, y se deben realizar pruebas diagnósticas apropiadas para determinar un diagnóstico. Para la confirmación del diagnóstico final de enfermedad de Hirschsprung, la biopsia endorrectal es lo indicado.
La medición simultánea de hidrógeno y metano mejora el rédito diagnóstico del test de aire espirado en el sobrecrecimiento microbiano intestinal
Authors: Soifer Luis , Man Fernando , Man Melina
Published: June 2024

Introducción. Se ha generalizado el empleo de los test de aire espirado para el diagnóstico de sobrecrecimiento microbiano del intestino delgado. Algunos de los equipos empleados actualmente para la medición de gases suelen tener limitaciones; los equipos portátiles, más simples, miden solamente hidrógeno, mientras que los más completos permiten la medición simultánea de hidrógeno, metano, CO2 y, recientemente, el sulfuro de H2. La presencia de valores elevados de metano suele coincidir con una disminuida excreción de hidrógeno y, por lo tanto, al medir solamente los niveles de hidrógeno espirado, se informa el estudio como normal, cuando en realidad no lo es. 
Objetivo. Analizar el rédito diagnóstico comparativo entre la medición aislada de hidrógeno con la simultánea de hidrógeno y metano. 
Material y métodos. Estudio observacional realizado mediante el análisis de las concentraciones de hidrógeno y metano en el aire espirado, empleándose lactulosa como sustrato. Se incluyó a 353 pacientes (78% mujeres), con rango de edad 18/75, que presentaban uno o más de los siguientes síntomas: dolor abdominal, distensión, flatulencia y cambios evacuatorios crónicos. Se consideraron como positivos valores ≥ 20 ppm para hidrógeno dentro de los 90 minutos posteriores a la ingesta de lactulosa, y para el Metano, valores ≥ 10 ppm en cualquier momento del estudio. Se calculó el rédito diagnóstico usando la fórmula: número de estudios positivos dividido por el total efectuados. Sobre la base de los valores normales de referencia, fueron calculados el número y el porcentaje de diagnósticos de sobrecrecimiento bacteriano del intestino delgado, sobrecrecimiento metanógeno intestinal y sobrecrecimiento microbiano mixto. 
Resultados. Sobre un total de 353 pacientes, 111 (31,44%) fueron TAE positivos; 78 (22,09%) presentaron flora mixta (SIBO + IMO); 54 (15,29%) tenían sobrecrecimiento metanógeno; 55 (15,62%), sobrecrecimiento bacteriano del intestino delgado, aceptada como respuesta hidrogénica positiva en forma exclusiva, y 55 (15,62%) fueron negativos. Cincuenta y cuatro (15,29%) tenían curva plana. El rédito diagnóstico varía si consideramos solamente SIBO positivos mediante la medición exclusiva de hidrógeno; en ese caso fue de 0,16 (IC95% 0,12-0,19). No obstante, al considerar los casos mixtos (diagnóstico parcial) el rédito diagnóstico fue de 0,47 IC95% 0,41-0,52). En cambio, la medición simultánea de hidrógeno y metano se adicionan como positivos los que presentaron sobrecrecimiento metanógeno (111+55+78/353) y el rédito diagnóstico es de 0,69 (IC 0,64-0,73). 
Conclusión. La medición simultánea de H2 y CH4 mejoraría el rédito diagnóstico en comparación con la medición aislada de hidrógeno.
Experiencia en el uso de tofacitinib para el tratamiento de colitis ulcerativa en dos pacientes en edad pediátrica: reporte de casos
Authors: Velásquez Vanegas Karen , Cuadros Mendoza Carlos Augusto , Daniels García María José , Parra Izquierdo Viviana
Published: June 2024

Introducción. Se describe la experiencia con el uso de tofacitinib en dos pacientes pediátricas con diagnóstico de colitis ulcerativa, en el Hospital Internacional de Colombia, y se realiza una revisión del estado del arte. 
Casos clínicos. Se presentan 2 pacientes de sexo femenino, de 14 y 15 años de edad, en las que se intenta inicialmente el manejo convencional de la colitis ulcerativa, sin respuesta adecuada después de dos años de tratamiento. En el primer caso se logró la remisión clínica a la semana de inicio del tratamiento con tofacitinib. En el segundo caso se logró la remisión clínica a las 3 semanas y la endoscópica a las 6 semanas de inicio del tratamiento. 
Discusión. Recientemente, se ha demostrado la eficacia del tofacitinib como terapia de inducción y mantenimiento en pacientes adultos con colitis ulcerativa activa de moderada a grave, con un perfil de seguridad aceptable. Sin embargo, en la edad pediátrica la información sobre su uso es limitada. 
Conclusión. El tofacitinib es una alternativa promisoria para el tratamiento de la colitis ulcerativa sin respuesta o con pérdida de respuesta al tratamiento convencional. Presentamos la experiencia de dos pacientes adolescentes en las que se logró la remisión clínica de la enfermedad antes de lo esperado, documentándose también la remisión endoscópica e histológica en una de ellas.
Estudio retrospectivo: comparación de Scores AIMS65, Rockall y Glasgow Blatchford para hemorragia digestiva alta
Authors: Alvarado Gallo Virgilio , Arias Crespo Jimmy , Cepeda Mullo María , Campoverde Duchitanga Silvia , Vera Gordillo Víctor , López Pinto Jorge , Pico Rodríguez Rita , Chamba Molina Paúl
Published: June 2024

Introducción. La hemorragia digestiva alta constituye a nivel mundial una emergencia primordial para los servicios de urgencia. Tiene etiología variada y una terapéutica amplia, por lo que es necesario el uso de escalas pronósticas para establecer el riesgo del paciente. 
Objetivos. Determinar cuál de las cuatro escalas estudiadas presenta una mayor capacidad de discriminación entre los casos de alto riesgo para resangrado, necesidad de transfusión sanguínea y muerte. 
Materiales y métodos. Se realizó un estudio de cohorte retrospectivo usando la base de datos del Hospital General Guasmo Sur desde el año 2020 hasta el 2022, comparando los puntajes obtenidos al aplicar las escalas a pacientes diagnosticados con hemorragia digestiva alta y su evolución para conocer su potencial pronóstico. 
Resultados. En predicción de mortalidad, tuvieron mejores AUC: Rockall preendoscópica y AIMS65. con 0,701 y 0,689 respectivamente; las escalas más útiles son Rockall y Rockall preendoscópico, con sensibilidad 95% y VPN 98,3%, con puntos de corte de 4 y 3, respectivamente. En predicción de resangrado, la de mejor AUC fue Rockall con 0,724, y junto con Rockall preendoscópico fueron las más útiles, con una sensibilidad del 91,8% y VPN de 89,8% y 90,1%, con puntos de corte de 4 y 3. En predicción de necesidad de transfusión, el de mejor AUC fue GBS con 0,766, y punto de corte de 5, es la más útil consensibilidad 97,1% y VPN 82,6%.
Conclusión. Las escalas más útiles para los diferentes outcomes evaluados fueron Rockall, Rockall preendoscópico y GBS.
Tratamiento de la incontinencia fecal: una visión quirúrgica
Authors: Moreira Grecco Alejandro , Flores Tomás
Published: June 2024

Se presenta una revisión sobre los diferentes tratamientos para la incontinencia fecal, con especial énfasis en los resultados de los procedimientos quirúrgicos para esta afección. La revisión aborda un enfoque integral y personalizado para el manejo de los pacientes con incontinencia fecal, que es de capital importancia, en el que se deben ponderar los resultados de las diferentes opciones terapéuticas en su relación con la calidad de vida de los pacientes. Por último, se sugiere un algoritmo de tratamiento para dicha condición.
Tuberculosis intestinal en paciente inmunocompetente: reporte de un caso
Authors: Bazzano Bruno , Pontet Yessica , Arriola Alejandra , López Virginia
Published: June 2024

La tuberculosis intestinal es una patología poco frecuente. Aunque presenta una baja incidencia, esta se encuentra en ascenso por el aumento del número de casos de infección por VIH, la resistencia a los fármacos antituberculosos y los cambios migratorios. Es una enfermedad de difícil diagnóstico dada su heterogeneidad clínica. Puede simular otras enfermedades intestinales, lo que puede conducir a un retraso en su detección y en el inicio de tratamiento. Es por este motivo que el diagnóstico suele realizarse en etapas avanzadas o graves.
Se presenta el caso de una mujer de 53 años inmunocompetente que consultó por fiebre, repercusión general, síntomas respiratorios y diarrea de 3 meses de evolución. La videocolonoscopía evidenció lesiones en ciego con biopsias que confirmaron Mycobacterium tuberculosis, presente también en muestras respiratorias. Pese al tratamiento anti tuberculosis instaurado, la paciente presentó perforación intestinal con mala evolución y posterior fallecimiento.
From Intravenous to Subcutaneous Infliximab: the Same but Different? Real-World Evidence from a Tertiary Center
Authors: Temido María José , Silva Andrea , Lópes Sandra , Ferreira Ana Margarida , Mendes Sofía , Ferreira Manuela , Figueiredo Pedro , Portela Francisco
Published: June 2024

Introduction. Recently, a subcutaneous formulation of infliximab was approved. The switch from intravenous infliximab to subcutaneous infliximab may improve convenience, but data on pharmacokinetics and immunogenicity are limited. We aimed to compare the efficacy and tolerability of subcutaneous infliximab and to assess whether the formulation results in higher plasma levels of infliximab. 
Methods. Retrospective, single-center cohort study. Patients with Crohn’s disease or ulcerative colitis, 18 years of age or older, clinically stable, receiving intravenous infliximab (5mg/kg every eight weeks) for more than 6 months were switched. Subcutaneous infliximab (120 mg) was administered every 2 weeks. Clinical and analytical evaluations were performed on day 0, week 2, week 8, and week 16. Plasma levels of infliximab and anti-drug antibodies were measured at these time points. 
Results. 41 patients included (27 with Crohn’s disease and 14 with ulcerative colitis. Azathioprine was administered concomitantly in 47.6%. All patients remained in clinical remission. Analytical biomarkers remained stable. Treatment persistence: 95.1%. Median plasma levels of infliximab at day 0, week 2, week 8, and week 16: 4.89 (3.25 - 7.27), 9.17 (7.89 - 12.6), 19.91 (15.02 - 21.64) and 21.55 (17.18 - 29.57) ug/mL, respectively. Statistically significant difference of plasma levels of infliximab in day 0 vs. week 2 and week 2 vs week 8. Azathioprine resulted in a statistically significant difference in plasma levels of infliximab only at day 0 (not at week 2, week 8, or week 16). Plasma levels of infliximab at week 2, week 8, and week 16, but not at baseline, were statistically associated with body mass index. No anti-drug antibodies were detected. No severe adverse effects. Three patients developed injection site reactions. Three patients developed arthralgia of undetermined significance. 
Conclusions. Switching from intravenous infliximab to subcutaneous infliximab maintained clinical response. Plasma levels of infliximab at week two were still lower than expected, considering the results at week eight. A possible advantage of subcutaneous infliximab may be the diminished necessity for concomitant immunomodulators.
Elevation of Aminotransferases and Total Bilirubin Levels as Prognostic Markers of Mortality in Adults Hospitalized for COVID-19. A Cohort Study
Authors: Rodríguez-Gutiérrez Andrés Fernando , Duarte-Calderón Camilo Andrés , Moreno López Sergio Mauricio
Published: June 2024

Introduction. The liver is an organ that is affected by multiple mechanisms in the presence of COVID-19. The aim of this study was to determine whether elevated alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels are predictors of mortality in adults with COVID-19.
Materials and methods. A retrospective cohort study of adults hospitalized between 2020 and 2022 at a university hospital in Bogotá for COVID-19 and hypoxemia. All-cause mortality was the primary outcome. An independent multivariate model was built for each of the following markers of liver injury: alanine aminotransferase, aspartate aminotransferase, and total bilirubin. Each model was adjusted by age, presence of diabetes mellitus, presence of fever during hospitalization, lymphocyte count, D-dimer, and lactate dehydrogenase.
Results. A total of 704 patients were included. The mortality rate was 38%. Elevated alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels on admission were reported in 64%, 64%, and 8.3% of patients, respectively. According to the multivariate analysis, the elevation of both aspartate aminotransferase (OR = 1.06,95% CI: 1.02-1.11 for each 40 U/L increase, p - value = 0.009) and total bilirubin levels (OR = 1.26, 95% CI: 1.08 -1.47 for every rise in 1mg/dl, p - value = 0.003) were independently associated with death. Total bilirubin level was also associated with intensive care unit admission, need for invasive mechanical ventilation and length of hospital stay. The results for alanine aminotransferase did not allow us to conclude an independent association with death. Age, fever, and lowest lymphocyte count during hospitalization were also associated with death.
Conclusion. Elevated transaminases and total bilirubin levels are frequent findings in patients with COVID-19 and hypoxemia. Aspartate aminotransferase and total bilirubin were predictive of mortality in these patients, so their measurement on admission is a reasonable practice. Progress needs to be made in incorporating these markers into predictive models of mortality and clinical decision rules.
Endoscopistas en formación y la utilización de Over the Scope Clips como primera línea de tratamiento en hemorragia digestiva alta no variceal
Authors: Cabanas Sofía , Pérez Tomás , Mahler Spinelli Manuel Alejandro , González María Laura , Ortiz Suarez Paula , Abecia Soria Víctor Hugo , Marcolongo Mariano Martín
Published: June 2024

Introducción. El tratamiento con over the scope clips es útil en perforaciones, fístulas y hemorragias del tracto digestivo. Operado por endoscopistas expertos, es un método eficaz para el manejo del resangrado de úlceras y existe evidencia reciente de que su uso podría ser superior a la terapia combinada estándar como tratamiento de primera línea de la hemorragia digestiva alta no variceal en pacientes seleccionados. 
Objetivo. Describir los resultados de la utilización de over the scope clips en los pacientes con alto riesgo de resangrado, como primera línea de tratamiento, llevada a cabo por endoscopistas en formación en un centro de tercer nivel. 
Materiales y métodos. En un estudio de corte transversal se incluyeron pacientes sometidos a endoscopía por hemorragia digestiva alta no variceal tratados con over the scope clips como terapéutica endoscópica de primera línea. Los operadores fueron residentes de gastroenterología entrenados por simulación. Previo a la colocación del over the scope clip se realizó una inyección de adrenalina diluida al 0,01%. La hemostasia exitosa fue definada como ausencia de sangrado persistente o recurrente. Se analizaron las complicaciones posteriores: nueva endoscopía, necesidad de cirugía y/o muerte. 
Resultados. Se incluyeron 11 casos con una mediana de edad de 65 años. Del total de las causas de sangrado, 8 fueron úlceras, con predominio duodenal. En el 100% de los casos se obtuvo hemostasia, sin persistencia de sangrado. Requirieron soporte transfusional posterior 6 de los 11 pacientes. Se realizaron nuevas endoscopías en 4 pacientes; ningún caso tuvo evidencia de resangrado asociado a la lesión tratada inicialmente con over the scope clip. Sin embargo, a las 72 horas uno de ellos presentó melena e inestabilidad hemodinámica que requirió cirugía de urgencia, en la que se realizó una gastrectomía atípica. La pieza quirúrgica evidenció la presencia de una lesión vascular en la periferia del over the scope clip. En ninguno de los casos se detectó mortalidad relacionada a la hemorragia digestiva dentro de los primeros 30 días. 
Conclusión. El sistema over the scope clip podría ser considerado para su utilización por endoscopistas en formación en el tratamiento de la hemorragia digestiva alta no variceal, bajo supervisión y con capacitación previa en modelos de simulación, realizando una adecuada selección de los pacientes.
Skiing and Alpine Culture in Austria and the United States: Transatlantic Relations, Networks, and Practices (1930s–1960s)
Authors: Praher Andreas
Published: June 2024

The history of Alpine skiing is linked to a transfer of knowledge and culture and a global winter sport business that is based on migration and shaped societies. This article examines the transatlantic relations between Austria and the United States with regard to skiing from the 1930s to 1960s. It analyzes the development of a transnational Alpine skiing culture as a cross-border community achievement influenced by various sociopolitical factors and different individuals collaborating over decades.
TARİH VE COĞRAFYA BAĞLAMINDA BİNGÖL TAVZ AŞİRETİ
Authors: Alan Suat
Published: June 2024

Bir aşiretin varlığını sürdürmesinin ortak müştereklerinden olan ortak tarih, ortak soy ve ortak coğrafya aşiretin aynı zamanda varoluş şartlarındandır. Bingöl’de varlığını sürdüren Tavz aşireti bu ortak müşterekler bağlamında değerlendirildiğinde ortak soy, ortak tarih anlatısı ve ortak coğrafyanın varlığı dikkat çekmektedir. Tavz aşiretinin bu yönünü ele almayı amaç edinen bu çalışmada nitel araştırma yöntemi benimsenmiştir. Bu bağlamda 6 kişi ile derinlemesine görüşme gerçekleştirilmiş, ikincil veri kaynağı olarak da doküman incelemesi yapılmış, tarih ve coğrafya bağlamında Tavz aşiretinin durumu ortaya konulmaya çalışılmıştır.
La ética de Kant, la ética kantiana y la ética contemporánea
Authors: de Haro Romo Vicente
Published: June 2024

Among the basic elements of Immanuel Kant's ethics, stand out the categorical imperative as the main reason of ethical determination, its appeal to the capacity to judge, and the possibility of considering Kantian ethics of duty also as the model for the formation of character and therefore also as virtue ethics. Kant's approach is productive even in ethical proposals that differ from him in what could be called his "material ethics". Finally, it is show how contemporary ethical discussion cannot do without the insights offered by the philosopher of Königsberg.
La filosofía kantiana de la religión: una revisión y una valoración
Authors: Charpenel Eduardo
Published: June 2024

The academic and cultural events surrounding the 2024 tercentenary of Immanuel Kant's birth promise to be both extensive and diverse. Kant's enduring significance transcends mere philosophy, permeating and cultural fabric of the Western world. Thus, this milestone year presents a fitting occasion to delve into his manifold contributions across various domains of knowledge, notably within the realm of religious philosophy, and the themes and developments of greatest actuality.
Recent Trends In Management Of Occupational Stress
Authors: D Patil Anand
Published: June 2024

Today is the world of stressful life and our occupational work is also one which is in the vicious circle of stress. Stress in workplace is now a common phenomenon. Occupational stress has led to many health problems both physical and psychological. This article aims to explain recent trends in management of occupational stress. Today both employer and employee are adopting new techniques and method in managing occupational stress. Employers are providing health awareness programme, mindfulness, career guidance, counseling assistance, yoga, stress management sessions, employee assistance programme and so on. So it is need of the hour to do more on this front in future by both employer and employee. The employer should provide awareness about the occupational stress to employees, so that employee can handle stress. Employers apart from physical health are focusing more regarding the effect of occupational stress on the mental health. The data and information are used from secondary sources. The secondary data are gathered using web-based research methods. The present study is carried out only on basis of few web –based surveys, online interviews by few reputed companies and few web based articles and blog. Content analysis techniques has been adopted and applied to the internet research. The employer needs to find new ways of recognizing the signs of stress and help employee in coping stress with new techniques. Only few employersare investing on employee in managing the occupational stress. So there is need for more number of employers who actively help his employee in managing stress at the workplace.
The Importance Of Technological Advancement In Today’s Business Communication
Authors: Patil Anand D
Published: June 2024

Today’s world without technology it’s very difficult to manage things properly Take the daily routine of a person in this tech-savvy world. The day begins with a "good morning message" on social networking sites and ends with a "goodnight" on the same website. The social networking sites are a world in themselves, like a virtual world. There is the incessant use of mobiles and the Internet for communication, the whole day. To make the process quick and easy, there are modes like emails, teleconferencing, video conferencing, networking sites, etc., among other tools. Mobiles, emails, and social networking sites are the most popular means of communication among the current generation.
Life Of Luv And Kush In Valmiki’s Ashram: Green Cultural Studies Approach
Authors: Kunal kashyap Kishor , Jha Dr.Sneha
Published: June 2024

The Ramayana, the world's most seasoned legendary sonnet, has motivated numerous South and Southeast Asian scholars and craftsmen. The amazing, written in 500 Promotion by Maharshi Valmiki, investigates the four Purusharthas — Dharma, Artha, Kama, and Moksha — uncovering moral and social ideals. This undertaking will make an interpretation of the Valmiki Ramayana into English, including refrain importance and word plan, for current crowds new to Sanskrit. Amrithakataka, Dhramakutam, Tattvadipika Tilaka, and Siromani are meant feature their philosophical and moral commitments. The Ramayana's Luv and Kush stories at Valmiki's Ashram address Green Cultural Studies' accentuation on biology and culture. This multidisciplinary approach reprimands late private enterprise's predominance over nature and features culture-nature communications. Hindu way of thinking and formative brain science is utilized to contextualize the ashram thought in antiquated Indian writing. Looking at Valmiki's Ashram as a characteristic shelter features the legendary's significance in saving Indian culture and empowering environmental cognizance.
Real-time Animal Detection and Alert System using IoT and Deep Learning
Authors: R Mamatha K , A Hariprasad S , G Thippeswamy , H Girish
Published: June 2024

One pressing concern facing nations worldwide today is the incidence of fatalities and injuries resulting from road accidents. Human-animal collisions stand out as a prominent cause of many fatal accidents. Road accidents occur with alarming frequency every few seconds across the globe. The core objective of our project is to detect animals and issue warnings to vehicles, thereby mitigating highway accidents involving animals. Leveraging IoT technology, the implementation of a detection and alert system designed to significantly reduce animal-related accidents is proposed here. This alert system is engineered to transmit signals that promptly notify highway drivers when a detection event is triggered. IoT technology takes center stage in our solution, with the Raspberry Pi 3 Model B serving as the cornerstone for animal detection and vehicle alerting. Employing sensors, we identify obstacles that activate the Pi Camera, configured by the Raspberry Pi, to capture real-time images and video footage of animal movements using image detection techniques. Subsequently, individuals and vehicles navigating forested highways are issued alerts. Additionally, during nighttime hours, lights to mark specific distances are employed. Ultimately, the paper's primary objective is to safeguard animals from accidents and protect countless lives from potential danger. To achieve this, the YOLO (You Only Look Once) algorithm is implemented, which boasts the capability to process 45 frames per second and analyze the entire image to predict object presence.