bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSISTÊNCIA OBSTÉTRICA DURANTE A PANDEMIA DA COVID-19
Authors: Ferreira da Costa Barbara Brenda , Geber Corrêa Rachel , Coelho Prata Maria do Livramento , Costa de Morais Pontes Munique Therense
Published: April 2023

Este trabalho teve como objetivo compreender a assistência ao parto durante a pandemia da Covid-19, a partir da experiência das mulheres. Trata-se de uma pesquisa qualitativa, descritiva, com abordagem fenomenológica. A amostra foi definida por saturação e composta por nove mulheres que vivenciaram o pré-natal, trabalho de parto e parto durante a pandemia da Covid-19 em Manaus-AM, entre março e dezembro de 2021. A coleta de dados ocorreu no período de novembro de 2021 a fevereiro de 2022, por meio de entrevista guiada por roteiro semiestruturado, cujo foco foi direcionado à assistência obstétrica recebida durante a pandemia da Covid-19. Os dados foram analisados pelo método fenomenológico de Giorgi. Como resultados foram encontradas três unidades de significados: 1) Emoção básica - medo; 2) Dificuldades declaradas e não declaradas - a falta de orientação e comunicação; 3) Avaliação da assistência obstétrica na maternidade - boa receptividade da equipe de saúde. As conclusões indicam déficit na comunicação entre profissional e parturiente, havendo uma lacuna de informações da assistência obstétrica durante a pandemia, coadunando com a falta de orientações para a prevenção da violência obstétrica. Os resultados da pesquisa ajudam a entender os problemas enfrentados na assistência obstétrica brasileira durante a pandemia da Covid-19.
PALAVRAS-CHAVE: Humanização da assistência; Covid-19; Violência obstétrica; Saúde da mulher
CARACTERIZAÇÃO SOCIODEMOGRÁFICA E CLÍNICAS DOS ÓBITOS MATERNOS POR COVID-19 NUMA MATERNIDADE DE REFERÊNCIA, 2020-2021
Authors: Viana Ramos Carmen , Martins Silva Zenira , Coelho Holanda Ana Maria , Maria Rebelo Sampaio da Paz Suzana , Gomes Pereira Theonas , Vieira Batista Luiza Ivete , Lopes Moreira de Almeida Isabel Marlúcia , Cangussu Oliveira Góis Adelice , Carvalho de Sousa Amanda , Fronteira Inês
Published: April 2023

Este estudo tem por objetivo apresentar as características sociodemográficas e clínicas dos óbitos maternos causados por covid-19, em uma maternidade de referência no Nordeste, Brasil. Foi realizado um estudo retrospectivo, do tipo série de casos, descritivo, utilizando dados do Sistema de Informações sobre Mortalidade, fichas de investigação e ficha de análise dos óbitos ocorridos entre 2020 e 2021. As variáveis foram analisadas com a estatística descritiva. Identificaram-se 24 óbitos por covid-19,22 na gravidez; em mulheres com idade mediana de 30 anos (intervalo interquartil: 25,5 – 37,0). A maioria dos óbitos ocorreu em residentes em outros municípios do Piauí (n=17), com companheiro (n=13), multíparas (n=18), fizeram consulta pré-natal (n=16), com menos de seis consultas (n=9), parto/aborto na maternidade de referência (n=23), realizado por obstetras (n=23), via de parto cesárea (n=12); internadas na unidade de terapia intensiva (n=24), não tomaram vacina contra covid-19 (24). Quanto as comorbidades e complicações, 11 eram obesas e 11 apresentaram infecções secundária a covid-19. Houve aumento de mortes maternas entre 2020 e 2021 devido a ocorrência da covid-19, principalmente, em mulheres jovens, durante a gestação e com comorbidades e complicações clínicas.
PALABRAS-CHAVE: Mortalidade Materna. Covid-19. Sistemas de Informação em Saúde. Epidemiologia Descritiva.
A importância das Marcas na Proteção Patentária
Authors: Balloussier Priscila , Santos Douglas , Islabão Genizia Islabão , Rosa Jeferson , Santos Jonas
Published: April 2023

No mundo, as vantagens e desvantagens da implementação dos sistemas marcário e patentário vigentes são bastante conhecidas, tanto em seus aspectos sociais quanto econômicos. A Marca e a Patente são ativos de Propriedade Industrial (PI) e são utilizados estrategicamente nos mais variados tipos de mercado, de maneira a otimizar a apropriação dos lucros e recuperar os investimentos empregados. A estratégia de combinação destes ativos é bastante conhecida e difundida em determinadas áreas tecnológicas. Neste sentido, o presente estudo busca identificar as principais estratégias adotadas pela empresa brasileira Natura Cosméticos S.A., no tocante à proteção de marcas e patentes, observando suas inter-relações. Aplica-se aqui uma metodologia que analisa a evolução dos depósitos de marcas e patentes nas últimas quatro décadas, alinhada às informações de investimentos realizados no mesmo interstício temporal pela empresa. Como principal resultado, verificou-se uma crescente na mudança de patamares de proteção de PI ao longo das últimas décadas até os dias atuais, assim como um crescente investimento em inovação. Disto, infere-se que a utilização das estratégias de associação entre marcas e patentes, não apenas auxilia no investimento em inovação, como também são essenciais para garantir o destaque da empresa Natura em seu segmento de atuação.
Palavras-chave: Propriedade Intelectual. Inovação. Investimentos. Marcas. Patentes.
A proteção nacional e internacional aos deslocados ambientais no município de João Pessoa (PB)
Authors: Portela Silva Matteucci Mayra , Maria Calazans Pacheco Pacifico Andrea , Patrícia Ferreira de Vasconcelos Granja Júlia
Published: April 2023

Enchentes, deslizamentos, secas, processos de desertificação, megaeventos, projetos de desenvolvimento, entre outros, causam conflitos e destroem o ambiente de inúmeras pessoas, forçando deslocamentos intramunicipais e culminando na necessidade de novas formas de proteção ambiental e de indivíduos dependentes deste ambiente, embora rupturas ambientais também possam ocorrer como consequência desses movimentos migratórios. Diante desse cenário, regimes internacionais precisam ser reavaliados para proteger deslocados ambientais, focando na sua vulnerabilidade no local de residência e arredores. Este artigo identifica, em João Pessoa, focos de deslocamento interno de pessoas por questões ambientais, categorizando-os a partir das causas e das consequências para o migrante, para a sociedade e para o governo, haja vista chuvas, deslizamentos e projetos de desenvolvimento, por exemplo, causarem, na localidade, destruição de vidas humanas e do ambiente local. O problema foi “até que ponto os deslocados internos ambientais de João Pessoa, PB, são migrantes forçados sujeitos à proteção internacional?”, com o fim de localizar os focos destes deslocamentos no município, suas causas e consequências, formas de proteção aos deslocados, em nível local, nacional e internacional, e propor medidas para protegê-los, com método indutivo, bibliográfico e de estudo de caso.
Palavras-chave: Proteção Internacional. Deslocados ambientais. João Pessoa (PB).
Nota Editorial
Authors: Sobreira de Moura Alexandrina
Published: April 2023

Os artigos selecionados para esta edição da Revista Ciência & Trópico representam contribuições originais para repensar debates teóricos que marcam análises multidisciplinares e contemporâneas.

A construção do conhecimento expressa pela reflexão dos autores nesta edição da Revista Ciência & Trópico significa o compromisso de partilhar valores democráticos e difundir a cultura do diálogo e da tolerância. A missão de formar vínculos é fundamental para criar condições de “estar-juntos”. Stefan Zweig, na conferência Unidade Espiritual do Mundo, proferida no Rio de Janeiro, em 1936, expressou, com atualidade, esse pensamento: “Não são as línguas e as montanhas e os mares que separam as pessoas, mas seus preconceitos e sua desconfiança”.
Гендерна толерантність особистості в кризових умовах
Authors: Яремчук Віталія
Published: April 2023

Стаття присвячена актуальній проблемі гендерної толерантностіообистості в кризових умовах (на прикладі студентської молоді). Визначено, що гендерна толерантність – це неупереджене ставлення до представників іншої статі та людей, яким притаманна поведінка не характерна для своєї статі; недопустимість приписування людині недоліків за ознакою статі, наслідування гендерних стереотипів, прояву дискримінації за ознакою як біологічної, так і соціально-культурної статі. Це особистісна позиція, у якій виявляються установки, цінності, мотиви особистості, а на їх основі здійснюється обдуманий вибір, що є визначальним при побудові стратегії поведінки.Виявлено, що у студентів які мають вищий рівень розвитку емоційної сфери спостерігається вищий рівень гендерної толерантності. Показано, що вміння проявляти та контролювати свої емоції, проявляти чуйність та емпатійність безпосередньо впливають на формування гендерної толерантності. Чоловіча стать характеризується стриманістю та контролем емоційних проявів, дівчата в свою чергу більш емоційні, яскраво виявляють свої відчуття, а також проявляють співпереживання, краще розуміють та зчитують емоції при міжстатевій взаємодії. Встановлено, що емоційна сфера (вміння проявляти та контролювати свої емоції, здатність до емпатійності), гендерна ідентичність (наявність жіночих, чоловічих або спільних рис обидвох статей) та нервово-психологічна стійкість (здатність до адаптації, ризику та самовладання) тісно пов'язані із рівнем гендерної толерантності студентів.Проведене емпіричне дослідження показало, що емоційна сфера (вміння проявляти та контролювати свої емоції, здатність до емпатійності), гендерна ідентичність (наявність жіночих, чоловічих або спільних рис обидвох статей) та нервово-психологічна стійкість (здатність до адаптації, ризику та самовладання) тісно пов'язані із рівнем гендерної толерантності студентів. Проблема потребує подальшого дослідження та розробки рекомендацій щодо формування гендерної толерантності студентів.
Проблема образи, прощення та примирення: огляд наукових підходів
Authors: Гарькавець Сергій , Яковенко Сергій
Published: April 2023

У статті розглядаються теоретичні та прикладні аспекти щодо проблеми подолання образи, дарування прощення та пошуку шляхів примирення ображеного з кривдником.
Встановлено, що ефективне вирішення проблеми подолання образи, дарування прощення та пошуку шляхів примирення конфліктуючих сторін є важливим завданням для сучасної психологічної науки, практики застосування медіації, реалізації інституту амністії та помилування.
Зазначається, що прощення найуспішніше відбувається у тому випадку, коли особистість здатна до рефлексії, продуктивного мислення, відчуває потребу в афіліації, вибирає таку стратегію поведінки, за яку вона прагне до співпраці, взаємодії на основі взаємного прийняття, довіри, толерантності, поваги та безпеки.
З’ясовано, що натепер відсутні узгоджені уявлення дослідників щодо змістовного наповнення понять образи та прощення. Пропонується широкий спектр психологічних і соціально-психологічних практик щодо можливої редукції образи та артикуляції прощення, але зазначається, що такі інсталяції поки що не мають достатньої наукової валідності.
Констатовано, що позитивна редукція образи, нівелювання образливості особистості та спроможність індивіда до прощення значно залежать від: подолання психологічних захистів, що пов’язані з витисненням базальної агресії; усвідомлення та переживання провини, що призводить до покаяння; формування та розвитку емпатії, рефлексії психологічних зисків від прощення та духовного зростання; розвиненості емоційного інтелекту; зцілення на ґрунті любові, а не провини та покарання; знаходження особистісного смислу у стражданні та прощенні; трансформації енергії стресу в енергію подолання образи; подолання патологічного злиття; досягнення автономії особистості та відмова від непродуктивних типів поведінки; медитаційне доведення образи до знецінення; набуття позитивного досвіду примирення.
Adolescents and young adults with newly diagnosed primary immune thrombocytopenia
Authors: Schifferli Alexandra , Moulis Guillaume , Godeau Bertrand , Leblanc Thierry , Aladjidi Nathalie , Michel Marc , Leverger Guy , Elalfy Mohsen , Grainger John , Chitlur Meera , Heiri Andrea , Holzhauer Susanne , Le Gavrian Gautier , Imbach Paul , Kühne Thomas
Published: April 2023

Current immune thrombocytopenia (ITP) guidelines target children and adults, leading to oversimplification. Adolescents and young adults (AYAS) comprise a separate group with distinct health and psychosocial issues. This study aimed to describe the clinical presentation and therapeutic strategies of ITP among AYAS. We analyzed data from two large ITP registries (PARC-ITP; CARMEN-France) and included newly diagnosed ITP patients (aged 12–25 years) with an initial platelet counts of <100×109/L. Patients with secondary ITP or non-immune thrombocytopenia (n=57) and pregnant women (n=10) were excluded. Of the 656 cases of AYAS with primary ITP registered from 2004 up to 2021, 12-month follow-up data were available for 72%. The initial median platelet count was 12×109/L. In 109 patients (17%), the diagnosis was incidental, without documented bleeding. Apart from gynecological bleeding, the clinical and therapeutical characteristics of females and males were similar. Platelet-enhancing drugs were reported in 66%, 45%, and 30% of patients at diagnosis, 1–6 months, and 6–12 months after diagnosis, respectively. Corticosteroids were the preferred treatment at all time points. At 12 months, 50% of all patients developed chronic ITP. In the subgroup of patients with initial severe thrombocytopenia (<20×109/L), those receiving frontline treatment had a higher remission rate at 1 year than those who followed an initial watch-and-wait strategy (53% and 32%; P<0.05). Our analysis indicates that the remission rate at 1 year may be associated with the initial treatment strategy. This hypothesis must be confirmed in prospective studies.
An Interconnection between Earnings Quality and Earnings Management in the Business Environment
Authors: EL Agha Emad Saleem , Norfadzilah Rashid
Published: April 2023

This paper reviews the interconnection between earnings quality and earnings management in the business environment, through the use of flexibility in determining the practices and methods as well as accounting estimates, to change the income that affecting disclosure process when preparing the financial statements. Which will be based on many of the misinformation, through corporate management manipulation results of company profits and losses and financial position statement. These multiple reasons include capital market motivations to raise their share prices and attract potential shareholders. In addition, the motives of borrowing loans and funding. All this leads to the loss of the most important characteristics of the quality of representation is sincere of accounting information. Therefore, will negatively affect the quality of accounting profits. This is one of the most important information that concerns the shareholders. By consideration, the earnings quality and earnings management are two related challenging interwoven issues in financial reporting as earnings management is an aspect influencing earnings quality. In this paper, fundamental scientific processes such as analysis, synthesis, induction, and deduction have been utilized in order to achieve the objective of this paper. This paper concluded that earnings management has a negative impact on the quality of earnings if it distorts the information in a way that is less useful for forecasting future cash flows, which in turn result in unreliable financial reports leading to incorrect decision. Also, corporate earnings of high quality are those that have a high level of persistence, are more timely, more predictable, less volatile and have lower level of earnings management. And on the other side it is important to understand that lower earnings quality are not indicators of poor financial situation or the misapplication of accounting policies, judgments, and estimates.
Prevalencia, factores de riesgo y terapias psicológicas asociados a la diabulimia: revisión sistemática en adolescentes y adultos
Authors: Sierra Ayala Nancy , Luzuriaga Mera Johanna Cristina , Ramírez Coronel Andrés Alexis
Published: April 2023

Introducción. La Diabulimia (DB) hace referencia al trastorno de la conducta alimentaria que puede manifestarse en pacientes diagnosticados con diabetes tipo 1, debido a que, de manera voluntaria, omiten inyectarse insulina, con el propósito de perder peso. Por lo que en torno al tema se sintetizó los resultados de las investigaciones más recientes. Objetivos. Examinar en la bibliografía de los últimos cinco años la prevalencia, factores de riesgo y terapias psicológicas asociados a la DB en adolescentes y adultos. Además, se plantearon como objetivos específicos los siguientes: a) revisar en la literatura científica sobre las prevalencias y terapias psicológicas de la DB en adolescente y adultos considerando la región, durante los últimos 5 años; y b) describir los factores de riesgo de la DB en adolescentes y adultos. Metodología. Revisión sistemática de la literatura científica obtenida en bases de datos como: Pubmed, Scopus, Web of Science, Lilac y Google Scholar. Resultados. Luego del análisis de 32 artículos seleccionados que abordan a la DB se obtuvo una prevalencia promedio de 25.46 %. Los factores de riesgo asociados a la DB más frecuentes son: Índice de Masa Corporal alto, la insatisfacción con la imagen corporal, la falta de apoyo familiar, ser mujer y adolescente, presentar altos niveles de insatisfacción corporal y falta de apoyo social y familiar, asociado a los comentarios negativos sobre el peso. El abordaje psicológico que más reporta es la Terapia Cognitiva Conductual y la técnica más efectiva es la Psicoeducación, así como las Intervenciones Psicosociales. Conclusión. En los estudios incluidos en esta revisión, el valor de la prevalencia no es un valor exacto debido a la escasez de estudios; sin embargo, se pudo evidenciar que Brasil e Inglaterra son los países que mayor número de investigaciones realizan sobre la temática; además, según los resultados de los estudios revisados, los pacientes de estos países presentaban un alto índice de Diabetes tipo I, por lo que la DB es más frecuente. Los factores de riesgo mencionados en el apartado de resultados parecen ser un predictor importante para el padecimiento de DB. Respecto a las intervenciones psicológicas para el tratamiento de DB, se puede concluir que es necesaria la incorporación de diseños longitudinales, que permitan que las investigaciones evalúen la efectividad de las terapias psicológicas en el tratamiento de la diabulimia, debido a que este tipo de estudios fueron escasos según la revisión realizada. Área de estudio: Psicología.
Procesos de implementación de un gestor documental: caso de estudio unidad académica de administración
Authors: Calderón Curipoma Mireya Alexandra , Lugo García Jorge , Ormaza Andrade Jorge Edwin
Published: April 2023

Uno de los objetivos que se enmarcan en la educación superior es mejorar el servicio académico y administrativo a todos sus estudiantes, docentes y funcionarios,  en este sentido, implementar un sistema de gestión documental, ayuda a optimizar los procesos universitarios e implementa políticas de gestión de documentos tales como: la legitimidad, temporalidad, trazabilidad basados en entornos digitales para su posterior registro (archivo) que sirva de repositorio interactivo de edición y consulta, bajo este contexto, lo que propone este estudio es brindar desde un aspecto metodológico una guía de implementación de un gestor documental, que sirva como eje transversal para los modelos de negocio que busquen mejorar sus procesos organizacionales,  la comunicación de sus clientes internos y externos y su productividad, en consecuencia, para el diseño de esta base metodológica primero se realizó el levantamiento de la situación archivística y gestión documental, posteriormente se utilizó técnicas de análisis documental y entrevista, por último, al procesar la información, se evidenciaron problemas de conservación y almacenamiento del fondo documental, demora en recuperación de documentos para consultas de usuarios internos y externos, duplicidad de información e información innecesaria, de manera que, se consideraron los diversos escenarios de la gestión documental y mediante el prototipado se establecieron las bases para la implementación total de los procesos estudiados, en conclusión, la revisión y dirección eficaz de los documentos generados y la metodología propuesta permitió el trabajo coordinado en los ámbitos académico-administrativo de la unidad académica utilizada como caso de estudio.
A Comparative Study between Metal Clip Application and Suture Ligation of Cystic Duct in Laparoscopic Cholecystectomy
Authors: Hasan Chowdhury Mahmudul , Ullah Md Aziz , Rahman Md Zillur , Rahman Sadia , Arefin Nazmul , Islam Md Ashraful
Published: April 2023

Introduction: Laparoscopic cholecystectomy has been performed for decades and is a fairly standardized procedure throughout the world. Occlusion of the cystic duct is popularly done with the help of metal clips. There are many other techniques described in the literature to deal with occlusion of the Cystic Duct. Suture ligation of the duct is one such way.To evaluate the effectiveness in term of cost, safety, and complication in occlusion of cystic duct with suture ligation compared to clip application.
Materials and Methods: A prospective cross sectional comparative study was carried out From June 2020 to November 2020. Data were collected from 80 patients undergone laparoscopic cholecystectomy for Gall stone diseases. 40 patients were enrolled in each group by consecutive purposive sampling. Complete history was taken. Thorough clinical examination was done. Relevant investigations report was collected.
Results: Female patients were predominant in both groups and most of the patients were underweight. Mean time for ligation was more in occlusion of cystic duct with clip application. Bile leakage was found and duration of drain in situ was more in occlusion with clip application. Cost was high in occlusion with clip application.
Conclusion: : Time for ligation, Bile leakage, mean duration of drain in situ (days), and cost of Cystic Duct occlusion and port closure were significantly higher in Laparoscopic Cholecystectomy with conventional Clip application of Cystic Duct group in comparison to Laparoscopic Cholecystectomy with ligation of the Cystic duct with no-1vicryl by extra corporeal knotting group.
Medicine Today 2023 Vol.35(1): 27-30
Outcome and Evaluation of the Patient Thyroidectomy with Hyperthyroidism: A Case-Control Study
Authors: Rashid Md Harun Ur , Haque Muhammad Mahmudul , Islam Md Shafiul , Rahim Hasan Md Abdur , Tasrif Samir Mohammad , Mahmud Bhuiya Md Monwar
Published: April 2023

Introduction: According to reports, pediatric patients with hypothyroidism have a higher risk of complications following surgery than adults. Specifically, this Study's aimed to evaluate how complete thyroidectomy is in youth (18 years) and adults.
Materials and Methods: A retrospective case-control study of all (n=100) complete thyroidectomies was performed on 32 pediatric and 68 adult patients who were consecutive from were compared at the Department of ENT, Head & Neck Surgery, Islami Bank Medical College and multicentral base hospital, Rajshahi, Bangladesh, from July 2018 to June 2021.
Results: The average patient age in children was 9.7 years (range 3.4-17.9 years) against 44.9 years (range 18.4-84.2 years) in adults. Compared to adults, surgical procedures on children took an average of (2.18 ± 0.08 hrs.) longer to complete in adults (1.66 ± 0.03 hrs) (p = 0.003). The average weight of a thyroid specimen was 48.0 ± 6.4 grams in adults and 38.6.0 ± 8.9 grams in children (range, 6.6-203 grams; p = 0.34). Children had a higher ratio of thyroid weight to body weight (0.94 ± 0.11 gm/kg) than adults (0.67 ± 0.8 gm/kg; p = 0.05). After surgery, the hyperthyroid condition improved in every patient. There were no operational deaths, recurrences, or long-term hypoparathyroidism.
Conclusion: It is clear that the technical difficulties associated with treating Graves' disease surgically in children and adults result in longer operational periods. There was no difference in the chances of long-term consequences, including recurrent laryngeal nerve damage or neck hematoma.
Medicine Today 2023 Vol.35(1): 40-43
Correlation of Body Mass Index with Vitamin D and Parathormone (PTH) in Obese and Overweight Children, Study from a Tertiary Care Hospital of Bangladesh
Authors: Shyamaly Kohinoor Jahan , Karim Muhammad Rezaul , Tithi Baraka Badruddoza , Akther Romana , Parvin Rokhsana , Begum Suraiya
Published: April 2023

Introduction with aim and objectives: Childhood obesity and vitamin D deficiency both are emerging health issues. Vitamin D is essential for normal growth and development and frequently found low in obese and overweight children. The aim of this study was to assess serum vitamin D level, calcium, inorganic phosphate, alkaline phosphatase and parathormone (PTH) in obese and overweight children and to see the correlation between BMI, vitamin D and parathormone.
Materials and Methods: This study was conducted at Pediatric Endocrinology clinic of department of Paediatrics of Bangabandhu Sheikh Mujib Medical University from the period of November 2016 to October 2018. We assessed 50 obese and overweight children for serum vitamin D, calcium, inorganic phosphate, alkaline phosphatase, and parathormone and we also tried to find out the correlations among the parameters in this cross sectional study.
Results: Endocrine society clinical practice guideline was used to define vitamin D status. Result found that all of the obese/overweight children had low vitamin D (82% had deficiency and 18% had insufficiency). There was a statistically significant negative correlation between BMI and serum vitamin D level and positive correlation between BMI and the parathormone level (p value < 0.05). In this study significant negative association was found between vitamin D level and the PTH level p value <0.05.
Conclusion: All the studied obese and overweight had vitamin D deficiency or insufficiency. There was negative correlation between BMI and serum vitamin D level and positive correlation between BMI and the parathormone level (PTH).
Medicine Today 2023 Vol.35(1): 52-55
Pattern and Frequency of Microalbunuria with Different Types of Stroke
Authors: Ahammed Zaman , Majumder Pijush , Ferdous Rushmila , Hossen Talukder Mohammad Mosharaf , Hoque Anisul
Published: April 2023

Introduction with aim and objectives: Cerebrovascular diseases have recently emerged as a major health problem affecting the elderly population. The spectrum includes some of the most common and devastating disorders like ischemic stroke, hemorrhagic stroke and anomalies in vascular system. Microalbuminuria is an early finding in urine in the patients of diabetes and hypertension and it is associated with macrovascular complications like cerebrovascular accident and myocardial infarction. The aim of this study was to find out the pattern and frequency of microalbunuria with different types of stroke.
Materials and Methods: Fifty cases of stroke Patients admitted in CMCH medicine and neurology department from 1 January 2019 to 31 June 2019 were analyzed and urine for microalbumin was done. Univariate statistical analyses were performed to see the outcome in relation with blood volume by SPSS-19.
Results: Regarding analysis of gender distribution of 50 study patients, 27(60%) were found male and 23(40%) were found female. Male to female ratio was 1:0.4. Among the 50 patients, different types of occupation were found. House wife was common occupation. Among the total patients, most of them were from lower middle class 24(61.4%). Others were from low 16(32.0%) and upper middle class 10(5.75%) group. Most of the patients were from rural residence 41(80%). In our study, 13(71.42%) patients had hypertension. Diabetes mellitus was found among 13(8.57%). Different examination findings were analyzed where mean GCS of ischaemic stroke was 14.5 and mean GCS of hemorrhagic stroke was 10.6, 12 patients had abnormal fundoscopic findings. Regarding analysis of serum LDL and serum Creatinine, mean LDL level was 123.95 and mean serum Creatinine level was 1.19. After analysis, mean of urine for Microalbumin of 30 Ischaemic stroke patients was 71.96mg/L and mean of urine for Microalbumin of 20 Hemorrhagic stroke patients was 80.70mg/L.
Conclusions: We found high frequency of microalbuminuria in patients with stroke Therefore; microalbuminuria could be is a useful modifiable factor, in addition to conventional risk factors, in identifying those at increased risk of stroke.
Medicine Today 2023 Vol.35(1): 63-66
Yolk Sac Tumor of Testis Diagnosed 10 years after Orchidopexy in 24-year-old Adult: A Case Report
Authors: Lamichhane Ramesh , Chaudhary Saroj
Published: April 2023

Introduction: Yolk sac are a rare type of germ cell tumors that occurs most commonly in prepubertal age but are rare in adults.
Case report: We present a case of a yolk sac tumor in a 25-year-old man with a history of bilateral cryptorchidism diagnosed at the age of 10 for which bilateral orchidopexy was done at the age of 19.
Discussion: Delayed diagnosis of cryptorchidism are common in developing countries. Most adults with cryptorchidism prefer orchidopexy instead of orchiectomy. Due to a lack of adherence to follow-up, late presentation with complications is common.
Conclusion: Yolk sac tumor can rarely occur in cryptorchid testis after post-pubertal orchidopexy. As lack of adherence to follow-up is common in developing countries, orchidopexy should be avoided.
Medicine Today 2023 Vol.35(1): 67-69
Intraligamentary Pregnancy- A Rare Obstetric Event
Authors: Khair Asma Binte , Rahman Mahmuda , Afroz Rumana
Published: April 2023

Introduction: Intraligamentary pregnancy is a rare form of ectopic pregnancy, where the gestation grows within the leaves of the broad ligament. Clinical presentation, diagnosis and outcome are highly variable.
Case report: Here, we report a case of a 30 years old lady (P2G7), presented at her 13+ weeks of pregnancy with acute abdomen and severe anaemia. USG revealed extrauterine alive pregnancy with huge peritoneal collection. Emergency laparotomy was performed and final diagnosis was made as ruptured intraligamentary pregnancy. Right sided salpingooophorectomy was done. Our main challenge was to control bleeding and to maintain haemostasis at the placental implantation site.
Conclusion: Although, definite preoperative diagnosis based on clinical sign symptoms and sonographic evaluation is elusive, proper resuscitation and surgical expertise can save a mother’s life. Role of MRI and Laparoscopy in selected cases should be in consideration.
Medicine Today 2023 Vol.35(1): 70-72
Un modelo SIG para salvar (o no olvidar) el barranco de Janá de Oria (Almería)
Authors: Moya Muñoz Jorge
Published: April 2023

La obras previstas para encauzar los colectores de la futura estación depuradora de Oria (Almería) en el conocido como barranco de Janá supondrían la destrucción de buena parte de la infraestructura de su huerta histórica de origen medieval y la imposibilidad de regar sus tierras. Pese a existir alternativas viables para reconducir estos colectores y evitar poner en riesgo este entorno de gran valor cultural y natural, las administraciones responsables hacen caso omiso a la petición vecinal para preservarlo. Ante tal circunstancia, con la sombra de las máquinas acechando, hemos decidido inventariar de manera organizada todos los elementos que integran esta zona de la huerta centenaria con un doble propósito: construir un argumento más sólido en nuestra lucha colectiva, a la cual no vamos a renunciar; y recabar la máxima información sobre unos bienes culturales que, desgraciadamente, pueden desaparecer pronto. Para vehicular dicha acción, planteamos la creación de un modelo SIG. El uso de esta tecnología digital nos permite, por un lado, identificar geográficamente los diferentes elementos que definen la huerta histórica del entorno señalado y, por otro, atribuir información asociada a cada elemento a partir de la toma de datos en campo, desde fuentes bibliográficas y archivísticas hasta testimonios orales. El resultado obtenido permite tanto la salida de mapas temáticos en formato de imagen como compartir un tipo de archivo vectorial fácilmente reproducible en diferentes visores cartográficos a través de Internet. Además, el modelo generado tiene un carácter abierto, por lo que puede ampliarse al resto de la huerta histórica.
Treatment with levosimendan in an experimental model of early ventilator-induced diaphragmatic dysfunction
Authors: Zambelli Vanessa , Murphy Emma J. , Del Vecchio Paolo , Rizzi Laura , Fumagalli Roberto , Rezoagli Emanuele , Bellani Giacomo
Published: April 2023

Introduction: Mechanical ventilation (MV) is a life-saving approach in critically ill patients. However, it may affect the diaphragmatic structure and function, beyond the lungs. Levosimendan is a calcium sensitizer widely used in clinics to improve cardiac contractility in acute heart failure patients. In vitro studies have demonstrated that levosimendan increased force-generating capacity of the diaphragm in chronic obstructive pulmonary disease patients. Thus the aim of this study was to evaluate the effects of levosimendan administration in an animal model of ventilator-induced diaphragmatic dysfunction (VIDD) on muscle contraction and diaphragm muscle cell viability.
Methods: Sprague-Dawley rats underwent prolonged MV (5 hours). VIDD+Levo group received a starting bolus of levosimendan immediately after intratracheal intubation and then an intravenous infusion of levosimendan throughout the study. Diaphragms were collected for ex vivo contractility measurement (with electric stimulation), histological analysis and Western blot analysis. Healthy rats were used as the control.
Results: Levosimendan treatment maintained an adequate mean arterial pressure during the entire experimental protocol, preserved levels of autophagy-related proteins (LC3BI and LC3BII) and the muscular cell diameter demonstrated by histological analysis. Levosimendan did not affect the diaphragmatic contraction or the levels of proteins involved in the protein degradation (atrogin).
Conclusions: Our data suggest that levosimendan preserves muscular cell structure (cross-sectional area) and muscle autophagy after 5 hours of MV in a rat model of VIDD. However, levosimendan did not improve diaphragm contractile efficiency.
Marine turtle regional management units 2.0: an updated framework for conservation and research of wide-ranging megafauna species
Authors: Wallace BP , Posnik ZA , Hurley BJ , DiMatteo AD , Bandimere A , Rodriguez I , Maxwell SM , Meyer L , Brenner H , Jensen MP , LaCasella E , Shamblin BM , Abreu Abreu-Grobois FA , Stewart KR , Dutton PH , Barrios-Garrido H , Dalleau M , Dell’amico F , Eckert KL , FitzSimmons NN , Garcia-Cruz M , Hays GC , Kelez S , Lagueux CJ , Madden Hof CA , Marco A , Martins SLT , Mobaraki A , Mortimer JA , Nel R , Phillott AD , Pilcher NJ , Putman NF , Rees AF , Rguez-Baron JM , Seminoff JA , Swaminathan A , Turkozan O , Vargas SM , Vernet PD , Vilaça S , Whiting SD , Hutchinson BJ , Casale P , Mast RB
Published: April 2023

Delineating spatial boundaries that accurately encompass complex, often cryptic, life histories of highly migratory marine megafauna can be a significant conservation challenge. For example, marine turtles range across vast ocean basins and coastal areas, thus complicating the evaluation of relative impacts of multiple overlapping threats and the creation of coherent conservation strategies. To address these challenges, spatially explicit ‘regional management units’ (RMUs) were developed in 2010 for all marine turtle species, globally. RMUs were intended to provide a consistent framework that organizes conspecific assemblages into units above the level of nesting rookeries and genetic stocks, but below the species level, within regional entities that may share demographic trajectories because they experience similar environmental conditions and other factors. From their initial conception, RMUs were intended to be periodically revised using new information about marine turtle distributions, life history, habitat use patterns, and population structure. Here, we describe the process used to update the 2010 RMU framework by incorporating newly published information and inputs from global marine turtle experts who are members of the IUCN Marine Turtle Specialist Group. A total of 48 RMUs for 6 of 7 marine turtle species and 166 distinct genetic stocks for all 7 species are presented herein. The updated RMU framework reflects a significant advance in knowledge of marine turtle biology and biogeography, and it provides improved clarity about the RMU concept and its potential applications. All RMU products have been made open access to support research and conservation initiatives worldwide.
The Missing Dispute Resolution Mechanisms in International Climate Change Agreements
Authors: Reichenbach Clara
Published: April 2023

An often-overlooked feature of international climate change agreements is their dispute resolution provisions. An effective dispute resolution framework is essential for holding States to account and ensuring compliance with treaty obligations. However, many of the dispute resolution mechanisms in international climate change agreements were never brought into existence. These include arbitration, conciliation and non-compliance procedures. This article analyses the dispute resolution mechanisms of the United Nations Framework Convention on Climate Change (1992) (‘UNFCCC’), the Kyoto Protocol (1997), and the Paris Agreement (2015) with a view to establishing which are missing, which have been successful in keeping States in check, and which should inform future amendments or treaties. Notably, a non-compliance procedure was never introduced under the UNFCCC, a successful one came into existence under the Kyoto Protocol, and a watered-down version is being discussed under the Paris Agreement. Further, although the treaties refer to an arbitration annex and a conciliation annex, none of these ever materialized. The article compares and contrasts the various procedures and their different successes, including through the use of case-studies, and makes a number of recommendations for future amendments or treaties.
Viewing our World through a Different Lens: Environmental and Social Considerations in International Arbitration
Authors: Greenwood Lucy
Published: April 2023

Climate change is the greatest challenge humanity will face this century, yet the international arbitration community has been slow to recognize its significance and to react to its effects. The international arbitration community was similarly slow to address the under-representation of women in arbitration, with measurable change in this area only being seen in the last five years. We have yet to realize any significant improvement achieving a more diverse community more generally, beyond the narrow issue of the under-representation of women.

This article addresses the behavioural changes which have been achieved in these areas and considers those that remain to be implemented to embed environmental and social considerations into the culture of international arbitration. It argues that every dispute should be viewed through a diversity and an environmental lens and identifies the changes that are needed now. We must secure change to ensure that arbitration meets the needs of its users, as we look to a future which looks very different to even the recent past.
Relación de edad y sobrevida tras cirugía con intención curativa por cáncer gástrico en adultos
Authors: Guerrero Barrera Karla Daly , Gallegos Maldonado Verónica Elizabeth , Bravo Muñoz Marx Ítalo
Published: April 2023

Introducción: El cáncer gástrico constituye como una de las enfermedades de mayor morbimortalidad a nivel mundial; no obstante, la mortalidad se puede reducir con intervenciones tempranas. El objetivo del presente estudio fue determinar la relación entre la edad y la sobrevida tras cirugía con intención curativa por cáncer gástrico en pacientes atendidos en el Instituto del cáncer SOLCA, Cuenca, en el periodo 2012-2017.

Métodos: El presente estudio analítico, retrospectivo fue realizado con la base de datos del Instituto del Cáncer SOLCA-Cuenca. Los datos fueron presentados en tablas de frecuencia y porcentajes. Se aplicó Chi-cuadrado (X2), análisis de Kaplan Meier y regresión de Cox, para relacionar las variables edad y años de sobrevida, considerándose estadísticamente significativo cuando P<0.05.

Resultados: De los 603 pacientes con cáncer gástrico registrado durante el periodo de evaluación, el 35.3% fueron intervenidos quirúrgicamente, lográndose el seguimiento del 45.1%. Un total de 96 pacientes fueron incluidos, el 70.8% fueron intervenidos quirúrgicamente con intención curativa. En la muestra predominaba los hombres (52.9%) y el grupo etario de 70 a 79 años (30.2%). La tasa de sobrevida a los 5 años fue de 69.1% con un tiempo promedio de supervivencia de 7.24±0.49 años. La edad no se relacionó significativamente con la sobrevida de los pacientes (X2=3.15; P=0.667).

Conclusión: existe una elevada tasa de sobrevida a los 5 años en los pacientes con cáncer gástrico intervenidos quirúrgicamente con intención curativa, la cual no asoció con la edad.
Effects of human placenta cryopreservation on molecular characteristics of placental mesenchymal stromal cells
Authors: Navakauskienė Rūta , Žukauskaitė Deimantė , Borutinskaitė Veronika Viktorija , Bukreieva Tetiana , Skliutė Giedrė , Valatkaitė Elvina , Zentelytė Aistė , Piešinienė Lina , Shablii Volodymyr
Published: April 2023

Cryopreservation of placenta tissue for long-term storage provides the opportunity in the future to isolate mesenchymal stromal cells that could be used for cell therapy and regenerative medicine. Despite being widely used, the established cryopreservation protocols for freezing and thawing still raise concerns about their impact on molecular characteristics, such as epigenetic regulation. In our study, we compared the characteristics of human placental mesenchymal stromal cells (hPMSCs) isolated from fresh (native) and cryopreserved (cryo) placenta tissue. We assessed and compared the characteristics of native and cryo hPMSCs such as morphology, metabolic and differentiation potential, expression of cell surface markers, and transcriptome. No significant changes in immunophenotype and differentiation capacity between native and cryo cells were observed. Furthermore, we investigated the epigenetic changes and demonstrated that both native and cryo hPMSCs express only slight variations in the epigenetic profile, including miRNA levels, DNA methylation, and histone modifications. Nevertheless, transcriptome analysis defined the upregulation of early-senescence state-associated genes in hPMSCs after cryopreservation. We also evaluated the ability of hPMSCs to improve pregnancy outcomes in mouse models. Improved pregnancy outcomes in a mouse model confirmed that isolated placental cells both from native and cryo tissue have a positive effect on the restoration of the reproductive system. Still, the native hPMSCs possess better capacity (up to 66%) in comparison with cryo hPMSCs (up to 33%) to restore fertility in mice with premature ovarian failure. Our study demonstrates that placental tissue can be cryopreserved for long-term storage with the possibility to isolate mesenchymal stromal cells that retain characteristics suitable for therapeutic use.
Mesenchymal stem cell therapy for non-healing diabetic foot ulcer infection: New insight
Authors: Mahmoudvand Golnaz , Karimi Rouzbahani Arian , Razavi Zahra Sadat , Mahjoor Mohamad , Afkhami Hamed
Published: April 2023

Diabetic foot ulcer (DFU) is considered the most catastrophic complication of diabetes mellitus (DM), leading to repeated hospitalizations, infection, gangrene, and finally amputation of the limb. In patients suffering from diabetes mellitus, the wound-healing process is impaired due to various factors such as endothelial dysfunction and synthesis of advanced glycation end-products, hence, conventional therapeutic interventions might not be effective. With increasing therapeutic applications of mesenchymal stem cells (MSCs) in recent years, their potential as a method for improving the wound-healing process has gained remarkable attention. In this field, mesenchymal stem cells exert their beneficial effects through immunomodulation, differentiation into the essential cells at the site of ulcers, and promoting angiogenesis, among others. In this article, we review cellular and molecular pathways through which mesenchymal stem cell therapy reinforces the healing process in non-healing Diabetic foot ulcers.
SUMOylation patterns and signature characterize the tumor microenvironment and predict prognosis in lung adenocarcinoma
Authors: Chen Zhike , Yang Jian , Tang Lijuan , Sun Xue , Li Yu , Sheng Ziqing , Ding Hao , Xu Chun , Tong Xin , Zhao Jun
Published: April 2023

Background: Recent studies have revealed that SUMOylation modifications are involved in various biological processes, including cancer development and progression. However, the precise role of SUMOylation in lung adenocarcinoma (LUAD), especially in the tumor immune microenvironment, is not yet clear.

Methods: We identified SUMOylation patterns by unsupervised consensus clustering based on the expression of SUMOylation regulatory genes. The tumor microenvironment in lung adenocarcinoma was analyzed using algorithms such as GSVA and ssGSEA. Key genes of SUMOylation patterns were screened for developing a SUMOylation scoring model to assess immunotherapy and chemotherapy responses in lung adenocarcinoma patients. Experiments were conducted to validate the differential expression of model genes in lung adenocarcinoma. Finally, we constructed a nomogram based on the SUMOylation score to assess the prognosis of individual lung adenocarcinoma patients.

Results: Two patterns of SUMOylation were identified, namely, SUMO-C1, which showed anti-tumor immune phenotype, and SUMO-C2, which showed immunosuppressive phenotype. Different genomic subtypes were also identified; subtype gene-T1 exhibited a reciprocal restriction between the immune microenvironment and stromal microenvironment. High SUMOylation scores were indicative of poor lung adenocarcinoma prognosis. SUMOylation score was remarkably negatively correlated with the infiltration of anti-tumor immune cells, and significantly positively correlated with immune cells promoting immune escape and immune suppression. In addition, patients with low scores responded better to immunotherapy. Therefore, the developed nomogram has a high prognostic predictive value.

Conclusion: The SUMOylation patterns can well discriminate the tumor microenvironment features of lung adenocarcinoma, especially the immune cell infiltration status. The SUMOylation score can further assess the relationship between SUMOylation and immune cell crosstalk and has significant prognostic value and can be used to predict immunotherapy and chemotherapy response in patients with lung adenocarcinoma.