bluuebunny/crossref_metadata_2025 huggingface dataset:
Tranexamic acid is associated with decreased transfusion, hospital length of stay, and hospital cost in simultaneous bilateral total knee arthroplasty
Authors: D'Souza Ryan , Duncan Christopher , Whiting Daniel , Brown Michael , Warner Matthew , Smith Hugh , Kremers Hilal , Stewart Thomas
Published: October 2020

Tranexamic acid (TXA) reduces blood loss and transfusion rates in unilateral total knee arthroplasty (TKA), but there is limited data regarding its efficacy in bilateral TKA. This study reports the impact TXA has on clinical outcomes and hospital cost of care in simultaneous, primary bilateral TKA. The 449 patients were retrospectively reviewed. Primary outcomes included the rates of allogeneic and autologous blood transfusion. Secondary outcomes included hospital length of stay (HLOS), post-hospital discharge disposition, 30-day thromboembolic events (TEE), and mean hospital cost of care. Total direct medical costs were obtained from an institutional research database and adjusted to nationally representative unit costs in 2013 inflation-adjusted dollars. Our study revealed that in patients undergoing simultaneous bilateral TKA, TXA use was associated with reduced allogeneic (OR 0.181, 95% CI 0.090-0.366, p<0.001) and combined allogeneic and autologous transfusion rates (OR 0.451, 95% CI 0.235-0.865, p=0.017). TXA was associated with a HLOS reduction of 0.9 days (β-coefficient -0.582, 95% CI -1.008– -0.156, p=0.008), an increased likelihood of hospital discharge over skilled nursing facility (SNF) (OR 2.25, 95% CI 1.117-4.531, p=0.023) and reduced total hospital cost of care by 6.45% (p<0.001), room and board costs by 11.76% (p<0.001), and transfusion costs by 81.65% (p<0.001). In conclusion, TXA use in bilateral TKA is associated with lower blood transfusion rates, reduced hospital length of stay, reduced cost of hospital care and skilled nursing facility avoidance.
1 Preparation of Mica Substrate v1
Authors: J. Haynes Philip , H. S. Main Kavit , L Pyne Alice
Published: October 2020

This is part 1 of the "Atomic Force Microscopy of DNA and DNA-Protein Interactions" collection of protocols. Collection Abstract: Atomic force microscopy (AFM) is a microscopy technique that uses a sharp probe to trace a sample surface at nanometre resolution. For biological applications, one of its key advantages is its ability to visualize substructure of single molecules and molecular complexes in an aqueous environment. Here, we describe the application of AFM to determine the secondary and tertiary structure of surface-bound DNA, and it’s interactions with proteins.
Эстетика. Эстетика постмодернизма
Authors: Кульбижеков В.Н
Published: October 2020

Чтобы судить об эстетике постмодернизма – значительном, но не бесспорном культурном явлении конца второго – начала третьего тысячелетия – необходимо попытаться объективно его осмыслить и образно представить. Для этого учащимся предлагается ознакомиться с философско-эстетическими наработками, посвященными постмодернизму как феномену (глава 1), с конкретными его проявлениями в различных видах культурной деятельности (глава 2), а также с фрагментами текстов видных теоретиков постмодернизма.
REPERTOIRES OF CONTENTION IN REPRESSIVE STATES: THREE-GORGES-DAM MIGRANTS’ PETITIONING IN BEIJING*
Authors: Ho Wing-chung
Published: October 2020

This study advances our understanding of the processes whereby actors select and play out particular tactics and framings from “repertories of contention” to fight against repressive states. Empirically, it focuses upon a unique dataset captured from a discussion group of 140 participants in an instant messenger app—WeChat. Related to a petition campaign in Beijing, the data reflect the claims of over 1,000 petitioners who had been forced to relocate to different parts of China by the building of the Three Gorges Dam (1994–2006). The real-time chronological exchanges online among petitioners and other displaced persons reveal the petitioners’ tactics against the state’s counterpetition strategies, and the motives behind the petitioners’ repertoire selection. Theoretically, this study seeks to understand this case of grassroots resistance in terms of Bourdieu’s concept of habitus. It shows that the actors pursued parochial and rent-seeking motives—as symbolized in the discursive usage of nao (or troublemaking)— more than their defense of legal and constitutional rights as citizens. Both the characteristics and outcomes of such repertoire selection, shaped by what I call the habitus of nao, are discussed.
Psychological characteristics of patients with primary dysmenorrhea
Authors: Makaricheva E V , Burguvan M S
Published: October 2020

Aim. To study the psychological characteristics of women with primary dysmenorrhea.

Methods. We examined 77 women of childbearing age, divided into the main (40 women) and control (37 women) groups. The criterion for inclusion in the main group was a clinically confirmed diagnosis of primary dysmenorrhea with a regular menstrual cycle. The exclusion criteria were an organic gynecological pathology, a diagnosis of secondary dysmenorrhea and an irregular menstrual cycle. The criterion for inclusion in the control group was absolute painlessness of menstruation and the absence of gynecological diseases. The survey was conducted using psychodiagnostic techniques: a method for self-assessment of anxiety, rigidity, and extroversion; test Express diagnosis of the level of self-esteem; a technique for studying accentuation of personality traits; test-questionnaire of psychological defense mechanisms Life Style Index; questionnaire Methods of coping behavior, statistical methods. Also, a specially developed questionnaire was used, including questions related to socio-psychological parameters, as well as the nature and intensity of pain.

Results. Significant differences between the groups characterizing coping strategies were found: distance (p 0.002); escape-avoidance (p 0.029); psychological defenses: denial (p 0.006), regression (p 0.011). The subjects of the main group were characterized by significantly high anxiety levels (p 0.020) with the average score 47.21.15 corresponding to a hyperanxious and low self-esteem (p 0.001) with the average score 30.11.43 compared to women in the control group: 42.71.53 average anxiety level and 27.41.31 normal self-esteem.

Conclusion. The features of the relationship of the psychological characteristics of women with primary dysmenorrhea were revealed; it was proved that the subjects of the main and control groups differ in the features of coping behavior, psychological defenses and accentuation of personality traits, and also have reliably distinguishable levels of anxiety and self-esteem.
Is thyroid stimulating hormone titration mandatory in the routine work-up of African males from infertile couples?
Authors: Ngowa Jean D. Kemfang , Tchawe Yvan S. Ngaha , Voundi Esther V. , Toukam Michel , Ngassam Anny , Noa Cyrille C. , Nshalai Christiane , Metogo Junie , Sobngwi Eugene
Published: October 2020

Background: The impact of thyroid hormones on male reproductive function is still insufficiently understood. The objectives of this study were to determine the frequency of thyroid dysfunction in men from infertile couples and to establish an association between TSH (thyroid stimulating hormone) values and sperm parameters.Methods: We conducted a cross-sectional analytical study on a consecutive series of men managed for couple infertility in two reference hospitals of Yaoundé from November 2017 to May 2018. For each participant, a questionnaire was administered, TSH was assayed using electro-chemo-luminescence and sperm analyzed. Statistical methods used were the Mann-Whitney test and the Spearman correlation coefficient with a significance threshold of 5%.Results: Overall, 123 men were recruited. The median age was 44 years old [38-50 years]; 60 (48.79%) patients had couple infertility lasting between 1 and 5 years. Primary infertility of the couple was the most common (82 cases, 66.70%). After sperm analysis, 86 patients (70%) had one or more anomalies. TSH titration revealed 03 (2.44%) cases of subclinical hyperthyroidism, 05 (4.06%) subclinical hypothyroidism and 115 (93.50%) euthyroidism. Significant associations were found between TSH and sperm parameters in the group of patients with thyroid dysfunction, but none in the euthyroid group.Conclusions: Frequency of dysthyroidism is low among African males from infertile couples. We noted significant correlations between TSH values and sperm parameters. The low frequency of thyroid dysfunction would be against a TSH titration in the routine work-up of these patients.
Effect of triple drug antiretroviral therapy on CD4+ count in pregnant women with HIV and prevention of parent to child transmission
Authors: Dwivedi Akanksha , Gupta Ratan , Agarwal Kailash C. , Rani Kumari U.
Published: October 2020

Background: India has moved from single drug Antiretroviral Therapy (ART) in 2002 to triple drug ART in 2013 to prevent parent to child transmission of HIV. The aim of the study was to know the effects of triple drug ART on maternal CD4+ count and prevention of HIV transmission to baby along with its adherence, side effects and pregnancy outcome.Methods: A prospective study wsas done in Safdarjung Hospital, New Delhi on 40 HIV positive pregnant women who received single dose combination of triple drug ART. CD4+ count, LFT and KFT were done before beginning of ART and repeated after 6 months of ART. The infants received nevirapine prophylaxis and HIV status was determined by DBS PCR at 6 weeks.Results: The median CD4+ count was 317 and 397 pre and post ART for 6 months respectively (p value<0.001. Low birth weight (LBW) was seen in 43.59% which was statistically significant but confounded as 76.4% of these babies were preterm. 23.08% of babies had an APGAR of < 7 at 1 minute, out of which 77.7% were preterm. Nine out of 39 infants (one had abortion) needed NICU admission. Only one baby (2.56%) was HIV positive who died at 4 months of age due to pneumonia. There was no defaulter and no statistically significant changes in LFT and KFT after 6 months of ART.Conclusions: Triple drug ART offers greater convenience improves fetomaternal outcome and minimize the risk of HIV transmission from mother to child.
Major congenital malformations of foetus: a bane in pregnancy
Authors: Christe D. M. , Mohana D. , Shobha S.
Published: October 2020

Background: The aim of the study was to find out the numbers of women presenting with pregnancy complicating with major congenital anomalies of the fetus.Methods: This study was conducted over a period of fifteen months in the year 2018-2019. The types of congenital anomalies were that of the central nervous system, cardiac, renal, gastrointestinal, skeleto-muscular, hydrops foetalis, chromosomal, single umbilical artery and other multiple anomalies. Other variables regarding the age group of the mother, gravida, parity and gestational age at which the pregnancy was terminated was also noted.Results: A total of 212 pregnancies were diagnosed with major congenital anomalies of fetus and opted for termination. Malformations of the central nervous system (CNS) of fetus, formed the largest group of 56.6%, and fetal gastrointestinal malformations and fetal renal anomalies occupied the second major groups forming 11.8% and 11.3% respectively. The age group of women ranged between 23 years to 38 years. The largest group of pregnant women with fetal malformations were aged between 23-27 years. Primigravida with zero parity women were 60.4% of the total group of women with major fetal anomalies.Conclusions: Maximum number of congenital anomalies were seen in primigravida and para one mothers. Genetic counseling should be offered for women at clinics, before planning further pregnancy. Facilities should be made available for poor people from remote areas for early detection of congenital anomalies.
Comparative study between laparoscopic hysterectomy and abdominal hysterectomy for the treatment of early stage endometrial cancer
Authors: Bhattacharjee Rumi , Dhungat Nitin P. , Sheth Vishal
Published: October 2020

Background: Aim was to study the feasibility of total laparoscopic pan hysterectomy in patients with early stage endometrial cancer.Methods: Retrospective and prospective study of 100 patients with clinical early stage endometrial cancer was done in Bombay Hospital & Research Center over 3 years. 44 patients underwent total laparoscopic hysterectomy while 56 patients underwent abdominal pain hysterectomy. Pelvic lymphadenectomy was performed in patients with myometrium invasion greater than 50%, size of tumor >2 cm, non-endometroid pathology, Grade 3.Results: The mean operating time was 2 hours in the abdominal hysterectomy group and 2.5 hrs. In the laparoscopic group. Average blood loss was 350 ml in the abdominal (Abd) group & 250 ml in the laparoscopic (lap) group. Which was comparable. The abdominal hysterectomy group experienced more postoperative pain than the laparoscopy group. However, cost wise laparoscopy group incurred more expenditure than the abdominal group. Among the post-operative complications, nausea vomiting, paralytic ileus and wound dehiscence were significantly more in the abdominal group as compared to the laparoscopy group.Conclusions: Morbidity is much less in laparoscopy route compare to open abdominal hysterectomy with equivalent survival.
Study on fetomaternal outcome in antepartum haemorrhage
Authors: Nathwani Naimish D. , Vyas Rupa C. , Shah Sapana R. , Parikh Purvi M.
Published: October 2020

Background: Any bleeding from or into the genital tract after the period of viability, but before the birth of the baby is termed as antepartum haemorrhage (APH).Methods: 110 cases of bleeding per vaginal (pv) after 28 weeks of gestation were studied retrospectively from August 2018 to June 2019 and were grouped as placenta previa, placental abruption and indeterminate.Results: 35.45% cases were of placenta previa, 53.63% cases were of placental abruption and 10.90% cases were of indeterminate. Majority were delivered by lower segment caesarean section (LSCS) and most of the cases required blood transfusion.Conclusions: APH cannot reliably be predicted .It is major cause of maternal and perinatal mortality and morbidity. Multidisciplinary approach and senior input is necessary in making decision about timing and mode of delivery. Presently increase in use of ultrasonography (USG) for placental localisation and to diagnose abruption, improved obstetrical and anesthetic facilities, increase in use in blood products to correct anemia and advanced neonatal care facilities, all of these have played important role in decreasing perinatal as well as maternal mortality and morbidity
A study of post-dated pregnancy with special reference to maternal and perinatal outcome in nulliparous women
Authors: Karmakar Shreyasi , Bid Sabyasachi , Maiti Tapan Kumar
Published: October 2020

Background: The study was aimed to determine the mode of delivery, maternal outcome and perinatal outcome in prolonged pregnancy.Methods: It was a prospective observational study. Uncomplicated nulliparous singleton pregnancies who have completed 37 weeks of gestation were included in the study. Inclusion and exclusion criteria were strictly followed. Total 200 cases were divided into study group and control group. Those who have crossed their Estimated date of delivery (EDD) were compared with term pregnancies (not crossed their EDD).Results: The study group and control group consist of 114 and 86 women respectively. The incidence of caesarean section (64.04%), induction of labour (50.88%) is significantly higher in the study group. It also shows that the occurrence of caesarean section (63.79%) is more in post-dated pregnant women who underwent induction of labour. The most common indication for caesarean section was fetal distress in both groups. The commonest maternal complication was prolonged labour and perinatal complication was fetal distress in both groups. The incidence of low birth weight was significantly less in post-dated pregnancy.Conclusions: Our study suggests that the incidence of induction of labour and caesarean section is significantly higher in post-dated pregnancy. Although the mean birth weight baby is more in them, a definite policy should be recommended for optimum timing of intervention to avoid maternal and perinatal complications.
Is fear of COVID-19 influencing cancer patients to report for follow-up? experience from a tertiary care oncology center in eastern India
Authors: Ray Chandrima , Singh Priyanka , Mandal Ranajit
Published: October 2020

Background: The Coronavirus disease 2019 (COVID-19) pandemic led to the implementation of lockdown in India in March, 2020 which has posed a great challenge for both oncologic health care providers and cancer survivors alike as cancer patients have been unable to report for follow-up visits due to the same. The present study aims to assess the psychological impact of COVID -19 on female cancer patients undergoing treatment in a tertiary care oncology centre in Eastern India.Methods: The present study is a prospective cross-sectional study conducted on 80 female patients who were undergoing treatment for various gynecologic malignancies at a tertiary care oncology cancer centre in Eastern India. Fear of COVID-19 scale (FCV-19S) was used to assess the psychological impact of COVID-19 among the study population. Telephonic interviews were also conducted to collect data. Data was analysed using Microsoft excel and Statistical package for social sciences (SPSS) version 20.Results: Seventy-eight percent of the patients were afraid of contracting COVID-19 on coming out of their house, higher number of poorly educated patients had fear of the COVID-19 infection. Fifty-one percent patients were ‘very fearful’ of the COVID-19 infection and the most common cause of fear was of ‘losing life due to corona virus’. Eighty-six percent of the patients found talking to the doctor telephonically reassuring.Conclusions: The COVID-19 pandemic has instilled fear and anxiety among the patients of gynecological cancer preventing them to report for follow-up. Alternative strategies need to explored to render effective follow-up care to oncology patients.
Uterine malformations and pregnancy: about 11 cases seen university hospital center of gynecology- obstetric Befelatanana Antananarivo Madagascar
Authors: Housni Ibrahim , Tanjona Ratsiatosika A. , Rakotonirina Martial A. , Romuald Randriamahavonjy , Fleurian Sidy , Halissiot Bacar A. , Rokotovao Hery A.
Published: October 2020

Birth defects in the uterus result from abnormal fusion of the miler ducts and / or failure. Uterine malformations are a common cause of infertility, but if pregnancy occurs absorption from the septum. They are relatively frequent and concern 0.1-3% of the female population, such a situation is potentially high risk obstetric. We report here, 11 cases of uterine malformations during pregnancy seen at the CHUGOB from May 01, 2017 to May 01, 2018. We observed 11 cases of uterine malformations during pregnancy, including 3 cases of didelphus uterus, 3 cases of pseudo-unicornuate uterus, 3 cases of bicornuate uterus, 1 case of septate uterus and 1 case of true unicornuate uterus. The age of the parturients ranged from 22 to 26 with a mean of 23.63 years. Regarding pregnancy, 5 women were primigest, 4 were paucigest and 2 were multiparous. For gestational age, 09 cases came to term and 2 cases pregnancy stopped at 17 weeks. The average birth weight was 2215g. The diagnosis of the malformation was made before the caesarean section in 2 out of 10 cases. Eight out of 10 cases of the fetuses were alive. Congenital uterine malformations are often asymptomatic. The occurrence of pregnancy in a malformed uterus is a rare but potentially serious situation. The diagnosis of these abnormalities is based on new advanced imaging means such as 3D ultrasound.
General anesthesia for cesarean section in the presence of mitral stenosis associated with severe pulmonary hypertension
Authors: Bansal Usha V. , Bansal Varun V. , Patel Bhavesh R.
Published: October 2020

Rheumatic heart disease (RHD) is the most common cause of cardiac disease during pregnancy in India. A case of severe pulmonary hypertension (pulmonary arterial pressure- 98 mm Hg) secondary to mitral stenosis associated with RHD in a 28-year old woman, is described. She underwent a high risk elective cesarean section under general anesthesia at 36 weeks of gestation. The intraoperative and postoperative course was uneventful. The advantages of general anesthesia over neuraxial blockade during cesarean section are discussed in this report. The management of patients at a high risk of developing pulmonary edema and decompensated heart failure in the perioperative period has been stressed upon. A thorough understanding of the pathophysiology and complications of RHD during pregnancy and cesarean section is required for managing the disease successfully.
ALMAN DOKTOR KOCH’UN KAYITLARI IŞIĞINDA TRABZON VE YAKIN ÇEVRESİ
Authors: KIRCA Çiğdem , KUŞ Ayşegül
Published: October 2020

Coğrafi olarak Anadolu’nun kuzey doğusunda bulunan Trabzon, tarih boyunca önemini korumuş bir şehirdir. Daha ilkçağlardan itibaren bölgenin tek limanı olması, Anadolu’nun içlerine, hatta Doğu Anadolu üzerinden Güney Kafkasya ve İran’a ulaşan konumu ile geniş bir hinterlanta sahip olması kentin önemini artıran bir unsur olmuştur. Ayrıca şehrin kendine özgü jeo-stratejik konumu ve önemli ticaret yolları üzerinde bulunması, Yunan kolonileri, Medler, Persler, Romalılar, Bizanslılar ve Osmanlılar gibi pek çok devletin bölgede siyasi hâkimiyet kurmalarına sebebiyet vermiştir. Trabzon’un ne zaman ve kimler tarafından kurulduğuna ilişkin herhangi bir kesin bilgi olmamakla birlikte, M.Ö 756’da bir Milet kolonisi olarak ortaya çıktığı düşünülmektedir. Yapılan kimi arkeolojik çalışmalar neticesinde kent ve yakın çevresinin iskân tarihinin çok eski dönemlere kadar gittiği ortaya çıkmıştır. Buna ek olarak, Trabzon, Akdeniz’in uluslararası seyahatler için güvenli olmadığı 13. yüzyıldan Karadeniz’in Osmanlı gölü haline gelişine kadar olan süreçte, doğu-batı geçişinin önemli bir kapısı olmayı sürdürmüştür. Bu nedenle, antik dönemlerden itibaren bölgeye olan ilginin daha sonraki dönemlerde de devam ettiği görülmektedir. Özellikle 19. yüzyılda kente yönelik olan bu ilgi, sadece Avrupa Rönesans’ı ve Aydınlanma’sının antikçağlara duyduğu romantik kültürel ilgiyle sınırlı kalmamış, batılı devletlerin doğrudan siyasi ve ekonomik çıkarları ile de iç içe geçmiştir. Bu bağlamda, bölgeyi tüccar ve konsoloslar, gezginler, misyonerler, botanikçiler, tarihçi ve sanat tarihçileri gibi çok sayıda meslek grubuna mensup seyyah ve araştırmacı ziyaret etmiştir. Bunlardan birisi de Alman asıllı tıp ve bitki koleksiyoncusu olan Karl Heinrich Emil Koch’dur. Bu çalışmanın amacı, onun 1843 yılında Trabzon, Of ve Sürmene’ye dair gözlem ve incelemelerinden yola çıkarak bölgeye dair verdiği bilgileri değerlendirmeye tabi tutmak ve böylece hem alan literatürüne hem de bölge tarihinin aydınlatılmasına kimi katkılar sağlamaktır.
SON DEVİR İSLAMCILARINDAN ABDÜRRAHİM RAHMİ’NİN (ZAPSU) TRABZON’DA TEKRAR BASILARAK KURTARILAN BİR KİTABI: ESİR BİR ÇOCUĞUN BAŞINA GELENLER
Authors: CANER Fırat
Published: October 2020

Birinci Dünya Savaşı sırasında Kafkas Cephesi’ndeki muharebelerde çok sayıda Türk askeri Ruslara esir düşmüştür. Bu esirler Sarıkamış, Kars ve Tiflis istasyonlarında toplandıktan sonra Bakü’ye sevk edilmişlerdir. Esirlerin bir kısmı Sibirya’daki esir kamplarına gönderilmiş, bir kısmı da Hazar Denizi’nde Bakü’nün 10-15 kilometre açığında bulunan Nargin Adası’na sevk edilmiştir. Adada Türk askerlerinin yanı sıra Alman ve Macar askerleri de esir tutulmaktadır. Bunların dışında, Rus ordusunun 1916 yılında yeniden başlattığı saldırılarda ele geçirdiği Erzurum, Erzincan, Bayburt, Gümüşhane ve Trabzon gibi vilayetlerdeki sivil halktan da çoğu Ermenilerce ihbar edilen çocuk, kadın ve ihtiyarları da esir alınıp Nargin Adası’na gönderilmiştir. Bunlardan biri de bu çalışmanın konusunu teşkil eden Trabzon’un Sürmene ilçesinin bir köyünden olan Yusuf adlı gençtir. Abdürrahim Rahmi Zapsu, bu gencin Nargin’de yaşadıklarını anlatan bir risale kaleme almıştır. Aynı adada esarette bulunan Abdürrahim Rahmi Zapsu ile ilgili sınırlı kaynaklarda 1918 yılında Nargin’deki esir kampından kaçtıktan sonra Bakü’de Bir Esir Çocuğun Hâtırası adlı manzum piyes yayımladığı belirtilir. Bu piyes Yusuf hakkındadır. Bakü nüshası da kayıp olan bu risale aynı yıl içinde Trabzon Serasî Matbaası tarafından Abdürrahim Rahmi’nin Esir Bir Çocuğun Başına Gelenler Veyahûd Rusya’da Sekiz Yaşındaki Bir Esirin Felâketi: Esâret Hâtıralarından adıyla basılmıştır. Trabzon’da basılma sebebi muhtemelen manzumede hâtıraları aktarılan Yusuf adlı çocuğun Trabzon’un Sürmene kazasına bağlı bir köyden olmasıdır. 1918’de Trabzon’da da basılan ve tek nüshası Bilkent Üniversitesi Kütüphanesi’nde bulunan eserin içeriğinde Yusuf’un ağzından Nargin’e gönderilişi ve şartlar hakkında bilgi verilmektedir. Çalışmada orijinal metnin tamamı Latin harflerine aktarılmış olarak sunulacaktır.
SOĞUK SAVAŞ SONRASI DÖNEM KARADENİZ’DE GÜÇ MÜCADELESİ
Authors: KÖSE İsmail
Published: October 2020

Soğuk Savaş bittikten hemen sonra Karadeniz Havzası’nda son yüzyılda oluşan güç dengesi bozuldu. Böylece bölge geniş anlamda alışıldık üstünlük mücadelesinin ötesinde küresel çıkar çatışmalarına sahne olmaya başlamıştır. Karadeniz ve çevre çapındaki hinterlant topraklarda biçimlenen yeni güç mücadelesi asimetrik olduğu kadar tarihte ilk defa hibrit özelliklere de sahiptir. Yeni güç mücadelesinde yakın aktörlerle birlikte yeni düzenin uzak aktörleri de yer almıştır. Çarlık Rusyası, büyük güç statüsüne yükselebilmesinin Karadeniz ve Doğu Akdeniz hâkimiyeti sayesinde gerçekleşebileceğini biliyordu. Benzer şekilde Soğuk Savaş sonrasının ilk döneminde rakipsiz kalan hegemon güç ABD; Balkanları rehabilite edip sınırlarını Karadeniz’e kadar uzatmak isteyen AB; Karadeniz ve yakın çevresini yaşam sahası olarak görüp, bu bölgede sahildar olmayan güce tahammül etmek istemeyen Rusya Federasyonu ve mevcut statükoyu, dengelenmiş kuvvet dengesi içinde muhafaza etmeyi arzulayan Türkiye yeni güç mücadelesinin taraflarını oluşturmuşlardır. Tarafların çıkarları kontjonktürel olarak uzlaşıp zaman zaman çatıştığından, Asya ile Avrupa arasındaki alternatif enerji kaynaklarının, kadim ticaret yollarının ve bölge deniz hâkimiyet merkezinin kavşağında yer alan Karadeniz Havzası, umulmadık ittifak ve rekabet gruplaşmalarına sahne olmaktadır. Bu çalışmada son 30 yılda Karadeniz Havzası’nda gerçekleşen güç mücadelesi analiz edilmeye çalışılacak, Havza’da faaliyet halinde olan başat aktörlerin dış politika öncelikleri değerlendirilecektir.
Challenges in private practice during novel coronavirus disease 2019 (COVID-19) pandemic
Authors: Jangla Sunayana M , Nanaware Amol S
Published: October 2020

An outbreak of respiratory illnesses of unknown etiology which was later identified as novel coronavirus (nCov) contagion with its axis in Wuhan, People’s Republic of China rapidly emerged as a public health emergency of global concern. This started as a cluster of cases in December 2019 and there have been large numbers of confirmed cases of novel coronavirus disease (COVID-19) ever-since worldwide including India. Because of its encyclopaedic quandary, COVID-19 was labelled as a pandemic by World Health Organisation (WHO). Thus, it became important to strengthen the health care delivery system at the public as well as private sector. Here we describe the challenges faced in private practice by a clinician in patient management during this pandemic in India and measures taken to overcome them with the help of WHO and national guidelines, clinician’s professional expertise and optimum infection prevention and control practices.
Health benefits of ghee (clarified butter) - A review from ayurvedic perspective
Authors: Shivananjappa Mahesh , S Sindhuja , M Prakruthi , R Manasa , Naik R Shekhara
Published: October 2020

Ghee is identified as valuable natural source of food which has several health benefits entirely beneficial to the human population. It is one of the popular ingredients in the Indian diet and takes prevalent position in the dairy industry market. The focus of the present review paper is the demonstrated and potential health benefits associated with the consumption of ghee. Consumption of ghee in an adequate amount, imparts various health benefits such as binds toxins, enhances complexion and glow of the face and body, an amazing rejuvenator for the eyes, increases physical and intellectual stamina etc. in addition to imparting sustaining energy.
The Human Microbiome: History and Future
Authors: Hayes Wallace , Sahu Saura
Published: October 2020

The microbiome plays an important role in human health and disease. Our current understanding of the human microbiome is limited. A significant amount of progress has been made in this area of research in the last two decades. The human microbiome plays an important role in host metabolism and physiology. Recent studies suggest a critical relationship between the human microbiome and host metabolism. The interactions between the microbiome and host metabolism affect human health and disease. However, this review of the literature indicates that more studies are required using new technologies to have a greater understanding of the role the human microbiome plays in human health and disease.
Molecular Gut-Content Analysis of Adult Ground Beetles (Coleoptera: Carabidae) Provides No Evidence of Predation of Western Corn Rootworm (Coleoptera: Chrysomelidae) in a Nebraska Corn Agroecosystem
Authors: Oliveira-Hofman Camila , Victor Vinícius S. , Meinke Lance J. , Peterson Julie A.
Published: October 2020

This study was conducted to characterize the ground beetle (Coleoptera: Carabidae) community in Nebraska continuous cornfields and investigate the potential for predation of the western corn rootworm, Diabrotica virgifera virgifera LeConte, a key root-feeding insect pest that is an annual management challenge in this system. Seven collection dates were conducted at five commercial cornfields in west central Nebraska during the growing season of 2014. In each field, carabids were sampled using five 24-h pitfall traps. Carabid specimens were placed in 95% ethanol in the field and stored at –20°C to preserve DNA. After identification to the species level, DNA was extracted and polymerase chain reaction was conducted for gut-content analysis using D. v. virgifera-specific primers. Data from single-plant emergence cages and yellow sticky cards showed high abundance of D. v. virgifera prey in three of the five fields sampled. Sixteen genera and 36 carabid species were found in pitfall traps. Of the total 235 carabid specimens tested in this study, zero tested positive for D. v. virgifera DNA. The lack of positive results for the presence of D. v. virgifera DNA in the gut-contents of carabids, despite abundant pest populations, indicates that, in this system, ground beetles may not be a strong mortality agent of D. v. virgifera. However, results presented here contribute to our knowledge of carabid diversity in agroecosystems and indicate that future D. v. virgifera biological control efforts in this region should focus on other natural enemies and/or other life stages of carabids, such as larvae.
Penicillin Impact on Survivorship, Development, and Adult Longevity of Drosophila melanogaster (Diptera: Drosophilidae)
Authors: Üstündağ Gökçe , Büyükgüzel Kemal , Büyükgüzel Ender
Published: October 2020

Survivorship, developmental period, and adult longevity of the fruit fly, Drosophila melanogaster Meigen (Diptera: Drosophilidae), exposed to penicillin G, a beta-lactam antibiotic, was determined in laboratory testing. In the study, neonate larvae were placed and reared on dietary antibiotics at concentrations of 100, 200, 400, or 800 mg/L. All penicillin concentrations significantly decreased survivorship in an inverse relationship with third instars, pupae, and adults. Larvae fed on control diets of 0 mg/L of penicillin had a survival level of 91.00 ± 3.27% to third instar and pupation, and 89.00 ± 4.09% to adult emergence. Feeding on a diet containing the highest concentration of penicillin (800 mg/L) significantly decreased survivorship to third instar to 11.00 ± 2.59% (χ2 = 128.051; df = 1; P = 0.0001) and to pupation (χ2 = 131.233; df = 1; P = 0.0001) and adult emergence to approximately 10.00 ± 1.00% (χ2 = 124.832; df = 1; P = 0.0001). The highest concentration of dietary penicillin (800 mg/L) also significantly prolonged developmental time from neonate to third instars by 1.5 d (F = 17.229; df = 4; P = 0.0001) and from neonate to adult emergence by 3 d (F = 2.004; df = 4; P = 0.032). Compared to the control group, adult longevity was significantly reduced by the antibiotic in a dose-related manner. The use of this antibiotic in insect artificial rearing enables an extensive search of possible insecticidal action of penicillin with high dietary levels for agricultural purposes.
Link between Occupational Fatigue and Medical Errors in Surgical Technologists
Authors: Imani Fatemeh , Zadi Akhuleh Omid , Memarbashi Ehsan , Nasiri Ebrahim
Published: October 2020

Background: Regarding the operating room's sensitivity and performing various invasive procedures, it is important to investigate the relationship between occupational fatigue and the occurrence of medical errors. Thus, this study was conducted to determine the relationship between occupational fatigue and medical errors among surgical technologists.
Methods: This cross-sectional descriptive study was conducted in operating rooms of hospitals of Mazandaran University of Medical Sciences in 2019. The research population included 141 surgical technologists selected via stratified random sampling. Data were collected using the Multidimensional Fatigue Inventory (MFI) and nursing errors in the operating room questionnaire. The data were analyzed using SPSS16 software.
Results: 82.2% of surgical technologists had moderate to severe fatigue. Non-compliance with the sterile technique with a 49.6% incidence rate was the most frequent error among participants. The findings showed that there was a significant positive correlation between the incidence of medical errors among surgical technologists with mental fatigue (r =0.160, P=0.04) and reduced motivation (r =0.185, P=0.02).
Conclusion: The level of mental fatigue and reduced motivation among surgical technologists was directly related to the level of the incidence of medical errors. Therefore, it is recommended to implement effective programs to adjust and decrease mental fatigue and increase motivation to improve surgical technologists' performance.
Occupational Exposure to Nickel in the Ceramic Workers: Biological Monitoring and Respiratory Outcomes
Authors: Kargar-Shouroki Fatemeh , Shahtaheri Seyed Jamaleddin , Barkhordari Abolfazl , Halvani Niloofar
Published: October 2020

Background: Nickel (Ni) compounds such as nickel oxide are used as pigments in ceramic industries. The toxicity of nickel can occur in the glaze preparation processes. This study aimed to ascertain whether exposure to Ni dust is associated with pulmonary response.
Methods: This cross-sectional study was performed on 49 ceramic workers (exposed group) occupationally exposed to nickel dust, as well as 55 unexposed employees (referent group). Information about smoking habits, overtime work, length of employment, skin dermatitis, job title, use of respiratory protection equipment, ventilation system, age, and BMI index were collected through questionnaires. The parameters of pulmonary function were measured. Urine samples were taken from 49 workers at both pre- and post-shift (98 samples). The referent group was examined only once (55 samples). To determine the nickel, the samples were pre-concentrated by Solid Phase Extraction (SPE) and analyzed using  inductively coupled plasma-atomic emission spectroscopy (ICP-AES).
Results: Urinary Ni value in the exposed workers was significantly higher than that in the referent group. All pulmonary function parameters in the exposed group were significantly lower than those of the referent group (P<0.001). Those using respiratory protection equipment also exhibited a significantly lower urinary Ni concentration than those not using respiratory protection equipment.
Conclusion: These findings indicate that exposure to Ni in the ceramic industry is higher than the recommended biological exposure index and is associated with a significant decrement in the pulmonary function parameters.
Evaluation of failure of a titanium conventional plate in mandibular reconstruction and improve the performance with fibula free flap
Authors: Kargarnejad Sahand , Ghalichi Farzan
Published: October 2020

Maxillofacial extensive defects are caused by various factors such as tumor, osteomyelitis and trauma. Reconstruction of such injuries become a major challenge for maxillofacial surgeons. Clinical experiments indicate that one of the serious problems associated with conventional plate systems is the frequent incidence of complications such as screw loosening, plate exposure and plate fractures. To improve the performance of reconstruction system with new procedure. A 42-year-old male patient suffering from Ameloblastoma tumor in the lateral large defect was selected as case study. Initially, after cutting the cancerous tissue, a titanium conventional plate (TCP) model had been utilized as mandibular reconstruction system which failed due to plate exposure. Patient's CT-scan images were prepared, and geometry and shape of the plate were evaluated using Computer-Aided Design & Computer-Aided Manufacturing (CAD/CAM) and Additive Manufacturing (AM) technology. Then, its effect on the biomechanical performance of the failed system TCP model was investigated by finite element method (FEM). Fibula Free Flap FFF model as alternative and improved reconstruction system was selected. FEM evaluation of two models showed inevitable results which tip the scales in the favor of FFF model. The maximum Von-Mises stress had been exerted at the interface between screw-cortical bone. In TCP model, the peak value of Von-Mises stress exerted at the interface between screw-bone was 110 MPa, which exceeded the yield strength of the cortical bone, while, this factor fell to 68 MPa in FFF model. Furthermore, comparison with TCP model, the sensitivity of the plates and screws to the chewing load variations in FFF model decreased 20%. The results showed that the FFF model was more stable and flexible than the TCP model.
Oral Health Knowledge, Attitudes, and Practices of People with Diabetes in South of Tehran, Iran
Authors: Nazari Mohammad Hadi , Mohebbi Simin Zahra , Kharazifard Mohammad Javad
Published: October 2020

Objective: This study assesses the oral health knowledge, attitudes, care practices, and related underlying factors of people with diabetes.
Materials and Methods: In a descriptive cross-sectional study using a random sampling method, 201 patients who referred to five comprehensive health centers in the South of Tehran,Iran, participated. A previously published questionnaire was used, and its reliability and validation analyses were performed. There were 31 Open-Ended, Closed-Ended, and Likert scale questions, including 26 on key underlying factors, one with 13 parts in oral health knowledge, one with nine parts related to oral health attitudes, and three on care practices. Data were entered into SPSS software version 24, and descriptive statistics and regression were used to analyze and report the results.
Results: The mean age of participants was 49 years (σ=7.6), and males accounted for 58.2% of the study population. 37.48% of the patients had poor oral health knowledge, whereas 61.76% of them reported average care practices, with 68.29% above average attitudes. Among the study population, only 33.3% brushed more than once per day. 35.8% considered bleeding gums while brushing unacceptable, and 42.3% reported gums swelling and redness as signs of disease. Over half of respondents (52.2%) strongly supported the idea of keeping their natural teeth as long as possible, while 41.8% were only agreed. On the other hand, patients with a higher level of education scored better in knowledge, attitudes, and care practices (p-value<0.05).
Conclusion: As the knowledge, care practices, and to some extent attitudes of people with diabetes toward their general oral health were unsatisfactory, an appropriate training program should be developed to warn diabetic patients of the importance of oral health and its two-way impact on diabetes.
Investigation of the Impact Pattern of Maxillary Third Molars in Ardabil Population
Authors: Hajmohammadi Emran , Eslami Zahra , Mortazavi Zahra , Khalili Vahid
Published: October 2020

Purpose: The aim of present investigation was to evaluate frequency of different angles, numbers of roots, depth of impaction in maxillary third molarsand their damages to nearby structuresby analyzing panoramic radiography.
Materials and Methods: This study was conducted by analyzing panoramic radiography 382(124 men & 258 women) patients who referred to Baser radiography center, Rad radiography center and Ardabil dental school between year 2014 to 2015
Results:The most frequent angle of impacted teeth in maxillary third molar in both genders was vertical (48/9%), and the most frequent depth was class C according Winter Classification System(46/8%), in approximately 85% of casesNo space between teeth and sinus was observed and according to numbers of roots 54% of teeth had 2 roots, 22% 3 roots and 8% had only one root.The most important damage to nearby structures was angular periodontal lesions which were demonstrated in radiography (52%), making caries on second molars (100%),root resorption on second molars(6%) and in 18% no harmful lesions on molar 2 or radiographic lesions were detected
Conclusions: Within the limitations of this study, most of third impacted maxillary molars had enough space to maxillary sinus and most of them were vertically, thus extraction of these impacted teeth seems simple and possible.
The importance of reporting the effect size in quantitative studies
Authors: Nikpeyma Nasrin , Maroufizadeh Saman , Esmaeili Maryam
Published: October 2020

The article's abstract is not available.
Leadership roles of nurse managers from the Portuguese nurse’s viewpoint
Authors: Mota Liliana , Príncipe Fernanda , Cruz Adelaide , Melo Manuel
Published: October 2020

Background & Aim: The leadership role adopted by nurse managers has a fundamental role in the quality of care. Leadership is fundamental to the successful provision of health services due to its effect on health professionals and patients. This study aims to characterize the leadership roles of nurse managers in clinical nurse’s perspective.
Methods & Materials: This is a descriptive and correlational study. Non-probabilistic convenience sampling with 219 nurses from different health institutions in Portugal. Data collection occurred from November 2019 to January 2020 using the Leadership Skills Questionnaire adapted by Parreira and collaborators o the Portuguese population, based on Quinn’s framework and the instrument developed by him. The data were analyzed using SPSS (version 22) with descriptive and inferential statistics according to the nature of the variables.
Results: The results demonstrated that the study participants recognize the leadership roles of their nurse managers in a balanced manner: Mentor (4.85±1.53), Director (4.62±1.32), Coordinator (4.56±1.34), Producer (4.55±1.31), Monitor (4.40±1.30), Broker (4.36±1.40), Facilitator (4.35±1.40), and Innovator (4.03±1.38).
Conclusion: It is observed greater orientation to the fulfillment of goals. There is a clear orientation to compliance with rules and, therefore, to internal orientation and control. The current study has different implications for nurse managers, education, and research.
The impact of social network-based nursing care training on oncology nurses’ occupational stress and self-efficacy: Non-randomized clinical trial
Authors: Bozorgnejad Mehri , Najafi Ghezeljeh Tahereh , Haghani Hamid , Iri Amin
Published: October 2020

Background & Aim: Inadequate clinical knowledge is one of the leading causes of stress and low occupational self-efficacy among nurses. Nursing training can enhance self-efficacy and reduce stress. Therefore, this study aimed to determine the effect of social network-based nursing care training, using mobile phones, occupational stress, and self-efficacy among oncology nurses.
Methods & Materials: This non-randomized clinical trial study was conducted on 78 nurses working in oncology wards of two selected educational hospitals in Tehran in 2018. The nurses entered the study through available sampling. They were randomly assigned to two groups of control and intervention. Nursing care training in chemotherapy was provided to the nurses in the intervention group through a mobile phone social network for four weeks. On the other hand, the nurses in the control group were provided with the routine training pamphlets and brochures in the oncology ward. The nurses’ stress level was examined using an expanded nursing stress scale and their occupational stress was measured using a job self-efficacy questionnaire once before the intervention and then one month after the intervention. The data analysis was then performed according to independent t-test, paired t-test, and chi-square using SPSS software version 16.
Results: The two groups were homogeneous in terms of age, gender, work experience, and education. There was no significant difference in terms of occupational stress and self-efficacy between the two groups before the intervention (P<0.05). The changes in the occupational stress score were statistically significant (P<0.05) among the nurses in the intervention group. Moreover, the changes in the occupational self-efficacy score were statistically significant among nurses in the intervention group compared to the control group (P<0.05).
Conclusion: Educational intervention through social networking can lead to a reduction of occupational stress and an increase in self-efficacy among oncology nurses. Reducing stress and increasing nurses’ occupational self-efficacy will improve their performance at the bedside. This is an easy, inexpensive, and effective training method that can be used by health managers and educators to enhance employee’s performance.
Determinantes del control interno en la gestión del crédito de las cooperativas del Ecuador
Authors: Espinoza Farfán Verónica Natalia , Vázquez Loaiza Juan Pablo
Published: October 2020

Este artículo presenta los factores de control interno que impactan positivamente en la gestión del crédito de las cooperativas de ahorro y crédito del segmento 1 del Ecuador, con información primaria obtenida tras la aplicación de un instrumento de medición mediante escala de Likert a la muestra seleccionada, la misma que es tratada con el modelo de Logit ordenado procurando encontrar la relación entre las variables que intervienen en la investigación. Los resultados muestran que los factores de control interno relacionados con el ambiente de control, la evaluación de riesgo, las actividades de control y la información y comunicación desempeñan un papel muy importante para predecir la probabilidad de que estas instituciones cuenten con una buena gestión del crédito, mientras que el factor de control interno concerniente a la supervisión y monitoreo tiene un impacto no significativo debido a que ya se encuentra inherente en la operatividad de los otros factores.