bluuebunny/crossref_metadata_2025 huggingface dataset:
Biochemical Markers of Ovarian Reserve in Females, Effect of Exercise on Such Reserves
Authors: Zubair Ayesha , Khalil Anas , Jamil Hassan , Rehman Anam , Shaheen Bashir Ahmed , Hafeez Samra
Published: September 2021

Background: Female who are in fertile period of their life and prefer a sedentary life style rather than performing regular physical exercise, whether light or heavy exercise show different hormonal pattern which effect their physical health. Such hormonal changes are directly related to the level of ovarian reserve of hormones which are negatively affected by lack of exercise. The ovarian pool of hormones decline with age and also lack of physical exercise. Among the large pool of biochemical markers AMH (anti-mullerian hormone) appears to be the most important and helpful indicator of ovarian reserve. Inclusion criteria: Healthy females between 25 to 35 years of age were included in the study. Exclusion criteria: Females below 25 years and above 35 years of age were excluded from the study, in addition those females having some medical problem or using some medication were also excluded from the study. Material and Methods: 20 females consented to participate in the study who were divided in two groups. These females were living a sedentary life before they joined the gymnasium. One group was subjected to light aerobic exercise and other group to heavy physical exercise. Tests before the start of study were conducted and were repeated after 08 weeks of study to observe the effect of both exercises on the ovarian reserves of different hormones. Results: The comparison between both groups were observed, the values before and after exercise has a remarkable difference, a decrease in values were observed in body weight, BMI, waist and hip ratio after exercise. Slight reduction in E2 and FSH level after aerobic exercises was observed. Whereas in heavy exercise group significant difference i.e. increase in level of FSH was observed at the same time, significant decrease in AMH level was also observed. The difference between E2 and LH had no significance in heavy exercise group. Conclusion: Those females who were living sedentary life and performed light aerobic exercise, even for a longer time period did not showed significant change in the E2, LH, FSH and AMH level of hormones. However, heavy exercise reduces the level of AMH and increases the level of FSH. These finding suggest heavy exercise may affect fertility in a negative way especially in females with low ovarian reserves. Keywords: Exercise, spinning, ovarian reserve, AMHh anti-mullerian hormone
Health Promotion Practices in Nursing: A Scoping Review
Authors: S. Orte Christian Jay , Nwosu Ngozi O.B. , . Man , Maniago Jestoni D. , Matibag Ruby S. , Corpuz Alma M. , Cabaluna Johdel C.
Published: September 2021

This review aimed to describe the concept of health promotion in nursing as one of the domains of nursing practice. Among three-thousand five hundred four (n=3,504) articles from EBSCO, Medline, and Web of Science regarding the health promotion practices in different fields of nursing, only 29 were selected based on the eligibility criteria. Two themes have emerged with five subthemes were developed. The first theme is the health promotion barriers with a subtheme of financial barriers in attaining health promotion and addressing health literacy while the second theme is the health promotion field practices with a subtheme of hospital health promotion set-up, community health promotion set-up, and school health promotion set-up. This literature emphasized that health promotion is important especially in attaining wellness among client/s as well as providing nursing services. ORCID for all authors: Christian Jay S. Orte, PhD, RN (ORCID No. 0000-0002-7230-9491) Ngozi O.B. Nwosu, PhD (c), MAN (ORCID No. 0000-0002-2823-7355) Jestoni D. Maniago, DNS, RN (ORCID No. 0000-0002-8603-3094) Ruby S. Matibag, EdD, RN (ORCID No. 0000-0002-6360-0391) Alma N. Corpuz, EdD, RMT (ORCID No. 0000-0002-0477-8317) Johdel C. Cabaluna (ORCID No. 0000-0002-8289-5973) Ethical Code: IRB Log Number: Not Applicable IRCT Code: Not applicable Conflicts of interest: The authors declare that there are no conflicts of interest. Authors' contributions: C.J.S.O., N.O.B.N., J.D.M., R.S.M., A.M.C., J.C.C. conceived and planned the study. C.J.S.O., N.O.B.N., J.D.M. carried out the data collection. C.J.S.O., J.D.M., R.S.M., A.M.C., J.C.C. contributed to the interpretation of the results. C.J.S.O., J.D.M. took the lead in writing the manuscript. All authors provided critical feedback and helped shape the research, analysis and manuscript. Acknowledgment: The authors would like to thank their institutions for the support in conducting this research. Financial support and sponsorship: This study was funded by the researchers themselves. Keywords: community health promotion; health education; health literacy; health service settings; nursing
Antioxidant activity of purslane (portulaca oleracea l.) Leaf extract on ovarian oxidative stress levels and reproductive hormone levels of female white rats (rattus norvegicus) exposed to cigarette smoke
Authors: Ningrum Astika Gita , Frety Endyka Erye , Wittiarika Ivon Diah , Shabaran Zidni Hasbuna , Setiani Rida Eka , Dewi Erni Rosita
Published: September 2021

Purslane (Portulaca oleracea L.) is a wild plant that grows in Indonesia and is considered a weed, but the highest antioxidant activity was found in the leaves and stems. Cigarette smoke is one of the exogenous free radicals that can enter the blood circulation, so that it can interfere with all cells and tissues in the body, including the reproductive organs. The research that will be conducted is about the antioxidant effect of purslane leaf extract on oxidative stress levels, namely ovarian malondialdehyde levels and reproductive hormone levels, namely Follicle Stimulating Hormone (FSH) and 17ß-estradiol levels in female white rats exposed to cigarette smoke. This study is an experimental study with Randomized Post Test Only Control Group Design, using 24 female white rats aged 3 months weighing 200-250 g divided into 4 groups, namely the control group (K), the cigarette smoke group (P1), the purslane leaf extract group. (P2) and the group of cigarette smoke accompanied by purslane leaf extract (P3). Ovarian MDA measurement is a measurement of MDA levels as an indicator of oxidative stress in the ovaries determined by the spectrophotometry method. Measurement of FSH and 17ß-estradiol levels in blood taken intracardially through the right ventricle of the heart as measured by the ELISA method. The results showed that purslane leaf extract at a dose of 200mg/KgBW reduced ovarian MDA levels of female white rats exposed to cigarette smoke significantly with p-value <0.05. However, there has been no significant change in FSH and 17ß-estradiol. Keywords: purslane leaf extract, cigarette smoke, Follicle Stimulating Hormone, 17ß-estradiol, malondialdehyde, health risk
Endoscopic and Histopathological Characteristics of Polypoid and Non-Polypoid Colorectal Lesions in Patients of a Social Security Hospital of Lambayeque, Peru
Authors: Chumpen Jhon Franksis Munoz , Valladares-garrido Mario J.
Published: September 2021

Objective: To describe the endoscopic and histopathological characteristics of polypoid and non-polypoid colorectal lesions at the Luis Heysen Inchaustegui hospital, Peru, 2017-2018. Materials and methods: Descriptive-analytical cross-sectional study. We study epidemiological, endoscopic and histopathological variables. location, Size and shape of the lesions taking into account the Paris classification. Results: Endoscopically, of a total of 81 colorectal lesions, the majority were non-polypoid (71.6%). Lesions smaller than 10mm represented 90.1% in non-polypoid lesions and 56.5 % in polypoid lesions. Histopathologically, non-adenomatous lesions predominated (53.0%). Conclusions: The most frequent lesions were non-polypoid, the main location being the rectum; while in polypoid lesions, the transverse colon. Regarding size, lesions smaller than 10mm predominated in both non-polypoid and polypoid lesions. Histopathologically, the most frequent were non-adenomatous lesions (hyperplastic polyps); for its part, the predominant adenoma subtype was tubular. Keywords: Adenomas; Polyps; Intestinal Polyps; Colon (source: DeCS BIREME).
The Effectiveness of Health Management in Schools Scale (EHMSS): A Validity and Reliability Study
Authors: ERÇETİN Şefika Şule
Published: September 2021

The aim of this study is to develop a valid and reliable measurement tool that can measure the effectiveness of health management at schools according to teachers' opinions. The study group of the research consists of teachers working in pre-school, primary, secondary and high schools in Çankaya district of Ankara in fall semester 2019. In this study, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyze the data. The findings of EFA and CFA were obtained from two different study groups consisted of 387 and 283 people respectively selected by simple random sampling method, which is a probabilistic sampling method. To this end, the scale consisted of 22 items and 4 sub-dimensions was formed. CFA that was conducted to determine the construct validity revealed that the model fit values of the scale were appropriate. The sub-dimensions of the scale were ‘Food and Equipment Health, Hygiene Health, Awareness and Physical Space, and Environmental Health’. The scale had four items coded in reverse. A total score was obtained from EHMSS and its dimensions, and the high score obtained from the scale means that the effectiveness level of health management at school is high, and the low score obtained means that the effectiveness level of health management at school is low. Cronbach's Alpha reliability coefficient of the scale indicated that the scale is a reliable measurement tool. Results and findings overall indicated that ‘Effectiveness of Health Management in Schools Scale (EHMSS)’ is a valid and reliable measurement tool that can be used psychometrically.
Türkiye’deki Mevduat Bankaları Üzerine VZA Araştırma Yöntemi İle Etkinlik Analiz
Authors: ÖZBEY Nurullah , AKAN Yusuf
Published: September 2021

Bu çalışmanın amacı, Türkiye’deki bankacılık sektöründe
2000-20018 yılları aralığında sürekli faaliyet gösteren 3 adet kamu sermayeli, 8 adet özel sermayeli ve 6 adet yabancı sermayeli olmak üzere toplam 17 adet mevduat bankasının etkinlik analizinin yapılmasıdır. Sermaye yapılarına göre kamu, özel ve yabancı sermayeli bankaların içerisinde etkin olan bankalar tespit edilmiştir. Araştırmada söz konusu bankaların yıllar itibariyle ortalamaları alındığında; %98,20 oranıyla T.C. Ziraat Bankası A.Ş., özel sermayeli bankalar içerisinde %99,09 oranıyla Akbank A.Ş. ve yabancı sermayeli bankalar içerisinde de %91,84 oranıyla Denizbank’ın diğerlerinden daha etkin olduğu tespit edilmiştir. Bankalar içerisinde etkinlik sıralaması üst seviyede olan üç banka sırasıyla ÖSAKB, KSZB ve KSHB’sı olmuştur.
Araştırmadaki mevduat bankalarının veri zarflama analizi sonucu kullanılan girdi-çıktı değişkenleri çerçevesinde yıllara göre elde edilen ortalama etkinlik düzeylerinin genelde birbirleriyle benzerlik gösterdikleri belirlenmiştir. Ayrıca araştırmaya tabi tutulan bütün bankaların analizinde genel itibarla ekonomik krizlerin başlamadan 1 yıl önce ve başladıktan 1 yıl sonraki dönemler hariç genelde banka etkinliklerinin %90’nın üzerinde oldukları görülmüştür. 2001 yılı ekonomik krizi 2008 yılı krizinden daha fazla banka etkinliklerini olumsuz etkilemiştir.
Diversificação Produtiva e Forma de Organização dos Agricultores Familiares: Um Estudo de Caso do PAA no Município de Caxias-MA
Authors: Carneiro Joabe Alves , Montebello Adriana Estela Sanjuan
Published: September 2021

O estudo tem como objetivo verificar, por meio de um estudo de caso no município de Caxias-MA, a ocorrência da diversificação da produção familiar antes e depois do PAA bem como aferir se o programa tem contribuído para a organização dos agricultores em associações/cooperativas, e se tem estimulado a revitalização das organizações como forma de facilitar a operacionalização do programa. A metodologia consistiu na aplicação de 44 formulários semiestruturados aos agricultores. Como principais resultados, verificou-se que antes do PAA, os agricultores produziam 11 tipos de diferentes culturas. Com a participação no mercado institucional via o PAA, estes agricultores passaram a cultivar 30 tipos de culturas diferentes. A pesquisa também identificou o desinteresse dos beneficiários que fazem parte do PAA em participar de associações e cooperativas. Conclui-se que o associativismo e o cooperativismo rural são uma realidade para o enfrentamento de crises econômicas para os pequenos produtores rurais, entretanto, o perfil dos beneficiários do PAA no município de Caxias não apresenta relação direta ou forte vínculo com o associativismo e o cooperativismo.
Study on the synthesis of antibacterial plastic by using silver nanoparticles doped in zeolite framework
Authors: Le Anh Quoc , Dang Van Phu , Nguyen Ngoc Duy , Nguyen Thi Kim Lan , Vo Thi Kim Lang , Nguyen Quoc Hien
Published: September 2021

Silver nanoparticles (AgNPs) doped in the zeolite framework (AgNPs/Z) were successfully synthesized by γ-irradiation in ethanol solution of silver ion-zeolite (Ag+/Z) prepared by ion exchange reaction between silver nitrate (AgNO3) and zeolite 4A. The effects of the Ag+ concentration and irradiation dose on the formation of AgNPs/Z were also investigated. AgNPs/Z with the silver content of about 10,000 ppm and the average particle size of AgNPs of about 27 nm was characterized by ultraviolet-visible spectroscopy, powder X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM). Firstly, AgNPs/Z was added into PP resins for creation of PP-AgNPs/Z masterbatch (Ag content of ~10.000 ppm) and then PP-AgNPs/Z plastics were preapared by mixing masterbatch with PP resins. The antibacterial activity of the PP-AgNPs/Z plastics was investigated against Gram-negative bacteria Escherichia coli (E. coli). The results showed that PP-AgNPs/Z plastic contained 100 ppm of Ag possessed a high antibacterial property, namely the bactericidal effect was more than 96 % on the platic surface. In conclusion, possessing many advantages such as: vigorously antibacterial effect and good dispersion in plastic matrix, AgNPs/Z is promising to be applied as bactericidal agent for plastic industry.
Representative neutronic characteristics calculations for the VVER-1000 reactors using SRAC and MCNP5
Authors: Nguyen Huu Tiep , Tran Viet Phu , Nguyen Tuan Khai , Tran Vinh Thanh , Nguyen Minh Tuan
Published: September 2021

This paper presents the results of neutronic calculations using the deterministic and Monte-Carlo methods (the SRAC and MCNP5codes) for the VVER MOX Core Computational Benchmark Specification and the VVER-1000/V392 reactor core. The power distribution and keff value have been calculated for a benchmark problem of VVER core. The results show a good agreement between the SRAC and MCNP5 calculations. Then, neutronic characteristics of VVER-1000/V392 such as power distribution, infinite multiplication factor (k-inf) of the fuel assemblies, effective multiplication factor keff, peaking factor and Doppler coefficient were calculated using the two codes.
Water-sediment distribution and behaviour of Polonium (²¹⁰Po) in a shallow coastal area with high concentration of dissolved organic matters in water, North Vietnam
Authors: Tran Thi Van , Nguyen Duc Tam , Dang Duc Nhan , Nguyen Quang Long , Duong Van Thang , Bui Duy Cam
Published: September 2021

The behaviour and water-sediment distribution of particle-reactive Polonium-210 in the marine environment with high concentration of total suspended particulates (TSP) and dissolved organic matters (DOC) along the coast of the Tonkin Gulf (North Vietnam) were investigated. It was revealed that the water-sediment distribution coefficient, Kd(s), of 210Po varied from 2.39x103 to 1.9x104 (L kg-1) and from 7x103to 2.5x105 (L kg-1), respectively, in the rainy and dry season. This implies that in the aquatic environment 210Po tends to be of high affinity to suspended particulates. The 210Po Kd(s) was positively correlated with salinity in both rainy and dry seasons. With DOC the Kd(s) was positively correlated in the rainy season, but in the dry season the relationship tended to be reverse. This behaviour of 210Po in the coastal region was explained by the variation of pH of seawater and by the complexation of the isotope with DOC. The Kd(s) found in this study was in an order lower compared to that reported by Malaysian researchers for the Thailand Gulf. The most important source of 210Po was suggested to be from in-situ generation by the decay of its grand-parent 210Pb which mainly derived from the atmospheric fall-out.
Establishment of neutron dose calibration fields based on a ²⁵²Cf source by Monte-Carlo method
Authors: Hoang Van Nguyen , Ho Huu Thang , Tran Ngoc Toan , Nguyen Xuan Hai
Published: September 2021

This paper presents calculation results based on Monte-Carlo method to select an appropriate neutron moderator and design four configurations for a 252Cf irradiation system. These configurations provide six neutron spectra with the various average energies (1.04 MeV, 1.38 MeV, 1.69 MeV, 2.05 MeV, 2.46 MeV and 2.93 MeV) suitable for the calibration of neutron survey meters and personal dosimeters.
Equipment for measuring the characteristics of X-ray
Authors: Nguyen Thi Bao My , Nguyen Van Sy , Vu Van Tien , Ho Quang Tuan , Nguyen Thi Thuy Mai , Le Ngoc Thiem , Vo Thi Anh , Nguyen Manh Hung
Published: September 2021

X-ray measurement equipment is designed which utilizes a pair of photodiode detectors. The equipment is designed which utilizes a pair of photodiode detectors units which receive X-rays through filters with different attenuation coefficients for X-rays. The photodiode detector units preferably includes two pairs of photodiode detectors arranged symmetrically in four quadrants with the diodes in each detector unit in diagonally opposite quadrants. The outputs of the detector units are passed to variable gain amplifiers, gains of which are adjusted to bring the output voltages within a desired range, and the outputs of the amplifiers are integrated by integrators. After a selected period of time, the integration is stopped and the output voltages of the integrators are held and transmitted to an analog-to-digital converter. The ratio of the two output signals from a pair of photodiode detectors represents the kVp value of the X-ray machine and another pair of photodiode detectors used to measure the relative current in milliamps (mA) and exposure time of the x-ray unit.In this study,  the equipment have been made for measuring the characteristics of X-Ray with an accuracy of kVp (kV), I (mA) is 5% and the 2% T.
Study, design and manufacture eddy current probes for industry applications
Authors: Nguyen Phuc , Nguyen Van Thuy , Vuong Binh Duong , Do Minh Duc , Trinh Dinh Truong , Do Tung Khanh , Dang Quang Trung
Published: September 2021

This study is based on the studying, designing and manufacturing of eddy current probes for industry applications. The main tasks of this study include:

+ Describes the overview and classification of eddy current probes (which can be classified into three categories based on the mode of operation: absolute eddy current probe, differential eddy current probe and reflect eddy current probe).

+ Describes the three methods of probe designing and manufacturing (including experimental, analytical and numerical designs).

+ Describes the designing and manufacturing of eddy current probes for industry applications, which based on experimental and analytical methods.

Based on this study, we have successfully manufactured some current probes (including absolute eddy current probe, differential eddy current probe and reflect eddy current probe) for surface and tube inspections.
Treatment of Dysmenorrhea with Physiological Modulators (A28): A Registry Study
Authors: U Cornelli
Published: September 2021

Background: Dysmenorrhea is a diseases affecting about 45% of menstruating women (approximately between 45 to 95 % of females) during the time of menses and causing a reduction of the quality of life. Objective: To reduce the symptoms of dysmenorrhea using a natural Physiological Mosdulator (A 28) consisting of low dosages of calcium salts, Vitamin D, bioflavonoids, lycopene, and astaxanthin. Material and methods: Forty patients with severe dysmenorrhea were analyzed during two menstrual cycles: the first as baseline following a run-inn period, and the second during the treatment with A28. A simple VAS scale scoring the daily discomfort (from 0 =no discomfort to 6 =maximum discomfort) was used to measure the severity of the symptoms.The total score of first 3 days following the start of menses was calculated.The use of pain rescue cps during the two period was compared. Results: Thirty-eight cases completed the experience. Before treatment, the mean of total scores was 8.1±2.40, while after A28 it was reduced to 1.7± 1.39 (U Mann Whitney p< 0.01) . The mean of pain rescue cps used was respectively 6.1±1.21 and 0.5±1.15 before and after the A28 treatment (p <0.01). No side effects were reported. Conclusion: The use ofa combination of Physiological Modulators effectively decreased the daily discomfort due to dysmenorrhea.
Analysis of COVID -19: Where Do We Stand?
Authors: Umberto Cornelli
Published: September 2021

Background: The COVID-19 is a real pandemia and only very few countries in the world were minimally affected. Objective: To measure the impact of COVID-19 deaths in 49 countries (49 SC or selected countries) and correlate them with, ecological, demographical, social, economic variables, aging and chronic diseases. Material and methods: The 49 SCs are those considered by WHO reliable in term of deaths records. Data concerning COVID-19 were taken from John Hopkins records updated to December 5th. The ecological, demographical, social, economical variable were consistent with the CIA Fact Book 2020. The deaths due to the most common diseases and cancers were taken from the WHO records in term of ASDRs (Age Standardized Death Rate). The age index was taken from The World Bank. The correlations were calculate in term “r” (linear correlation). Results: The 49 SC represent about 19% of the world population accounting for about 61% of the total worldwide deaths. Very consistent differences among countries were shown, from 0% deaths up to 1.5 % deaths/1000 inhabitants. Any correlation was found with aging and ecological, demographical/social, economic variables. The same was for the most common diseases (a part of peptic ulcer) and cancers (a part of bladder cancer). Conclusion: The COVID-19 seems to be an independent disease, and the efficiency in reducing deaths belongs mainly by political issues.
Software and Performance Testing Tools
Authors:   Department of Computer Science and Engineering, Amity University Uttar Pradesh Lucknow Campus, India, Srivastava Nishi
Published: September 2021

Software Testing may be a method, that involves, death penalty of a software system program/application and finding all errors or bugs therein program/application in order that the result is going to be a defect-free software system. Quality of any software system will solely be acknowledged through means that of testing (software testing). Through the advancement of technology round the world, there inflated the quantity of verification techniques and strategies to check the software system before it goes to production and astray to promote. Automation Testing has created its impact within the testing method. Now-a-days, most of the software system testing is finished with the automation tools that not solely lessens the quantity of individuals operating around that software system however additionally the errors which will be loose through the eyes of the tester. Automation take look acting contains test cases that make the work simple to capture totally different eventualities and store them. Therefore, software system automation testing method plays a significant role within the software system testing success. This study aims in knowing differing kinds of software system testing, software system testing techniques and tools and to match manual testing versus automation testing.
Short Term Load Forecasting of Distribution Feeder Using Artificial Neural Network Technique
Authors:   Department of Electrical and Computer Engineering, Dilla University, Ethiopia, Chane Kumilachew , Gebru Fsaha Mebrahtu ,   Department of Electrical and Computer Engineering, Haramaya University, Ethiopia, Khan Baseem ,   Department of Electrical and Computer Engineering, Hawassa University, Ethiopia
Published: September 2021

This paper explains the load forecasting technique for prediction of electrical load at Hawassa city. In a deregulated market it is much need for a generating company to know about the market load demand for generating near to accurate power. If the generation is not sufficient to fulfill the demand, there would be problem of irregular supply and in case of excess generation the generating company will have to bear the loss. Neural network techniques have been recently suggested for short-term load forecasting by a large number of researchers. Several models were developed and tested on the real load data of a Finnish electric utility at Hawassa city. The authors carried out short-term load forecasting for Hawassa city using ANN (Artificial Neural Network) technique ANN was implemented on MATLAB and ETAP. Hourly load means the hourly power consumption in Hawassa city. Error was calculated as MAPE (Mean Absolute Percentage Error) and with error of about 1.5296 % this paper was successfully carried out. This paper can be implemented by any intensive power-consuming town for predicting the future load and would prove to be very useful tool while sanctioning the load.
Media Control Using Hand Gestures
Authors:   Department of Computer Science and Engineering, Amity University Uttar Pradesh, Lucknow Campus, India, Singh Mrigank
Published: September 2021

The corporate world today basically relies on presentations of ideas and statistics. In the board room, the presenters are highly conscious of depicting confidence in their presentation. This would entail accessibility and mobility to the presenter or media viewer. As the extent of Artificial Intelligence is increasing in all directions, I am utilizing its extreme capabilities to create a software that would help in accessibility and save time and money. This paper describes software written in Python 3.8 and makes use of Python libraries like OpenCV and PyAutoGUI to receive input from the computer’s Webcam and recognize gestures to control the PowerPoint Presentation and Portable Document Format (PDF) files or the Media Control. The user interface is built with the Python library PyQt5. This paper aims are to help people control their Presentations and Portable Document Format (PDF) files, and many other media through their hand gestures, without using a mouse or any other pointing device. The software would not require any other external hardware; hence it would not burn a hole in people’s pockets.
Outlook On Oral Health: A Questionnaire Survey Of General Population
Authors: Singh Gehlot Mahendra , Agarwal Amit , Sharma Sakshi , Chaudhry Kalpana , Sharma Diwakar
Published: September 2021

Introduction: Poor oral health and untreated oral conditions are not readily identifiable by general population and morbid oral status is widely accepted as a norm, creating a significant impact on quality of life. Oral diseases are a major public health concern due to their high prevalence and neglect. The outlook of people towards oral health and disease, therefore, has an important influence on dental health.

Methods: A structured questionnaire was posed to general Indian population. 1008 completed responses were collected and analyzed for association amongst discreet variables using Pearson’s Chi-square test and a P-value below 0.05 was considered statistically significant.

Results: The relationship between dental awareness and demographic variables like gender, socioeconomic background, and education are discussed. Awareness amongst rural and less educated populations is low. The children face dental neglect, people are unaware of the need for regular dental visits and systemic correlation of poor oral hygiene. Females are more aware of hygiene practices than male population.

Conclusion: The present study found that there is an immediate need to create awareness amongst general population about the necessity to follow proper oral healthcare measures, especially amongst rural and less educated groups, parents of young children, pregnant females, and the elderly.
Prevalence of Hypertension, Pre-Hypertension and Associated Risk Factors in Rural Field Practice Area of a Private Medical College in South-India
Authors: Prageetha K  , Koushik M  , VM Ananthaeashwar , Mohan Yogesh , Jain Timsi
Published: September 2021

Introduction: Globally hypertension is responsible for majority of mortality and morbidity among the non-communicable disease burden. A Community based cross sectional study was carried out to find the prevalence of hypertension, pre-hypertension and associated risk factors in the rural field practice area of Saveetha Medical College between January to March 2020.

Methodology: The sample size calculated was 203 and equal numbers of participants between the age group of 30 to 60 years were selected from each of the 6 villages in field practice area by Stratified Random sampling method. A semi- structured pretested questionnaire was used for data collection.

Results: The prevalence of hypertension and pre-hypertension was found to be 29.4% and 28.9% respectively. Major determinants of hypertension were age, marital status, diabetes mellitus, excess salt intake, sedentary lifestyle, stress, family history of hypertension and disturbed sleep pattern. Increased odds of hypertension were seen in marital status, diabetes mellitus and excess salt intake.

Conclusion: Interventional measures done in the pre-hypertensive stage prevents risk of developing hypertension. Regular screening for high blood pressure, lifestyle modifications, treatment with antihypertensive medication are required to decrease the prevalence of hypertension in the community.
Correlation between Stress and Empathy in Medical Students As Compared To General Population
Authors: Mehta Kinjal , Patel Prakash , Patel Swati , Pawar Ajay
Published: September 2021

Background: Medical students are exposed to numerous internal and external pressures exerted by the environment which may affect their empathy towards patients. This study was conducted to find association between perceived stress and empathy.

Methodology: The study was conducted in Surat, Gujarat, India from August 15 2021 to September 15 2021 among 225 participants using perceived stress score and using the Toronto Empathy Questionnaire. Two groups -Undergraduate medical students and general population were compared.

Results: Out of 160 medical undergraduates and 65 people from general population below average empathy was noted in total 51.1%. High empathic attitude was noted in general population in comparison to other medical undergraduates. 24.4% reported low stress, 64% moderate stress and 11.6% high stress and we can appreciate that low stress scores were calculated in general population in comparison to medical undergraduate students. A weak negative correlation between empathy and perceived stress was calculated in medical students whereas strong positive correlation between empathy and perceived stress was calculated in general population.

Conclusion: A significant proportion of medical students had a comparatively higher stress scores and decreased empathy hence their stress is considered distress whereas general population’s high stress scores were corelating to high empathic attitude, therefore their stress can be considered eustress.
Utilization of imaging for active surveillance in testicular cancer: Is real-world practice concordant with guidelines?
Authors: Gyawali Bishal , Griffiths Rebecca , Robinson Andrew G. , McInnes Matthew D.F. , Bedard Philippe L. , Booth Christopher M.
Published: September 2021

Introduction: Imaging is an integral component of active surveillance following orchiectomy for stage 1 non-seminoma (NSGCT) and seminoma germ cell tumors. In this population-based study, we describe use of imaging among patients with early-stage testicular cancer and evaluate whether they are concordant with guideline recommendations.
Methods: This is a population-based, retrospective cohort study to describe utilization of imaging among all patients with early-stage testicular cancer treated with active surveillance in the Canadian province of Ontario. The Ontario Cancer Registry was linked to electronic records of treatment to identify use of chest and abdomen/pelvis imaging. Data from 2000–-2010 were included with followup for up to five years for patients with non-seminoma and 10 years for patients with seminoma. The key outcome of interest was the frequency of imaging at temporal milestones following orchiectomy. Compared to the most contemporaneous guidelines in Ontario, any discordant frequency of imaging was defined as underutilization or overutilization. Substantial under- or overutilization was defined as >1 imaging test less/more than what was recommended during a 12-month period.
Results: The study population included 569 patients with NSGCT (median age 28) and 1107 with seminoma (median age 37). Among patients with NSGCT, adherence with body imaging was low in years 1–3 of surveillance (range 26–37%, predominantly underuse) and higher in years 4–5 (63–67%, predominantly overuse). Adherence with chest imaging was even lower (range 11–34% during years 1–5). Among patients with seminoma, adherence with abdominal and chest imaging was relatively stable and comparable throughout the 10-year followup period (range 23–47% abdomen and 28–47% chest). Multivariable analysis confirmed that underutilization of imaging was more common in recent years. NSGCT histology was associated with underutilization in years 1–2 but overutilization in years 3–5.
Conclusions: In routine clinical practice, patients with testicular cancer commonly receive imaging discordant to the protocol for active surveillance, with a substantial proportion receiving both under- and overutilization at various times during surveillance followup.
Assessing geographic and industry-related trends in bladder cancer in Ontario: A population-based study
Authors: Stringer Leandra , Ly Tina Luu , Vanin Moreno Nicolas , Hewitt Christopher , Haan Michael , Power Nicholas
Published: September 2021

Introduction: Bladder cancer (BC) is the fifth most prevalent cancer in Canada, with 9000 Canadians diagnosed each year.1 While smoking is the most important risk factor, environmental and occupational carcinogens have been found to significantly contribute to BC rates.2 As Canada is highly reliant on natural resource industries, this study seeks to identify geographical and industry-related trends of BC rates in Ontario.
Methods: The 1991 and 2001 Canadian Census Health and Environment Cohort (CanCHEC; Statistics Canada) was used, along with individual years of Census data. Maps identifying hot and cold spots for BC within Ontario were generated, and the former were assessed for industry patterns between location and BC rates. Cox proportional hazards models were run for each age cohort to predict the likelihood of developing BC by industry of work.
Results: Significant geographical and industrial trends in BC rates were identified. For 1991–2001; hot spots included the Cochrane, Manitoulin, Parry Sound, and Sudbury (90% confidence interval [CI]), and Nipissing and Temiskaming (95% CI) regions. Toronto and York were cold spots. Concurrently, metal (p=0.039), paper and publishing (p=0.0062), and wood and furniture (p<0.0001) industries had increased rates of BC. Notably, these industries had high employment density in our hot spot areas and low density in our cold spots.
Conclusions: Significant geographical and industrial BC trends were found in Northern Ontario regions reliant on heavy employment in natural resource-based industries, such as forestry, agriculture, and wood/paper. These findings may inform future screening guidelines and aid in identifying individuals at risk of BC development.
Small cell carcinoma of the bladder: A population-based analysis of long-term outcomes after radical cystectomy and bladder conservation with chemoradiotherapy
Authors: Oh Justin , Eigl Bernhard , Black Peter C. , Pickles Tom , Villamil Carlos , Sunderland Katherine , Tyldesley Scott
Published: September 2021

Introduction: We aimed to describe the oncological outcomes after radical cystectomy and chemo-radiation for localized small cell bladder cancer (SCBC).
Methods: This population-based analysis of localized SCBC from 1985–2018 in British Columbia included an analysis (analysis 1) of cancer-specific survival (CSS) and overall survival (OS) of patients treated with curative-intent radical cystectomy (RC) and radiation (RT), and an analysis (analysis 2) of CSS and OS in patients treated with RC and chemoRT consistent with the SCBC Canadian consensus guideline.
Results: Seventy-seven patients who were treated with curative intent were identified: 33 patients had RC and 44 had RT. For analysis 1, five-year OS was 29% and 39% for RC and RT, respectively (p=0.51), and five-year CSS was 35% and 52% for RC and RT, respectively (p=0.29). On multivariable analysis, higher Charlson comorbidity index (CCI) and the lack of neoadjuvant chemotherapy (NACHT) were associated with worse OS, while higher CCI and Eastern Cooperative Oncology Group (ECOG) were associated with worse CSS. For analysis 2, five-year OS was 56% and 58% for the RC and chemoRT groups, respectively (p=0.90), and five-year CSS was 56% for RC and 71% for chemoRT (p=0.71). Four of 42 (9.5%) chemoRT patients had RC at relapse.
Conclusions: SCBC is a rare entity with a poor prognosis. RC and chemoRT offer similar CSS and OS for localized SCBC, even when focusing the analysis on patients treated according to the modern consensus guidelines. NACHT should be considered for eligible patients. Both chemoRT and RC treatment options should be discussed with patients with SCBC.
De regeling van de schriftelijke wilsverklaring euthanasie in artikel 2 lid 2 Wtl
Authors: Postma L. (Liselotte)
Published: September 2021

De regeling van de schriftelijke wilsverklaring euthanasie in artikel 2 lid 2 Wtl

Een arts kan op grond van artikel 2 lid 2 Wtl euthanasie toepassen bij een inmiddels wilsonbekwame patiënt op basis van een schriftelijke wilsverklaring. In deze bijdrage staat de regeling van de schriftelijke wilsverklaring centraal. Aan de hand van de ontstaansgeschiedenis van de regeling en de huidige stand van zaken met betrekking tot euthanasie op basis van een schriftelijke wilsverklaring, verdedigt de auteur het standpunt dat de huidige wettelijke modaliteit van regeling van de schriftelijke wilsverklaring niet houdbaar is. De bijdrage sluit af met de noodzaak tot wijziging van de regeling naar een adequate(re) modaliteit en een concreet voorstel daartoe.
Een generieke strafbaarstelling van nieuwe psychoactieve stoffen in de Opiumwet: einde van een wapenwedloop in zicht?
Authors: Blom T. (Tom)
Published: September 2021

Een generieke strafbaarstelling van nieuwe psychoactieve stoffen in de Opiumwet: einde van een wapenwedloop in zicht?

In dit artikel wordt onderzocht wat de effecten zijn van de invoering van een generieke strafbaarstelling van stofgroepen waarmee (nieuwe) psychoactieve middelen kunnen worden gemaakt. Deze generieke strafbaarstelling is een belangrijke wijziging in ons bestaande systeem van strafbaarstellingen en wordt verondersteld een belangrijk instrument te zijn om de georganiseerde misdaad te bestrijden. Belangrijker is echter dat hiermee ook een wetgevingsgat wordt gedicht dat was ontstaan door het oordeel van het Hof van Justitie van de Europese Unie dat de productie en handel in NPS’en niet langer mogen worden bestreden als overtreding van de Geneesmiddelenwet. De generieke strafbaarstelling is niet in strijd met het legaliteitsbeginsel, maar zorgt er wel voor dat ook stoffen die niet schadelijk zijn voor de volksgezondheid en mogelijk zelfs geen psychoactief effect hebben onder de Opiumwet komen te vallen. De vraag is hoe de rechtspraktijk in de toekomst met dergelijke verweren zal (moeten) omgaan.
Enkele opmerkingen naar aanleiding van het vonnis van de rechtbank Den Haag in de zaak van IS-propagandiste Yousra L: deelname aan een criminele organisatie en de interactie tussen het humanitair oorlogsrecht en het strafrecht.
Authors: Zwanenburg M.C. (Marten) , Bartels R.J. (Rogier)
Published: September 2021

Enkele opmerkingen naar aanleiding van het vonnis van de rechtbank Den Haag in de zaak van IS-propagandiste Yousra L: deelname aan een criminele organisatie en de interactie tussen het humanitair oorlogsrecht en het strafrecht.

Op 29 juni 2021 veroordeelde de rechtbank Den Haag een Nederlandse vrouw, die vanuit Nederland op sociale media materiaal van IS had gedeeld en uit Syrië afkomstige video’s waarop schendingen van het humanitair oorlogsrecht te zien waren had becommentarieerd, voor onder meer deelname aan een criminele organisatie en het oorlogsmisdrijf van aanranding van de persoonlijke waardigheid. Dit artikel gaat in op de voornoemde aspecten van de uitspraak en bespreekt de interactie tussen het humanitair oorlogsrecht en het strafrecht, specifiek ten aanzien van het geografische, temporele en persoonlijke toepassingsbereik van het humanitair oorlogsrecht.
Performing the COVID-19 Crisis in Flemish Populist Radical-Right Discourse
Authors: Meijen Jens
Published: September 2021

Performing the COVID-19 Crisis in Flemish Populist Radical-Right Discourse: A Case Study of Vlaams Belang’s Coronablunderboek

In June 2020, the Flemish populist radical right party Vlaams Belang (VB) published the Corona Blunder Book (CBB; Coronablunderboek in Dutch), detailing the government’s mistakes in handling the COVID-19 crisis. Populist parties can ‘perform’ crisis by emphasising the mistakes made by opponents (Moffitt, 2015) and may use a specifically populist discursive style, consisting largely of aggressive and sarcastic language (Brubaker, 2017). This paper takes the CBB as a case study in the populist performance of crisis and the populist style, finding that the book is, first, a clear example of populist ‘everyman’ stylistics and the performance of crisis, and, second, that VB uses the book to shift the COVID-19 crisis from a public health crisis to a crisis of governance, seeking to blame Belgium’s federal structure for the government’s alleged mismanagement of the COVID-19 pandemic and hence arguing for Flemish independence, one of the party’s main agenda points.
The Praise for a ‘Caretaker’ Leader
Authors: Deswert Clémence
Published: September 2021

The Praise for a ‘Caretaker’ Leader

Studies on media coverage of women politicians have underlined how the media contribute to the association of the figure of the political leader with masculinity. Yet, the social construction of leadership seems to evolve towards a more ‘femininity-inclusive’ definition. Research on the ‘glass cliff’ phenomenon suggests that stereotypical feminine attributes might be expected from political leaders in a time of crisis. We investigated the gendered construction of political leadership in the press in a COVID-19 context through the case of former Belgian Prime minister Sophie Wilmès. In line with the ‘think crisis-think female’ association, our discourse analysis shows an appreciation of traditionally feminine traits, and particularly care-related qualities, in the evaluation of what a ‘good’ leader should be in pandemic times, although some characteristics traditionally associated with masculinity are still considered valuable assets in the journalistic portrayal of Wilmès’ leadership.
Omgevingsfondsen bij wind- en zonneparken
Authors: Bakker D.E. (Dorien) , Tolsma H.D. (Hanna)
Published: September 2021

Omgevingsfondsen bij wind- en zonneparken. Pecunia non olet?

Dorien Bakker en Hanna Tolsma gaan in op het betrekkelijk nieuwe fenomeen van omgevingsfondsen bij wind- en zonneparken. De fondsen zijn bedoeld om te komen tot een eerlijke verdeling van de lusten en de lasten bij duurzame energieprojecten een beogen het draagvlak voor duurzame energieprojecten te bevorderen. Aangezien een wettelijke regeling omtrent omgevingsfondsen ontbreekt, staat het de betrokken partijen in grote mate vrij om de vormgeving van een omgevingsfonds te bepalen. In hun bijdrage leggen auteurs het omgevingsfonds onder de juridische loep en beantwoorden zij de vraag in hoeverre het huidige juridische kader regels over zeggenschap en waarborgen voor een eerlijke verdeling van gelden uit omgevingsfondsen kent.
Ambivalente illusies
Authors: Woldendorp H.E. (Hans)
Published: September 2021

Ambivalente illusies. Het arrest van het Europese Hof over grondwateronttrekking in het Natura 2000-gebied Doñana

Op 27 juni 2021 heeft het Hof van Justitie arrest gewezen over de grootschalige onttrekking van grondwater in de omgeving van het Natura 2000-gebied Doñana in het zuiden van Spanje. De overexploitatie van de aanwezige grondwatervoorraden rond het gebied vindt, vooral, plaats voor de landbouw en, in mindere mate, het toerisme. Hans Woldendorp gaat in op de vraag wat Spanje aan deze overexploitatie had moeten doen en verdiept zich in de mogelijke betekenis van het arrest voor Nederland. Moet er in ons land niet meer worden gedaan tegen verdroging van Natura 2000-gebieden (en wellicht ook andere natuurgebieden) en aan het tegengaan van bodemdaling als gevolg van het waterbeheer in het landelijk gebied? Het arrest is om verschillende redenen interessant. Vanwege de vergelijking tussen de toepassing van het stand still-beginsel in Kaderrichtlijn water en de Habitatrichtlijn maar ook omdat het gaat over het (weinig aan de orde komende) kwantitatieve grondwaterbeheer. In een van zijn conclusies stelt de auteur dat het hem geen slechte zaak lijkt om meer te doen aan het tegengaan van de verdroging van belangrijke natuurgebieden en van verdere bodemdaling. Die bodemdaling, in combinatie met de gevolgen van klimaatverandering op termijn, zet immers zelfs de bewoonbaarheid van de laaggelegen delen van ons land op het spel.
Naar een effectieve handhaving op maat in het omgevingsrecht
Authors: Essens O.F. (Oda)
Published: September 2021

Naar een effectieve handhaving op maat in het omgevingsrecht

Op 26 november 2019 promoveerde Oda Essens aan de Universiteit Utrecht op haar proefschrift getiteld ‘Operationalising Effective Public Enforcement of Environmental Law in the European Union, with a focus on England, Germany and the Netherlands’. In haar proefschrift heeft zij een model voor effectieve handhaving op maat ontworpen. Dit model bevat eisen aan de handhavingsorganisatie (institutionele eisen) en eisen aan de sancties (instrumentele eisen), zoals vastgelegd in wet- en regelgeving voor de publiekrechtelijke handhaving van het omgevingsrecht. Vervolgens heeft zij dat model toegepast op de publiekrechtelijke handhavingsorganisatie en sancties voor het omgevingsrecht in Nederland, Engeland en Duitsland. De toepassing heeft geleid tot good practices voor een ‘effectieve handhaving op maat’ in de drie landen en vanuit die good practices heeft zij aanbevelingen gedaan voor verbetering van de handhavingsorganisatie en de beschikbare sancties in de drie landen onderling. In dit artikel zet zij haar model voor effectieve handhaving op maat uiteen en belicht zij enkele belangrijke uitkomsten van de toetsing van de Nederlandse organisatie en sancties voor de publiekrechtelijke handhaving van het omgevingsrecht.