bluuebunny/crossref_metadata_2025 huggingface dataset:
Step up to ST3 emergency medicine simulation course
Authors: Keitley James , Rajan Dan , Walthall Kirsten , Brown Annemarie
Published: November 2022

The UK Emergency Medicine training pathway has three phases; Core (CT1-2), Intermediate (ST3), and Higher (ST4-6) [1]. The transition from Core to ST3 can be daunting – whilst not ‘registrars’, ST3s are often on ‘middle grade’ rotas. Trainees are expected to manage complex adult and paediatric cases with new portfolio requirements to demonstrate these competencies. They further develop leadership skills when supporting junior doctors and managing the department [2]. An ‘Introduction to ST3’ course was developed initially in the North West Deanery to address this transition. Using the original concepts, course content and format were adjusted for a Merseyside step up course.

The redesigned three-day course contained workshops including ST3 challenges, paediatrics, night shifts, and wellbeing. 12 scenarios were organised into ‘leadership’ (sick medical and trauma patients), paediatrics (including major trauma and safeguarding), and ‘challenges’ (e.g. behavioural disturbance, burns, managing conflict with colleagues and supporting juniors). They took place in a simulation suite with either manikins or simulated patients. Data were analysed pre-course, post-course, and at one to two years post-course with thematic analysis used for free-text responses.

47 candidates took part in 2019–2021. Pre-course questionnaires showed a key concern was caring for paediatric patients. Other themes were supporting juniors, management skills, being an isolated leader, and confidence. Contemporaneous feedback showed the simulations and talks were rated positively throughout. Simulations were challenging and rated as a useful aspect. The highest rated talks have been night shift work (9.78/10, n=18), supervising others (9.67/10, n=12), and paediatrics (9.67/10, n=12). Improved confidence particularly in challenging situations has been a common theme. Lower rated talks from 2019 were replaced subsequently, and the course remains receptive to feedback. In 2021, ‘The Floor’ game [3] was incorporated for departmental management skills and participants found this particularly useful. One to two years later, candidates reiterated the importance of the course in their transition, particularly regarding paediatric cases. They highlighted the benefit of discussing portfolio requirements and the value of networking with peers.

The step up course has been an important aid when transitioning to ST3 with feedback consistently positive at the time of the course and subsequently. Analysis of this feedback has informed improvements for the 2022 iteration happening shortly, and reinforced aspects including ‘The Floor’, to provide a supportive transition for trainees. As one trainee reported, the course ‘made me excited for ST3, [a] reminder why I’m an ED trainee’.

1. The Royal College of Emergency Medicine, 2021. Curriculum 2021.

2. Walthall K, editor. Introduction to ST3; Course Guide. 2019.

3. Focus Games, 2022. The Floor Game.
Utilisation of digital authoring platform to enhance simulation delivery
Authors: Muir Cheryl
Published: November 2022

The development and ongoing critique of simulation-based scenarios is critical to ensure a researched and standardised approach to learning [1]. This is achieved by creating scenarios that have set learning objectives to improve clinical practice within multidisciplinary teams and patient safety. Additionally, a robust scenario leads to stimulating and open debriefings [2]. Whilst a paper-based scenario will do this, the aim is to highlight the benefits of using a digital platform for both creating and updating scenarios.

Paper scenarios have been used for many years to achieve the goals highlighted above but it became increasingly obvious that the resources needed to review, critique, and update those scenarios were no longer effective. This situation was emphasised due to the need to have multiple copies of scenarios across many sites. In order to maintain a quality service, whilst still being able to maintain resources to redevelop and enhance existing scenarios, we implemented a digital authoring platform called IRIS.

Scenarios were transferred and created allowing a centrally controlled catalogue that could be audited and version controlled. Any changes made would automatically update the scenario on all the users’ tablets thus ensuring the same version of the scenario was used across all sites. An immediate benefit was the reduction in time spent redeveloping scenarios. This allowed for added details to be entered dependent on if it was a standardised patient or manikin driven scenario. Another benefit was the ability to rapidly collaborate and co-author with peers and subject matter experts. IRIS interfaces with manikins from leading vendors, sending patient data states directly to the manikins reducing setup time. We noticed an increase in simulation engagement as authors were able to log on remotely to update work.

IRIS allows easy design and supports the development of high-quality scenarios. Its implementation saved resources in terms of time, staffing and environmental footprint. It enabled us to have a central hub of scenarios that dismissed the need to do multiple updates in multiple places and enabled us to have an audit trail of changes, by date time and user. Moving to a digital platform enhanced the experience of our users giving them a better learning experience leading to improved patient care.

1. Alinier G. Developing high-fidelity health care simulation scenarios: A guide for educators and professionals. Simulation & Gaming. 2011;42(1):9–26.

2. Dieckmann G, Gaba D, Rall M. Deepening the theoretical foundations of patient simulation as social practice. Simulation in Healthcare Journal. 2007;2(3):183–193.
Using virtual reality to educate healthcare professionals on patients’ experience of delirium
Authors: Cyrus Angelus , Chubb Rebecca
Published: November 2022

Delirium is an acute onset confusion that has fluctuating consciousness symptoms such as hallucinations, mood changes and distractibility. It is experienced by around 2 in 10 patients within the hospital [1]. Amongst these patients, 96% are older adults and their outcomes are consistently worse due to the delirium alone, including increased mortality rates [2]. It can also be extremely frightening and distressing. Hence, the attitudes and knowledge of healthcare professionals surrounding delirium is an important topic to address in order to aid prevention as well as manage delirium. Despite training, delirium is under reported and generally poorly managed. Studies have found that the use of virtual reality in medical education has improved empathy, depth of knowledge, and self-awareness [3]. Using a 360° camera and virtual reality headsets, an in-patient scenario was created whereby the effects of delirium such as hallucinations and disorientation were depicted. The aim of the project was to establish whether virtual reality can be used to improve healthcare professionals understanding and awareness of patients’ experience of delirium. The virtual reality video and the interviews can be found on YouTube.

Eight people were recorded using the VR and five of them were interviewed afterwards. The interviews were conducted using an unstructured approach in which the topics of how the virtual reality tool changed their perception of dementia, what they learnt from the tool, and whether they thought the tool was useful, were discussed. Thematic analysis was carried out retrospectively.

The thematic analysis of the qualitative data highlighted four key themes amongst the healthcare professionals’ responses. These themes were education, insight, empathy, and future practice. The most common theme was insight, with comments such as ‘having the virtual reality, it breaks that barrier between you and them,’ ‘you realise how just isolated that person is,’ and how the virtual reality made them feel like they are ‘in the room,’ emphasising this theme.

The outcome has been to prove concept and highlight the usefulness of virtual reality as a method of educating healthcare professionals. We have been emboldened by the feedback received. We are looking to incorporate the VR film as part of a broader simulation-based training. The training is already being adopted by local clinical teams and our local university partners.

1. Combined NHS (National Health Service). Delirium Training Video (Virtual Reality). 2022.

2. Royal College of Nursing. Delirium | Older people | Royal College of Nursing. The Royal College of Nursing. 2013.

3. Dyer E, Swartzlander BJ, Gugliucci MR. Using virtual reality in medical education to teach empathy. Journal of the Medical Library Association. 2018;106(4):498–500.
Creating a sustainable weekly interprofessional simulation for the emergency department (ED) clinicians
Authors: Diaz Celia , Shah Rupali , Dawson Neil , Ray James
Published: November 2022

Simulation-based education has been shown to improve clinical practice [1]. It offers an environment whereby complex real world situations can safely be practised facilitating learning through immersion, reflection, and feedback [2].There has been an increasing awareness amongst the medical profession as to the importance of simulation, we therefore created a sustainable simulation programme for the multidisciplinary team (MDT) at the Horton General Hospital (HGH) Emergency Department (ED) – Oxford University Hospitals NHS Foundation Trust.

Several simulations were designed involving trauma, airway management, and acute adult and acute paediatric presentations. The focus of the simulations was based on identifying errors due to human factors. The simulations were designed utilising feedback forms as well as analysing information from clinical incident forms. These provided a platform to understand areas of improvement and targeted scenarios were created. A weekly simulation programme was then created involving the ED MDT (doctors, nurses, allied healthcare professionals) as well as other specialities (Paediatrics, Trauma and Orthopaedics, Anaesthetics and Acute General Medicine). The session was run every week for 2 hours in the ED as an ‘in-situ’ educational activity to provide a higher level of fidelity and provide an immersive environment for the participants. These scenarios were then debriefed by senior members of the team including speciality registrars and consultants trained on debriefing and human factors.

The debriefings involved the discussion of human factors pertaining to the simulations and were learner-led. The feedback from the MDT was grossly positive; nursing staff and healthcare professionals in particular felt more empowered after the sessions to raise concern. Feedback was collected using an online survey which was sent to the participants following the session. Feedback obtained from participants aided improvement of targeted learning points and therefore aided debriefing.

Our simulation programme has been run over 18 months and has had excellent feedback. We continue to improve our simulations and increase the participant numbers through the use of video links for the sessions; thereby engaging a wider audience. This has been crucial throughout the pandemic due to various reasons (room constraints, staff isolation).

1. Al-Elq AH. Simulation-based medical teaching and learning. Journal of Family & Community Medicine. 2010;17(1):35–40.

2. Datta R, Upadhyay KK, Jaideep CN. Simulation and its role in medical education. Medical Journal of the Armed forces India. 2012;68(2):167–72
Breaking bad news: a multiple cohort student paramedic simulation event with integrated service users
Authors: Geis Emma
Published: November 2022

This simulation aimed to meet the indicative content of a communication module, which focused on breaking bad news. The aim of this session was for first year paramedic students to observe bad news being given in a simulated environment. The objectives were for students to understand the emotive realism [1] behind breaking bad news, highlight the importance of integrating service users into simulated healthcare education, and to recognise the impact of observation and feedback.

The first-year paramedic students were introduced to the SPIKES [2] model prior to the event being commended due to its ability to allow patients and relatives to have their own reaction to bad news. The first year students then observed the second and third year students undertake two simulations and used the SPIKES tool to structure feedback on how they broke the bad news. One of the simulations was a cardiac arrest case in which the patient was pronounced deceased by the paramedics, and the second was the treatment of a patient that was suffering from a myocardial infarction. Within both simulations the students were expected to treat the patient utilising best practice and then break the bad news. The final element to this simulation was the inclusion of service users who acted as patients and relatives, and were given the opportunity to feedback as to how they felt during the communication [3].

We gathered feedback via a Microsoft form from all parties with a total of 23 responses: 11 first year students, five 2

Overall, this simulation-based activity brought together the theoretical subject matter of communication and created an inclusive learning space for a variety of people to learn.

1. Buckman R. How to break bad news: a guide for health care professionals. University of Toronto Press; 1992 Aug 8

2. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES – a six-step protocol for delivering bad news: application to the patient with cancer. The oncologist. 2000;5(4):302–11.

3. Orr F, Kellehear K, Armari E, Pearson A, Holmes D. The distress of voice-hearing: The use of simulation for awareness, understanding and communication skill development in undergraduate nursing education. Nurse Education in Practice. 2013;13(6):529–35.
Boot camps and academia: odd bedfellows for a national collaborative approach to training non-medical cystoscopists
Authors: Rafferty Brian , Fraser Fiona , Ker Jean , Robertson Allison , Brown Mary , Cooper Mark
Published: November 2022

Scottish cystoscopy service provision faces significant challenges in the years ahead driven by COVID-19’s impact on diagnostic waiting times, the development of national treatment centres to expand infrastructure/service delivery, and limited short-term medical capacity to support recovery. These factors have greatly increased demand for the rapid development of a supportive non-medical cystoscopist workforce [1]. There is currently no agreed national approach to non-medical cystoscopy training in Scotland despite clear guidance on competencies from the British Association of Urology Nurses (BAUN). Our proposed solution has been to collaboratively develop and pilot an accelerated learning programme, including a simulation ‘bootcamp’, that pump primes adaptation to the role and clinical training requirements through technical and non-technical skill rehearsal.

We invited experts from clinical practice, education, and simulation to form a national short life working group (

Diagram of the national short life working group

A unified model for pilot was developed, integrating clinical simulation, theory, and work-based learning (WBL). It focuses on core cystoscopy skills initially, providing the necessary knowledge and ‘hands on’ ability required for independent practice. The process is primed by a two-day ‘cystoscopy bootcamp’ using simulation-based education (SBE). This comprises of a variety of methods including high volume cystoscopy skill rehearsal of increasing realism, progressing to cadaver. Non-technical skills are simulated through bespoke scenarios relevant to the role including obtaining informed consent, team communication, and delivering bad news. Expert discussion and debriefing is interwoven throughout. Formal evaluation is ongoing with early reports of increased preparedness and quicker adaptation to the clinical environment. In addition to the anticipated benefits, bootcamp also established early peer support mechanisms and, through the engagement and networking of diverse faculty, fostered integration with the wider community of practice, and a commitment to building a continually improving, user-informed simulation programme.

The method provides a cost-effective collaborative way to explore research, educational models, and the challenges of implementation in real time, through a multi-professional lens. The approach has been crucial to ownership, commitment and acceptance of the programme while fostering integrated cross discipline delivery.

1. Scottish Government Endoscopy and urology diagnostic recovery and renewal plan. 30 Nov 2021 Endoscopy and urology diagnostic: recovery and renewal plan – gov.scot (
Improving obstetrics and gynaecology departmental induction using simulation
Authors: Matary Rania El , Obadahun Wuraola , Herridge Daniel
Published: November 2022

It is well established that trainee doctors struggle with the transition into a new department. There is evidence that simulation-based education (SBE) improves competence and confidence [1]. At our Trust, there is a one-day induction for Obstetrics and Gynaecology (O&G) introducing logistics of the Department and basic skills (e.g. rota and speculum examination). However, it had limited coverage of clinical knowledge, trust protocols, and management of common O&G presentations. The aim of this study was to improve the confidence of new doctors beginning their O&G clinical rotation by increasing their knowledge-base of common presentations, protocols, and procedures through designing and implementing a trainee-focused simulation-based training programme into their induction.

We collected feedback from six trainees who had undergone the previous induction programme regarding its utility and how confident the trainees felt on starting their rotation. It was evident from this that the induction did not adequately prepare them for their role and all were in agreement to have simulation embedded into the induction programme. We designed six scenarios based on common O&G presentations and used Trust Protocols (consenting, postnatal ward round checks, bleeding in pregnancy) as a guide for best practice. The programme was delivered to two cohorts (total of 12 trainees) in December 2021 and April 2022. During the new simulation-based induction, trainees completed a pre- and post-programme questionnaire which measured self-reported changes in confidence levels, O&G knowledge, and departmental protocols via a 5-point Likert scale. The questionnaire also explored their expectations of the day, whether they were met, and if this programme should feature permanently in the O&G departmental induction. These responses were analysed using the framework analysis.

Quantitative results revealed: increased confidence (+80%; p<0.001), decreased anxiety (-53.4%; p<0.001), increased knowledgebase (+50%; p=0.003), increased knowledge of Trust protocols (+82.6%: p=0.001), and all 12 participants were able to locate them when needed. Analysis of qualitative results revealed common themes of improved confidence, increased knowledgebase, clearer expectations of their job roles, and 100% of participants agreed that simulation should form a permanent part of their induction. Furthermore, their expectations of the programme were met was confirmed by the thematic analysis of participants’ expectations before and after the induction.

We recommend the use of simulation in departmental inductions as it is essential in improving trainee confidence; increasing their knowledge of common O&G presentations and of Trust protocols and procedures, and of their roles within the department.

1. Lateef F. Simulation-based learning: Just like the real thing. Journal of Emergencies, Trauma and Shock. 2010;3(4):348.
Introduction of an internal medical trainee high-fidelity simulation course programme
Authors: Simkin Mark
Published: November 2022

The Trust felt that a targeted programme was needed to help further prepare Internal Medical Trainees’ (IMT) for their current duties and forthcoming roles as registrars. We wanted to provide them with the opportunity to boost their confidence and practice working alongside junior medical colleagues, in order to enhance patient safety [1]. These programmes could also work alongside the regional THRIVE and STRIVE sessions.

A three-year programme was introduced. For IMT year 1, it is a half-day of 3 scenarios following a patient’s journey through an admission with key objectives being around difficult decision-making and communication. For IMT year 2, this includes a day of 5 challenging scenarios based around situations the IMT’s are called for. They look at non-technical aspects of their job in the context of complex clinical situations including bradycardia, supraventricular tachycardia, cardiac arrests, mental capacity, and duty of candour. IMT year 3, includes two days with the IMT3A course involving trainees working with Foundation Year Doctors over 5 scenarios where they are escalated to as the senior on call. The focus is developing skills such as prioritisation, leadership and communication. All candidates take part in the debriefing. The IMT3B course is a day of 5 extremely challenging scenarios in difficult settings such as out of hours or with limited senior presence. These scenarios are devised to push the IMT3 candidates in order to help prepare them for working under pressure. Scenarios include difficult ethical decision-making, litigation issues, and complex patients (e.g. pregnancy).

The sessions were positively evaluated by the IMT who expressed how they will help change their practice and enhance patient safety (see

Feedback from the internal medical trainees

We feel that as the IMT work through the programme prepares them for what is a difficult transition. Over their IMT simulation training they will take part in 18 scenarios either as a candidate or in the debriefing. It has given the IMT the chance to have high quality training in a high-fidelity environment thus promoting enhanced care and patient safety.

1. Wayne D, Didwania A, Feinglass J, Fudala M, Barsuk J,McGaghie W. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: A case controlled study. Chest. 2008;133(1):6–9.
Medical procedures initiative from simulation laboratory to medical wards
Authors: Hatta Syarifah Syafiqah Binti Wan Muhamad , Mahmoud Huda , Christian Vicky , Webb Steve , Oduntun Olawale , Marriot Joel
Published: November 2022

Historically, attaining medical procedural competency during training has been challenging [1–3]. At a small district general hospital, initiatives were implemented to address these mandatory curriculum components.

1) Ten skill-sessions were organized, to encompass all mandatory procedures such as skills in central venous catheter, chest drain, ascitic drain, lumbar puncture, DC cardioversion, pacing, and interosseous access. Doctors, advanced clinical and nurse practitioners were invited to attend a face-to-face procedure session. Manikins alongside medical procedure toolkits were provided to assist in simulation training. Pre- and post-Likert Scale questionnaire was used to assess skill-specific confidence levels.

2) A specific WhatsApp group was used to alert doctors of procedural training opportunities within the hospital. Terms of reference and clear clinical governance guidance were provided prior to sign-up. To assess the effectiveness of this method, a questionnaire was distributed amongst the users.

Thirty-eight professionals in training attended the sessions. The cumulative rating of all skills revealed an improvement in skill confidence from 15% to 80%. This was most marked in the interosseous access (17% to 100%) and abdominal paracentesis (27% to 100%). However, aptitude in central venous catheter was identified as having the lowest confidence skill level both pre-and post-sessions (0% to 60%). 86% of trainees found the WhatsApp group to be effective or very effective to communicate procedural training opportunities within the hospital. Within six-months, bedside training in DC cardioversion, ascitic drains, interosseous access, pleural aspiration, and drains were achieved.

The training sessions improved skill-specific confidence. Equally, the more challenging procedural skills were identified for more training. Further plans for this Quality Improvement Programme will include utilizing the hospital’s online communication platform, organizing procedure-specific human factors teaching, and extending training sessions to consultants to evidence the upkeep of procedural competency.

We would like to thank and acknowledge the contribution of the Dinwoodie Charity Company of Physicians. The medical registrar: Empowering the unsung heroes of patient care. RCP, 2013.

1. Tasker F, Dacombe P, Goddard AF, Burr B. Improving core medical training – Innovative and feasible ideas to better training. Clinical Medicine. 2014;14(6):612–617.

2. Tasker F, Newbery N, Burr B, Goddard AF. Survey of core medical trainees in the United Kingdom 2013 – Inconsistencies in training experience and competing with service demands. Clinical Medicine. 2014;14(2):149–156.

3. Lim CT, Gibbs V, Lim CS. Invasive medical procedure skills amongst Foundation Year Doctors – a questionnaire study. JRSM Open. 2014;5(5):2054270414527934.
Correlation of cholesterol ratios and conventional isolated lipid parameters as cardiovascular risk markers to anthropometric and hemodynamic variables in healthy overweight/obese subjects
Authors: Kanawjia Preeti , Srivastava Chitra , Gupta Anupama
Published: November 2022

Background: Isolated lipid derangements are no longer considered as an ideal tool to predict cardiovascular (CV) morbidity. Hence, novel parameters, that is, lipid ratios are being resorted to label CV risk. However, which of the ratios stand out as the most specific, sensitive, and earliest predictor in individual cases is still to be elucidated.

Aims and Objectives: The aim of the study was to study correlation of cholesterol ratios and conventional isolated lipid parameters as CV risk markers to anthropometric and hemodynamic variables in healthy overweight/obese subjects.

Materials and Methods: This was an analytical, observational, and pilot study enrolling 30 overweight/obese subjects as cases and 30 non-obese subjects as controls segregated on basis of body mass index (BMI) and WHR. All subjects with secondary cause of abnormal blood flow were excluded from the study. Blood pressure measurement and venous blood sampling for serum glucose and fasting lipid parameters were duly done.

Results: Of all the isolated lipid values and the three lipid ratios (Total Chl a [T. Chl]/high density lipoprotein [HDL], low-density lipoprotein [LDL]/HDL, triglyceride [TG]/HDL), the two groups differing significantly only in T. Chl/HDL ratio which, in turn, significantly strongly positively correlated to both LDL/HDL and TG/HDL ratio ([r = 0.684, P = 0.000] [r = 0.433, P = 0.001]), respectively. All the physical hemodynamic parameters (systolic blood pressure, diastolic blood pressure, and pulse pressure) were significantly different in both groups but none of them correlated with the lipid parameters. Of the two (waist hip ratio and BMI) anthropometric measures, only BMI had significant positive moderate strength correlation to lipid parameters and ratios.

Conclusion: T. Chl/HDL ratio seems to be the ideal lipid marker in early prediction of CV disease in apparently healthy obese subjects. Lipid derangements in apparently healthy mild-to-moderate grade obese subjects may not universally present with hemodynamic derangements.
Japonya'da İslam Peygamberi Hz. Muhammed Hakkında Yapılan Çalışmalar (1873-1926): Dinler Tarihi Açısından Değerlendirme
Authors: KUŞÇULU Ayhan , KARAOĞLU Yetkin
Published: November 2022

Amaç: Bu makalede, 1873-1926 yılları arasında Japonya’da Hz. Muhammed hakkında yapılan tercüme ve telif çalışmaların dinler tarihi perspektifinde değerlendirmesi amaçlanmıştır.

Yöntem: Nitel araştırma yöntemi bağlamında yürütülen makale, doküman incelemesine uygun olarak oluşturulmuştur.

Bulgular: Bu makalede, 1873-1926 yılları arasında Hz. Muhammed hakkında yapılmış çalışmaların hangi dini bakış açısından ele alındığı ve hangi kutsal kişi anlayışların ilgili eserlerde ağırlık kazandığına dair incelemeler yürütülmüştür. Bu sayede Hz. Muhammed’in kutsal bir şahsiyet olarak görüldüğüne dair bulgulara ulaşılmıştır.

Sonuç: Çalışmada Hz. Muhammed ilk olarak dini bir uzman ve kutsal kişi olarak algılanmıştır. İkinci olarak Hz. Muhammed, misyonu gereği kutsaldan emirler alan, dini kurallar belirleyen, bu kuralların nasıl uygulanması gerektiğine karar veren ve buna yönelik eylemlerde bulunan bir din kurucu olarak algılanmıştır. Üçüncü olarak Hz. Muhammed kendi toplumu için yabancı olmayan bir dini tesis etme gayretinde bulunan reformcu olarak algılanmıştır. Dördüncü olarak Hz. Muhammed mistik bir şahsiyet olarak algılanmıştır. Dolayısıyla Hz. Muhammed Japonya’da 1873-1926 yılları arasında dini uzman, din kurucu, reformcu ve mistik bir şahsiyet olarak dört bakış açısından ele alınmış onun kutsal bir şahsiyet olduğu ifade edilmiştir.

Özgünlük: Bu makalede, Hz. Muhammed’in 1873-1926 yılları arasında Japonya’da nasıl anlaşıldığı ilgili alan literatürü çerçevesinde açıklamaya kavuşturmaya yönelik incelemeler yürütülmüştür. Bu sayede ele alınan veriler Hz. Muhammed’in Japonya’da kutsal kişi olarak çeşitli bakış açılarından değerlendirildiği ve nitelendirildiğine dair özgün izahlara dönüştürülmüştür.
Prolonged Cholestasis Due to Hepatitis A Virus Infection in a Young Adolescent Male with a Known Case of Hemoglobin E Disease: Early Response to Steroid Therapy
Authors:   Department of Gastroenterology, Evercare Hospital Dhaka, Bangladesh, Yasmin Afsana , Latif Chowdhury Lutful ,   Department of Gastroenterology, Evercare Hospital Dhaka, Bangladesh
Published: November 2022

Background: Acute hepatitis due to hepatitis A virus infection is a self-limiting mild disease. Sometimes, it may have an atypical course in few percentages. We reviewed with characteristics, response to steroid therapy, and outcome of prolonged cholestatic jaundice in hepatitis A virus infection. Case Summary: We analyzed acute hepatitis with a prolonged cholestatic course due to hepatitis A virus infection in an adolescent with preexisting hemoglobin E disease. Bilirubin was gradually increasing, the maximum total bilirubin was 48.3 mg/dl, and direct 46.6 mg/dl at day 50 of symptoms onset. After that, the steroid was started along with ursodeoxycholic acid. The patient gradually improved clinically and biochemically. Conclusion: Hepatitis A virus infection may cause prolonged cholestatic severe jaundice in a patient with preexisting congenital hemolytic disease. Steroid therapy may induce early recovery.
CONTANDO HISTÓRIAS E INSPIRANDO CRIANÇAS COM NARRATIVAS DE MULHERES CIENTISTAS
Authors: Soares Sara Silva , Hyrycena Ana Carolina , Pricinotto Gustavo , Crespan Estela dos Reis , Marciniuk Letícia Ledo
Published: November 2022

Reflete-se neste texto a respeito de uma experiência mediante ao trabalho realizado na disciplina de “Instrumentação para o ensino de Química” em que nos propusemos em representar mulheres cientistas por meio de uma roda de conversa pautada na literatura de rachel ignotofsky em seu livro “As Cientista, 50 mulheres que mudaram o mundo”  em um centro de convivência em uma região marginalizada na cidade de Campo Mourão (PR). O presente estudo apresenta um olhar sobre os efeitos motivadores de espaços não formais e suas possíveis contribuições para o ensino de Química, pois acreditamos que os ciclos de leituras em ambientes não institucionalizados é uma alternativa que aponta caminhos e possibilidades para romper com roteiros preestabelecidos em nossa sociedade patriarcal.
UM ESTUDO DO AVANÇO DA INDÚSTRIA 4.0 E OS DESAFIOS LOGÍSTICOS DO POLO INDUSTRIAL DE MANAUS
Authors: De Souza Carolina Gonçalves , Santos Luciano Balbino dos
Published: November 2022

A presente pesquisa busca identificar o nível de maturidade da indústria no Brasil e no Estado do Amazonas, com relação as tecnologias que marcam a Quarta Revolução Industrial, conhecida pela expressão “indústria 4.0”. O objetivo consiste em avaliar em que medida, esse novo modo de produção impacta os processos logísticos experimentados pelas empresas que integram o Polo Industrial de Manaus (PIM), Capital do Amazonas, considerando o fato de que a logística se constitui no principal impedimento ao desenvolvimento desse Estado, em função do isolamento da região. Para isso, se faz uso de uma metodologia de natureza bibliográfica e exploratória, buscando identificar na literatura mais atualizada e pertinente ao tema, sinalizações que possam atender ao objetivo proposto.  Os resultados mostram que os avanços do PIM, na direção da migração para a indústria 4.0 ainda é inexpressivo e que os desafios logísticos que impedem o aumento da competividade das empresas do Polo, também se configura como um grave problema para evolução das práticas que caracterizam a indústria 4.0, que precisa ser superado.
Alturistik Liderlik Algısının Prososyal Hizmet Davranışı Üzerindeki Etkisinde Sosyal Karşılaştırma Yöneliminin Rolü: Konaklama İşletmelerinde Bir Uygulama
Authors: TÜRKOĞLU Nuray , TÜRK Okan
Published: November 2022

Amaç – Bu çalışmanın amacı konaklama işletmelerindeki çalışanların alturistik liderlik algılarının prososyal hizmet davranışları üzerindeki etkisinde sosyal karşılaştırmanın rolünü belirlemektir.
Yöntem/Metodoloji/Dizayn- Araştırmanın evrenini 4 ve 5 yıldızlı konaklama işletmeleri çalışanları oluşturmaktadır. Araştırmada kolayda örnekleme yöntemi kullanılarak Antalya ilinde faaliyet gösteren 4 ve 5 yıldızlı konaklama işletmelerinde çalışan 437 kişiden veriler elde edilmiştir. Elde edilen veriler Yapısal Eşitlik Modeli kullanılarak analiz edilmiştir.
Sonuçlar- Araştırma sonucunda katılımcıların alturistik liderlik algısının prososyal hizmet davranışlarını ve sosyal karşılaştırma yönelimlerini olumlu yönde etkilediği, sosyal karşılaştırma eğiliminin ise prososyal hizmet davranışı üzerinde etkisinin bulunmadığı tespit edilmiştir. Katılımcıların alturistik liderlik algılarının prososyal hizmet davranışları üzerindeki etkisinde sosyal karşılaştırma yöneliminin negatif yönde düzenleyici bir etkiye sahip olduğu ancak, aracı etkisinin bulunmadığı belirlenmiştir.
Katkı/Farklılıklar- Literatür incelendiğinde alturistik liderlik algısı, prososyal hizmet davranışı ve sosyal karşılaştırma yönelimi arasındaki etkileşimi inceleyen çalışmaya rastlanmamıştır. Bu nedenle araştırma literatürdeki bu boşluğun doldurulması açısından katkı sağlayacaktır. Ayrıca araştırmadan elde edilen sonuçlar sektörde faaliyette bulunan konaklama işletmelerinin sahip ve yöneticilerine çalışanların alturistik liderlik algısı, prososyal hizmet davranışı ve sosyal karşılaştırma yönelimi konuları ile ilgili eğilimini göstermesi açısından uygulamaya yönelik yol gösterebilecektir.
Search and Multiple Jobholding
Authors: Lalé Etienne
Published: November 2022

This paper develops an equilibrium model of the labor market with hours worked, offand on-the-job search, and single as well as multiple jobholders. The model quantitatively accounts for the incidence of and worker flows in and out of multiple jobholding. Central to the model’s mechanism is that holding a second job ties the worker to her primary employer, at the benefits of having a stronger outside option to bargain with the outside employer. The model is also informative of how multiple jobholding shapes the outcomes that are typically the focus of search models. Multiple jobholding has opposing effects on job-to-job transitions that mostly offset each other. At the same time, since the option of having second jobs makes the main job survive longer, it reduces job separations and increases the employment rate. These findings have material implications for the calibration of standard models which ignore multiple jobholding.
Effect of grazing and stall feeding on the productive performance, carcass traits and meat quality attributes of Jamuna basin lambs
Authors: Hossain MA , Rahman MM , Rahman MW , Hossain MM , Haque ME , Hashem MA
Published: November 2022

The aim of this study was to evaluate the productive performance, carcass traits and meat quality under two rearing system of Jamuna basin lambs. Twenty selected lambs were divided into two treatments like T1 (grazing) and T2 (stall feeding) having ten lambs per treatment. Data was analyzed with unpaired t-test along with GLM procedure of SAS statistical packages. Traits evaluated were carcass traits, proximate components viz. dry matter (DM), crude protein (CP), ether extract (EE) and ash, physicochemical (Ultimate pH, cooked pH, cooking loss, drip loss, water holding capacity-WHC), sensory analysis (color, flavor, tenderness, juiciness, overall acceptability) and instrumental color value (L*, a* and b*). Average daily gain (ADG), hot carcass, skin, viscera, head, pluck, neck, heart, lung, and spleen wt. were found significantly differed (p<0.05) in both treatments. Dressing% and EE% was significantly (p<0.001) higher in grazing than stall feeding. Instrumental color values CIE L*, a* and b* were found significantly higher (p<0.001) in grazing. It may be concluded that grazing group had positive effects on ADG, carcass traits, proximate components, physicochemical, sensory evaluation and instrumental color value in Jamuna basin lamb.
Meat yield and meat quality characteristics of indigenous, Hilly♂×Sonali♀ crossbred and commercial broiler chicken of similar weight at different storage time
Authors: Ali MH , Habib M , Bhuiyan MSA , Azad MAK , Hashem MA , Ali MS
Published: November 2022

The experiment was conducted to investigate meat yield and quality characteristics of indigenous, crossbred Hilly♂ × Sonali♀ and commercial broiler chickens at similar live weight. For this purpose male and female indigenous chickens were purchased from local market, while Hilly♂ × Sonali♀ crossbred was reared up to 12 weeks at Bangladesh Agricultural University (BAU) poultry farm. Sexed male and female of Ross 308 broiler chicks were also reared BAU poultry farm up to 30 days. Six male and six female chickens from each of indigenous, Hilly♂  Sonali♀ and commercial broiler were slaughtered, eviscerated and dissected to compare meat yield and meat quality characteristics during 0, 15 and 30 days of storage period at 1000 g (±50 g) body weight. The eviscerated and defeathered carcasses were stored at -18°C for 0, 15 and 30 days .Considering Indigenous, Hilly♂ ×Sonali ♀ and Broiler chickens of both sexes, shank, neck, carcass yield, dressed weight, breast meat weight were significantly (p<0.05) higher in commercial broiler while wing meat and thigh meat were higher in Hilly♂ × Sonali♀ chicken. The dry matter, crude protein were significantly higher in indigenous chicken while cooking loss, ether extract, ash, peroxide value, free fatty acid value and thiobarbituric acid value were found significantly higher in commercial broiler during different storage time in both sexes. The meat yield parameters did not differ significantly among three storage time. However, cooking loss, pH and crude protein decreased, while dry matter, ether extract, ash, peroxide vale, free fatty acid value, thiobarbituric acid value, increased with the increasing of storage time.
Legal Protection of Land Use in the Context of Opening and Development of Agricultural Land for Public Interests
Authors: Akiruddin Ahmad
Published: November 2022

Land as a source of life and one of the important factors of production, besides being able to guarantee the availability of space to build infrastructure and facilities for development needs in accordance with the priorities that have been set, it is also necessary to maintain its fertility and sustainability in order to create a comfortable living environment. The pattern of land use in supporting development will experience a shift in accordance with developments in each development sector. Policies in the land sector are aimed at achieving three main things that complement each other, namely efficiency and economic growth, social justice, environmental conservation and sustainable land use patterns. Government has given legal protection to agricultural land by issuing several regulations such as Law Number 41 of 2009 concerning the Protection of Sustainable Food Agricultural Land. This rule emphasizes that sustainable food agricultural land must be protected and cannot be converted unless it is in the public interest.
Strengthening US–EU cooperation on trade and technology
Authors: Schneider-Petsinger Marianne
Published: November 2022

— The Trade and Technology Council (TTC) launched in 2021 has become the primary platform for US–EU cooperation at the intersection of economics, technology and security. The council is intended to deepen cooperation via bi-annual ministerial meetings and 10 working groups. — Contentious issues have been excluded from the TTC’s scope. However, new transatlantic disagreements (such as that over the US’s Inflation Reduction Act) are emerging and risk overshadowing its work. — Although the TTC’s focus is on deepening bilateral cooperation on future-oriented issues, its work also responds to the wider geopolitical context, particularly with regard to China and Russia. — The greater flexibility of the TTC gives it a better chance of success compared to previous initiatives, such as the Transatlantic Trade and Investment Partnership (TTIP). However, such flexibility also comes with risks. — The TTC is at an inflection point and needs to turn ambitions into tangible outcomes. The extensive US–EU network of officials and stakeholders formed through the TTC may already be its most significant achievement – especially at a time of uncertainty in the transatlantic relationship in light of the 2024 electoral cycle. — To successfully tackle the most pressing global problems in trade and tech, the US and EU will have to work with like-minded partners, either directly or via adjacent forums such as the G7.
ОСОБЕННОСТИ ПРОГНОЗИРОВАНИЯ ДЕГРАДАЦИИ БЕТОННЫХ КОНСТРУКЦИЙ В БИОЛОГИЧЕСКИ АГРЕССИВНЫХ СРЕДАХ
Authors: Логинова С.А.
Published: November 2022

В настоящее время вопросам биоповреждения материалов и конструкций в строительной нормативной литературе уделено недоста- точное внимание. В статье аргументирована необходимость проведения комплексных исследований биодеградации бетона в биологи- чески агрессивных средах. Приведены результаты исследований по определению механизмов и особенностей биологической деструкции бетона. В экспериментальных исследованиях преимущественно моделировались агрессивные среды, воздействию которых подвергаются бетонные конструкции гидротехнических сооружений. Полученные экспериментальные данные могут служить основой для достовер- ного прогнозирования долговечности и надежности бетонных конструкций в биологически активных жидких средах путем математи- ческого моделирования с позиции теории массопереноса. Анализ причин и механизмов биодеградации строительных конструкций даст возможность проводить своевременный мониторинг по предупреждению этого отрицательного явления в будущем.
The Use of the SQ4R Technique in Enhancing Grade 11 Student Critical Reading
Authors: Churat Jiraporn , Prommatha Ratipong , Pengsawat Wanitcha , Upanit Wirakan , Chaemchun Sasiprapa , Intasena Autthapon , Yotha Nattapon
Published: November 2022

The objectives of the study were to study the effectiveness of the SQ4R technique in enhancing grade 11 students' critical reading and to investigate the students’ satisfaction with the SQ4R technique as a model of learning management in a reading class. A quasi-experimental approach was selected, and one group of participants was employed. The participants were 31 Thai grade 11 students in a secondary school in Thailand. The instruments were an SQ4R learning management plan, a critical reading test, and a satisfaction questionnaire were research instruments. The data were collected in a public school in Thailand. It took a semester to complete a pre-test, an implementation of the SQ4R learning management, a post-test, and a satisfaction survey. The data were analyzed using percentage, mean score, standard deviation, a paired samples t-test, and effectiveness index with the determining criteria of 80/80. the result shows positive effects of the SQ4R model on participants’ critical reading. It also indicates students’ satisfaction with the instructional model.
Exploraciones tecno-estéticas: reinterpretar el mundo a través de sus materialidades. Entrevista a Juan Pablo Zaramella
Authors: Martinez Luján Ailen , Zaramella Juan Pablo
Published: November 2022

Juan Pablo Zaramella es uno de los realizadores de animación más destacados de este tiempo. Trabaja tanto en publicidad como en ficción y su técnica predilecta es el stop motion, a través del cual explora con distintas materialidades y posibilidades expresivas, para crear mundos, viñetas de universos alternativos que se imbrican en las posibilidades de lo cotidiano. Su obra propone volver a mirar y experimentar de otro modo los límites de lo real, entre la ficción, el humor y la sensibilidad artística. 

En las líneas que siguen, se comparte una breve entrevista a Juan Pablo Zaramella en donde convergen la reflexión de su trayectoria profesional, sus búsquedas artísticas, las tecnologías y las dinámicas de la industria de la animación en Argentina.
Todo para ver
Authors: Michelazzo Sergio
Published: November 2022

Nicolosi, A. P. (Comp.) (2021). Paisaje ficcional en la TV Pública: la oferta de ficción seriada en la emisora estatal, 2009-2019. Bernal: Universidad Nacional de Quilmes.
Microbial Diversity and Degradation of Petroleum Hydrocarbon in Impacted Soils and Water Bodies in Niger Delta Area of Nigeria
Authors: F I Onianwah , V C Nwaugo , R O Chikezie-Abba , J Onajafe
Published: November 2022

Microbial diversity of hydrocarbon in polluted soil and water bodies explains the variability that exists among various species of microorganisms inhabiting such environments. Sources of these pollutions include among others polycyclic hydrocarbons, heavy metals contamination, industrial wastes and the unregulated use of pesticides. No doubt, Niger Delta region is heavily polluted due to unregulated exploration activities of the petroleum prospecting and exploration industries, including the illegal activities of the locals. This has grossly affected the distribution and existence of some species of microorganisms. The survival of microbes in such polluted sites depends largely on their ability to adapt, tolerate and/or degrade these pollutants. The degradation of these hydrocarbons has resulted in the formation of metabolites some of which influences diversity among the indigenous microbial species. There is a significant relationship between the level of contamination and alterations in the microbial community. Decontamination of polluted sites can be used to increase biodiversity. Therefore, biodiversity is influenced by the concentration of the pollutants. The ecotoxicological effect of petroleum pollution is the need for oxygen during degradation of the hydrocarbon. In a reduced oxygen supply, serious ecological damage may take place. Also, the presence of heavy metals and organic compounds may enhance toxicity to microorganisms.