bluuebunny/crossref_metadata_2025 huggingface dataset:
The Great Discrepancy: Political Action, Sustainable Development and Ecological Communication
Authors: Konold Dieter , Schwietring Thomas
Published: February 2021

The term ‘sustainable development’ was coined to denote a political goal some 40 years ago; debates about sustainability date back considerably further. These debates reflect the growing awareness of the destructive effects of human activities on the natural foundations of life. Numerous initiatives have been launched to trigger a turnaround, with the 2030 Agenda and the SDGs being the latest attempt. However, substantial progress has been rather limited thus far. This discrepancy is the subject of the article. Starting from a historical overview of sustainability politics, the argument develops in three steps. First, it is shown that conventional conceptions to promote environmental change fall short in depicting the broader societal context. To provide a comprehensive picture of the challenges related to transformation processes, a theory of the functional differentiation of societies is presented in a second step. A systems theory perspective offers a convincing theoretical explication of the problem. Third, this approach is scrutinized with regard to the political system and the politics of sustainability. The key finding is that the specific functional logics of the different social subsystems must be taken into account when analysing sustainable development and the discrepancy between the aims and ambitions of (global) environmental policy and the visible consequences. On the one hand, the functional differentiation of modern society guarantees its high degree of effectiveness and flexibility. On the other hand, implementing fundamental change, such as a transition towards sustainability, is not simply a question of strategy or of political willingness and steering. Rather, there is a need for more elaborate explanatory instruments. As a result, we argue for a linking of theories of sustainable development and advanced social theory.
A New Generation of Sustainability Governance: Potentials for 2030 Agenda Implementation in Swiss Cantons
Authors: Bornemann Basil , Christen Marius
Published: February 2021

Governments and administrations at all levels play a central role in shaping sustainable development. Over the past 30 years, many have developed differentiated sustainability governance arrangements (SGAs) to incorporate sustainability into their governing practice. The 2030 Agenda for Sustainable Development, which the UN adopted in 2015, brings with it some significant conceptual shifts in sustainability thinking that, in turn, entail new governance requirements. Starting from practical calls for improved understanding of the requirements and conditions of 2030 Agenda implementation ‘on the ground,’ this article examines existing SGAs’ potential to deal with the generational shift that the 2030 Agenda implies. To this end, four ideal-typical SGAs representing an early generation of sustainability governance at the subnational level in Switzerland are related to five specific governance requirements emerging from the 2030 Agenda. The analysis highlights different possibilities and limitations of the four SGAs to meet 2030 Agenda requirements and points to the need for context-specific reforms of first-generation sustainability governance in the wake of the new Agenda.
Modern concepts of treatment of complicated diaphyseal forearm fractures (literature review)
Authors: Chernyaev Sergey N. , Neverov Valentin A.
Published: February 2021

The analysis of modern domestic and foreign literature on the issues of surgical treatment of patients with diaphyseal forearm fractures is presented in the article, the main problems at these injuries are noted. The analysis has been carried out on the basis of databases of medical publications of CyberLeninka, eLibrary, PubMed and biliary databases. The treatment of complicated diaphyseal forearm fractures in the form of nonunions, pseudoarthrosis, defects and malunion is serious problem in traumatology and orthopaedics, because according to the literature data, unsatisfactory results in the treatment of this pathology reach 2047%. This problem requires the development and implementation of modern functional methods of treatment, which would allow to combine the period of restoration of segment integrity with the period of rehabilitation without risk of osteosynthesis instability and nonunion. The problem of choosing the optimal tactics and methods of surgical fixation of these lesions remains a subject for discussion, which is the basis for scientific research on optimization of tactics and methods of surgical treatment of patients with consequences of diaphyseal forearm fractures.
Neuropathy of the peroneal nerve as a complication after total knee arthroplasty: characteristics of rehabilitation
Authors: Novikov AleksandrAleksandr V. , Antonova Viktoriya A.
Published: February 2021

Knee arthroplasty is recognized as the gold standard in the treatment of stage IIIIV degenerative diseases and the consequences of traumatic injuries. The number of surgeries is growing, and the number of complications after considered interventions is growing as well. Frequency of peripheral nerve neuropathies is not high, but damage to the peroneal nerve after total arthroplasty of the knee joint can lead to severe dysfunction of the lower limb, decrease in daily activity and the patients quality of life. The article analyzes the treatment results of 254 patients after primary and secondary knee arthroplasty. Signs of damage to the peroneal nerve upon admission to the second stage of rehabilitation were identified in 3.9% of cases. The clinical and functional examination performed in dynamics showed that the presence of neuropathy of the peroneal nerve aggravated the severity of the existing functional disorders in patients after knee arthroplasty. It has been established that complex intensive rehabilitation treatment, which should begin immediately after the diagnosis is made and be carried out intermittently for at least six months, restore the function of the affected nerve in 75% of cases.
Whipple's pancreaticoduodenectomy: perioperative outcomes in a tertiary care hospital in Dhaka, Bangladesh
Authors: Hossain A. B. M. Bayezid , Afroz Sadia , Shovon M. Tasnimul Khair , Anjuman Nabila , Chackraborty Mitul
Published: February 2021

Background: Pancreaticoduodenectomy is one of the most complex surgery with significant mortality and morbidity. Though the mortality rate has steadily improved, morbidity continues to be high. The aim of this study was to demonstrate the perioperative outcome following this procedure at our hospital.Methods: This retrospective study was conducted in the department of Surgery, Sir Salimullah medical college and Mitford hospital from July 2018 to December 2019. A total of 29 patients who undergone pancreaticoduodenectomy were included in the study. Preoperative, intra-operative and post-operative data were analyzed with emphasis on the morbidity and mortality rates. None of the operated patients received any types of neoadjuvant therapy.Results: Out of 29 patients who underwent PD, 18 (62.1%) were male and 11 (37.9%) were female with a median age of 53.7 years. The most common (34.5%) age group of the patients were 51-60 years. Jaundice was the commonest (89.7%) presenting symptoms followed by anorexia (75.9%) and abdominal pain (48.3%). Overall complications occurred in 37.9% patients, including wound infections (31.0%) and post-operative pancreatic fistula (6.9%). The post-operative mortality rate was 6.9%.Conclusions: PD still causes considerable morbidity and mortality. With careful patient selection, adequate preoperative preparation, surgical technique, excellent critical care management PD can be performed safely. At our center we have a reasonable volume and our data are comparable to literature data.
A study to screen infertile couples for psychological problems by using the perceived stress scale, brief COPE scale and hospital anxiety and depression scale
Authors: Singh Vikas , Bhirud Yogesh Rajesh , Lele Prasad , Bhagasra Santosh
Published: February 2021

Background: Infertility refers to the biological inability of a couple to contribute towards conception, or the state of a woman, who is unable to carry a pregnancy to full term. Though infertility is not only a disease per se it embraces a wide spectrum, but its treatment also affects all aspects of people’s lives. Aim of the study was to screen infertile couples for psychological problems, and to identify various psychological problems and factors associated with these problems.Methods: It was a cross-sectional study with total of 270 consecutive couples (patients) either of them diagnosed with infertility. All the patients who were found to have anxiety and depression score above seven were then interviewed by the psychiatrist for anxiety and depression.Results: Mean age of the males and females was 32.2 years and 29.7 years, respectively. Duration of marriage was less than five years in 37% couples while it was more than ten years in 19.6% couples. The major cause of infertility was identified in about two-thirds of the cases (64.1%). Prevalence of anxiety was observed in 49.6% females and 45.6% of males. Prevalence of depression was significantly higher among females (41.9%) as compared to males (37%).Conclusions: The present study has endeavored to draw attention to the interrelation of anxiety and depression among infertile couples. Apart from searching for the gynecological causes of infertility; psychological morbidity should be considered as a serious concern affecting these women.
Aberrant immunophenotypic expressions in acute lymphoid leukemia: an observational analytical study
Authors: Sivakumar Monica , Basu Atoshi
Published: February 2021

Background: This study aims to find out the expression of aberrant immunophenotypic markers in acute lymphoid leukemia (ALL) and to co-relate its expression with cytogenetic and molecular data.Methods: Retrospective cum prospective study was carried out in 75 patients of ALL who presented to Apollo Gleneagles hospitals, Kolkata from January 2014 and March 2019. Flow cytometry analysis was done using FC500 (Beckman coulter) All cases were classified according to latest WHO classification.Results: Out of 75 cases of ALL, 23 cases (30.67%) showed aberrant cross-lineage expression. Amongst the B-ALL cases, the most common aberrant antigen expressed were myeloid antigens 17 cases (77.27%). Aberrant T- antigens were noted in 4 cases (18.10%). Aberrant co-positivity of myeloid as well as T-antigens was seen in 1 case (4.54%). The most common aberrant myeloid antigen expressed was CD33 (77.7%) followed by CD13 (22.2%) and then CD15 (11.1%). Co-positivity of CD13 and CD33 was noted in 2 cases. CD2 and CD33 co-positivity was noted in 1 case. The most frequently expressed aberrant T-antigen was CD2 seen in 3 out of 5 cases (60%).Conclusions: In B-ALL, the most common aberration was myeloid antigen positivity followed by cross-lineage T-antigen expression. Aberrant CD33 expression was most frequently associated with t(9;22) followed by t(12;21).  Aberrant CD15 was most frequently associated with t(4;11).  No association with adverse hematological parameters or any significant increase in cytogenetic and molecular abnormality was noted in cases expressing aberrant antigen in comparison to cases not expressing aberrant antigens.
A study on the proportion of hearing impairment among percussionists in Thrissur district of Kerala
Authors: A. T. Jubina Bency , . Sarangi , Roy Sebastian , Mathew Shalu Sara , A. Shamseena , K. Smrithi , G. Unnikrishnan U.
Published: February 2021

Background: Hearing loss is a cause of global concern. Percussionists are exposed to greater levels of continuous or intermittent noise than others. Little is known about the relationship between percussion activity and hearing impairment. The early detection of the same and subsequent management makes a significant reduction in the burden of health care services. The objective was to study the proportion of hearing impairment in percussionists in the district of Thrissur using an IOS based mobile application.Methods: A cross sectional study was done on percussionists from Thrissur district who has experience of more than five years and has no congenital or traumatic hearing loss. A predesigned semi structured questionnaire was given and hearing tests were done using a mobile application U hear in a sound proof setting to understand the current state of hearing ability amoung the percussionists.Results: A total of 39 subjects were involved in our study of which all were males. Mean age of our study population was 30.44+12.04. most of them were diagnosed with at least mild degree of hearing loss of one of the ear or both the ears. 15.4% of them had mild degree of hearing loss, 64.1% had moderate degree of hearing loss and 20.5% had severe hearing loss.Conclusions: The study shows percussionists are more exposed to sounds of various frequencies for longer duration, they are more prone to hearing loss. The study brought out that age is directly proportional to hearing loss, music induced hearing loss progress at a rate proportion to the work experience.
Effect of hot and cooled carbohydrate diet on glycemic response in healthy individuals: a cross over study
Authors: Dhar Amrit , Kumar Dinesh , Sharma Anil , Dewan Deepika
Published: February 2021

Background: Cooling of starch after cooking is known to cause starch retrogradation which increases resistant starch content. Resistant starch cannot be digested in the gut and acts as dietary fiber. The study aimsed to determine the effect of cooling of carbohydrate rich diet on glycemic response on healthy adults.Methods: The present study was a randomized, single blind, crossover study where 20 healthy subjects were selected. Two rice preparations were used, one freshly prepared hot, second, cooked and cooled at 4°C for 12 hours. All subjects were evaluated after giving both rice preparations separately with a crossover period of 7 days.  Glycemic response was checked over a period of 2 hours at various time intervals using ACCU-CHEK® Active glucometer.Results: Glycemic response with cooled white rice was better in comparison to freshly prepared hot white rice at all time points (mean±SD, 121.9±17.4 vs 128.0± 22.1 mg/dl). However, the difference in means at 30 mins was maximum and statistically significant (p<0.001).Conclusions: Cooled white rice yields better glycemic response when consumed by healthy individuals possibly due to formation of resistant starch.
Anaesthesia considerations in a case of Morquio syndrome with bilateral mechanical vertebral artery occlusion: a case report
Authors: Nagtilak Harshada Hanamant , Shah Nishita , Daftary Swati , Mehta Hemant
Published: February 2021

Morquio syndrome (MS) or mucopolysaccharidosis (MPS) type IVA is a progressive lysosomal storage disorder with autosomal recessive inheritance. Deficiency of enzymes N-acetyl-galactosamine-6-sulphatase and beta-galactosidase which compromises the catabolism of the glycosaminoglycans (GAGs) leads to excessive accumulation of GAGs in soft tissue, cartilage and bone causing severe skeletal dysplasia and difficult airway. Other systems commonly involved systems are cardiovascular, respiratory, neurological, ophthalmological, otolaryngological and hepatosplenic. Most of the patients with MPS survive up to second or third decade only. We present a case of 7 years old male child, known case of Morquio syndrome who presented with acute cerebral arterial stroke due to bilateral mechanical vascular occlusion of vertebral artery, posted for occipito-cervical fusion. Understanding Morquio syndrome, its airway and the anesthetic implications and careful planning of the anesthetic technique enabled us to manage this patient successfully.
Factors affecting self-efficacy against hypertension self-care in hypertension patients: a scoping review
Authors: Widiawatie Noni , Handayani Fitria , Sobirin Mochamad Ali
Published: February 2021

Hypertension is called the "silent killer" some individuals with hypertension are not aware of this problem and may even have no warning signs or symptoms. Low self-efficacy has referred to chronic disease self-care that individuals engage in various forms of hypertension self-care behavior. This scoping review aims to determine the factors that affect self-efficacy of hypertension self-care in hypertension patients. This study used a scoping review to identify factors that influence self-efficacy on hypertension self-care in hypertensive patients. Search relevant studies using a database: CINAHL, MEDLINE, Academic Search Ultimate, Francies Taylor, Sciencedirect and Google scholar. Inclusion criteria patient with hypertension, age >40 years with a span of 2011 to 2020. Factors that influence self-efficacy are intentional non-adherence, (β=-0.02, p=0.031), low adherence to treatment (β=-0.05, p=0.017), effectiveness of doctor communication (β=0.11), p<0.001), positive beliefs about treatment (β=0.13 p<0.001), and social support (β=0.05, p<0.001). These factors serve as basic data in the development of further research in the prevention of stroke risk, with hypertension management capabilities.
Diabetes as the risk of cancer: a literature review
Authors: Tedjamartono Theodore Dharma
Published: February 2021

Cancer is a non-communicable disease with high mortality and morbidity rates. Data recorded by GLOBOCAN in 2018 shows the number of cancer patients is reached 18 million people with a death rate of 9 million people and predicted to increase every year. Diabetes is known to affect morbidity and mortality in cancer patients through increasing cancer cell proliferation and the risk of metastasis. This literature study not only explains the epidemiology, but also the mechanisms underlying the association of diabetes to cancer in general. Literature search was done using four search engines from PubMed, ProQuest, Science Direct and Google Scholar in the last 5 year, but relevant older articles were included. Cancer occurs due to the carcinogenesis process. This process is complex, where normal cells do not immediately mutate and become cancer cells but through several stages. The possible mechanisms underlying carcinogenesis in diabetic patients are hyperglycaemia, hyperinsulinemia, chronic inflammation, genetic variation, obesity, and hyperlactatemia. Examination of sugar levels in cancer patients, as well as cancer screening in patients with diabetes need to be done to detect early events and reduce morbidity and mortality.
Trends and outcomes in the management of vascular trauma: institutional experience at a level 1 trauma center
Authors: Weller Justin , Bowles Madison
Published: February 2021

Background: Vascular trauma remains a complex area for clinicians and its management is constantly evolving. The increasing use of endovascular modalities and non-operative management has led to significant changes in the treatment of vascular trauma. The aim of this study was to identify the current management and outcomes of vascular trauma at a Level 1 trauma centre in Queensland, Australia and compare this with the current literature.Methods: All individuals who presented to GCUH with vascular injuries between January 2014 and December 2019 were identified from the GCUH trauma database. A descriptive analysis was performed on this cohort.Results: 213 patients were identified in our cohort; 51 were managed non-operatively, 121 were managed with open surgery, 37 were managed endovascularly and 4 had a combination of open and endovascular intervention.Conclusions: The proportion of vascular injuries managed with endovascular interventions or non-operatively has increased within the study period. This study shows that the trends of management for vascular trauma in Australia are consistent with recent international literature.
Efficacy of haemorrhoidectomy versus haemorrhoidectomy with internal sphincterotomy in treatment of haemorrhoids: a retrospective randomized controlled trial study
Authors: Selvarajan Rajasekar
Published: February 2021

Background: Role of internal sphincterotomy along with hemorrhoidectomy in reducing the pain among the cases with hemorrhoids is still a debate among most of the surgeons. Hence this study was conducted to compare the efficacy of haemorrhoidectomy with or without internal sphincterotomy in reducing the post-operative pain among the patients with haemorrhoids.  Methods: A hospital based randomized controlled trial study was conducted among the patients with haemorrhoids undergoing surgical intervention for the same in department of general surgery in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, during the study period from July 2017 to December 2019. A total of sixty cases with haemorrhoids were included in the study. Patients in group A (n=30) underwent haemorrhoidectomy alone and group B (n=30) underwent haemorrhoidectomy along with internal sphicterectomy. Data entry was done using Microsoft excel and data was analyzed using Statistical Package for Social Sciences (SPSS) version 17. Results: In the present study, mean pain scores on first three post-operative days and the duration required to resume the normal activities was found to be low in the group who underwent haemorrhoidectomy with internal sphincterectomy compared to the group who underwent haemorrhoidectomy alone. Duration of surgical procedure and the complications were found to be similar in both haemorrhoidectomy with internal sphincterectomy group and haemorrhoidectomy alone, group.  Conclusions: Haemorrhoidectomy with lateral Internal Sphincterotomy is better in terms of less pain but the complications were similar in both groups.
Studying the clinical profile of blunt hepatic trauma
Authors: Pal Vijay , Arora Bhavinder Kumar , Singh Rohit , Mittal Gourav , Shekhawat Monika , Garg Neha , Sirohi Vivek
Published: February 2021

Background: The liver is the largest intra-abdominal organ and is considered to be the second commonest organ to be injured in blunt abdominal trauma. Blunt hepatic injuries due to road traffic accidents are the sixth leading cause for death in India. Approximately 15-20% of abdominal injury presents as hepatic trauma and is liable for 50% of death resulting from abdominal trauma. The mortality rate is higher with blunt hepatic trauma than penetrating injuries. The advent of improved and expeditious imaging technologies amid advances in critical-care monitoring, prompted a significant shift towards conservative management of solid-organ abdominal injuries.Methods: The study was conducted over 96 patients in General Surgery Department, PGIMS, Rohtak with a history of blunt hepatic injury. The study duration was from 16th May 2018 till 1st June 2020. The aim of the study was to evaluate the pattern of blunt hepatic trauma and the patterns with which they presented in the emergency department.Results: In this study, 98.96% of the patients were managed conservatively whereas only 1.04% of patients needed surgical intervention. Conservative approach was possible because of strict patient monitoring, availability of experienced surgeons and radiologists, good intensive care unit care.Conclusions: The study concluded that conservative management of the patient is better than operative management and can be done in the patients who are hemodynamically stable. Most of the patients settle after 48 hours if managed conservatively.
RIPASA score or Alvarado score: diagnosing acute appendicitis
Authors: Parmeshwar Talabadi , Ghag Geeta Sandeep , Nandu Vipul Versi
Published: February 2021

Background: Appendicitis is a much studied about topic since the early years. Even with the advances in imaging techniques, appendicitis still relies upon clinical examination as a main resort of diagnosis. To aid this, several scoring systems have been developed taking into account various symptoms, signs and some basic laboratory investigations. Many studies have been done worldwide to check the sensitivity and specificity of each of these clinical scoring systems in the diagnosis of acute appendicitis. Though the most famous one is the Alvarado scoring system, there is none universally accepted scoring system used for diagnosis so far.Methods: 100 patients with RIF pain and who were suspected of acute appendicitis were evaluated for a period of 24 months. Evaluation was done with regards to RIPASA and Alvarado scoring in all these patients. All the results of both the scoring systems were reported and correlated with histopathological findings. Statistical test were applied to calculate the p value for the association between the variables of studied.Results: There was definitive agreement that both the scoring systems are positively correlating with each other with respect to the diagnosis of the disease (p value 0.0001). The difference in diagnostic accuracy of 25% between the RIPASA score and Alvarado score was statistically significant (p<0.0001). On analysis with chi-square test, both scores are significant at level 1 (p=0.0001). But RIPASA score has higher sensitivity and diagnostic value when compared to Alvarado score.Conclusions: The use of RIPASA scoring would help in decreasing the unwarranted patient admissions and also expensive radiological investigations.
Computed tomography severity index and serum CRP concentration for predicting the severity of acute pancreatitis
Authors: Nagarchi Abdul Rashid , Babu Manohar , Saad Syed
Published: February 2021

Background: The assessment of the severity of pancreatitis is important for management of this challenging disease. An accurate system which could predict the severity and identify the local extent and complications of a serious inflammation is beneficial for the patient outcome. The aim was to establish the value of the CTSI in predicting the severity of acute pancreatitis and to compare it with the accuracy of the serum CRP concentrations.Methods: Prospective clinical study based on analysis of 55 patients. Each patient underwent thorough clinical and biochemical analysis and CECT abdomen. CTSI within 5 days, serum CRP level 48 hours after admission.Results: The mean values of predictive markers in the mild and the severe pancreatitis groups were: computed tomography severity index 1.26 and 6.30 (p<0.001) and CRP 96.0 mg/l and 192.4 mg/l (p<0.001), respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for the CTSI (greater than 3: 85%, 98%, 92%, 95%, and 95%) and for CRP (equal to, or greater than 150 mg/l: 85%, 74%, 50%, 94%, and 76%).Conclusions: We found a close correlation with CRP levels and the CTSI of patients having severe pancreatitis and a CTSI score greater than 3 had a serum CRP level in excess of 150 mg/l. CRP is incapable of identifying local complications. The CTSI is a reliable method for staging the severity of acute pancreatitis and showing the local extent of the inflammation and the occurrence of local complications.
Efficacy of laparoscopic guided transversus abdominis plane block in post operative analgesia requirement in elective laparoscopic cholecystectomy
Authors: Khoja Hanuman Ram , Kunchagi Dhanush Kumar , Joshi Praveen Kumar , Om Prabha
Published: February 2021

Background: Minimal invasive surgery has many advantages. In order to maintain and control  pain, one of the most effective technique is Transversus abdominis plane (TAP) block technique. Aim of the study was to demonstrate the efficacy of laparoscopic guided transversus abdominis plane block in post-operative analgesia requirement in elective laparoscopic cholecystectomy.Methods: It was a hospital based prospective interventional study. Sample size was calculated at 0.05 α error and 80% study power assuming mean difference of VAS score between TAP block +/A group  and TAP block- /B group is 1 and standard deviation of VAS score 1.3 among patients undergoing elective laparoscopic cholecystectomy.Results: A total of 60 patients were enrolled in this study. The mean age of group A was 48.56 years and for group B was 43.53 years. In group A 80% patients were females and for group B 83.3% patients were females. There was significant difference in VAS score at immediate post operation, at 1 hour, at 6 hours, at 18 hours and at 24 hours as p value was <0.0001 for all these groups. The mean VAS score was recorded less in group A at all the time duration compared to group B.Conclusions: With advantages like maximum safety, efficacy, potential for lower visceral injury risk and shorter operational time and other numerous advantages (decreased analgesic requirements, etc.)  laparoscopic-guided TAP block counts as an ideal abdominal field block in the patients.
A comparative study on RIPASA and modified Alvarado score in the diagnosis of acute appendicitis in tertiary care hospital
Authors: Rao Kodenge Raghavendra , Harika D. Navya Sesha , Narayana Suragani V. , K. S. Vinodh Kumar , Kumar Yadav Chavala Pavan , Usha Kiran Samireddi Harshita , Pavani Namburi
Published: February 2021

Background: Acute Appendicitis is common surgical emergencies with a lifetime prevalence of approximately 1 in 7. Despite advances in diagnosis and treatment; acute Appendicitis is still associated with morbidity (10%) and mortality (1-5 %). Presentations of acute Appendicitis can mimic various acute medical and surgical conditions, and the diagnosis is predominantly a clinical one-different scoring systems used for aiding in early diagnosis of Acute Appendicitis and its prompt management. Alvarado score and RIPASA score are the most popular ones. So we retrospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute Appendicitis in Indian population.Methods: In this study, we compared RIPASA score and Alvarado scoring system retrospectively by applying to 74 patients. This study period from November 2018 to March 2020. Both scores were calculated for patients presented with right iliac fossa pain. Sensitivity, specificity, positive predictive value (PPV), negative predictive (NPV), diagnostic accuracy for RIPASA and Alvarado system was calculated.Results: The sensitivity and specificity of the Alvarado score were 85.07% and 57.14% respectively. The sensitivity & specificity of RIPASA score were 91.04% and 71.42% respectively. Accuracy of the Alvarado scoring system is 82.44% and for RIPASA scoring system is 89.18%. The results show that the RIPASA scoring system is a better diagnostic tool for the diagnosis of Acute Appendicitis.Conclusions: RIPASA scoring system is simple, accurate, convenient, and more specific scoring system than the modified Alvarado scoring system for the Indian population.
Surgical management and follow up of patients with bile duct injuries in tertiary health care institute
Authors: Akram Shahnawaz , Ali Sadaf , Shah Omer Javid , Santosh Anzar
Published: February 2021

Background: Bile duct injury is an iatrogenic catastrophe associated with significant mortality, morbidity, decrease quality of life and higher rates of subsequent litigation. We conducted a study to analyse the presentation and pattern of bile duct injury managed at our surgical unit. Operative details, type of surgery, complications associated with the repair and Follow up in terms of liver function tests.Methods: The study included evaluation of 56 patients who had suffered bile duct injuries and then were subsequently being managed surgically at our institute retrospectively from October-2009 to 2012 and prospectively onwards till October- 2014. The mean follow up period in case of our study was 26.8 months. The follow up LFTs were performed at regular intervals. MRCP was used as a gold standard investigation.Results: jaundice (64.2%) was the most common presentation. Injuries noted were, type E1 in 16 (28.5%),type E2 in 11(19.6%), type E3 in 1 (1.8%), type A in 2 (3.6%), type B in 3 (5.4%), type C in 5 (9%) and type D in 18 (32.1%) of patients. Roux-en-y Hepatico-jejunostomy was the common definitive repair performed (85.7%) with various modifications. The mean bilirubin levels and ALP levels showed a downward trend in follow up .5 patients were readmitted with features of cholangitis in which 2 patients were reoperated and 3 patients were managed conservatively, 2 patients died.Conclusions: The management of patients with BDI is a challenge for a surgeon and often requires the skills of experienced hepatobiliary surgeons at tertiary referral canters.
Fecal impaction and colon obstruction
Authors: Saimeh Haitham A.
Published: February 2021

Fecal impaction is an important cause of lower gastrointestinal tract obstruction and carries high risk of mortality and morbidity, it is highly emphasized to early identify it to minimize any risk of complication. Recurrence is common, therefore preventive modalities as increasing the dietary fiber content to 30 gm/day, water intake, or discontinuation of medications that contribute to colon hypomotility. In this paper, I am pointing off the early recognition and treatment of fecal impaction to avoid lethal complications, therefore physicians should have higher level of suspicions because if fecal impaction goes unrecognized this will lead to fatal morbidity and mortality.
A case of traumatic isolated duodenal perforation due to blunt abdominal trauma
Authors: Ansari Waqar A. , Gadekar Deepak B. , Ansari Asif , Ghosh Ahana , Malgaonkar Sumit , Swami Aishwarya
Published: February 2021

Isolated duodenal injury following blunt abdominal trauma is a rare clinical entity and is often unnoticed leading to delay in management thereby increasing morbidity and mortality. We report a case of isolated duodenal perforation following blunt abdominal trauma and highlight the challenges and decision-making dilemmas associated with its management. The present patient had two perforations, one on the anterior and the other on the posterior wall of the duodenum. Complete duodenal mobilization during laparotomy and a decision of performing pyloric exclusion aided momentously in the management.
VIVÊNCIAS DE JUVENTUDES EM ESPAÇOS URBANOS: GRAFITE E PICHAÇÃO COMO EXPRESSÕES DE SUBJETIVIDADE
Authors: Bueno Luciano Domingues , Rocha Maria Laura Barros da , Oliveira Adélia Souto
Published: February 2021

Grafites e pichações são recursos privilegiados de aproximação entre processos psicossociais constitutivos das juventudes e movimentos sociais. Para tanto, objetiva-se refletir sobre as juventudes no contexto urbano e estabelecer suas relações psicossociais com os territórios e seus processos de constituição mútua, por meio do registro de 224 fotografias em 24,2 quilômetros de vias públicas de Maceió, Alagoas. Na análise qualitativa delinearam-se 326 inscrições, presentes nas imagens, com as categorias temáticas: Assinaturas, Torcida Organizada e Política. Os resultados indicam o grafismo urbano como objetivação da pluralidade das juventudes em suas marcas, discursos e utilização de via alternativa aos canais hegemônicos de comunicação. Conclui-se que as inscrições urbanas grafites/ pichações são expressões da subjetividade. Ideias políticas, culturais, desportistas, vivenciadas na cidade são compartilhadas e difundidas, por essas produções, e constituem memória, com seus conteúdos sociais e históricos, ou seus efeitos estéticos - das formas e cores - que as constituem.
NONIMATA 2019
Authors: Neves Silva Rosemary Francisca
Published: February 2021

A revista Fragmentos de Cultura da Pontifícia Universidade Católica de Goiás agradece aos avaliadores ad hoc pelo excelente trabalho colaborativo aos editores e autores dos trabalhos publicados no ano de 2019, o que certamente muito contribuiu para a manutenção do nível científico de nossa revista.
NOS VENTOS DA MUDANÇA: UMA EXPERIÊNCIA INTER E TRANSDISCIPLINAR
Authors: Martins Filho José Reinaldo Felipe , Batista Eurípedes Garcia , De Jesus Leonice Ângela
Published: February 2021

Este artigo tem em vista apresentar a experiência desenvolvida junto aos estudantes das turmas do 9º ano do Ensino Fundamental da Escola Centro de Orientação e Valorização da Adolescente e Mulher, no munícipio de Aparecida de Goiânia, em Goiás. Está, portanto, disposto como estudo de caso e imersão junto à realidade dos alunos. Tendo como base a tentativa de superação de um modelo educacional altamente centrado na perspectiva disciplinar, o projeto em questão tentou romper com um olhar fragmentado acerca dos conhecimentos, dispondo-os de maneira simultânea e não hierarquizada, chamando a atenção para o fato de que a experiência concreta não se constroi de forma cindida, mas articulada – e daí a necessidade de sempre relacionar a teoria e a prática. Para isso, valeu-se de saberes oriundos de diferentes áreas, tais como a geografia crítica, a língua inglesa e a música, dispondo-as de forma simultânea e colaborativa. Entre outras contribuições, tem-se em vista a discussão de uma educação que rompa com o sistema disciplinar, o que apenas será possível pondo em questão o paradigma atual e substituindo-o por novas chaves de leitura, por ora inter e transdisciplinares.
TERREIRO TUMBENCI E O USO DAS PLANTAS QUE CURAM: MUTALOMBÔ E CATENDÊ, PROTEGEI OS NOSSOS CORPOS
Authors: Costa Hildete Santos , Vitorino César Costa
Published: February 2021

Apresentar dados sobre Candomblé Angola na cidade de Salvador –BA é um grande desafio devido ao fato de escassa produção acadêmica. É possível observar que, quase sempre, há reflexo da concentração de nações jeje e nagô na cidade de Salvador e no Recôncavo baiano. Nesse artigo, escolhemos dar voz a Mameto Lembamuxi, líder religiosa de tradição angolana, que no século XXI mantém-se fiel aos ensinamentos do candomblé Angola. A Mameto,com as orientações do Caboclo Pedra Preta, no bairro periférico do Beiru,na cidade de Salvador – Ba,cultua as tradições,rezas,cânticos e recomenda banhos de folhas sagradas.Nas poderações feitas por Nunes (2017,p.210)“a indumentária dos caboclos geralmente está concentrada no uso de plumas coloridas, a exemplo de arcos, flechas e cabaças.O jogo de semelhanças entre Candomblés de Caboclos e Candomblés de Angola, Congo-Angola, aqui parece se aproximar ”.
Transformação digital dos governos brasileiros: Satisfação dos cidados com os serviços públicos digitais
Authors: Lafuente Mariano , Leite Rafael , Porrúa Miguel , Valenti Pablo
Published: February 2021

O documento resume os resultados de uma nova pesquisa de satisfação cidadã sobre os serviços públicos digitais no Brasil. Mostra que a população brasileira está conectada e se considera bem adaptada ao mundo digital, mesmo com desigualdades esperáveis de idade, nível de educação formal e renda. Nos três níveis de governo, o nível de satisfação com os serviços digitais foi muito superior aos níveis de insatisfação. Uma parte importante da população não conhecia a oferta de serviços digitais dos municípios. A diferença de satisfação com os serviços digitais do setor privado é importante, marcando a necessidade de aprofundar e acelerar a transformação digital no setor público. A pesquisa foi realizada entre os meses de outubro e dezembro de 2020, com uma amostra representativa da população brasileira de idade superior aos 16 anos, entrevistando 13.250 pessoas distribuídas em todo o território nacional. Teve como objetivo coletar informações sobre a adaptação dos cidadãos ao mundo digital, seu nível de conectividade percebido e uso de internet e sua avaliação sobre a qualidade dos serviços digitais do setor público (com foco no nível estadual, mas também com perguntas sobre os níveis federal e municipal) e do setor privado, entre outros temas.
Cerrando la brecha de conectividad digital: Políticas públicas para el servicio universal en América Latina y el Caribe
Authors: García Zaballos Antonio , Huici Héctor , Puig Gabarró Pau , Iglesias Rodriguez Enrique
Published: February 2021

Este documento analiza el estado de los fondos de servicio universal en América Latina y el Caribe y desarrolla recomendaciones específicas relativas a criterios de eficiencia, estabilidad, interoperabilidad, flexibilidad, sostenibilidad e igualdad de oportunidades. Garantizar una infraestructura de telecomunicaciones que sirva a todos por igual, con independencia de la ubicación geográfica y de la condición socioeconómica de cada uno, es una labor muy compleja en la que los países en desarrollo deben hacer frente a escenarios donde predominan las grandes cantidades de territorio, población rural dispersa, y bajo poder adquisitivo. En sus inicios el servicio universal estaba enfocado en la extensión del servicio de telefonía de voz fija y servicios como los de emergencias, guía telefónica y el acceso a ellos por parte de determinados usuarios. Hoy en la mayoría de los países de la región el concepto de universalización ha cambiado de telefonía fija al de acceso a la banda ancha.
Dialectical Materialist Logic of “I Will Work Selflessly and Live up to the Expectations of the People”
Authors: Li Qinghong
Published: February 2021

“I will work selflessly and live up to the expectations of the people” is the true expression of seeking happiness for the people in the new era. In the decisive year of building a moderately prosperous society in an all-round way, further implementing the core concept of “serving the people” in the new era will promote the speed of building a well-off society. “I will work selflessly and live up to the expectations of the people” firmly takes the people as the center, which shows that our party adheres to guiding our country’s practice with the basic viewpoint of Marxism, takes the
people’s aspiration as the direction of individual struggle, and shows the great spirit of responsibility. Thinking “I will work selflessly and live up to the expectations of the people” with dialectical materialist logic will promote the people of the whole country to deeply understand the purpose of our party and further grasp the party’s original heart in the new era.
The Words We Use, the Actions We Take, and the Perceptions We Hold: First-step assessments to inform wellness curricula and burnout prevention programming
Authors:   Western Michigan University, Horneffer-Ginter Karen
Published: February 2021

Introduction: In response to concerns about burnout, many medical schools have been initiating wellness curricula and programming. A key to the success of these efforts is having engagement from targeted audiences. Gathering input from these groups regarding preferred lexicon, wellness actions, and perceptions of judgement or guilt around such actions can help in developing and promoting such curricular and programmatic offerings. Engagement is especially important when it comes to the predictors of burnout (e.g., self-care, self-compassion, and emotional self-disclosure). Methods: Utilizing a focus-group methodology as a preliminary step, medical school faculty and students discussed terms regarding burnout predictors. Thematic analysis using grounded theory was used to analyze transcriptions with the generated preferred terms being incorporated into a follow-up survey. Surveys were completed by 23 faculty, 65 students, 23 residents, and 124 staff (n = 235). The survey asked for ranked preferences of lexicon terms, ratings of engagement and importance around wellness actions, perceptions of judgement and guilt around engaging in self-care, and disengagement and exhaustion via the Oldenburg Burnout Inventory. Results: Overall, results revealed a preference for alternative language (i.e., “personal well-being” (p < 0.001), “being kind to yourself” (p < 0.001), “sharing your feelings” (p < 0.001)) compared to phrases commonly used in the wellness literature (i.e., self-care, self-compassion, and emotional self-disclosure). Engagement in self-care (p < 0.001), and self-compassion actions (p = 0.001) were inversely correlated with burnout, while perceptions of being judged (p < 0.001) and feeling guilty for self-care (p < 0.001) were positively correlated with burnout. Conclusion: Incorporating preferred lexicon terms and mitigation factors (correlating with the reduction of burnout) into wellness curricular development is encouraged as a valuable initial step for medical schools and organizations as they reach out to their intended audiences.
Adsorção do corante verde de malaquita utilizando casca de banana e sabugo de milho como adsorvente
Authors: Dantas Sandra Cristina , Teixeira Gustavo Fernandes , Ferrari Júlia Galvani , Ruy Letícia Motta , Trindade Renata Soares , Carmello Victória De Oliveira
Published: February 2021

O Brasil é responsável por 3% da produção mundial de indústrias têxteis, segundo a ABIT. E grande parte dos corantes utilizados são descartados de maneira incorreta, causando poluição dos corpos hídricos receptores, além de serem altamente tóxicos aos seres humanos e, por esse motivo, precisam ser retirados, visto que não são retirados por processos de tratamento comuns. O objetivo do presente trabalho foi comparar a adsorção do corante verde malaquita utilizando casca de banana e sabugo de milho, com tratamentos in natura, em ácido e em base, observando os diferentes comportamentos e rendimentos de cada um. O equilíbrio de adsorção do corante foi atingido depois de 45 min para a casca de banana, e entre 60 e 80 min para o sabugo de milho, para todos os tratamentos. O melhor modelo cinético encontrado foi o de pseudo segunda ordem para ambas as biomassas em todos os tratamentos, sendo que a maior remoção com casca de banana como adsorvente foi com o tratamento alcalino com solução inicial de 5 mg/L. Já para o sabugo de milho, a melhor remoção foi com tratamento ácido com solução inicial de 100 mg/L. As eficiências encontradas foram de 99,0968% para a casca de banana e de 90,8581% para o sabugo de milho. O modelo das isotermas que melhor se ajustou foi o de Freundlich, exceto para a casca de banana com tratamento em água, que o melhor modelo foi o de Tóth, além disso, todas tiveram tendências lineares, exceto para a casca de banana com tratamento em água, que apresentou comportamento favorável.
AS CONTRIBUIÇÕES DA LINGUAGEM AUDIOVISUAL NAS PRÁTICAS EDUCATIVAS NA EDUCAÇÃO INFANTIL
Authors: Martinello Ana Caroline , Giacomazzo Graziela Fátima
Published: February 2021

Este trabalho buscou verificar contribuições da linguagem audiovisual e os recursos oferecidos por ela nas práticas educativas na Educação Infantil nos municípios de Criciúma e Forquilhinha. Esse foi o objetivo geral da pesquisa que teve como objetivos específicos: identificar quais recursos audiovisuais são utilizados pelos professores; compreender qual a importância da linguagem audiovisual para os professores da Educação Infantil; verificar em quais práticas educativas os recursos audiovisuais são trabalhados; e verificar se há, no Projeto Político Pedagógico da escola, orientação para o uso da linguagem audiovisual. Caracteriza-se como pesquisa qualitativa, sendo que a análise de dados, realizada a partir do referencial teórico contemplou autores Amante (2011), Brasil (2017), Brasil (1996), Coutinho (2006), Duran (2010), Kenski (2008), Libâneo (2004), e Mercado (2002), Martin-Barbero (2000), Moran (2006) e Tardif (2004), que discutem linguagem audiovisual. A pesquisa, por meio de entrevista, foi realizada com quatro professores da Educação Infantil de rede pública e filantrópica nos municípios de Criciúma e Forquilhinha. Os dados coletados foram organizados em tópicos e analisados a partir do referencial teórico. Os resultados obtidos mostram que os professores da Educação fazem uso dos recursos audiovisuais sem suas práticas educativas.Palavras-chave: Linguagem Audiovisual. Práticas educativas. Recursos tecnológicos. Professores da Educação Infantil.