bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination and Risk Associated with Phthalic Esters Distribution from the Ekpan River, Effurun, Delta State, Nigeria
Authors: Edjere Oghenekohwiroro , Igiegie Daniel , Rim-Rukeh Akpofure
Published: July 2022

Phthalates are additives or plasticizers added to make plastics soft. However, they could leach into the environment and cause harm to human health when contacted. Sites along the Ekpan river have been used for open dumping of refuse. The river also serves as a point source for the disposal of effluents from the Warri Refinery and Petrochemical Company Limited (WRPC). Hence, the need for a preliminary study of phthalates across the river system. Surface water samples were collected from six points along the Ekpan river. Phthalates were extracted using USEPA standard method 3535 and EPA method 8061. Gas Chromatography-Mass Spectrometer (GC-MS) was used for the analysis of six PAEs including di-n-butyl phthalate (DnBP or DPX), butyl benzyl phthalate (BBP), di(2-Ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (D-n-OP)), Dimethyl phthalate (DMP), and Diethyl phthalate (DEP) in the river system. Analysis of phthalates in the Ekpan river system showed that DEP across the Effurun river system ranged from 4.22 – 13.81 μg/L, DPX; 3.03 – 11.5 μg/L, BBP; 0.11–1.39 μg/L, DEHP; 0.12 – 3.33 μg/L. D-n-OP and DMP were below the limit of detection of the analytical instrument used (0.1 μg/L). The distribution of PAEs along the network of the river revealed that the sampling sites in the urban region were more contaminated with PAEs due to urbanization and an increase in population across the river network. Human health risk assessment revealed that the hazard quotient (HQ) for DEP, DPX, DEHP, and D-i-NP were below 1, indicating an acceptable risk of PAEs via ingestion or bathing of the river water. In addition, the Hazard Index (HI) via ingestion and bathing of the river water was less than 1 indicating acceptable risks. According to this study, these PAEs congeners are safe for toddlers, adolescents, and adults to eat and bathe in tap water. Even DEHP, the only PAEs congener designated as a carcinogenic agent by WHO, was shown to have a tolerable cancer risk. These findings indicate that there is no harm to children, adolescents, and adults from DEHP in the river water studied.
Enumeration of Triangles and Hamiltonian Property of The Zero-Divisor Cayley Graph of The Ring G(Zₙ,⊕,⊙)
Authors: Devendra Jangiti , Madhavi Levaku , Nagalakshumma Tippaluri
Published: July 2022

In this paper an enumeration method to find the number of triangles in the zero-divisor Cayley graph G(Zₙ,D₀ ) associated with the ring (Zₙ,⨁,⨀),n≥1 of integers modulo n,  an integer and its subset D0 of zero-divisors is presented. Further it is shown that this graph is Hamiltonian, not bipartite  and  Eulerian graph when n is odd.
Hypertension and Physical Intimate Partner Violence among Female HIV Patients in Butiama District, North-Western Tanzania
Authors: Nyangi Getera Isack , Mackanja Elizabeth Emmanuel
Published: July 2022

Highly active antiretroviral therapy (HAART) has greatly improved life expectancy and quality of life among people living with HIV. However, hypertension has been reported to increase among HIV patients. Yet the exact cause has not been established. We conducted a cross-sectional study involving female HIV-infected patients on ART who attended care and treatment clinics (CTCs) between August 2020 to December 2020. The participants were consecutively enrolled until the targeted sample size was attained. Hypertension was defined as systolic blood pressure (SBP) ≥ 140mmHg and, diastolic blood pressure (DBP) ≥ 90mmHg. The exposure variable of interest was self-reported physical intimate partner violence in the last 12 months which was collected and defined according to World Health Organization (WHO) criteria. We investigated 526 female HIV patients on ART with a mean age of 42.8 years. Of all participants, 87.1% were peasants, about 60% were greater than 60 years old and 22.5% were currently consuming alcohol.  23.8 % of the participants had reported a history of physical intimate partner violence in the last 12 months. The overall prevalence of hypertension in female HIV patients on ART was 31.4% and it was not statistically significant associated with physical intimate partner violence in the last 12 months before and after adjusting for other covariates. The prevalence of hypertension in female HIV patients on ART was higher but was not found to be influenced by physical intimate partner violence in the last 12 months. Further studies are recommended to investigate the influence of physical violence on hypertension among HIV patients.
INTERNALISASI NILAI-NILAI KEARIFAN LOKAL MASYARAKAT MELAYU DALAM CERITA RAKYAT SEI TUALANG RASO DI SMP IT DARUL FIKRI TANJUNGBALAI
Authors: Simarmata Efy Handayani , Syahfitri Mita , Kurniawan Rahmad Edi
Published: July 2022

Kajian ini dilakukan untuk menganalisis tentang nilai-nilai kearifan lokal dan internalisasinya dalam cerita rakyat Sei Tualang Raso di SMP IT Darul Fikri Tanjung Balai. Cerita Rakyat Sei Tualang Raso merupakan salah satu cerita rakyat yang terdapat di Kota Tanjung Balai dimana ceritanya tentang Tualang dan Raso yang sama-sama anak dari Raja dan saling mencintai kemudian bersatu hingga akhirnya cerita ini menjadi nama salah satu kecamatan yang ada di Kota Tanjung Balai. Terdapat beberapa unsur kebudayaan pada orang Melayu di Tanjung Balai diantaranya adalah sistem religi, sistem mata pencaharian, sistem bahasa, sistem sosial, sistem pengetahuan, sistem teknologi, dan sistem kesenian. Dan internalisai nilai pendidikan dari cerita rakyat Sei Tualang Raso terhadap siswa di SMP IT Darul Fikri Tanjung Balai adalah nilai religius, nilai kejujuran dan nilai kerjasama.
Performar como mujer en el kárate Olímpico: un análisis cualitativo del Mundial 2018
Authors: Turelli Fabiana Cristina , Kirk David , Tejero-González Carlos María , Vaz Alexandre Fernandez
Published: August 2022

Con esta investigación hemos tratado de verificar procesos subjetivos de negociación del lugar de las mujeres en el kárate, entendido como masculino, y elevado a deporte olímpico. Para tanto, realizamos un estudio cualitativo de carácter interpretativo, valiéndonos de las técnicas de recogida de informaciones observación sistematizada no-participante y análisis documental, contrastando los materiales provenientes del campo con la literatura. Nuestra base teórica ha estado apoyada en trabajos etnográficos y antropológicos que tienen en común, también con nosotros, algún grado de inspiración en la teoría crítica del deporte. La observación se ha centrado en el 24th Karate World Championships Madrid 2018. Con los resultados y discusión percibimos preliminarmente, pues se trata del inicio de una investigación mayor, algunos elementos para la reflexión, por ejemplo: sobre la mujer karateca recae una gran exigencia de eficiencia técnica; se espera que ella presente capacidad de enseñar la feminidad hegemónica de forma objetiva, algunas veces incluso atestando orientación heterosexual; se valora en el medio que la mujer corresponda a unos estándares de belleza estipulados por la industria de consumo, incluyendo estereotipos relacionados a la sensualidad. En conclusión, el espacio designado a la mujer en este ambiente masculino parece requerir negociaciones para su aceptación y pertenencia.
Fixed point theorems of contraction type mappings and some of their applications in fractal geometry
Authors: Barcz Eugeniusz
Published: July 2022

The paper contains several theorems about the Browder type contraction fixed points and some of their applications
What do we mean by mean?
Authors: Barańska Barbara , Zambrowska Małgorzata
Published: July 2022

In order to be successful with a certain concept at school, it is often sufficient to master some types of tasks, without having to be aware of the different perspectives that a concept can be viewed from. It is, however, definitely not enough when the goal is to understand mathematics and become flexible and creative in solving mathematical tasks. Not only school students, but also prospective teachers should be encouraged to reflect on what particular concepts actually mean and how they can be thought of.

In this article we focus our attention on the concept of mean. In the introduction we outline the gaps that our paper partially fills. Then we provide a brief review of how the Polish core curriculum and two very popular mathematics textbook series (one each for primary and secondary school) treat the topic of means. Next, we present results from a study conducted on a group of first-year students of mathematics and a group of teachers undertaking postgraduate studies qualifying for teaching mathematics as a second subject. We show the results obtained in two tasks concerning the arithmetic and geometric mean. The paper ends with several teaching suggestions and recommendations for mathematics teachers’ educators.
Modernize the teaching of mathematics at the secondary level through R programming
Authors: Amimour Amine , Lynda Benbessai, Kada Becharef, Hafida Mokhenfer
Published: July 2022

Teaching mathematics using programming has cognitive benefits, improves practical skills, and provides powerful independent thinking and problem-solving strategies. R is a free software environment and one of the most popular programming tools, which allows for solving various mathematical problems through coding. In this work, we will use the R language to solve some problems posed in complex numbers and cover some exercises from the third-grade mathematics textbook in Algeria.
Anatomical risks and complications associated with myocardial bridging
Authors: Mahajan Rupali , Meshram Preeti , Ranadhir Nisha Vinod , Hattangadi Shantha
Published: July 2022

Objective: Myocardial bridging (MB) is an asymptomatic, benign, and congenital coronary anomaly with several possible manifestations. MB is formed by a segment of a coronary artery taking an intra-myocardial course.  As of date, huge knowledge gap exists in the literature in terms of MB and its associated complications.

Methods: This single-centre, observational, non-randomised study was conducted over a period of 20 months to identify the rare anomalies such as MB using coronary angiograms.

Results: Eight of 400 cases screened have been found to have MB bridging in mid left anterior descending artery (LAD) segment. The male to female ratio was 7:1 all within an age range of 24 years to 45 years. Most of the patients were asymptomatic with no history of drug usage (6/8) and family history (3/8) of coronary disorders. In symptomatic cases, the most common presenting symptoms were observed to be typical chest pain, dyspnea, nausea, light-headedness, or headaches, diaphoresis, and tachycardia. In most of the patients, MB showed systolic shortening with resultant flow limitation on coronary angiography. The segments were reported to be 1 mm to 10 mm in size and traversed 1 cm to 3 cm length. All the patients were treated symptomatically and were kept on follow-up. No mortality was observed in any case with MB.

Conclusion:  Even though MB is a benign condition, but its vast array of related complications was reported to be life threatening and require prompt diagnosis and treatment. This study focus on such MB related risks by highlighting the importance of differential diagnosis and the treatment followed by to avoid all possible complications in all those patients presenting with possible signs and symptoms.
Considerations for a shared decision-making conversation when initiating food oral immunotherapy
Authors: Greenhawt Matthew , Fleischer David
Published: July 2022

Oral immunotherapy (OIT) is an office-based procedure that offers potential treatment of immunoglobulin E mediated food allergy. OIT has multiple benefits, e.g., the ability to desensitize the individual with food allergy, which shifts the eliciting dose threshold required in that individual to trigger an allergic reaction, and also potentially to decrease the severity of any resulting reactions. However, OIT is not a cure and has distinct risks, including the risk of allergic reactions (including anaphylaxis) from the therapy itself, the potential risk of developing eosinophilic esophagitis (or similar clinical symptoms without a formal biopsy), and logistical issues in coordinating when to give the daily dose, and there are still uncertain intermediate‐to‐long-term outcomes with regard to OIT. The decision to start OIT is complex and potentially nuanced. Shared decision-making is a process that allows the patient and family and the clinician to undergo a mutual discussion of the risks, benefits, alternatives, and other considerations with regard to a medical decision (such as starting OIT) whereby there is an exchange of information that allows the patient and family to formally clarify and express their values and preferences with regard to facets of the decision in this particular context. The goal is for the patient to be able to make a fully informed decision that is reflective of his or her goals, values, preferences, and desires. This article outlined some of the key considerations to discuss with parents and patients before enrolling in an OIT program with regard to the risks and benefits, to assist in engaging in shared decision-making and obtaining informed consent.
A practical focus on legume oral immunotherapy
Authors: Chua Gilbert T. , Chan Edmond S.
Published: July 2022

Legumes other than peanut are an important source of protein and consist of a wide variety of species, such as soy, peas, chickpeas, lentils, and lupin. Due to their health benefits and the rising popularity of veganism, legume consumption has increased. Legume allergy, cross-sensitization, and cross-reactivity between different species have been reported in the literature and are increasingly recognized. Unlike peanut, oral immunotherapy (OIT) for nonpeanut legumes has not been well studied and published protocols are lacking. Future studies are needed to provide real-world data on the safety and effectiveness of nonpeanut legume OIT, and whether desensitization to one legume leads to desensitization to other legumes in patients with multiple legume allergy. Nevertheless, due to the abundance of clinical trial and real-world data for peanut OIT, it is reasonable to use protocols that substitute peanut protein with other legume protein when desensitizing individuals with nonpeanut legume allergy. Clinicians who are starting to offer legume OIT in their practices may consider starting with preschoolers, an age group for whom real-world data has shown the greatest safety and effectiveness.
Food allergy: History, definitions and treatment approaches
Authors: Purswani Pooja , Kim Edwin H.
Published: July 2022

Allergen-specific immunotherapy for the treatment of immunoglobulin E mediated food allergies, specifically oral, epicutaneous, and sublingual immunotherapies, are promising options that may provide an alternative to strict avoidance of the dietary allergen. Of these potential therapies,
oral immunotherapy is the furthest along in development, with strong evidence of efficacy in clinical trials, and has achieved regulatory approval. Nevertheless, oral immunotherapy may not be a suitable therapy for some patients due to the risk of adverse effects. In contrast to oral immunotherapy,
epicutaneous and sublingual immunotherapies have demonstrated modest efficacy in clinical trials, with a favorable adverse effect profile, which suggests that these therapies may be possible contenders to oral immunotherapy in certain clinical situations. Familiarity with the various treatment
approaches is vital for guiding patients and families as more therapeutic modalities become available for use outside of the research setting.
Practical aspects of oral immunotherapy: The importance of optimal office design and workflow
Authors: Jones Douglas H. , Williams Aerik , Nguyen Lisa
Published: July 2022

Oral immunotherapy (OIT) is an emerging treatment, but it is more than products and protocols. Office setup, including spacing, staffing, and logistics, is critical to assess to fully implement OIT into clinical practice. To provide insights into what needs to be considered in setting
up an office to practically implement OIT into clinical practice. Most of the clinical research about OIT focuses on the products and protocols used for OIT. However, to safely and effectively integrate this into clinical practice, there are many practical aspects that need to be considered.
Proper staffing, office space, scheduling, and on-call responsibilities all need to be considered because OIT will impact all of these aspects of practice. We provide suggestions and considerations as you think through these vital logistics in your office. These are practical considerations
that must be determined to effectively handle OIT in an office setting. OIT products and protocols are one aspect of OIT. Actually delivering the treatment with staff, office space, and handling the patient needs after hours is really when OIT becomes more of a reality for the physician and
the patient.
A practical focus on egg oral immunotherapy
Authors: Anagnostou Aikaterini
Published: July 2022

Egg allergy usually develops in the first year of life, with an estimated prevalence of 2.6%‐9%. Rates of resolution and timing vary, with approximately one-third of patients outgrowing their egg allergy by age 6 years. Persistent egg allergy has been associated with high egg white specific immunoglobulin E levels and sensitization to the egg allergen component Gal d 1, which is resistant to heat and digestion. These individuals seem to have a more severe and persistent phenotype of egg allergy. Recently, an active approach has emerged for patients with food allergy, including those with egg allergy, in the form of oral immunotherapy. Egg oral immunotherapy consists of the administration of gradually increasing doses of egg, with the aim to enable patients to consume small amounts of egg without having allergic reactions, which thus provides protection from accidental exposures to egg-containing foods. This article aims to discuss published evidence on egg oral immunotherapy, provide practical information on dosing protocols, and address special challenges associated with this intervention.
A practical focus on fish and shellfish oral immunotherapy
Authors: Mack Douglas P. , Woch Margaret , Rodríguez del Río Pablo
Published: July 2022

Although fish and shellfish allergies represent common worldwide allergies, with anaphylaxis being reportedly frequent, treatment approaches, e.g., oral immunotherapy (OIT), are uncommonly performed. A review of the limited literature is discussed here. Both practical and immunologic
challenges are common with seafood OIT, including taste, odor, unclear and potentially inconsistent cross-reactivity, and alteration of protein concentration during the cooking process as well as other concerns. Ongoing attempts at standardization of this OIT process should be considered.
The experienced OIT physician may consider this treatment in patients who are motivated to begin OIT.
Efficacy, effectiveness and other patient-centered outcomes of oral immunotherapy
Authors: Upton Julia E.M.
Published: July 2022

Oral immunotherapy (OIT) is the medically supervised ingestion of a food allergen. Understanding of the expected outcomes of OIT allow for risk-benefit assessments for patient-centered decisions. The efficacy of OIT to achieve desensitization in children has been confirmed in multiple meta-analyses, even with vastly disparate study populations and methodologies. Most children initiated on OIT will achieve the ability to eat more allergen before experiencing an allergic reaction than if they continue to avoid their allergen. This effect is diminished without regular ingestion. Previous meta-analyses showed increased allergic reactions on OIT versus avoidance or placebo due to the dosing itself; however, a recent meta-analysis showed that peanut OIT in children did not lead to an increase in allergic reactions. Analysis of emerging data suggests that OIT may reduce reactions to accidental exposures over time. Important patient-centered outcomes, including reaction avoidance or amelioration, and psychosocial impacts and/or quality of life, and studies of more demographically representative populations are also necessary.
A practical focus on milk oral immunotherapy
Authors: Anagnostou Aikaterini
Published: July 2022

Cow’s milk allergy (CMA) is a common childhood food allergy associated with a significant burden for those children who are affected and their families, including unintentional exposures that result in allergic reactions, severe allergic reactions, and anaphylaxis. In young children,
cow’s milk is one of the most frequent food triggers in anaphylactic episodes, and fatalities have also been described as a result of unintentional exposures, which reinforces the notion that milk allergy can be severe in some individuals. The natural history of CMA is favorable, with
the allergy resolving over time in the majority of individuals, although some will have persistent allergy that does not resolve. The standard management approach for CMA consists of strict avoidance of milk and carriage of emergency medication for use in accidental exposures. Recently, a
novel approach has emerged as an alternative option for management in patients with CMA in the form of oral immunotherapy (OIT). The aim of milk OIT is to protect patients from accidental exposures to milk-containing foods and allow patients to introduce larger amounts of milk into their diet.
The goal of this article was to review the available evidence, discuss key studies that focused on milk OIT, and provide practical information and useful tips related to this novel treatment.
Risk factors for reactions and adverse effects during oral immunotherapy
Authors: Fitzhugh David J.
Published: July 2022

Oral immunotherapy (OIT) involves the potential for a variety of adverse events, which range from serious systemic reactions that require epinephrine to minimal oral reactions that require no treatment. This chapter describes common types of reactions seen in the course of OIT, reviews
the frequency of and risk factors for different types of events as reported in recent literature (with a focus on real-world reports from private practice), and discusses treatment strategies for these adverse events. As the availability of OIT expands, it is paramount to ensure that allergists
who offer OIT have a robust understanding of these reactions and mechanisms, with the overarching goal being the safety and tolerability of the therapy for the individual patient.
Approaches to maintenance dosing during oral immunotherapy
Authors: Inamdar S. Rubina , Mandal Binita
Published: July 2022

Long term daily dosing for patients and families may be challenging due to food aversions, dosing protocols, and age of the patient. The few long term studies suggest that low quantity daily dosing is associated with passing higher dose challenges over the long term, whereas high dose
maintenance may protect for longer avoidance intervals. We review the data for peanut and suggest several strategies for your patients.
PENGARUH TRANSFORMATIONAL LEADERSHIP & COMPENSATION TERHADAP EMPLOYEE PERFORMANCE DIMEDIASI OLEH JOB SATISFACTION
Authors: Budiratmoko Mohammad Eko , Tajib Erny
Published: July 2022

This study aims to analyze the effect of transformational leadership and compensation on employee performance mediated by job satisfaction variables. The job satisfaction variable here functions as a mediating variable that researchers want to prove that it has an impact on employee performance. A company has an important component, namely employees as a fundamental asset. If employees are satisfied with what the company has given them, it can affect the progress of the company because employees feel motivated to work. Things that can affect employee performance include the supervisor's factor leading the employees, and also the compensation factor given to employees. So that if the two components are fulfilled properly it will have an impact on increasing employee performance which of course brings benefits to the company. The sample companies in this study are PT. Waskita Karya (Persero) Tbk. The data collection method in this study used a question questionnaire which was distributed to employees to be filled out. Then the data obtained were analyzed by multiple regression analysis using SPSS software. The results showed that there was a positive effect of transformational leadership and compensation on employee performance mediated by job satisfaction. All hypotheses in this study are proven except for hypothesis number 4, namely transformational leadership has a negative effect on employee performance, due to the COVID-19 pandemic which affects the company's production decline from the target. However, if job satisfaction is included as a mediating variable, transformational leadership will have a positive impact on employee performance. From the results obtained, the leader must be able to teach his employees to be more creative at work and compensation must also be increased so that employee performance can increase
PENGGANTIAN AC TIPE SPLIT-DUCT DENGAN SISTEM WATER COOLED CHILLER DI PUSAT PERBELANJAAN X BANDUNG
Authors: Jumairi Endi , Rangkuti Chalilullah , Supriyadi Supriyadi
Published: July 2022

Penurunan konsumsi energi sistem HVAC menjadi semakin penting karena meningkatnya biaya bahan bakar fosil yang berdampak juga kepada meningkatnya biaya pembangkit listrik dan masalah lingkungan. Karena itu, untuk mengurangi konsumsi energi di gedung tanpa mengorbankan kenyamanan dan kualitas udara dalam ruangan merupakan tantangan penelitian yang sedang berlangsung. Setiap disiplin HVAC memiliki persyaratan desain khusus dan masing-masing memberikan peluang untuk penghematan energi. Dengan tingginya konsumsi energi listrik untuk HVAC ini yang rata–rata 50% dari total penggunaan listrik gedung, maka pihak pengelola dan pemilik gedung melakukan berbagai upaya untuk melakukan penghematan energi listrik, salah satunya dengan mengganti AC splitduct yang sudah terpasang selama 20 tahun dengan water cooled chiller. Total unit AC Split Duct yang terpasang untuk mendinginkan seluruh pusat perbelanjaan adalah sebanyak 280 unit dengan total kapasitas 1860 TR, penggantian dilaksanakan secara  bertahap, untuk tahap pertama dengan mengganti 43 unit AC split duct dengan total kapasitas 500 TR dengan water cooled chiller kapasitas 500 TR, sehingga dengan penggantian ini ada lantai yang disupply dari AC splitduct dan ada yang di suplai water cooled chiller system. Penulis menghitung konsumsi energi listrik yang dibutuhkan untuk kedua tipe AC ini dengan membandingkan beban actual (kWatt) dari AC splitduct dengan water cooled chiller system, dengan cakupan luas area yang sama dari kedua Tipe AC tersebut, dari nilai penghematan yang diperoleh, dihitung waktu pengembalian investasi dari water cooled chiller system
POTENSI BATUAN INDUK FORMASI TALANGAKAR DAN LEMAT PENGHASIL HIDROKARBON DI CEKUNGAN SUMATRA SELATAN
Authors: Riyandhani Cahyaningratri Prima
Published: July 2022

Terdapat beberapa formasi pada Blok Western South Sumatra Extention, Zona Musi Platform, Cekungan Sumatra Selatan tetapi hanya Formasi Lemat dan Formasi Talangakar yang akan dianalisis. Dari kedua formasi ini memiliki lingkungan pengendapan mulai dari fluvial sampai laut dangkal. Untuk Formasi Lemat terendapkan di lingkungan fluviodeltaik dan merupakan serpih yang berguna sebagai batuan induk. Formasi Talangakar yang terdiri dari batupasir, serpih dan sisipan batulanau diendapkan pada lingkungan fluvial hingga deltaik dan berperan sebagai batuan induk. Hasil analisis dari geokimia organik sampel-sampel batuan dari kedua formasi menunjukkan adanya potensi hidrokarbon yang baik dan dapat dipastikan Formasi Lemat dan Formasi Talangakar merupakan batuan induk potensial di Cekungan Sumatera Selatan.Kata Kunci: Geokimia hidrokarbon, geokimia organik, Formasi Talangakar, Cekungan Sumatera Selatan.
Confiabilidade interobservadores do diagnóstico de congestão pulmonar de pacientes em hemodiálise por exame ultrassonográfico Point-Of-Care (POCUS)
Authors: Coelho Eduarda de Souza , Ferreira Júlia Lage Costa , Cambraia Audrey Tue Domingos Diniz , Castro Isadora Campos de , Coelho Luciana , Rodrigues Anderson Tavares , Vieira Ana Luisa Silveira , Lucinda Leda Marília Fonseca
Published: July 2022

Objetivo: Comparar a confiabilidade da avaliação de congestão pulmonar pela ausculta e pelo POCUS em pacientes hemodialíticos realizada por diferentes examinadores: médico habilitado e acadêmico de Medicina. Métodos: Estudo com pacientes em hemodiálise na clínica Pró-Renal. Foram coletadas as comorbidades e sinais clínicos de congestão em conjunto com a ultrassonografia, escaneando oito áreas pulmonares para identificar presença de linhas B. Resultados: De 30 pacientes, 36,6% apresentavam edema periférico e 13,3% turgência jugular. A prevalência de congestão pulmonar avaliada pelo médico na ausculta e no exame ultrassonográfico foi de13,3% e de 50,0%, respectivamente. Na avaliação dos acadêmicos, ambos obtiveram prevalência de 20% pela ausculta, já pela ultrassonografia foi de 60,0% e de 50,0%. Na avaliação pela ausculta entre o médico e os acadêmicos, observou-se uma concordância moderada (κ=0,48) e baixa (κ=0,19), respectivamente. Na congestão pulmonar avaliada pelo POCUS, entre o médico e o acadêmico 1 observou-se uma concordância substancial (κ=0,67), e moderada (κ=0,47) para o acadêmico 2. Conclusão: O POCUS para o diagnóstico de congestão pulmonar foi superior à ausculta, sendo confiabilidade moderada e substancial entre o médico e os acadêmicos no diagnóstico pelo POCUS, no entanto, na ausculta encontrou-se uma concordância moderada e baixa.
Qualidade de vida e repercussões da Covid-19 em indivíduos sem doenças pré-existentes
Authors: Sousa Thaynara Campos de , Campos Mara Marusia Martins Sampaio , Alves Jamille Soares Moreira , Batista Adelina Braga , Farias Francisca Nayara Queiroz , Moreira Ailla Maria Sousa , Dias Aline Bezerra , Freire Quênia Cândido , Araújo Maria Valdeleda Uchoa Moraes , Andrade Emília de Alencar
Published: July 2022

Objetivo: Investigar a qualidade de vida e as repercussões da Covid-19 em indivíduos sem doenças pré-existentes. Métodos: Foi realizada uma análise descritiva de uma série de casos de sujeitos com histórico de testagem positiva para a Covid-19 sem comorbidades pré-Covid-19 em um município do Ceará. A coleta de dados ocorreu entre junho e dezembro de 2021 de modo transversal através de entrevistas, contendo os dados de identificação dos participantes, percepção de sequelas pós-Covid e a versão brasileira do questionário de Qualidade de Vida SF-36 e outra contendo os dados do Teste de Caminhada de Seis Minutos. Resultados: Participaram 9 usuários com idade entre 23 e 50 anos. A maioria referiu sintomas como anosmia, dor na coluna e cansaço físico e 88,8% apresentaram diminuição da capacidade funcional no Teste de Caminhada de Seis Minutos. Na Qualidade de Vida, o domínio Estado Geral de Saúde demonstrou o menor escore. Conclusão: Os participantes apresentaram Síndrome Pós-Covid, baixo desempenho no teste de caminhada parecendo não ter afetado a percepção de qualidade de vida.
Ações de prevenção em saúde sexual para adolescentes: a atuação de acadêmicos de medicina em programa de saúde na escola
Authors: Veneziani Maria Cecília Minhoto , Alonso Rosane Aparecida Gomes Moscardini
Published: July 2022

Objetivo: Relatar a experiência de atividade realizada por acadêmicos do curso de medicina com alunos do primeiro ano do ensino médio abordando assuntos de saúde sexual, principalmente métodos contraceptivos e gravidez na adolescência. Relato de experiência: A atividade realizada por alunos do curso de graduação em Medicina do terceiro período com alunos do primeiro ano do ensino médio abordando assuntos de saúde sexual, principalmente métodos contraceptivos, Infecções Sexualmente Transmissíveis (ISTs) e gravidez na adolescência, de maneira dinâmica e adaptada ao público-alvo. A vivência trouxe à tona reflexões pertinentes sobre a vulnerabilidade dos adolescentes alvo da ação, a importância do entendimento de tal situação para a criação de ações de saúde específicas para aquele público e a intersetorialidade entre saúde e educação como estratégia facilitadora para tais ações. Considerações finais: O Programa Saúde nas Escolas impacta de forma positiva a sociedade e os indivíduos que nela estão envolvidos, sejam estudantes de escolas públicas, sejam universitários da área da saúde, sendo importante lembrar a necessidade da abordagem da sexualidade e educação sexual de maneira constante e frequente no contexto escolar.
Caracterização do uso de vancomicina, posologia e indicadores clínicos de pacientes críticos neurocirúrgicos e politraumatizados
Authors: Macêdo Giovanna Gabrielly Custódio , Maia Thaís de Souza , Cardoso Flávia Pessoa de Belmont Fônseca , Carvalho Mariana Albernaz Pinheiro de , Dourado Cynthia Angélica Ramos de Oliveira
Published: July 2022

Objetivo: Descrever as características de utilização da vancomicina, posologia e indicadores clínicos de pacientes críticos neurocirúrgicos e politraumatizados. Métodos: Estudo transversal prospectivo, não-controlado e com abordagem quantitativa, realizado entre fevereiro e julho de 2021. Foram incluídos 36 pacientes. O instrumento de coleta abordou variáveis sociodemográficas, de caracterização do uso do fármaco e indicadores clínicos. A análise das variáveis ocorreu por estatística descritiva, precedida por teste de verificação da normalidade dos dados. Resultados: Houve ocorrência de frágil assistência antimicrobiana no geral, dado o curto período de tempo para início do fármaco, ausência de culturas que justificassem a sua prescrição, aplicação antimicrobiana empírica e frequentes níveis subterapêuticos da droga. Observa-se ainda uma variabilidade dos valores séricos de vancomicina especialmente em função da depuração de Creatinina (CR) e Taxa de Filtração Glomerular (TFG). Conclusão: A insegurança terapêutica instituída incide sobre a necessidade de parametrização farmacoterapêutica e de vigilância infecciosa, considerando a criticidade do perfil de pacientes do estudo.
Cuidados paliativos como terapêutica no conforto do paciente
Authors: Glória Fabiana Pereira , Tavares Paulo Eugênio do Val , Coriat Junior Apaestegui , Fernandes Rayssa Nogueira Leite , Portela Tiago Wagner da Silva
Published: July 2022

Objetivo: Averiguar as evidências cientificas sobre o conforto de pacientes em cuidados paliativos. Métodos: Trata-se de uma revisão integrativa da literatura com buscas dos dados no período de maio e junho deste ano nas bases Pubmed, Scielo e Embase, publicados nos últimos cinco anos. Resultados: Foram encontrados 15 artigos condizentes com nosso objetivo. Os estudos descrevem os cuidados paliativos como uma forma terapêutica para o conforto do paciente diante de várias patologias como as doenças crônicas, doenças incuráveis e o câncer. Apontam os principais sintomas relatados pelos pacientes e os cuidados paliativos ofertados e descritos como apoio desde o diagnóstico da doença, entre eles a comunicação efetiva, alívio da dor, hidroterapia, musicoterapia e satisfação espiritual. Considerações finais: Observa-se a necessidade de fortalecimento desses cuidados pelos profissionais de saúde-paciente-família,  buscando melhorar a assistência ao paciente em cuidado paliativo, abrangendo as suas esferas física, psicológica, social e espiritual do paciente.
Increased risk of atrial fibrillation in patients with psoriasis: A meta-analysis of observational studies
Authors: Yang Hsuan Chia , Poly Tahmina Nasrin , Islam Md. Mohaimenul , Walther Bruno Andreas , Wu Chieh-Chen
Published: July 2022

Background:

Several epidemiological studies have shown that psoriasis increases the risk of developing atrial fibrillation but evidence of this is still scarce.

Aims:

Our objective was to systematically review, synthesise and critique the epidemiological studies that provided information about the relationship between psoriasis and atrial fibrillation risk.

Methods:

We searched through PubMed, EMBASE and the bibliographies for articles published between 1 January 2000, and 1 November 2017, that reported on the association between psoriasis and atrial fibrillation. All abstracts, full-text articles and sources were reviewed with duplicate data excluded. Summary relative risks (RRs) with 95% CI were pooled using a random effects model.

Results:

We identified 252 articles, of these eight unique abstracts underwent full-text review. We finally selected six out of these eight studies comprising 11,187 atrial fibrillation patients. The overall pooled relative risk (RR) of atrial fibrillation was 1.39 (95% CI: 1.257–1.523, P < 0.0001) with significant heterogeneity (I2 = 80.316, Q = 45.723, τ2 = 0.017, P < 0.0001) for the random effects model. In subgroup analysis, the greater risk was found in studies from North America, RR 1.482 (95% CI: 1.119–1.964, P < 0.05), whereas a moderate risk was observed in studies from Europe RR 1.43 (95% CI: 1.269–1.628, P < 0.0001).

Limitations:

We were only able to include six studies with 11,178 atrial fibrillation patients, because only a few such studies have been published.

Conclusion:

Our results showed that psoriasis is significantly associated with an increased risk of developing atrial fibrillation. Therefore, physicians should monitor patient’s physical condition on a timely basis.
Myths, misconceptions and attitudinal trends among patients with acne
Authors: Ansari Farzana , Khare Ashok Kumar , Gupta Lalit Kumar
Published: July 2022

Background

Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it.

Aims/Objectives

To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it.

Methods

A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India.

Results

Most (84.8%) patients belonged to the age group of 16-25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education.

Limitations

A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results.

Conclusion

Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.
Comparison of alternate erythrocyte sedimentation rate measurement by automated Celltac α+ (MEK 1305) and reference Westergren method
Authors: Kahar Manoj A.
Published: July 2022

Objectives:

Manual Westergren method is routinely used for ESR measurement; however, it has many limiting factors which include inherent and technical factors. Alternate/modified Westergren methods have been devised to overcome the limitations of the manual Westergren method. These new methods must be properly evaluated before introducing in clinical laboratories.

Material and Methods:

A total of 350 randomly collected Ethylene Diamine Tetraacetic Acid (EDTA) samples from hospitalized and ambulatory patients were assayed parallelly in the recently launched Hematology Analyzer Celltac α+ (MEK 1305) and manual Westergren method. Results of these assays were subjected to statistical analysis using a coefficient of correlation, Passing-Bablok regression, and the Bland-Altman statistical methods and the results of the present study were also compared with 16 selected similar studies published in the past 22 years. Intrarun precision using patient samples and inter-run precision using manufacturer’s controls (MEK-3DN and MEK-3DL) were also determined.

Results:

The present study revealed a Pearson correlation of 0.9058, mean bias of −6.43, and limits of agreements 17.5–−30.4, between Celltac α+ (MEK 1305) and the reference Westergren method. Intrarun precision using patient samples yielded a coefficient of variation ranging from 0% to 14% and inter-run precision using commercial controls yielded a CV of 9.32% for abnormal (MEK-3DL) control and 13.6% for normal level control (MEK-3DN).

Conclusion:

With good correlation between Celltac α+ (MEK 1305) and the reference Westergren method, acceptable bias, and limits of agreements, automated Celltac α+ (MEK 1305) with its additional advantages is a valid substitute for the reference ESR method in clinical laboratories.
THE ABILITY TO READ RESEARCH ARTICLES: PROFILE OF STUDENTS IN THE BIOLOGY EDUCATION PROGRAMS' OF UIN WALISONGO SEMARANG
Authors: Wijayanti Erna , Adi Widi Cahya
Published: July 2022

This study aims to determine the profile of students of the undergraduate Biology Education program at UIN Walisongo Semarang. This study is descriptive qualitative with a survey method. The number of participants was 96 students of the Biology Education Program from different years. The instruments used were reading scientific articles and tests of the ability to read scientific articles. Data in the form of test answers, given a score and analyzed using the formula mean and percentage, then categorized. The results showed that the student's ability to read research articles was categorized as very low (Counterargument (15.67%) and Refutation (1.8%)), low (Motive (35.62%), Support (23.85), and Implication (28.17)), moderate (Novelty, 52.92%), and high (Objective (75.59%) and Main Conclusion 76.55%)). This research concludes that the ability to read scientific articles of undergraduate biology education students still needs improvement by applying learning methods/models or giving an assignment that can improve the ability to read scientific articles.
EFFECTS OF NATURAL EXTRACT OF CELERY LEAVES ON THE KIDNEYS OF WHITE RATS (Rattus novergicus) AFTER ASPIRIN INDUCTION
Authors: Indriana Edni , Titrawani Titrawani
Published: July 2022

Herbal plants can be used as a treatment option, including the treatment of kidney disease. The administration of herbal remedies such as celery is a more natural and safe treatment healing alternative. The study aims to determine the effect of celery extract in repairing the damage to the kidney cells of aspirin-induced white mice. This study used a completely randomized design (CRD) consisting of 5 groups with 3 replications: K- (aspirin 12.6 mg/kg BW), K+ (feed normal), P1 (celery extract 200 mg/kg BW + aspirin 12.6 mg/kg BW), P2 (celery extract 100mg/kg BW + aspirin 12.6 mg/kg BW) and P3 (celery extract 50 mg/kg BW) + aspirin 12.6 mg/kg BW). From the results of observations on kidney histology of rats after giving aspirin, it is known that there is damage to the nucleus of cells undergoing pyknosis and swelling of the glomerulus, which is characterized by narrowing of the Bowman's space. This suggests that the celery extract at a stratified dose may affect the histopathological kidney of aspirin-induced mice.
Experience of switching biological therapy in a patient with juvenile idiopathic arthritis and uveitis. Case report
Authors: Galstian Lelia A. , Verbitsky Maksim V. , Polyanskaya Angelina V. , Chebysheva Svetlana N. , Kudryashova Mariya A. , Batyreva Oksana V. , Tikhaya Margarita I. , Zholobova Elena S.
Published: July 2022

Uveitis associated with juvenile arthritis can be complicated by cataracts, retinal edema, and glaucoma, which carries a potential risk of disability in the child's organ of vision. Approximately 2540% of patients demonstrate insufficient effectiveness of the ongoing standard antirheumatic therapy, which requires the inclusion of genetically engineered biological therapy. According to the protocols, the drug of choice for juvenile arthritis associated with uveitis is adalimumab, which has shown high efficacy in many studies. However, some patients stop responding to therapy over time, which raises the question of switching to another genetically engineered biological drug (GЕBD). Our article presents a case of severe course with an early onset of juvenile idiopathic arthritis associated with uveitis. Due to the insufficient effectiveness of basic monotherapy with methorexate, as well as topical glucocorticoids, adilimumab was added to therapy a year after the onset of the disease. Over the next 5 years, the child was on this therapy with exacerbations of uveitis about 12 episodes per year. Subsequently, uveitis began to continuously recur, which raised the question of the development of probable resistance to adalimumab and the change of GEBD. The girl was switched to golimumab, which is a human monoclonal antibody that can bind to tumor necrosis factor-. This drug has been used for the treatment of juvenile idiopathic arthritis since 2017 for children weighing 40 kg and above, and after the completion of the multicenter GO-KIDS study, it is registered for children from 2 years of age. According to a number of studies, golimumab has shown its effectiveness in relation to the activity of uveitis in patients with arthritis, including those in childhood. In general, the issues of switching GEBD in cases of ineffective therapy with first-line drugs are a very urgent problem in pediatric rheumatology. In our case, switching to the GIBP golimumab resulted in a positive effect on the activity of rheumatoid uveitis and induction of remission of the articular syndrome.
Vitamin D as the essential immunonutrient – the evidence base update: A review
Authors: Makarova Svetlana G. , Emelyashenkov Evgeny E. , Yasakov Dmitry S. , Pronina Irina Yu. , Ereshko Oksana A. , Gordeeva Irina G. , Galimova Albina A. , Chumbadze Tamara R. , Lebedeva Ayina M.
Published: July 2022

The micronutrient status plays a key role for adequate immune response, including in diseases caused by respiratory viruses. Numerous studies conducted since the beginning of the COVID-19 pandemic, examining the impact of micronutrient availability, have shown their importance in the prevention of this disease. The largest number of publications is devoted to vitamin D. As a result, in less than two years, 17 meta-analyses and analytical reviews were published on the role of vitamin D and the availability of this micronutrient in various population groups in reducing the incidence, incidence of severe forms of COVID-19 and mortality. This review summarizes the results of published meta-analyses and systematic reviews. The analysis of literature data confirms that vitamin D has the highest evidence base as a micronutrient that reduces the risk of disease and the occurrence of severe forms of COVID-19. It also provides up-to-date recommendations on vitamin D supplementation for adult and pediatric patients.