bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of the cascade control system of the thermal regime of a technological object by the methods of synergetic control theory
Authors: Labutin A.N. , Nevinitsyn V.Yu. , Volkova G.V. , Panasenkova A.V. , Zaytsev V.A.
Published: July 2019

The paper considers technological control objects whose physical properties, state of aggregation and composition are changed by hydromechanical, physical and chemical effects on the flows of initial substances. The main feature of such objects is their multi-dimensionality, nonlinearity, multiconnectivity, and parametric uncertainty of the mathematical model at the design stage. One of such objects is the chemical reactor with the thermal regime predominantly controlled by single-loop or cascade automatic control systems based on linear algorithms. The main disadvantage of such systems is the problem of maintaining robustness, i.e. stability and control quality under the action of parametric disturbances. In our opinion, the method of analytical design of aggregated regulators (ADAR), developed within the framework of the synergetic control theory, is promising in this sense. The research uses methods of system analysis of technological processes as control objects, methods of the automatic control theory and analytical synthesis of control algorithms based on the synergetic control theory and computer simulation methods. Using the ADAR method, we have solved the problem of algorithmic synthesis of the cascade-coupled control system of the thermal regime of a technological object (chemical reactor) in the nonlinear formulation applying a nonlinear mathematical model of the object. Computer simulation methods have proved the functionality of the «object – control subsystem» complex: system stability, covariance with the set point. It is shown that in the systems controlling thermal processes of the considered type, the heat transfer coefficient parametric uncertainty can lead to an excessive value of the static error, which means that the algorithmic structure of the automatic control system has to be improved. To ensure full robustness of the automatic control system, it is recommended to make the system’s algorithmic structure more complex by introducing an astatic component into the control law and correcting the algorithm tuning parameters.
Cost comparisons of five leading brands of the Antiplatelet drug, Clopidogrel, available in an Indian town
Authors: Rajadnya Vikram A.
Published: July 2019

Background: Antiplatelet drugs need to be prescribed lifelong, for most of the selected patients, once started. Price disparity can lead to large financial stress on the patients, especially when cost related aspects are not paid heed to by the prescribing physician. This study was conducted to compare the cost, to the patient, of five most commonly prescribed preparations of different brands of Clopidogrel seventy five milligram, in Kolhapur city.Methods: The present study was undertaken during February 2019 to June 2019. Authors purchased a strip of 10 tablets each of the five leading brands of Clopidogrel seventy five milligram. The prices of the strip of 10 tablets of each of the five chosen brands were compared. Finally, the yearly cost of each of these five different preparations, was compared directly as well as using percentages. The data was collected, analyzed and presented in tabular forms and figures.Results: The data of the cost of five different brands of a single antiplatelet drug, Clopidogrel seventy five milligram shows that the annual cost of the costliest among the five brands of this drug is almost three times that of the cheapest brand, or in other words almost 300 percent that of the cheapest brand.Conclusions: The cost differences between the five brands were not negligible. India, with a major part of the population being very sensitive to the cost of medications, the prescribing physician must select the preparation wisely. The most costly preparation of Clopidogrel can significantly add to the the financial stress on the patient’s yearly expenditure. Thus, Pharmaco economic considerations must take a front seat while making a decision to prescribe medicines, especially in a country like India.
Analysis of clinical profile and prescription pattern of malaria in a tertiary care hospital in Karnataka, India
Authors: N. Raghu Murthy , Rai Seema
Published: July 2019

Background: Malaria is one of the leading causes of morbidity and mortality in developing countries like India. Plasmodium falciparum and Plasmodium vivax are the commonest species implicated for an increased incidence of malaria in India. The pattern of disease, signs, and symptoms vary from place to place, region to region due to demographic variations. The current study was undertaken to study the differences in the clinical profile of malaria, particularly signs and symptoms, complications and response to treatment in malaria.Methods: A retrospective, single center, surveillance study was carried out at a tertiary health care center in Mangalore. All patients aged above 18 years diagnosed as malaria by peripheral smear method and rapid diagnostic tests were included in the study. The clinical features, complications, and response to treatment were noted.Results: Fifty eight patients diagnosed as malaria were included in the study. Compared to other studies and nationwide incidences, here P. vivax emerged as the leading cause of malaria. All patients presented with fever varying from 3-20 days. About 30 patients complained of headache and 21 patients presented with malaise. In about 6 patient’s complications were seen. Majority of patients received artemisinin derivatives followed by chloroquine for treatment of malariaConclusions: Previous thinking that complications are only seen with P. falciparum has to be changed. Now many complications, mild as well as severe type are seen in P. vivax malaria. Drug resistance is another global problem which needs to be tackled wisely by systematic usage of antimalarials.
A cross sectional study to compare serum beta 2 microglobulin levels in oral leukoplakia and oral squamous cell carcinoma patients
Authors: Kulkarni S. R. , Garud Yogesh Prakash
Published: July 2019

Background: One of the major health problems in the world is cancer. More than 11 million people are diagnosed yearly with cancer. Oral cancer is one of the deadliest cancers. Oral cancer is generally preceded by precancerous lesions. India has highest number of oral cancer patients. β2 microglobulin (β2 m) is one of the tumor markers.Methods: We are correlating serum levels of beta 2 microglobulin in leukoplakia and oral squamous cell carcinoma. In our study, the serum β2 m levels were estimated in 2 groups of 30 subjects each with oral squamous cell carcinoma (OSCC) designated as Group A, 30 subjects with oral leukoplakia designated as Group B.Results: There were majority of participants from age group of 51 to 70 years (Group A-60%, Group B-53.33%). Group A had majority of females 20 (66.67%) while males were 10 (33.33%). Group B had majority of males 18 (60.00%) while females were 12 (40.00%). Major adverse habit was tobacco chewing (83.33% Group A and 73.33% in group B). Most common site was Left BM. Right BM was second. There was significant association between the groups and serum β2 m levels. Mean levels of Group A patients were 3.13±0.47 mg/L and Group B 1.43±0.29 mg/L.Conclusions: Adverse habits like tobacco chewing, smoking and alcohol increase chances of oral cancers and precancerous lesions. Significant correlation between oral cell carcinoma cases and serum β2 m levels is seen.
Tertiary care hospital based study of outcome of facet joint triamcinolone injection in combination with lignocaine in chronic low back ache
Authors: Ahsan Wani M. , Islam Nuzhat ul , Rasool Akther , Ganaiee Mushtaq Ahmed
Published: July 2019

Background: The objective of the study was to determine the effectiveness of facet joint triamcinolone steroid injection in combination with lignocaine in chronic low back ache by measuring the reduction of pain intensity.Methods: This descriptive study was conducted at the post graduate Department of Orthopedics, GMC Srinagar, Kashmir from June 2016 to September 2017. All patients with chronic low back ach (for three months or more) meeting the inclusion criteria were included. Pre pain was assessed using visual analog scale (VAS). Under image intensifier each facet joint was be infiltrated with a mixture containing 10 mg of steroid and 2 ml of 1% lidocaine. Follow ups were done at six weeks’ time and improvement was measured using the same grading system(VAS) to confirm the effectiveness of the procedure. Treatment was considered effective if the patient score below 4 on VAS after treatment with facet joint steroid injection.Results: In our study 100 patients with chronic low back ache were analyzed. The mean age was 56 years with SD ±22.91. The percentage of male patients were 52% while 46% were female. Mean duration of low back ache was 8 months with SD ±3.37. Facet joint steroid injection was efficacious in 67% patients and was ineffective in 33% patients.Conclusion: Facet joint steroid injection in combination with lignocaine is effective in reducing chronic backache and discomfort to the patients.
Successful outcome of pregnancy in a case of systemic lupus erythematosus : a case report
Authors: Mohan Gurinder , Kaur Avleen , Khullar Umang
Published: July 2019

Systemic lupus erythematosus (SLE) is a multisystem, auto immune connective tissue disease that commonly affects women of reproductive age and may coexist with pregnancy. The autoantibodies and immune complexes lead to damage of various organs and tissues. Pregnant woman with SLE have increased risk of spontaneous abortion, preterm delivery, intrauterine growth retardation, preeclampsia, neonatal lupus, stillbirth and intrauterine fetal death. The therapeutic intervention with anticoagulants, steroids, immunosuppressive agents pose a high risk to both mother and fetus. A multidisciplinary approach and close medical, obstetrical and neonatal monitoring leads to optimal outcome. Authors describe a successful management of an antenatal patient with positive antinuclear antibody, anti-ds DNA antibody and antiphospholipid antibody with bad obstetric history. She underwent an emergency cesarean section and delivered a healthy female child.
Prevalence of peripheral artery disease in diabetic patients of a tertiary care hospital
Authors: Meena Sangeetha , C. Manikandan R.
Published: July 2019

Background: Peripheral Arterial disease (PAD) is a major microvascular complication of diabetic mellitus. Patients with diabetes have an increased prevalence of PAD. The Ankle branchial Index (ABI) is an easy, noninvasive and often underutilized tool for diagnosis of PAD. The aim of this study is to detect the prevalence of PAD in diabetic patients using Ankle Brachial Index (ABI). Since most of the patients with PAD are asymptomatic, routine screening for the same is necessary to avoid lower limb ulcerations and amputation.Methods: In this cross-sectional study, 200 diabetic patients attending a tertiary care hospital in the Kancheepuram district of Tamilnadu were screened for the prevalence of PAD using ABI and to find out risk factors associated with it.Results: Among the 200 diabetic patients who underwent ABI measurements using handheld Doppler, 19.5% were found to be having PAD. Most of them were symptomatic. Age more than 50 years and female gender were considered as statistically significant (P<0.05) determinants of PAD.Conclusions: PAD is relatively common in elderly diabetics. ABI measurement is a valid tool in early detection of PAD and therefore regular follow up will decrease disabilities in the diabetic population.
Association of oral pre-malignant lesions with the consumption of tobacco
Authors: Joshi Arpita , Jani Chinmay , Jain Kushboo , Bala D. V. , Jetpariya Divyesh , Jadav Harshal
Published: July 2019

Background: Tobacco consumption in the form of chewing and smoking is one of the biggest addictions. It causes various oral pre-malignant lesions which mainly include oral sub-mucous fibrosis (OSMF) caused by betel nut consumption and tobacco quid lesion, leukoplakia, erythroplakia and smoker's palate caused by chewing and smoking tobacco.Methods: The data about the past and present consumption of tobacco was collected from 909 individuals. Based on the tobacco habits, the oral cavity findings were assessed and the statistical analysis was carried out to find the significance of associations observed between tobacco consumption and lesions.Results: Out of 909 subjects, 537 were consuming tobacco, out of which 284 were chewers, 65 were smokers and 76 were consuming in both forms. Out of the 284 tobacco chewers, 43% had oral lesions (19.4% had OSMF and 21.5% had tobacco quid) as compared to just 1% of workers having oral lesions (OSMF) amongst those who had no addiction. There was a high prevalence of lesion in tobacco chewers (p<0.005). Out of total smokers, 15.8% had smoker's palate whereas no lesion was seen in the non-addicted workers. The odds of developing oral pre-malignant lesion are 43.62 times higher in exposed individuals.Conclusions: The tobacco consumption in any form is hazardous. Betel nut exposure causes more harmful effect which goes unnoticed. Awareness should be created about various lesions caused by tobacco as well as betel nut and special steps should be taken for early diagnosis and its treatment.
Assessment of hearing among mobile phone users
Authors: Kanagamuthu Priya , Palanisamy Thirunavukarasu , Srinivasan Rajasekaran
Published: July 2019

Background: With the advent of new smart phones every day, health hazard related to it is also increasing. The usage of mobile phones has become a domineering activity of the students. Such usage have been documented to cause many health hazards like hearing loss, the mobile phone electromagnetic radiation has other potential risks like vehicular accidents, headache, and sleep disturbances, thermal effects and alteration of blood brain barrier. The objective of the study was to assess the hearing loss with pure tone audiometry due to chronic mobile phone usage among medical college students in a tertiary care hospital.

Methods: This was a cross sectional study conducted among the medical students from June 2018 to December 2018, with the sample size of 129. The participants were interviewed using pretested, validated questionnaire followed the participants were subjected to pure tone audiometry.  

Results: Among the 129 participants, the majority of the study participants (58.1%) were females. The median age of the participants was 20 and almost 42.7% of the participants used in ear media while using the phone. 10.9% and 19.4% showed symptoms of tinnitus and hard of hearing respectively. On testing the participants with pure tone audiometry, around 9.3% had mild hearing loss and 3.9% had moderate hearing loss.

Conclusions: The health hazard caused by the mobile phone usage may not be evident for many years. The students are exposed to smart phones frequently and hence periodic screening and health education regarding the harm of using mobile phones for longer duration should be made imperative.
A clinical study of surgical management of distal femur fracture using locking compression plate
Authors: Reddy A. Varun Kumar , Srikanth S. , Omkarnath Gudapati
Published: July 2019

Background: Fractures of distal femur are common due to increased road traffic accidents and fall from height because of increased construction activities. These fractures are quite disabling hence, these fractures necessitate early stabilization of fractures. Internal fixation with LCP has shown to give one of the best results in terms of recovery, fracture union, and clinical outcome. The aim of the study the clinical outcome of treatment of distal femur fractures using locking compression plates.

Methods: A total of n=20 cases of distal femur fractures treated with LCP from December 2013 to June 2015 at NMCH and RC, Raichur. They were admitted and examined according to protocol clinically and radiologically. All patients were followed up for a minimum of 6 months and outcome assessed with Neer’s score.

Results: All fractures healed with an average duration of 16 weeks which is comparable with other studies. We had two cases of varus collapse one was due to early weight bearing in one case and other case is due to gross communition. One case had an implant failure (plate breakage) due to early weight bearing. Cases needing hardware revision is comparable to other studies at 10%. Average Neer's knee score was 76.

Conclusions: we have found higher Neer’s scores in this study. The LCP also prevents compression of periosteal vessels. It may not completely solve the age-old problems associated with any fracture like non-union and malunion, but is a valuable technique in the management of these fractures. But however, in type C fractures the outcome is poorer.
Clinical profile of pityriasis rosea: a descriptive study from urban Karnataka
Authors: Raikar Dayanand , Javed Mohammed Waseem , Takalkar Anant A.
Published: July 2019

Background: Pityriasis rosea (PR) is common, self-limited papulo-squamous dermatosis of unknown origin, which mainly appears in adolescents and young adults (10-35 years). It has a sudden onset, and in its typical presentation, the eruption is proceeded by a solitary patch termed “herald patch”, mainly located on the trunk. The objective of the study was to assess the clinical profile of pityriasis rosea.

Methods: The data was collected from patients attending the Department of Dermatology, Basaveshwar Teaching and General Hospital attached to Mahadevappa Rampure Medical College, Gulbarga. It is a descriptive observational study. A total 79 patients suffering from pityriasis rosea who attended the outpatient department were included in the present study during the period from 2006 to 2007.

Results: Out of 79 patients studied, majority were from 11-20 years age group 33 (41.8%) followed by 27.8% from 21-30 years age group. The mean age of study population was found to be 21.3±6.4 years. 11% gave history of acne vulgaris, 8% each had history of atopy and drugs. Commonly observed prodromal symptoms were URTI (25.3%) and fever (17.7%). Herald patch was seen on trunk in majority of patients i.e. 36 (61%) followed by 18.6% cases on upper extremity and on neck (8.5%).

Conclusions: Our study concludes that pityriasis is common in 11-20 years age group with male predominance having URTI as common prodromal symptom and typical rash.
Preparation of the MoVTeNbBiO catalysts for selective oxidative conversion of light alkanes
Authors: Lazareva E. V. , Bondareva V. M. , Svintsitskiy D. A. , Kardash T. Yu.
Published: July 2019

Physicochemical properties of modified MoVTeNbО catalysts are shown to depend strongly on the preparation procedure and the source of bismuth. Addition of a pH-neutral organic bismuth-containing compound at the stage of mixing initial component solutions is accompanied by precipitation and formation of inactive phase but not the necessary phase M1. Irrespectively of the nature of the initial bismuth compound, the introduction of it to the dry MoVTeNb precursor results in destruction of the latter and, as a consequence, in a lower content of phase M1 and the formation of binary V-Mo and Te-Mo oxides. In the reaction of oxidative dehydrogenation of ethane (ODE), the maximal yield of ethylene (76.5 %) is observed with the catalyst obtained by impregnation of calcined MoVTeNb oxide catalyst with a solution of an organobismuth compound. The same catalyst provides the yield of acrylic acid of ca. 48 %. Nevertheless, a more practicable method for preparation of bismuthcontaining catalysts is the addition of bismuth nitrate to the solution of the initial components; such an ODE catalyst provides the maximal yield of ethylene of ca. 76 %.
Mito e interpretación de la Revolución Mexicana: Mariátegui y Haya de la Torre
Authors: Mora Duro Carlos Nazario
Published: July 2019

Este ensayo reflexiona sobre la constitución de la poética del mito de la Revolución Mexicana. Para ello, en la primera parte se caracteriza la noción de revolución, y cómo esta ha trascendido hasta delimitar una metáfora histórica como mito. En la segunda parte se analiza la revolución en México para destacar la configuración del mito que se constituyó de manera gradual y progresiva hasta quedar fincado como una ideología nacional de dimensión historiográfica, cultural e ideológica. Finalmente, se debate sobre la interpretación del proceso revolucionario por parte de Mariátegui y Haya de la Torre. Ambos representantes de la izquierda en América Latina en el siglo XX y, por lo tanto, referencias imperdibles de dichos procesos políticos.
Fatores biomecânicos: uma análise do trabalho dos enfermeiros
Authors: Lucas de Oliveira Marcos , Jordão Cristiane , Garcia Lupi Vergara Lizandra
Published: July 2019

Os fatores humanos e a ergonomia tem como cerne o domínio dos cuidados de saúde com foco na maximização do desempenho global dos sistemas. As atuais pesquisas sobre saúde e segurança do paciente tem centrado esforços na amplitude do termo resiliência do sistema. Assim dado o aumento de pesquisas de intervenção ergonômica na área da saúde e da importância dos fatores humanos e da ergonomia no âmbito hospitalar esse estudo tem por objetivo apresentar os principais problemas biomecânicos relacionados a atividade dos enfermeiros, por meio de uma revisão básica da literatura. Como resultado o estudo apresenta um dossiê dos estudos mais relevantes sobre riscos biomecânicos na atividade laboral dos enfermeiros. Conclui-se que ao setor da saúde no Brasil, não há ainda uma dispersão em grande escala dos equipamentos que visam prevenir os riscos biomecânicos relacionados a atividade laboral dos profissionais da saúde.
A INDETERMINAÇÃO DO CONCEITO DE SUJEITO DE DIREITO INTERNACIONAL PÚBLICO NA SOCIEDADE GLOBAL CONTEMPORÂNEA
Authors: Canzi Idir , Markus Marcelo Teixeira , Pereira Reginaldo
Published: July 2019

 O artigo problematiza a indeterminação do conceito de sujeito de direito internacional, realizando uma análise desde o paradigmático Caso Folke Bernadotte - remissivo ao parecer consultivo emanado pela Corte Internacional de Justiça (CIJ) no ano de 1949 do século passado. O desenvolvimento temático se concentra na dinamicidade do direito internacional público, possível em razão dos pressupostos únicos de seu ordenamento jurídico, tais como sua natureza originária e descentralizada. A análise do conceito de sujeito de direito internacional público na sociedade internacional contemporânea é mais que atual, já que cada vez mais catástrofes de ordem ambiental, econômica e social com impactos transfronteiriços requerem a reparação e punição daqueles que lhes dão causa. Neste fio condutor, a contribuição da teoria histórico-crítica de Paolo Grossi e da teoria institucionalista de Santi Romano concorrem para a crítica e possível revisão do conceito de sujeito de direito internacional público, no momento em que  a história recente aponta que o direito internacional vem se adaptando às profundas mudanças nas esferas econômica, social e política, motivadoras do fim da hegemonia do Estado como único sujeito de direito internacional e, por consequência da revisão do próprio conceito de sujeito de direito internacional. Trata-se de pesquisa bibliográfica, pautada pela utilização do método dedutivo.
Upstream Social Marketing for Implementing Mobile Government
Authors: Burkšienė Valentina , Dvorak Jaroslav , Dūda Mantas
Published: July 2019

The article analyses the main aspects of upstream social marketing for implementing of mobile government (MGov). The methodology of current research is based on the systematic literature review in the fields of MGov and social marketing. According to our findings, most researchers investigated MGov from the side of citizens (consumers) and emphasised the benefits to them while changing their attitudes and behaviours in employing mobile applications. However, as there is a lack of the researches from the side of governmental bodies, in this paper, we were contrary looking for new meanings, attitudes and values from their perspective. Limitations of employment of MGov occur due knowledge gap among decision makers and public policy formers (upstream audience). Therefore, we argue that upstream social marketing for the upstream audience would bring the success in faster MGov implementation. Specific social marketing would be mostly valuable on the municipal level that is the closest substance to the society. Thus, in our paper we emphasise the benefit of the MGov for the local upstream audience and propose possible external marketers as well as the motivating theses based on these 7P of marketing mix for the successful MGov on municipal level.
Manajemen Peserta Didik dalam Pembinaan Perilaku Keberagamaan
Authors: Diantoro Fery
Published: July 2019

Religious behavior becomes an important point that is very fundamental to be owned by every student, because this is closely related to the attitudes and behaviors that will be demonstrated by students in their daily life. Therefore, the schools should be able to present good behavior and religious attitudes to students. Religious behavior coaching is the process of behavior formation, morality and character for students to stock the present and future life. Behavior coaching of students into the work domain of the student management. The school must manage the students well to create students that are in accordance with what has been expected and aspired. In this study using a descriptive qualitative approach, describe the student management in the religious behavior coaching in MTs Al-Burhan Watulimo. With the findings consists of students' orientation activities, the worship habituation, reading Al-Qur'an, scientific and Islamic studies, and guidance of discipline and character.يصبح السلوك الديني نقطة مهمة جدا أن تكون مملوكة من قبل كل المتعلم، لأن هذا يرتبط ارتباطا وثيقا المواقف والسلوكيات التي سيتم إثباتها من قبل المتعلمين في حياتهم اليومية. لذلك، ينبغي أن تكون المدرسة قادرة على تقديم السلوك الجيد والمواقف الدينية للمتعلمين. توجيه السلوك الديني هو عملية تشكيل السلوك والأخلاق والطابع للمتعلمين لتخزن الحياة الحالية والمستقبلية. توجيه سلوك المتعلمين في مجال عمل إدارة المتعلمين. يجب على المدرسة إدارة المتعلمين بشكل جيد لخلق المتعلمين التي تتوافق مع ما كان متوقعا وتطلعا. في هذه الدراسة استخدم المنهج الوصفي النوعي، وصف إدارة المتعلمين في السلوك الديني في المدرسة الثناوية "البرهان" واتوليمو. مع النتائج التى تتكون من أنشطة توجيه المتعلمين، والعبادة التعود، وتعزيز قراءة القرآن، ودراسة علمية والإسلامية، وكذلك تدريب الانضباط والأخلاق.
Logic Model Evaluation to Work Oriented Education Program Through Joint Madrasah Community
Authors: Reflianto Reflianto , Sutadji Eddy , Ariani Farida , Zen Zulhendri
Published: July 2019

Program penguatan ekonomi kreatif pada siswa madrasah melalui Work-oriented education program di Pariaman dilakukan melalui pembentukan Joint Madrasah Community yang digagas oleh STIT Syekh Burhanuddin Pariaman. Program ini memberikan pendampingan pelatihan industri ekonomi kreatif yaitu pelatihan public speaking dan kaligrafi berbasis digital printing. Tujuan program adalah menyiapkan lulusan madrasah siap kerja dan sekaligus mengurangi pengangguran lulusan madrasah yang selama ini penyumbang terbesar di Sumatera Barat. Metode penelitian ini adalah penelitian evaluasi logic model menggunakan pendekatan mixed method yaitu pendekatan campuran kualitatif dan kuantitatif. Pendekatan program menggunakan Comunity Based Research design. Analisa data kualitatif meliputi pengumpulan data, display data, verifikasi data dan penarikan kesimpulan  Analisa data kuantitatif adalah uji independent t-test menggunakan program SPSS. Hasil program Work Oriented Education Program through Joint Madrasah Community terbukti berpengaruh signifikan terhadap penguatan life skill siswa madrasah dengan  nilai a=0.000 < 0.05. Keberhasilan program 64.71% lulusan Madrasah diserap kerja jurnalistik dan broadcasting dan 70 persen di sektor kerja digital printing art kaligrafi. Rekomendasi program perlu dilanjutkan dengan memperluas jaringan komunitas madrasah negeri dan swasta yang ada di Pariaman.   تم تنفيذ برنامج تعزيز الاقتصاد الإبداعي في طلاب المدارس من خلال برنامج تعليمي موجه للعمل في باريامان من خلال إنشاء مجتمع المدارس المشتركة الذي بدأه STIT الشيخ برهان الدين باريامان. يوفر هذا البرنامج المساعدة التدريبية في صناعة الاقتصاد الإبداعي ، وبالتحديد التدريب على التحدث العام والخط الرقمي. الهدف من البرنامج هو إعداد خريجي المدارس الجاهزة للعمل وفي نفس الوقت تقليل البطالة لخريجي المدارس الدينية الذين كانوا أكبر المساهمين في غرب سومطرة. هذه الطريقة البحثية هي بحث تقييم نموذج منطقي باستخدام نهج طريقة مختلطة ، وهي مزيج من النهج النوعية والكمية. يستخدم نهج البرنامج تصميم البحث القائم على المجتمع. يشتمل تحليل البيانات النوعية على جمع البيانات وعرض البيانات والتحقق من البيانات والاستنتاجات ، وتحليل البيانات الكمية هو اختبار t مستقل باستخدام برنامج SPSS. أثبتت نتائج برنامج التعليم الموجه نحو العمل من خلال المجتمع المدرسي المشترك aتأثيرًا كبيرًا على تعزيز المهارات الحياتية لطلاب المدرسة الدينية بقيمة  = 0.000 <0.05. نجاح البرنامج هو 64.71٪ من خريجي المدارس الثانوية الذين يستوعبهم العمل الصحفي والبث الإذاعي و 70٪ في قطاع فن الطباعة الرقمية. يجب أن تستمر توصيات البرنامج من خلال توسيع شبكة مجتمعات المدارس العامة والخاصة في باريامان.
An Analytical Production Model for Primary Production and Cyclic Solvent Injection in a Heavy-Oil Reservoir
Authors: Ma Hongze , Yu Gaoming , She Yuehui , Gu Yongan
Published: July 2019

In this paper, we formulated an analytical material–balance model (MBM) to predict cumulative heavy–oil and gas-production data, as well as the average reservoir pressures, during the primary production and subsequent cyclic solvent injection (CSI) in a heavy–oil reservoir. The theoretical MBM considers the nonequilibrium foamy–oil phase behavior and foamy–oil flow by invoking two kinetic equations with nucleation and decay coefficients. In addition, we conducted four laboratory sandpack tests of the primary production and subsequent CSI to validate the new production model. It was found that the predicted cumulative heavy–oil production data and average reservoir pressures agreed reasonably well with the measured data during the primary production and subsequent CSI. However, there were large discrepancies between the predicted and measured cumulative gas-production data in the CSI owing to its strong gas channeling, which is a major technical issue to be studied further. Moreover, dissolved CH4 in the heavy oil became dispersed CH4 bubbles more quickly when the nucleation coefficient was larger at a higher pressure–drawdown rate or in less–viscous heavy oil. The foamy heavy oil with dispersed CH4 bubbles was more stable when the decay coefficient was smaller at a higher pressure–drawdown rate or in more–viscous heavy oil. It was also found that the foamy–oil isothermal compressibility increased by 10 to 1,000 times and that the dispersed–gas percentage in the foamy oil could reach as high as 14 vol% during the primary production. The foamy–oil viscosity was reduced by 36 to 55%, and the solution CH4/heavy–oil ratio was decreased by 41 to 76% at the end of the CSI.
Addressing HIV-related stigma and discrimination in healthcare settings: development and contextualization of guideline recommendations
Authors: Feyissa Garumma , Woldie Mirkuzie , Munn Zachary , Lockwood Craig
Published: July 2019

Objective
This objective of this project was to develop and contextualize guideline recommendations to reduce HIV-related stigma and discrimination (SAD) in Ethiopian healthcare settings.
Results
A multidisciplinary expert panel comprising 13 experts was established. The panel suggested that the guideline should target both healthcare worker behaviors and attitudes, and institutional practices and programs. A systematic review of systematic reviews and best practice documents was conducted. An initial list of 31 recommendations was drafted through a content analysis of the included documents. Strength and quality of evidence were assigned for each recommendation using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The initial recommendations were framed under the following themes: structural, information-based and skills building, contact and empowerment, biomedical, measurement of SAD, and steps to integrate SAD reduction into healthcare settings. The tentative recommendations were evaluated both internally and externally through a series of Delphi surveys using Guideline Implementability Appraisal (GLIA V2.0) checklist. Finally, we explored facilitators and barriers to implement the guideline using key informant interviews to develop a framework to guide dissemination, implementation, and evaluation of the guideline in the local health system of Ethiopia.
Key words: Guideline development, guideline evaluation, HIV-related stigma and discrimination, Healthcare settings, Ethiopia
Assessment of the effect of solid waste dump site on surrounding soil and river water quality in Teppi town, Southwest Ethiopia
Authors: Mekonnen Besufekad Asres , Haddis Alemayehu , Zeine Wuhib
Published: July 2019

Background

An increase in the urban population and the rising demand for food and other essentials perpetuate a rise in the amount of waste being generated daily by each household. In low-income countries, this waste is eventually thrown into open dump sites. It can cause severe impacts on human health and the surrounding environment. This study was aimed at assessing the effect of a solid waste dump site of Teppi town on surrounding soil and river water quality.

Methods

A total of three surface water, one leachate water samples, and four soil samples were collected and were analyzed. Six heavy metals for surface water and leachate samples and four heavy metals for soil samples were measured by flame atomic absorption spectroscopy. Additionally, physical and chemical parameters were analyzed using standard methods. The soil and water data were analyzed statistically using Origin pro version 8.0 computer software packages. Analysis of variance (ANOVA) was used to assess whether the mean values of heavy metals and physicochemical parameters in soil and water samples varied significantly between distances and location from the dump site, possibilities less than 0.05 (p< 0.05) was considered statistically significant.

Results

pH of soil was slightly basic (pH 8±0.1 up to 8.7±0.21. Similarly, EC was lower in 60 meters (1800±0.5μs/cm) and higher in the other sample sites (3490±0.66-4920±1.04μs/cm). The concentration of heavy metals such as cadmium (0.53±0.01-2.26±0.02 mg/kg), zinc (623.93±0.29-859.41±0.02mg/kg), lead (3.26±0.25-57.560.26mg/kg), and copper (204.06±0.06 337.11±0.01mg/kg) in the sample soils has been found to be higher than Ethiopian EPA and USEPA guideline values. Lead, cadmium, manganese, nickel, copper, and zinc in the leachate water and nickel and manganese in nearby river water, total dissolved solid, BOD5, chemical oxygen demand, and turbidity for both leachate and stream water samples were found to be higher than the Ethiopian EPA and WHO standard guideline values.

Conclusions

The finding suggested that solid waste open dump site adversely affects soil and water quality in the study area and probable source of human health risks via the food chain. The soil in the area requires Phytoremediation technologies. In addition, sanitary landfill is recommended.
Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study
Authors: Sun Qiannan , Chen Si , Lu Wenhsuan , Zhang Yunfan , Peng Liying , Han Bing
Published: July 2019

Background

The morphology of the anterior alveolar bone may change after the retraction of incisors in premolar extraction cases in orthodontics.

Methods

Pre- (T0) and post-treatment (T1) lateral cephalograms of 502 subjects who underwent the orthodontic treatment with 4 first premolars extraction were included. Alveolar bone width and height in both the maxillary and mandible incisor area were measured at T0 and T1 respectively. By superimposing the T0 and T1 cephalometric tracings, changes of points A and B, and the movement of the incisors were also measured.

Results

The alveolar bone width (ABW) showed a significant decrease in both maxilla and mandible (P<0.001) except the labial side of the mandible, which exhibited slight increase, though statistically insignificant (P>0.05). The alveolar bone height (ABH) showed a significant increase in the labial side of maxilla and a significant decrease in the lingual side of mandible. A strong positive correlation was observed between incisor movement and position changes of points A and B both in the horizontal and vertical direction.

Conclusions

Anterior alveolar bone width and height generally decreased after orthodontic treatment. Incisor retraction led to a significant position changes of points A and B.
Determinants of First Line Antiretroviral Treatment Failure among Patients on Highly Active Antiretroviral Therapy in selected Public Hospitals Jimma, Southwest Ethiopia a Case Control Study
Authors: Asfaw Amrachu Bekele , Tekelehaimanot Aderajew Nigusie , Shewanew Tamirat , Gudina Esayas Kebede , Getnet Masrie , Amdisa Demuma , Lemma Tefera Belachew , Dadi Lelisa Sena
Published: July 2019

Background: Identifying determinant factors of antiretroviral therapy (ART) treatment failure are crucial to achieving 90-90-90 treatment target to help end AIDS epidemic by 2020. However, evidences on determinants of first line ART failure in Ethiopia are limited. Hence, the aim of this study was to assess determinants of first line ART failure among patients attending ART care in selected Public Hospitals Jimma, Southwest Ethiopia.

Methods: A case control study was conducted in March 2018 on sample of 384(288 controls and 96 cases) adult people living with HIV/AIDS (PLWHA). All available cases were enrolled in the study whereas controls were selected using simple random sampling. Cases were HIV patients aged 15 years or older who were on first line ART regimen with documented treatment failure (virologic, immunologic or clinical). Controls were HIV patients aged 15 years or older who were on first line ART regimen but without evidence of therapeutic failure. Data was extracted from electronic database and supplemented by data collected through interviewer administered questionnaire. Bivariate and Multivariate logistic regression analyses were used. Adjusted odds ratios and 95% confidence interval were used to report independently associated factors with the first line ART failure at P-value<0.05.

Results: Median ages of cases and controls were 28 (IQR 25-32) and 27 (IQR23-33), respectively. Being urban resident (AOR:2.2; 95%CI: 1.1, 3.6), smoking (AOR:5.9; 95%CI:3.2, 10.8), Khat use (AOR:2.2; 95%CI:1.3,3.7), poor treatment adherence (AOR: 2.2; 95% CI: 1.1,4.5), tuberculosis coinfection (AOR: 3.9; 95% CI:2.2, 6.8), prior exposure to ART (AOR: 3.8; 95% CI:1.7, 8.1), zidovudine based regimen (AOR: 4.8; 95% CI: 2.5,9.0) and median duration on treatment of more than 73 months (AOR:1.9; 95% CI:1.2, 3.3) were independently associated with first line treatment failure.

Conclusions: Multiple factors such as being urban resident, TB co-infection, poor treatment adherence, and zidovudine based regiment were independently associated with first line ART failure. Thus, strategies designed to curb the HIV pandemic should focus on these factors, among others, to achieve the ambitious target of ending AIDS pandemic by 2020 set by UNAIDS.
Key words: determinants, first line ART failure, HIV/AIDS, Jimma Zone, Public hospitals
Variation of malaria cases, parasite density and the multiplicity of Plasmodium falciparum infection throughout the year at three different health centers in Brazzaville, Republic of Congo
Authors: MAYENGUE - PEMBE ISSAMOU , Batsimba Dezi Kouhounina , Niama Roch Fabien , Ottia Reyna Ibara , Malonga-Massanga Alida , Fila-Fila Grâce Petula Urielle , Ahombo Gabriel , Kobawila Simon Charles , Parra Henri Joseph
Published: July 2019

Background: In the Republic of Congo, hot temperature and seasons distortions observed may impact seasonal variations of the development of malaria parasites. We investigate the variation of malaria cases, parasite density and the multiplicity of Plasmodium falciparum infection throughout the year in Brazzaville.

Methods: From May 2015 to May 2016, suspected patients with uncomplicated malaria were enrolled at the Hôpital de Mfilou, CSI « Maman Mboualé», and the Laboratoire National de Santé Publique. For each patient, thick blood was examined and parasite density was calculated. After DNA isolation, MSP1 and MSP2 genes were genotyped.

Results:
A total of 416, 259 and 131 patients with suspected malaria were enrolled at the CSI «Maman Mboualé», Hôpital de Mfilou and the Laboratoire National de Santé Publique respectively. Proportion of malaria cases and geometric mean parasite density were higher at the CSI «Maman Mboualé» compared to over sites (P-value ˂0.001). However the multiplicity of infection was higher at the Hôpital de Mfilou (P-value ˂0.001).
At the Laboratoire National de Santé Publique, malaria cases and multiplicity of infection were not influenced by different seasons. However, variation of the mean parasite density was statistically significant (P-value ˂0.01).
Higher proportions of malaria cases were found at the end of main rainy season including the beginning of the main dry season at the Hôpital de Mfilou and the CSI «Maman Mboualé»; while, lowest proportions were observed in September and January and in September and March respectively. Higher mean parasite densities were found at the end of rainy seasons with persistence at the beginning of dry seasons. The lowest mean parasite densities were found during dry seasons, with persistence at the beginning of rainy seasons. Fluctuation of the multiplicity of infection throughout the year was observed without any impact of different seasons.

Conclusion:
The current study suggests that malaria transmission is still variable between the north and south parts of Brazzaville. Seasonal fluctuations of malaria cases and mean parasite densities were observed with some extension to different seasons. Thus, both meteorological and entomological studies are needed to update the season’s periods as well as malaria transmission intensity in Brazzaville.
Accumulate evidence for IP-10 in diagnosing pulmonary tuberculosis
Authors: Qiu Xia , Xiong Tao , Su Xiaojuan , Qu Yi , Ge Long , Yue Yan , Zeng Yan , Li Wenxing , Hu Peng , Mu Dezhi
Published: July 2019

Backgrounds

Pulmonary tuberculosis (PTB) is a major health and economic burden. Accurate PTB detection is an important step to eliminating TB globally. Interferon gamma-induced protein 10 (IP-10) has been reported as a potential diagnostic marker for PTB since 2007. In this study, a meta-analysis approach was used to assess diagnostic value of IP-10 for PTB.

Methods

Web of Science, PubMed, the Cochrane Library, and Embase databases were searched for studies published in English up to February 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and hierarchical summary receiver operating characteristic (HSROC) curve were estimated by a HSROC model.

Results

Eighteen studies including 2836 total participants met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of IP-10 for PTB detection were 86%, 88%, 7.00, and 0.16, respectively. The pooled DOR was 43.01, indicating a very powerful discriminatory ability of IP-10. Meta-regression showed that there was no heterogeneity with respect to TB burden, study design type, age, IP-10 assay method, IP-10 condition and HIV-infection status.

Conclusions

Our results showed that IP-10 is a promising marker for differentiating PTB from non-TB.
Adapting a nurse-led primary care initiative to cardiovascular disease control in Ghana: A qualitative study
Authors: Haykin Leah , Francke Jordan A. , Abapali Aurelia , Yakubu Elliasu , Dambayi Edith , Jackson Elizabeth , Aborigo Raymond , Awuni Denis , Nonterah Engelbert A. , Oduro Abraham , Bawah Ayaga , Phillips James F. , Heller David J
Published: July 2019

Background

CVD is the leading cause of morbidity and mortality worldwide, and its prevalence is rising in Ghana. The Community-Based Health Planning and Services (CHPS) initiative has used community-level clinics, home visits by nurses, and outreach services to decrease maternal and child mortality across Ghana. However, CHPS currently lacks capacity to screen for or treat CVD and its risk factors.

Methods

We conducted in-depth interviews (IDIs) with 21 nurse community health officers (CHOs) and 10 supervising sub-district leaders (SDLs) to identify factors that constrain or facilitate CHPS screening and treatment for CVD through the World Health Organization’s HEARTS protocol in the rural communities of the Kassena-Nankana East and West districts of Ghana. We transcribed audio recordings of the interviews, coded their content, and analyzed codes for key themes.

Results

Respondents spoke to CVD care barriers across three themes: community demand for CVD care; community access to CVD care; and provider capacity to render CVD care. CHOs and SDLs noted that community members were often unaware of CVD, despite high reported local prevalence of risk factors such as alcohol use and stress. Moreover, community members were unable to travel to or pay for treatment once diagnosed. CHOs lacked training on CVD and its risk factors, as well as medications and supplies to treat conditions such as high blood pressure. However, CHOs and SDLs recognized the importance of CVD care, expressed interest in acquiring further training, and emphasized the need to improve logistical support for primary care as a precondition for CVD care.

Conclusion

Nurses and supervisors associated with the CHPS program voiced multiple obstacles to CVD care, but also listed several feasible steps to address them. Initiatives such as CVD-focused training; provision of essential CVD equipment and pharmaceuticals; community education campaigns; and transportation to aid patients and providers could address these barriers. Future work will explore the feasibility and acceptability of these interventions among staff and community members, in preparation for a locally adapted pilot initiative drawing from the HEARTS initiative designed to control CVD risk factors such as hypertension, depression, and alcohol abuse.