bluuebunny/crossref_metadata_2025 huggingface dataset:
Presente y futuro de la publicación y difusión del conocimiento jurídico
Authors: Bardales del Aguila Lionel
Published: November 2021

El sistema educativo universitario peruano con la entrada en vigencia de la Ley Universitaria 30220 incorpora un nuevo modelo educativo, en el que predomina el desarrollo de la investigación científica. La Universidad Nacional de San Martín, (UNSM) en el marco de la adecuación a la nueva Ley, reforma su estatuto, reglamenta y aprueba las normas pertinentes sobre la gestión de la investigación a nivel de estudiantes y docentes.
Estudio de las medidas de protección en los casos de Violencia contra la Mujer en el Primer Juzgado de Familia de Tarapoto 2017-2018
Authors: Mondragón Carrasco Esthefany , Siaden  Valdivieso José Roberto
Published: November 2021

La presente investigación, tuvo como objetivo principal analizar la relación entre las medidas de protección frente a los casos de violencia contra la mujer en el Primer Juzgado de Familia Tarapoto 2017–2018. El tipo de investigación fue básica con enfoque cuantitativo, de nivel descriptivo y diseño no experimental, la muestra estuvo conformada por 59 casos por violencia contra la mujer, para la recolección de datos se empleó como técnica el análisis documental y la entrevista, para la cual se emplearon como instrumentos la guía de análisis documental y la guía de entrevista. Llegando a concluir que se evidencia la relación significativa entre las variables en estudio, por lo tanto, se acepta la hipótesis de la investigación, asimismo tras el cálculo del coeficiente determinante se determinó que las medidas de protección influyeron en un 80% frente a los casos de violencia contra la mujer.
FMLN
Authors: González Luis Armando
Published: November 2021

No hay resúmenes disponibles.

ECA Estudios Centroamericanos, Vol. 53, No. 597-598, 1998: 657-661.
Deposit feeding of a foraminifera from an Arctic methane seep site and possible association with a methanotroph revealed by transmission electron microscopy
Authors: Schmidt Christiane , Geslin Emmanuelle , Bernhard Joan M. , LeKieffre Charlotte , Svenning Mette Marianne , Roberge Helene , Schweizer Magali , Panieri Giuliana
Published: November 2021

Abstract. Several foraminifera are deposit feeders that consume organic detritus (dead particulate organic material along with entrained bacteria). However, the role of such foraminifera in the benthic food-web remains understudied. As foraminifera may associate with methanotrophic bacteria, which are 13C-depleted, feeding on them has been suggested to cause negative δ13C values in the foraminiferal cytoplasm and/or calcite. To test whether the foraminiferal diet includes methanotrophs, we performed a short-term (1 d) feeding experiment with Nonionellina labradorica from an active Arctic methane-emission site (Storfjordrenna, Barents Sea) using the marine methanotroph Methyloprofundus sedimenti, and analyzed N. labradorica cytology via Transmission Electron microscopy (TEM). We hypothesized that M. sedimenti would be visible, as evidenced by their ultrastructure, in degradation vacuoles after this feeding experiment. Sediment grains (mostly clay) occurred inside one or several degradation vacuoles in all foraminifers. In 24 % of the specimens from the feeding experiment degradation vacuoles also contained bacteria, although none could be confirmed to be the offered M. sedimenti. Observations of the area adjacent to the aperture after 20 h incubation revealed three putative methanotrophs, close to clay particles. These methanotrophs were identified based on internal characteristics such as a type I stacked intracytoplasmic membranes (ICM), storage granules (SG) and gram-negative cell walls (GNCW). Furthermore, N. labradorica specimens were examined for specific adaptations to this active Arctic methane-emission site; we noted the absence of bacterial endobionts in all specimens examined but confirmed the presence of kleptoplasts, which were often partially degraded. Based on these observations, we suggest that M. sedimenti can be consumed by N. labradorica via untargeted grazing in seeps and that N. labradorica can be generally classified as a deposit feeder at this Arctic site. These results suggest that if methanothrophs are available to the foraminifera in their habitat, their non-selective uptake could make a substantial contribution to altering δ13Ctest values. This in turn may impact metazoans grazing on benthic foraminifera by altering their δ13C signature.
Last Interglacial sea-level data points from Northwest Europe
Authors: Cohen Kim M. , Cartelle Victor , Barnett Robert , Busschers Freek S. , Barlow Natasha L. M.
Published: November 2021

Abstract. Abundant numbers of sites and studies exist that document the Last Interglacial (Eemian, Ipswichian, MIS 5e) coastal record for geographically and geomorphologically diverse NW Europe. This paper documents a database of 141 known Last Interglacial sea-level indicative data points from in and around the North Sea (35 entries in Netherlands, 10 Belgium, 16 in Germany, 17 in Denmark, 8 in Britain) and the English Channel (28 entries for British and 25 for the French side, 3 on the Channel Isles), believed to be a representative and fairly complete inventory and assessment coming from some 80 published sites. The good geographic distribution (some 1500 km SW-NE) across the near field of the Scandinavian and British Ice Sheets and the attention paid to absolute and relative age control are assets of the NW European database compilation. The research history of Last Interglacial coastal environments and sea-level position for this area is long, methodically diverse and spread over regional literature in several languages. Last Interglacial high-stand shorelines of Dutch and German Bight parts of the North Sea, were of lagoonal and estuarine type and have preserved subsurface (data entry included estimates of non-GIA vertical land motion). In contrast, Last Interglacial high-stand shorelines along the English Channel are encountered above modern sea-level (data entry includes datum definitions). Our review and database compilation effort drew from the original regional literature, and paid particular attention to distinguishing between sea-level index points (SLIPs) and marine and terrestrial limiting-points. This paper describes the dominant sea-level indicators produced from region to region, compliant to the database structure of the special issue (WALIS), referenced to original source data. The sea level proxies in majority are obtained from localities with well-developed lithostratigraphic, morpho-stratigraphic and biostratigraphical constraints. Amino-Acid Racemization information is also prominent, especially in Britain, albeit for many sites the older, lesser quality applications of that technique. The majority of European continental sites have chronostratigraphic age-control, notably through regional Pollen Association Zones of known durations. This greatly helps to separate transgression, highstand (‘stillstand’) and regression subsets from within the interglacial, useful when summarizing and/or querying the dataset. In all regions, many SLIPs and limiting points have further independent age-control from luminescence (IRSL, OSL, TL), U-series and ESR dating techniques. Main foreseen usage of this database for the near field region of the European ice sheets is in GIA modelling.
Regional county-level housing inventory predictions and the effects on hurricane risk
Authors: Williams Caroline J. , Davidson Rachel A. , Nozick Linda K. , Trainor Joseph E. , Millea Meghan , Kruse Jamie L.
Published: November 2021

Abstract. Regional hurricane risk is often assessed assuming a static housing inventory, yet a region’s housing inventory changes continually. Failing to include changes in the built environment in hurricane risk modeling can substantially underestimate expected losses. This study uses publicly available data and a long short-term memory (LSTM) neural network model to forecast the annual number of housing units for each of 1,000 individual counties in the southeastern United States over the next 20 years. When evaluated using testing data, the estimated number of housing units was almost always (97.3 % of the time), no more than one percentage point different than the observed number, predictive errors that are acceptable for most practical purposes. Comparisons suggest the LSTM outperforms ARIMA and simpler linear trend models. The housing unit projections can help facilitate a quantification of changes in future expected losses and other impacts caused by hurricanes. For example, this study finds that if a hurricane with similar characteristics as Hurricane Harvey were to impact southeast Texas in 20 years, the residential property and flood losses would be nearly US$4 billion (38 %) greater due to the expected increase of 1.3 million new housing units (41 %) in the region.
Developing a radiation field-based monitoring system for the transport and storage cask inventory during extended interim storage
Authors: Stephan Mira , Reinicke Sebastian , Kratzsch Alexander , Wagner Michael , Kobelt Sebastian , Hampel Uwe
Published: November 2021

Abstract. High-level radioactive waste must be stored safely for a very long time but a
suitable site for long-term storage is yet to be found. Additionally, in
Germany the licence for transport and storage of casks is limited to 40 years,
beginning at the time of emplacement and begins to expire for the first
containers in the 2030s. To resolve the conflict between not having a final
repository in time and the licence expiring, the licence must be extended
while ensuring uninterrupted safe storage and safe transport. The DCS-Monitor
II research project supports this process by investigating approaches to
noninvasive, radiation field-based diagnostics that enable the observation of
potential geometric changes of the cask inventory. Previous feasibility
studies in the predecessor project DCS-Monitor I showed that cask monitoring
using gamma radiation, neutron fields and cosmic muons is promising. In the
ongoing research project presented here, the investigations on the
qualification of radiation field-based diagnostics are extended via
simulations. For muon imaging, a suitable procedure which solves the inverse
problem to monitor the cask inventory is implemented. In addition, a partially
automated gamma and neutron measurement system is being constructed and a muon
detector is being developed and built. Both systems will be tested in field
studies on large scale geometries and real containers.
Impact of Radiation-Induced Microstructures on the Integrity of Spent Nuclear Fuel (SNF) Elements in Long-Term Storage
Authors: Yanikömer Neslihan , Nabbi Rahim , Fischer-Appelt Klaus
Published: November 2021

Abstract. The current safety concept provides for a period in the range of 40 years for
interim storage of spent fuel elements. Since the requirement for proof of
safety for to up to 100 years arises, the integrity of the spent fuel elements
in prolonged interim storage and long-term repositories is becoming a critical
issue. In response to this safety matter, this study aims to assess the impact
of radiation-induced microstructures on the mechanical properties of spent
fuel elements, in order to provide reliable structural performance limits and
safety margins. The physical processes involved in radiation damage and the effect of
radiation damage on mechanical properties are inherently multiscalar and
hierarchical. Damage evolution under irradiation begins at the atomic scale,
with primary knock-on atoms (PKAs) resulting in displacement cascades (primary
damage), followed by the defect clusters leading to microstructural
deformations. In this context, we have developed and applied a multiscale
simulation methodology consistent with the multistage damage mechanisms and
the corresponding effects on the mechanical properties of spent fuel cladding
and its integrity. Within the improved hierarchical modelling sequence, the
effect of the radiation field on the fuel element cladding material
(Zircalloy-4) is assessed using Monte Carlo methods. A molecular dynamics
method is employed to model damage formation by PKAs and primary damage defect
configurations. The formation of clusters and evolution of microstructures are
simulated by extending the simulation sequence to a longer time scale with the
kinetic Monte Carlo (KMC) method. Transferring the calculated radiation-induced microstructures into macroscopic
quantities is ultimately decisive for the structural/mechanical behaviour and
stability of the cladding material, and thus for long-term integrity of the
spent fuel elements. Results of the multiscale modelling and simulations as
well as a comparison with experimental results will be presented at the
conference session.
Hydro-mechanical effects of seismic events in crystalline rock barriers
Authors: Kern Dominik , Magri Fabien , Malkovsky Victor I. , Nagel Thomas
Published: November 2021

Abstract. Under ideal conditions, owing to its extremely low matrix permeability, crystalline rock can constitute a suitable hydro-geological barrier. Mechanically, its high strength and stiffness provide advantages when constructing a repository and for long-term stability. However, crystalline rock usually occurs in a fractured form, which can drastically alter hydromechanical (HM) barrier functions due to increased permeability and decreased strength. Seismic events have the potential to alter these HM properties by activating faults, increasing their transmissibility, creating new fractures or altering network connectivity (De Rubeis et al., 2010). Therefore, it is of high importance to build computational models to allow assessment of the HM effects of seismic events in a Deep Geologic Repository (DGR) in crystalline rock, as illustrated in Fig. 1. For this purpose, we consider a DGR in Russia (Yeniseysky site) for high-level waste in crystalline rock (Proterozoic and Archaean gneiss complexes) that is located close to a potentially seismically active area (Jobmann, 2016). Here, we present a coupled HM simulation, using OpenGeoSys (Kolditz et al., 2012), of a large-scale, three-dimensional finite-element model of the Yeniseysky site to assess the consequences of seismically induced stress-field changes on the local stress field and the fluid flow. This research also provides an outlook of current model development geared towards a more detailed assessment of seismically induced hydro-mechanical processes in porous and fractured rocks.
The Secret of the Copper Box: public experiments and the prospects of living archives of Swedish nuclear waste
Authors: Keating Thomas P. , Storm Anna
Published: November 2021

Abstract. This paper approaches the question of nuclear safety in relation to the prospects of living archives, and in particular, it explores two public events where sociocultural aspects of nuclear waste management in Sweden were enacted. Drawing on an ongoing research collaboration with the Swedish Nuclear Fuel and Waste Management Company (SKB), the paper examines (1) a grass-roots play entitled Kopparkistans hemlighet (or The Secret of the Copper Box), and (2) a drawing competition hosted by schools located near a nuclear waste storage facility in the Östhammar municipality, considering how these events help reproduce certain kinds of social and cultural responsibility. Contributing to critical debates in the social sciences and humanities intersecting questions of memory preservation, nuclear waste, and post-nuclear natures, we consider how the forms of responsibility produced through these public experiments inform important, albeit unconventional, modes of nuclear waste management insofar as they suggest how long-lived nuclear waste sites might become living archives without assuming a narrow notion of heritage and human memory preservation for all time and space. To conclude, we evaluate how the legacy of the two events might be incorporated into wider strategies of nuclear waste management.
Justice in dealing with highly radioactive waste – an empirical perspective
Authors: Schwarz Lucas
Published: November 2021

Abstract. The introduction of the Site Selection Act
(Standortauswahlgesetz, StandAG) marked the initiation
of a new repository site-selection process as well as the elimination of
injustices of past procedures. In this context, the white map of
Germany served as a basis for and symbol of an unbiased search process
(Hocke and Smeddinck, 2017). However, the publication of the Sub-Areas
Interim Report has revealed injustices in the handling of high-level
radioactive waste. For example, there is criticism that the methods
used to determine the sub-areas are immature or scientifically
dubious. There are still fears that rural areas with a low population
density will be favored, that there are imbalances in the
site-selection process between West and East Germany, or that
the discrepancy in the sense of fairness between regions that drop out
of the process and those that remain will lead to problems in
subsequent stages of the process. All of these positions show that there is inherent injustice in the
search for a repository site: at the end of the site-selection
process, a single site will receive all the high-level radioactive
waste of the Federal Republic of Germany and thus bear the potential
risks. People at this one site will live with the uncertainties
associated with dealing with high-level radioactive waste. While the
debate about geological or technical factors and challenges is
multifaceted and specialized, the issue of fairness in the
site-selection process is rarely addressed. However, fairness is
immensely important to find
a socially acceptable repository site. This paper thus focuses on the
following questions: What are the prevailing notions of justice among
those involved in the repository site-selection process? From the
perspective of the involved parties, what characterizes fairness in
the site-selection process? Answering these questions should contribute to a better understanding
of whether the repository site-selection process is perceived as just,
and what this depends on. Starting from Rawls' theoretical perspective of
justice (2005 [1971]) and Latour's contribution of the values of modern
people (2014), an empirical understanding of the stakeholders'
perception and understanding of justice in the site-selection process
is synthesized. In the context of this work, results of an empirical
survey comparing different aspects of justice, e.g., procedural,
distributive, intergenerational, and interpersonal, but also justice
as recognition, are presented and related to adjacent factors, such as
trust, emotions, or experiences. The empirical survey is intended to
provide information on whether the perception of justice is more
strongly dependent on the process, on one's own affectedness, or on
adjacent factors.
Mobile attachment for automated crack milling
Authors: Froebus Birte , Gentes Sascha , Unverzagt Christoph
Published: November 2021

Abstract. In the dismantling of nuclear facilities, the decontamination and
remote-controlled crushing of reinforced concrete is a central point. The main
objective is to selectively remove the contaminated material in order to feed
the remaining material, which in relation to the overall system or overall
mass, represents the predominant part of the normal recycling cycle. For the
surface decontamination of the upper millimeters, several methods are
available that are constantly being optimized and further developed. However,
there is a great need for research in the demolition and selective deep
removal of reinforced concrete, e.g. in the case of cracks or eruptions into
which contamination could penetrate, or the removal of metallic fixtures. The
production of freely measurable surface geometries is a constant objective
(Edelmann et al., 2018). The German “Defined removal of highly reinforced concrete” (DefAhS) research
project was funded by the German Federal Ministry of Education and Research
(BMBF) from October 2013 to the end of March 2018. In the course of the
project, a new combination tool consisting of indexable inserts and impact
lamellas was developed. With this method it is possible to remove highly
reinforced concrete in one operation. The following property right could be
granted: “Device for removing building material” (DE102015114122B3). Within
the research project, concrete, reinforcement and fixtures (dowels, rails,
anchor plates, pipe penetrations) could be successfully cut. It could also be
shown that it is possible to remove several layers of steel reinforcement
within a concrete matrix. The “Mobile attachment for automated crack milling” (MAARISS) research
project has been running since November 2020. The hybrid milling technology
developed in DefAhS is intended to form the basis for the milling drum used in
MAARISS. The aim in MAARISS is, among other things, a new development of the
extraction system directly on the removal unit and an automation system for
use in a nuclear facility. Cracks are to be automatically milled over in order
to enable subsequent clearance measurement by the staff on site. The
physically very strenuous work of crack uncovering should be reduced to just
one operator in a safe environment. The construction of a scaffold should be
completely dispensed with and existing transport technology (forklift or
lifting platform) should be used.
From a hard nuclear state towards a soft nuclear repository state – participation, co-designing, learning and reversibility in the site selection process for a nuclear waste repository
Authors: Brunnengräber Achim , Di Nucci Maria Rosaria , Schwarz Lucas , Themann Dörte
Published: November 2021

Abstract. Since 2013 the site search for a repository for highly radioactive waste has been taking place in Germany within the framework of a new governance architecture and under new political guidelines. Based on experiences with nuclear politics in the past, Jungk (1977) coined the term hard nuclear state, characterized by decisions made in a top-down manner. The Decide-Announce-Defend (DAD) strategy, which branded the nuclear state at that time, led to conflicts, mistrust of authorities and blockages. In particular, massive resistance developed against the planned final repository site at Gorleben. Nowadays, after more than 60 years deploying nuclear energy, the (energy) political balance of power has fundamentally changed. Parts of the anti-nuclear movement have been integrated into the political party system and have contributed significantly to the nuclear phase-out. In the course of this, the unfinished task of final disposal has been readdressed: with the Repository Site Selection Act (StandAG, 2017), which was passed in 2013 and amended in 2017, an ongoing process of public participation is stated. The site selection process is required to be learning, self-questioning, science-based, reversible, and participatory. The StandAG § 5 not only provides a basis for a fundamental dialogue between the regulator, the operator, and the public, but also for „co-design“ by common citizens. The StandAG considers various elements from different participation-friendly theories of democracy as well as specific governance concepts, which we refer to collectively as the soft nuclear repository state (cf. Brunnengräber, 2021). Its characteristics need to be worked out, as the StandAG only provides some indications, but no criteria, for what good and sufficient participation in the site selection process means and what its conditions for success should be. Based on preliminary considerations on democratic theory and governance aspects (part 1), we present what good participation could mean in the current procedure and what the framework conditions for good participation could be (part 2). Additionally, we present main findings from participatory observations from the ongoing site search process and identify conditions and indications of a successful future participation process based on the ongoing process (part 3). In the résumé, we turn to the question of which of the democracy-theoretical elements of the soft repository state are already recognizable in the present procedure, but also whether the current procedure provides additional indications towards the soft nuclear repository state (part 4).
Development of an automated milling system for the decontamination of the wall surface in a nuclear power plant
Authors: Li Chang , Kazemi Siavash , Gentes Sascha
Published: November 2021

Abstract. Nowadays, concrete decontamination is done by, e.g., grinding, milling, etc.,
always combined with labor resources. In order to relieve employees from the
monotonous and physically stressful decontamination work, a novel milling
system for automated surface decontamination has been developed and
assembled. The current work presents this new concept for a milling tool that
could automatically position itself to the wall surface and subsequently
remove surface contamination. A process chain (Fig. 1) defined in the German
Federal Ministry of Education and Research (BMBF)-funded project ROBDEKON was
introduced first. The chain consists of a total of five steps for a compact
process, from environmental exploration to the transportation of waste. This
automated decontamination is the third step in the process chain for
decontamination of building structures in nuclear facilities. The structure
(Fig. 2) of the milling system and the function of each component
are then explained in detail. With the assembled sensors, such as a
laser distance sensor, a force sensor etc., the various physical quantities
can be measured in real time, thus enabling automation of the milling process
during decontamination.
Transport in tight material enlightened by process tomography
Authors: Kulenkampff Johannes , Bollermann Till , Cardenas Rivera Maria A. , Fischer Cornelius
Published: November 2021

Abstract. The analysis of fluid transport through tight barrier materials poses two
major challenges: (i) Long equilibration periods require long minimum
experiment durations, and (ii) the fluid transport frequently results in
complex pattern formation. Measuring times that are too short may feign
transport rates that are too low; intact homogeneous samples are often missing
problematic features, e.g. fractures. Both issues are detected and analyzed by
using process tomography techniques, thereby providing an improved
understanding of transport processes in complex materials. We thus continuously develop and apply the positron emission tomography (PET)
method for geomaterials (Kulenkampff et al., 2016). This is able to trace very
low concentrations of β+-emitting radionuclides during their
passage through drill cores of barrier material with reasonable resolution
(1 mm) and over variable periods (hours to years). The method yields
time-resolved quantitative tomographic images of the tracer concentration
(e.g. https://doi.org/10.5281/zenodo.166509), in contrast to
input-output experiments like common permeability measurements, diffusion
cells or break-through curves. Our current research includes the analysis of diffusive transport in
heterogeneous shales (sandy facies of the Opalinus Clay) (BMBF and HGF iCross
project), the reactive flow in fracture-filling materials of crystalline rocks
(Eurad FUTURE project) and transport in engineered barriers and the contact
zone (Euratom Cebama, Eurad Magic, as well as MgO and Stroefun BMWi
projects). The efforts combine flow field tomography, structural imaging and
reactive transport modelling to improve process understanding and to provide a
bridge from the molecular to the macroscopic scale. The benefits include:
Insight into temporal stability and spatial heterogeneity of the observed transport process Parameterization of local velocity distribution and effective volume as well as comparability with pore-scale model simulations Ability to quantify multiple internal transport rates without the need to register the delayed output signal Transparent and palpable visualization of processes hidden in the opaque material
The method requires specific constraints of the experimental setup (size,
fluid pressure, temperature). Nevertheless, it provides unique insight into
reactive transport processes observed in potential materials for nuclear waste
management.
The distribution of phosphorus from recycled fertilizers to different soil fractions determines the phosphorus availability in soil
Authors: Wang Yuan , Zhang Wei , Müller Torsten , Lakshmanan Prakash , Liu Yu , Liang Tao , Wang Lin , Yang Huaiyu , Chen Xinping
Published: November 2021

Abstract. Recycling of agricultural wastes to reduce mineral fertilizer input, in particular phosphorous (P), plays crucial role in sustainable agriculture production. Understanding the transformation of phosphorous (P) fractions and their bioavailability following soil application of different renewable P-contained fertilizers is very important for improving P use efficiency and reducing environmental risks. In this study, the effects of mineral P-fertilizer superphosphate and recycled P-fertilizers, i.e., poultry manure, cattle manure, maize straw and cattle bone meal, on their distribution to different soil P fractions, their transformation and the availability of soil P were determined by soil P sequential fractionation and 31P solution nuclear magnetic resonance (NMR). The results showed that addition of mineral P fertilizer, poultry manure and cattle manure increased P fixation in a red soil more than that in a fluvo-aquic soil. In both fluvo-aquic and red soils, cattle manure out-performed all other recycled P sources used in improving soil P availability. The concentration of Olsen-P in fluvo-aquic and red soils supplemented with cattle manure were increased by 41 %–380 % and 16 %–70 % than the other recycled P sources. A structural equation model (SEM) explained 95 % and 91 % of Olsen-P variation in fluvo-aquic and red soils, respectively. Labile P fractions had positive effects on Olsen-P of fluvo-aquic and red soils. 31P-NMR study showed that amount of orthophosphate was the main factor affecting the availability of P from different P sources. In summary, cattle manure was found to be a superior renewable source of P in improving bioavailable P in soil, and its use thus has considerable practical significance in P recycling.
Clinical Profile Of Hepatocellular Carcinoma-Experience At A Tertiary Care Hospital
Authors: din Rafi ud , Anjum Fauzia , Khattak Abdul Latif , Khan Rao Saad Ali , Shabbir Khawar , Khattak Abdul Latif
Published: November 2021

Objective: To determine the characteristics of Hepatocellular carcinoma (HCC) in patients visiting PEMH Rawalpindi. Study Design and Setting: Cross-sectional Study conducted at Department of Gastroenterology/hepatology in Pak Emirates Military Hospital Rawalpindi (PEMH) from Oct 2015 to Jan 2018. Methodology: In this study total 100 patients, with HCC of both genders were included. All the cases were discussed in multidisciplinary team (MDT) meetings which were held once every week. A decision on the best possible management for the given case was arrived at in the MDT meeting. All the relevant features of each case were recorded in the Performa. Descriptive statistics were used to calculate mean, standard deviation and frequencies for gender, various presenting features, co-morbidities and clinical features. Data was analyzed on SPSS version 21. P value <0.05 was considered as statistically significant. Results: Sixty seven men and 33 women with HCC were included in this study with a mean age of 58.23 years. The abdominal pain was the most common symptom present in 66 (66%) patients. Edema was seen in 30 (30%) and palpable splenomegaly in 26(26%). Diabetes mellitus was the most common co-morbidity found in 20(20%) patients. HCV was the commonest cause of HCC present in 79(79%) patients. Vascular involvement was seen in 15 (15%) patients. Most (62%) patients had a single HCC lesion and most belonged to Child –Pugh class A (68%) and BCLC stage B (42%). ECOG performance status was good in most patients with 49% patients scoring 0. The AFP levels were raised in 58 (58%) of the patients. Conclusion: HCV was the most common underlying etiology. Most of the patients were asymptomatic at the time of diagnosis. Majority of subjects reported with the complaint of abdominal pain and had no underlying co morbidity. The metastasis was negative in majority of cases
Superficial Surgical Site Infection after Primary Closure Versus Delayed Primary Closure of Wound in Perforated Appendicitis
Authors: Sahrish Yabinda , Kaludi Zainab Abdullah , Ayub Shamaila , Zia Khurram , Khan Muhammad Athar , Khalid Nadia
Published: November 2021

Objective: To assess the superficial surgical site infection after primary closure versus delayed primary closure of wound in perforated appendicitis. Study Design and Setting: This was an observational study conducted at Darul Sehat Hospital & Civil Hospital Karachi during March 2019 to August 2019 Methodology: All patients of either gender between 18-50 years of age undergoing open Appendectomy through standard gridiron incision in emergency having consented for participation in the study prior to surgery and with per-operative finding of perforated appendix in emergency were included. Patients on steroids or immunosuppressive agents, smoker staking 5 or more cigarettes per day, patients with history of Diabetes Mellitus, chronic liver disease and chronic renal failure were excluded from the study. Patients with perforated appendix were randomly allocated into two Groups. Group A received delayed primary closure at 3rd post-operative day while in Group B primary closure was done immediately after appendectomy. All patients were examined for signs and symptoms of superficial surgical site infection at the 5th postoperative day before discharge from the hospital. SPSS version 13 was used for data analysis. Chi square test was applied to compare the outcome (superficial surgical site infection) in both groups. P-value <0.05 was considered as significant. Results: A total sixty patients were allocated in each group. Wound infection was very high among patients with immediate closure (40%) as compared to group which received delayed primary closure (15%) (p=0.020). Conclusion: The superficial surgical site infection was significantly higher after primary closure versus delayed primary closure of wound in perforated appendicitis.
Emergence of Chikungunya Virus in Pakistan: What should be done?
Authors: Hussain Abbas Ali , Sarwar Rabia
Published: November 2021

Since 10 years, Chikungunya – a virus spread through Aedes spp mosquitoes – has reemerged in Africa, southern and southeastern Asia, and the Indian Ocean Islands.1 In SouthEast Asia, epidemics have been documented in India, Malaysia, Sri Lanka, Myanmar, Thailand, Indonesia, the Philippines, Cambodia, Vietnam, Hong Kong, and Pakistan
The effect of digital marketing, digital finance and digital payment on finance performance of Indonesian SMEs
Authors: Nurjannah Ibrahim Daud, Dewi , Mohyi Achmad , Ambarwati Titiek , Cahyono Yoyok , Haryoko Andrean Eko , Handoko Agus Leo , Putra Riyan Sisiawan , Wijoyo Hadion , Ari-yanto Aris , Jihadi M.
Published: November 2021

The purpose of this study is to analyze the effect of digital finance, digital marketing and digital payment variables on finance performance. This study uses quantitative methods and data analysis techniques is performed based on Structural Equation Modeling using SmartPLS 3.0 software. The method of selecting the sample using the snowball sampling methods. Online questionnaires were sent to 190 SMEs respondents in the province of Banten Indonesia and evaluated the returned questionnaires. The results of data analysis show that the digital finance had a positive and significant effect on the finance performance, the digital payment had a positive and significant effect on the finance performance and the digital marketing had a positive and significant effect on the finance performance. The findings of this research can provide benefits for MSME actors in developing their business to improve business performance, by paying attention to aspects of MSME digitization and financial literacy of MSME entrepreneurs. Keep in mind, the important role of information technology in business activities requires entrepreneurs to improve their digital literacy.
Quality factors in technology system capability decision interest in transactions using mobile banking
Authors: Suardana Ida Bagus Raka , Martini Luh Kadek Budi , Subawa Nyoman Sri , Setini Made
Published: November 2021

The purpose of this study was to determine the effect of ease of use, transaction success rate, and technological system capability on trust and to determine the effect of ease of use, transaction success rate, technology system capability and interest in transaction using mobile banking. This research was conducted at PT Bank NIAGA which is located in Denpasar. The data collection technique used a questionnaire to 160 PT Bank NIAGA customers who were selected as samples. Data were analyzed by Structural Equation Modeling (SEM) with AMOS program. Ease of use, transaction success rate, and technology system capability have a positive and significant influence on trust and interest in transacting using mobile banking. This means that the better the ease of use, the success rate of transactions, and the capability of the technology system, the higher the customer trust and interest in transactions using mobile banking.
The effects of different factors influencing commuterline in Indonesia
Authors: Suyaman Dede Jajang , Martini Nelly , Muslihat Asep , Jaelani Rahmat
Published: November 2021

Commuterline plays an important role for transportation planning in Indonesia, and it is essential to learn more on how to motivate people to actively use this public transportation facility. This paper presents an empirical investigation to explore different factors influencing the use of this publica transportation facility. The proposed study develops a questionnaire in Likert scale and distributes it among 374 people who had good experience of using commuterline in their daily lives. The questionnaire is designed to learn the effects of environmental, individual, consumer resources and psychological factors. Using some statistical techniques, the study has determined that psychological factors are the most important elements influencing consumer behavior to use this public transportation followed by consumer resources, product knowledge and individual characteristics.
The effects of entrepreneurial orientation, social media, managerial ties on firm performance: Evidence from Vietnamese SMEs
Authors: Nguyen An Thi Hong , Nguyen Phuong V. , Do Huynh Thi Sa
Published: November 2021

This study examines the effects of entrepreneurial orientation, social media, and managerial ties on the business performance of small and medium-sized enterprises (SMEs) in Vietnam. In addition, the mediating effects of social media and managerial ties on the causal relationship between entrepreneurial orientation and firm performance is investigated. A total of 180 senior managers of SMEs were collected for data analysis by using partial least squares structural equation modeling. The results reveal that entrepreneurial orientation strongly enhances social media and managerial ties, which are determinants of business performance. Specifically, entrepreneurial orientation has no direct impact on firm performance; but the mediating effects were confirmed. Based on the results, our study highlights some theoretical contributions and suggests practical implications for practitioners in Vietnamese SMEs to improve firm performance effectively and efficiently.
Desafios no diagnóstico das síndromes disautonômicas na gestação: relato de caso
Authors: Costa Ellen Tieko Tsugami Dalla , Campos Paula Faria , Siqueira Kelma Luana Abreu de , Rosa Lorena da Silva , Blum Catharina Maria Facciolli , Pultrin Carolina Genaro
Published: November 2021

Introdução: A gestação é um período singular, no qual alterações fisiológicas podem exacerbar os sintomas das síndromes disautonômicas. A síndrome de taquicardia postural ortostática (POTS) é uma disautonomia simpática caracterizada pelo aumento de ≥30 batimentos por minuto (bpm) na frequência cardíaca quando em posição ortostática, sem hipotensão, que pode estar associada a cefaleia, vertigem, ansiedade, turvação visual e síncope em pacientes acima de 19 anos. Os sintomas de taquicardia no paciente com a síndrome de POTS podem ser desencadeados por: hipovolemia, quando a diminuição da pré-carga provoca a taquicardia reflexa; disfunção neuroendócrina com estado hiperadrenérgico; e disautonomia do sistema nervoso adrenérgico. Por outro lado, a síncope vasovagal vasoplégica ocorre em consequência de uma hipotensão por bradicardia associada ou não a vasodilatação periférica. Relato de caso: Gestante, 20 anos, primigesta, 33 semanas, com história de transtorno depressivo recorrente, com tentativas de suicídio impulsivas e síncope quando em posição ortostática por mais de 10 min. Ao exame físico, apresenta frequência cardíaca de 108 bpm quando sentada; 118 bpm e tontura leve quando em pé por 3 min; 138 bpm e turvação visual quando em pé por 7 min; e 140 bpm, com piora dos sintomas, quando em pé por 10 min. O tilt test realizado foi tecnicamente limitado, pois descreveu aumento na frequência cardíaca e posterior queda da pressão arterial, evoluindo para uma pressão arterial inaudível, e considerou síncope vasovagal vasoplégica positiva, porém não computou o aumento da frequência cardíaca nos primeiros 3 min, critério para a síndrome de POTS. Diante dos achados clínicos e após a interpretação cuidadosa do tilt test, foi aventada a hipótese de síndrome de POTS associada à síncope vasovagal, além de depressão e ansiedade secundárias. Iniciou-se o tratamento com Fluoxetina; ingestão de 3 a 4 litros de água por dia; e uso de meia compressiva, com melhora na tolerância da posição ortostática. Entrou em trabalho de parto com 38 semanas e 6 dias, quando foi indicada a cesariana por desproporção cefalopélvica. O parto e o pós-parto evoluíram sem qualquer intercorrência. Conclusão: Perante os sintomas de disautonomia, os diagnósticos diferenciais devem ser cuidadosamente avaliados. A síndrome de POTS ou a síncope vasovagal vasoplégica não são contraindicações para a gestação. Durante o terceiro trimestre, a pressão uterina na veia cava inferior piora a pré-carga cardíaca, podendo piorar os sintomas de disautonomia. O diagnóstico adequado, associado ao acompanhamento especializado, possibilitam o controle dos sintomas e uma gestação mais segura.
Diagnóstico diferencial entre gestação heterotópica e gestação ectópica com Arias-Stella: relato de caso
Authors: Vilhena Thyene de , Câmara Felipe Clemente Colbert , Bonisson Lígia Sant Ana , Carvalho Talita Alvarenga Petrini , Veiga Sabrina Carpanez , Martinelli Silvio Guedes de Assis
Published: November 2021

Introdução: A gestação ectópica é caracterizada pela implantação do blastocisto em uma localização diferente da cavidade uterina. A compreensão de sua etiologia, fatores de risco e correto diagnóstico faz-se necessária para reduzir a mortalidade materna nesse período, pois ela ainda é a principal causa de óbito materno no 1º trimestre gestacional. Já a gestação heterotópica corresponde à presença de gestações simultâneas em dois locais de implantação diferentes. É um evento raro, que ocorre em 1:30.000 gestações. O diagnóstico precoce da gravidez heterotópica é difícil. Assim, um alto índice de suspeita é importante. Relato de caso: I.E.S., 37 anos, G4PC3, salpingectomia bilateral há 10 anos, com atraso menstrual de seis semanas e cinco dias e gonadotrofina coriônica humana beta (beta-HCG) de 61,87 em 6 de fevereiro de 2021. Compareceu ao pronto atendimento em 7 de fevereiro de 2021, estável, com queixa de sangramento vaginal em pequena quantidade há uma semana, associado a cólicas. Ao exame, identificou-se dor em anexo direito à palpação bimanual e colo fechado. Solicitou-se novo beta-HCG com valor de 1.021,2. Durante a observação, a paciente evoluiu com expulsão de material amorfo e colo aberto. O material foi enviado para estudo. Apesar de o quadro ser compatível com aborto em evolução, optou-se pela realização do ultrassom transvaginal em razão da salpingectomia prévia: foram identificados material heterogêneo em cavidade uterina compatível com aborto espontâneo e massa heterogênea em região anexial direita compatível com gestação ectópica rota. Aventou-se a hipótese de gestação heterotópica. A paciente foi submetida a laparotomia exploradora, com identificação de gestação ectópica rota em tuba uterina direita. Ao fim, o resultado do exame anatomopatológico identificou uma gestação ectópica em tuba uterina direita e fenômeno de Arias-Stella. Conclusão: Atenção especial deve ser dada às pacientes com fatores de risco para gestação ectópica, como cirurgia tubária prévia, gestação ectópica prévia, tabagismo, infertilidade na vigência de atraso menstrual e sangramento vaginal. O diagnóstico deve ser complementado com exame de imagem, dosagem de beta-HCG e, excepcionalmente, curetagem uterina para identificar a reação de Arias-Stella ou a presença de restos ovulares. Apesar da alta probabilidade de se tratar de uma gestação heterotópica nesse caso, o diagnóstico final é obtido apenas com o laudo anatomopatológico. Destaca-se a necessidade da avaliação global da paciente. Dessa forma, é possível aumentar a precisão diagnóstica, o diagnóstico precoce e a chance de sucesso terapêutico. Por fim, possibilita-se alcançar um dos maiores objetivos da obstetrícia, que é a redução da mortalidade materna.
Doença hemolítica perinatal em gestação gemelar dicoriônica diamniótica: relato de caso
Authors: Terra Maria Eduarda Furtado Fernandes , Jesús Guilherme Ribeiro Ramires de , Ribeiro Eduardo Teixeira da Silva , Peixoto Filho Fernando Maia
Published: November 2021

Introdução: Apesar da implementação da profilaxia com imunoglobulina antiD, a doença hemolítica perinatal (DHPN) continua a ser importante causa de morbidade perinatal. Casos de DHPN em gestações múltiplas são um desafio à prática clínica, pois há dificuldade técnica tanto para a realização de doppler de artéria cerebral média (ACM) para rastreio de anemia quanto para a cordocentese para diagnóstico e tratamento dos fetos. Neste trabalho, busca-se relatar o caso de paciente com DHPN em gestação gemelar dicoriônica diamniótica em que houve instalação de anemia grave em momentos diferentes da gestação, para cada feto. Relato de caso: Paciente de 32 anos, G6 P3C A2, com gestação gemelar dicoriônica diamniótica, tipagem sanguínea O negativo, aloimunizada, com primeira dosagem de Coombs indireto 1:1.024 (antiD e antiC), realizou rastreio de anemia fetal com doppler de ACM semanal desde 18 semanas e 4 dias de idade gestacional (IG). No exame realizado com 23 semanas e 6 dias de IG, constatou-se alto risco para anemia fetal em feto A (velocidade de pico da ACM correspondendo a 1,95 MoM), com exame normal para feto B. O feto A foi submetido a quatro transfusões intrauterinas (TIU), com 24, 25, 28 e 32 semanas de IG, enquanto o feto B foi acompanhado com doppler de ACM semanalmente até apresentar alto risco para anemia fetal com 32 semanas, quando foi submetido a uma TIU. Optou-se por antecipação do parto, e a paciente foi submetida a cesariana com IG de 33 semanas e 2 dias, com nascimento de G1 (feto A), masculino, com Apgar 7/9, pesando 1965 g e G2 (feto B), feminino, com Apgar 9/9, pesando 2240 g. Os dois recém-nascidos foram internados em unidade de terapia intensiva neonatal, com necessidade de hemotransfusão e fototerapia por sete dias. Conclusão: Com base no caso acima, pode-se observar que, sob as mesmas condições intrauterinas, os gemelares apresentaram diferentes graus de anemia. Isso sugere que fatores intrínsecos a cada feto interfiram na manifestação da doença. Em gestações dicoriônicas diamnióticas, tal fato poderia ser explicado pela presença de diferentes antígenos eritrocitários entre os fetos; no entanto, mesmo em gestações monocoriônicas, essa disparidade pode ser observada. Dessa maneira, é possível que outros fatores imunológicos e placentários estejam envolvidos no mecanismo da doença. Mais estudos sobre DHPN em gestações múltiplas contribuirão para o melhor entendimento de sua fisiopatologia.