bluuebunny/crossref_metadata_2025 huggingface dataset:
An Efficient Biosurfactant by Pseudomonas stutzeri Z12 Isolated from an Extreme Environment for Remediation of Soil Contaminated with Hydrocarbons
Authors: Pourfadakari Sudabeh , Jorfi Sahand , Ghafari Shokooh
Published: April 2020

Capability of a biosurfactant produced by Pseudomonas stutzeri Z12 for the removal of hydrocarbons from oily sludge contaminated soil was investigated. The effect of operating parameters, including pH, critical micelle concentration (CMC), salinity, and contact time were studied. The chemical structure of produced biosurfactant was characterized using FTIR and LC-MS-MS analysis, which revealed that the extracted biosurfactant was a combination of both mono- and di-rhamnolipid congeners. The main three congeners RhaC12:1C10 (529.9 m z–1), RhaC12C10 (531 m z–1), and RhaC10C10 (503.2 m z–1)

were associated to mono-rhamnolipid, while five congeners, RhaRhaC10C8 (621.2 m z–1), RhaRhaC12C12 (707.7), RhaRhaC10C12 (677.1), RhaRhaC10C12:1 (675.3 m z–1), and RhaRhaC10C1 (649.5 m z–1) were associated to di-rhamnolipid structures. The critical micelle concentration (CMC) was 80 mg L–1, and emulsification index (E24) values for n-hexadecane, n-hexane, kerosene, diesel oil, xylene, and crude oil were 62.1, 57.6, 54.4, 41.5, 46.9, and 30.2 %, respectively.
Theoretical Substantiation of Specifics of Formation of Ukrainian National Moral and Ethical Values of the Person at a Young School Age
Authors: Kopchuk-Kashetska Mariа
Published: April 2020

The article provides a theoretical substantiation of the specificity of formation of Ukrainian national moral and ethical values of younger students’ personality. The comparative analysis of existing points of view on the nature of moral and ethical values and their functional significance in the formation of personality is carried out. The content of national moral and ethical values as a historical property of the people, which determine its mentality and national character, is revealed. Ukrainian national moral and ethical values are as imperative entities, developed and formed, which exist throughout the life of the Ukrainian people, they have an intransitive character, moral requirements, regulate the regulatory function and use the necessary knowledge regarding their free species and personality. Ukrainian ethnology has shown that it is possible to preserve Ukrainian national moral and ethical factors by growing up in childbirth, defining enrichment and updating the most up-to-date elementary education. The younger school age becomes more sensitive in the development of moral and ethical and the qualities that determine the patterns, moral behavior is formed. The goals and content of the process of formation of moral and ethical values of junior students by means of the sciences are specified through adequate tasks, which reflect the main directions of educational influence on the personality of the student. In the formation of the system of moral and ethical values in the younger students pedagogical efforts and actions of the primary school teacher should be directed to the development of moral and ethical needs and motives of behavior, formation of ethical knowledge and education of ethical feelings, development of appropriate skills, habits, as well as strengthening of will qualities. In formation of moral and ethical values of people do not matter indirect educational actions, but the attitude of the pupil to them, transformation of external influences into the internal moral and psychological sphere of personality, internal perception of external influences, including educational ones.
The Concept of Diploma Thesis Using Design Thinking
Authors: Duda Aneta , Mazur Piotr
Published: April 2020

The article substantiates the urgency of the problem in the context of contemporary public challenges, in particular, the improvement of the quality of the provision of educational services for the training of teaching staff. One of these challenges is practically oriented pedagogy, which involves a close combination of theory and practice in a particular socio-cultural situation. In this sense, the need to develop teachers' professional competence, creativity, critical and design thinking is emphasized by the authors. The aim of this article is to present the concept of diploma thesis using the Design Thinking method. The goal of Design Thinking is to create new solutions based on a deep understanding of users' problems and needs. The human-centered design consists of five stages: empathisation, defining the problem, generating the ideas, prototyping and testing. The article is based on the authors' experience of implementing Design Thinking in education. The importance of design thinking in the educational process is stressed, in particular for the effective diagnosis of students' educational needs during the lessons preparation. It is mentioned that educators learning specific methods of work and project thinking could successfully organize lessons or create a school environment that addresses the interests and creative needs of students. The article is written using the practical experience of the authors to introduce design thinking into education. The researchers are convinced of the need to involve young people in the writing of diploma researchers on the development of design thinking, professional creativity. At the same time, it is also important to carry out pedagogical research in a particular field of scientific knowledge, since the scientific and pedagogical community needs experts and theorists in the field of education.
Twilight of Teacher’s Subjectivity?
Authors: Polak Krzysztof
Published: April 2020

The author deals with issues of the subjectivity of the teacher he treated as an idea of the past, which today is not found in the educational realities. Subjectivity, being receptive to decision-making and willingness to bear responsibility, is understood by the author as the ability of the teacher to engage in dialogue with himself. The author characterizes the main features of such a dialogue, indicating its determinants (power, market, ideological illusions, conventions and school culture). He stresses the negative impact of transformations in the field of education, among which the prevalence of the economic-political model of the educational system nullifying the subjectivity of the teacher dominates.
Formation of Competences of Future Educators for Requirements Education for Sustainable Development
Authors: Kondur Oksana , Mykhailyshyn Halyna , Ridei Nataliia , Katsero Oksana
Published: April 2020

With the help of analysis the recommendations of major international conferences, treaties and conventions over the last two decades of reforming the education system for sustainable development have substantiated that the range of scholars interested in addressing the issues of progress towards sustainability has expanded from economists to scientists and economists. Businessmen, educators and representatives of governments, politicians, managers who are trying to bring sustainable development ideas into practice with all stakeholders.  Attention is directed to finding new solutions to the problems of sustainability of the biosphere and society. The main solution to the problems is the formation of national educational systems for sustainable development, which should include environmental, social and economic, organizational and managerial aspects of shaping the quality of training of specialists and the quality of life of humankind, using formal, non-formal inclusive democratically oriented models of education and science. In all areas with public awareness, broad access to education and a reorientation of the entire education system to take into account sustainable issues of development. Education for sustainable development should be at the forefront of the concepts and strategies for moving towards sustainability, which provided for the development of a National action plan for the implementation of the United Nations Strategy for education for sustainable development. It is established that activities to disseminate his ideas will help to improve the quality of education and to implement the principles of “Education for All”. Sustainable development issues should be included more actively in higher education institutions (HEI) curricula and science, at all levels to promote the formation of a national education system for sustainable development, and to formulate five- and ten-year framework programs and National action plans for the implementation of the UN Strategy. Transformation of HEI curricula and curriculum, primarily those providing pedagogical education, to form sustainable development competencies for future and contemporary teachers (academics) should be a priority of the National Action Plan for the implementation of the Strategy. We describe the basic requirements for the preparation of a modern teacher who would possess communication managerial, qualitative competencies.
La experiencia psicológica del agresor en el conflicto violento
Authors: Prieto-Ursúa María , Ordóñez Carabaño Ángela
Published: April 2020

El artículo se centra en la experiencia del perdón desde la perspectiva del individuo que ha agredido violenta e injustamente a otro, a partir del modelo de desconexión moral y el proceso de perdón a sí mismo después cometer la agresión. Además, se detallan los pasos imprescindibles para iniciar y completar este proceso, y los puntos más difíciles o los peligros que pueden llevar a un “falso” perdón a uno mismo. Se ofrece un análisis cualitativo de entrevistas en profundidad llevadas a cabo en Ruanda con agresores que participaron activamente en el genocidio de Ruanda y con sus víctimas. Se confirma la aplicabilidad de los conceptos básicos del marco teórico en este caso concreto, tanto los referidos a la presencia de mecanismos de desconexión moral como los referidos a los pasos necesarios, según la psicología del perdón, para llegar a encontrarse con las víctimas, pedir perdón y empezar un camino de reconciliación.
УДОСКОНАЛЕННЯ ТАРИФНОЇ ПОЛІТИКИ У СФЕРІ ЕЛЕКТРОЕНЕРГЕТИКИ ДЛЯ ДОСЯГНЕННЯ СЕКТОРАЛЬНОЇ ТА МАКРОЕКОНОМІЧНОЇ ЗБАЛАНСОВАНОСТІ
Authors: ЛОГАЦЬКИЙ Віктор
Published: April 2020

Розглянуто проблеми формування тарифної політики в умовах переходу на нову модель ринку електричної енергії в Україні та впровадження стимулюючого ціноутворення у сфері електроенергетики. Визначено основні вади наявної моделі ринку електроенергії; інституціональну структуру і функціональну взаємодію ринкових сегментів нової моделі ринку, заснованої на вільному ціноутворенні на електричну енергію як товар. Акцентовано увагу, що для досягнення секторальної та макроекономічної збалансованості необхідним є належне обгрунтування цін на послуги з розподілу електричної енергії в умовах переходу на нову модель ринку, оскільки тарифи на ці послуги і надалі регулюватимуться державою.Показано, що основними критеріями при формуванні адекватних тарифів в Україні мають бути: посильне фінансове навантаження на більшість учасників ринку електричної енергії з метою забезпечення його збалансованості; достатнє фінансове забезпечення для підтримання належного технічного стану енергетичної інфраструктури. Визначено головні недоліки наявної нормативної бази для впровадження стимулюючого ціноутворення на послуги з розподілу електричної енергії в Україні та причини, пов’язані з відстроченням застосування стимулюючого ціноутворення на дані послуги в Україні.Охарактеризовано основні складові елементи структури стимулюючого ціноутворення, які закладено в економіко-математичну модель з метою сценарного прогнозування фінансово-економічних показників сектору розподілу електричної енергії. Розкрито, що отримані за результатами моделювання прогнозні показники тарифів на розподіл електричної енергії для різних категорій споживачів, а також агреговані фінансово-економічні показники електророзподільних компаній, слід розглядати як галузеві орієнтири для прийняття рішень на рівні національного енергетичного регулятора.
CITIES AS CENTERS OF ECONOMIC ACTIVITY IN THE DIMENSION OF THE OBJECTIVES OF INCLUSIVE DEVELOPMENT
Authors:   Institute of Regional Research named after M. I. Dolishniy of the NAS of Ukraine, MELNYK Mariana , LESHCHUKH Iryna ,   Institute of Regional Research named after M. I. Dolishniy of the NAS of Ukraine
Published: April 2020

The main tasks of inclusive growth are determined, in particular: development of human capital; improving the quality of life of citizens, reducing inequality and poverty; development of social and economic involvement; careful use of natural resources and protection of the environment; territorial unity and elimination of regional disparities. The tight dependence (R = 0.84) between the index of global competitiveness of the countries and the index of inclusiveness of development is shown. The authors reveal the relationship between the intensity of urbanization processes and indicators of natural and migration growth (reduction) of the population; indicators of economic development and quality (comfort) of life for the inhabitants of the cities of Ukraine; indicators of institutional (including infrastructure) development of cities and assessments of their inhabitants regarding quality and comfort of living; indicators of economic development and investment attractiveness of the cities of Ukraine. The current trends in the development of the IT sphere as a key driver for the implementation of inclusive development are analyzed. Priority measures for achieving the objectives of inclusive development of cities and regions are named, in particular: (i) the enhancement and effective use of human potential, which is primarily the education, retention in a city and preservation of the concentration in various fields of creative people who are able to develop creative and innovative activities; (ii) development and implementation at the national level of urban audit, such as in the EU countries; (iii) when developing an effective policy of reforms in Ukraine, taking into account not only statistical but also sociological results of the assessment of social sentiment, especially under conditions of decentralization of authority, responsibility and decision-making; (iv) use of participatory management and partner approach in developing a common vision of urban development based on inclusiveness.
Low-Temperature Luminescent Studies of Emissive Guanine Substitute for the Detection of Biopolymers
Authors: Kudrya V. Yu. , Yashchuk V. M. , Naumenko A. P. , Mely Y. , Gumenyuk Ya. O.
Published: April 2020

The optical absorption at 300 K and the fluorescence and phosphorescence at 78 K of the emissive guanine substitute, deoxythienoguanosine, (dthG) were investigated in aqueous and TRIS-HCl-buffer solutions. Two optical absorption and fluorescence centers at room temperature were attributed to two keto-enol tautomers of dthG, which confirms previously obtained results. In contrast to room temperature, only one emission band was observed at 78 K in fluorescence spectra that was close to the long-wave fluorescence band at room temperature and could be associated with the tautomer with long-wave absorption. This phenomenon can be explained by the energy transfer by excitations in a frozen solution between two types of the optical centers mentioned above. The similar conclusion is drawn for the phosphorescence: only one tautomer phosphorescence band is observed. The spectral positions of this band maximum are essentially different for aqueous and buffer solutions (∼50 nm).
Detection of Changes in Terrestrial Ecosystems of Ukraine Using Remote Sensing Data
Authors: Lyalko Vadym I. , Romanciuc Inna F. , Yelistratova Lesia A. , Apostolov Aleksandr A. , Chekhniy Viktor M.
Published: April 2020

In recent years, Ukraine has been affected by climate change. This has led to frequent extreme weather events (heavy / high rains, floods, droughts, squalls). As a result of droughts, desertification is one of the most dangerous and transient consequences of modern climate change. The research is devoted to the diagnostic assessment of the modern climate of Ukraine. Remote sensing data and instrumental observations of 30 weather stations of Ukraine were used. Temperature increase was registered in the study area by all stations, which significantly affected the level of precipitation. At the moment there is not enough moisture for the Earth’s surface. Precipitation in Ukraine is currently characterized by an uneven distribution. It leads to accelerated processes of soil degradation and it’s fertility loss. The aim of the study was to identify areas prone to desertification using satellite imagery and meteorological observations. Over the past 17 years (2000-2017), the average air temperature in Ukraine has increased by 1.5 ºC. Particularly anomalous warming has been recorded in recent years, starting in 2015. During the XXI century, a slight decrease in precipitation was observed in Ukraine. Both a decrease in precipitation and an increase in temperature may lead to a decrease in soil moisture levels. According to ground meteorological data, the tendency of dryness in Ukraine was confirmed. Lack of water leads to prompt manifestation of this process. Water indexes were used to estimate the moisture content of surface soils. It is possible to assess the susceptibility of the desert area to climate change. Relevant quantitative information on water availability in Ukraine is provided. Two water indices (Normalized Difference Infrared Index NDII and Ratio Drought Index RDI) have been taken estimate the moisture content. It can be estimated from the MODIS MOD13C2 product data obtained from the MODIS satellite sensor and used for regional research. The main conclusion of this study is to determine the changes in natural terrestrial ecosystems in Ukraine. This was shown on the basis of temperature and humidity. Such trends may lead to changes in the biodiversity of the territory and loss of natural soil properties.
Gradation and geochemistry of the Fenced Lagoon sediments (Bandar Anzali) with regard to source rock and tectonic location
Authors: Moghadam Behnaz Rafiei , Rezaei Khalil , Solgi Ali , Ghiahchi Pantea , AleAli Mohsen
Published: April 2020

The location of the Fenced Lagoon in the urban basin of Bandar Anzali, which should be considered due to its impact on the lives of the people of the region in terms of the conservation of the wetland and its environmental issues, and, on the other hand, the potential of this area to be introduced as a geotourism center determine the need to investigate the area’s sedimentology and geochemistry. Therefore, to study sedimentary and geochemical properties of the Fenced Lagoon sediments located in Bandar Anzali, 33 samples were taken in the form of 6 cores and 12 grabs, and basic sedimentation tests and heavy metals measurement were carried out on them .Studies show that the sediments range from sand to clay in terms of gradation and have mainly coastal-river origin. The sediments of this lake are classified into four sedimentary types: Muddy Sand, Slightly Gravelly Muddy Sand, Sand and Slightly Gravelly Sand, and sand is the main component of all of these sediments. The most abundant sedimentary types belong to Muddy Sand and Sand and the least abundant sedimentary types belong to Slightly Gravelly Muddy Sand and Slightly Gravely Sand. The nature of the source rock is derived from acidic to intermediate combination and in general, sedimentary rocks of the area under study are within the continental arch islands and, to a lesser extent, the active continental margin.
Mineralogical studies of amphibolite outcrops within the Kryvyi Rih Basin
Authors: Tikhlivets Svitlana V. , Yevtiehov Valeriy D. , Filenko Valentyna V. , Hrytsai Olena Y.
Published: April 2020

This study explores the mineralogical composition of the material of samples extracted from the outcrops of amphibolites located within the Kryvyi Rih Basin. Amphibolites of the Novokryvorizka suite of the Kryvorizka series are located in the area of Rodina mine of the Kryvyi Rih Iron Ore Enterprise (KRIOE) on the right bank of the Saksahan river, where the amphibolites crop out as an interrupted line. Over the recent years, industrial and geological tourism has been actively developing not only within Kryvyi Rih, but also in Ukraine in general. The Kryvyi Rih Basin has many objects which deserve the status of unique geological observation sites. One such site has amphibolites of the Novokryvorizka series, which rarely outcrop to the surface. Such an object is interesting and useful not only for interested tourists, but especially for geology students as an example of rocks that have been formed out of effusive eruption products during the geological process such as regional metamorphism. No other examples of their exposure have been observed in the area. The studied outcrops are unique, but recently, their reduction has been observed due to the poor level of their preservation. The relevance of this study is conditioned by necessity of conducting geological evaluation of the amphibolite outcrops with a view to the future use of this object for development of industrial and geological tourism within the Kryvyi Rih Basin. We studied all possible outcrops of the amphibolites within the surveyed territory, and analyzed the results of the previous studies on the topic. We developed a schematic image of the outcrops with consideration of their thicknesses. The mineralogical composition of all outcrops of the amphibolites was studied for further determination of the exact age of the amphibolites and opportunity of providing the amphibolite outcrops with the status of unique observation sites. For achieving the goal, we used the following methods of study: geological survey, selection of representative petrographic samples of the amphibolites, mineralogical and petrographic analyses, generalization of results of field and laboratory studies.
Status kesehatan ginggiva pengguna alat ortodontik cekat pada mahasiswa Fakultas Kedokteran Universitas Udayana, Denpasar, Bali
Authors: Diah Ni Made Yeni Septianing , Anggaraeni Putu Ika , Hutomo Louise Cinthia
Published: April 2020

Background: Maintaining the cleanliness of the oral cavity in users of fixed orthodontic devices is a difficult thing to do, due to the form of a complicated fixed orthodontic device. Therefore this initial study aimed to determine the health status of university students of Faculty of Medicine, Udayana University, using fixed orthodontic devicesMethod: An observational cross-sectional study was conducted among 67 students using fixed orthodontic devices at the Medical Faculty of Udayana University. Several questions regarding the use of fixed orthodontic devices and oral examination using the Modified Gingival Index (MGI) were carried out. Descriptive data is displayed in percentage using SPSS version 25 software.Result: Of the 67 samples, the majority were female (79.1%), 21 years old (32.83%), more than 2 years used fixed orthodontic devices (41.8%), and had a control schedule on follow up (67,16%). The healthy status of gingiva with fixed orthodontic appliance users was found as many as 52 people (77.6%) and had ginggival health status on the mild inflammation criteria of 15 people (22.4%). The healthy status of gingiva with fixed orthodontic appliance users was found as many as 52 people (77.6%) and had ginggival health status on the mild inflammation criteria of 15 people (22.4%). Based on gingival status, it was found that more healthy criteria were found in women (59.70%), age 21 years (23.9%), use of orthodontic devices more than 2 years (31.34%), and regularity of controls (50.75%).Conclusion: Most of the students of the Medical Faculty of Udayana University as users of fixed orthodontic devices have good health status.
Faktor-faktor yang mempengaruhi kualitas hidup pasien kanker tiroid berdiferensiasi baik (DTC) paska tiroidektomi total di Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar
Authors: Aryanata I Gusti Ngurah Gde Dwi , Sudarsa I Wayan , Adiputra Putu Anda Tusta
Published: April 2020

Background: Thyroid Cancer is the most common endocrine cancer. The majority of thyroid cancer (80-85%)Â  is well differentiated. Surgery is the treatment of choice for Well-Differentiated Thyroid Cancer (DTC). This research aims to evaluate the quality of life of patients with thyroid cancer who have undergone total thyroidectomy compared to the general population and also assess the influencing factors.Methods: This research includes 50 patients suffering from DTC after total thyroidectomy and 50 participants were selected to represent the general population who are then asked to fill out a detailed questionnaire EORTC QLQ 30 Indonesia Version including demographic data and clinical data as the TSH levels, the type of histopathology and interval of time since diagnosis, taken from the patient's medical record. Data were analyzed using independent t-test and linear regression in STATA 14 for windows.Results: It is evident that the quality of life of patients with DTC after total thyroidectomy is significantly lower compared to the general population (P<0.05). In addition, several factors such as age, educational level and income of the family give a strong influence as for gender, marital status, employment status, and the time interval since diagnosis gives a mild influence to the quality of life (P<0.05). However, TSH levels and type of histopathology was not proven to affect the quality of life (P>0.05)Conclusion: There are several factors related to quality of life among patients with DTC such as age, educational level and income of the family, gender, marital status, employment status, and the time interval since diagnosis
Profil gangguan fungsi kognitif pada pasien pasca stroke iskemik di RSUP Sanglah Denpasar Bali, Indonesia periode 2019
Authors: Laksono Bimo Adi , Widyastuti Ketut , Trisnawati Sri Yenni
Published: April 2020

Background: Stroke is a disease that affects straightly to the brain. Stroke occured due to obstruction of blood vessel that contain blood-transportingÂ  nutrients to the brain, which lead to impairment in brain function, as well as cognitive function. Because ofÂ  unavailibility of data in Sanglah General Hospital, this research must be done. This study aims to determine the cognitive function profile of post ischemic stroke patient in Sanglah General Hospital based on 5 cognitive domains.Methods: This study is an observational study, collecting data by cross sectional. Data sources were obtained from primary data in the form of interview and MoCA-Ina Test with data retrieval methods using totally sampling technique. The accessible population was patients post ichemic stroke in Sanglah General Hospital that is in a good awareness and fit for MoCA-Ina test.Results: From 26 patients that are accessible, 21 patients were diagnosed with cognitive impairment, which the majority in 41-50 range of age with 9 patients, male with 14 patients, last education of Junior High School with 7 patients, and memory being a domain which is most impaired with mean of 55,38% score.Conclusion: The most affected domain is after an ischemic stroke is memory and visuospacial function
'n Leë dop is soms beter as 'n halwe eier / An empty shell is sometimes better than half an egg – Gounden v Master of the High Court [2015] JOL 32896 (KZD) and Govender v Gounden 2019 2 SA 262 (KZN)
Authors: Gildenhuys Anel
Published: April 2020

The KwaZulu-Natal High Court, Durban, recently had the opportunity to interpret section 15(3)(b)(iii) of the Matrimonial Property Act 88 of 1984 within the context of the South African law of succession. This section states that: "A spouse shall not without the consent of the other spouse … receive any money due or accruing to that other spouse or the joint estate by way of … inheritance, legacy, donation, bursary or prize left, bequeathed, made or awarded to the other spouse." The question before the court was whether a person who is married in community of property requires the consent of his or her spouse in order to repudiate an intestate inheritance. The following aspects were considered by both the court a quo (Gounden v Master of the High Court [2015] JOL 32896 (KZD)) as well as the full bench on appeal (Govender v Gounden 2019 2 SA 262 (KZN)): the distinction between dies cedit and dies venit; the importance of this distinction in electing to either adiate or to repudiate an inheritance; and the implications for the joint estate of spouses married in community of property. The purpose of this contribution is to analyse and critically discuss the reasoning in the judgments in relation to these three aspects.
Revisiting the Geneva Conventions: 1949-2019
Authors: Rautenbach Christa
Published: April 2020

This contribution reviews the book titled Revisiting the Geneva Conventions: 1949-2019, and edited by two scholars, namely Md Jahid Hossain Bhuiyan and Borhan Uddin Khan. The book is a commemoration of the 70th anniversary of the Geneva Conventions and provides Asian perspectives on the challenges of the 21st century.
Opinions of Prospective Biology Teachers about “Outdoor Learning Environments”: The Case of Museum Visit and Scientific Field Trip
Authors: UZEL Nurcan
Published: April 2020

This study aims to determine the opinions of prospective biology teachers about outdoor learning environments by drawing on the cases of museum visit and scientific field trip. In line with this aim, phenomenology research design was utilized. Criterion sampling, which is one of the purposeful sampling methods used in qualitative research studies, was resorted to with a view to determining the participants. In accordance with the phenomenology of the research, 17 prospective biology teachers in their first year of their studies during 2018-2019 academic year in a public university constituted the participants of the research. In order to determine the opinions of prospective biology teachers about outdoor learning environments, an opinion form and an observation form were made use of as data collection tools. Content analysis was referred to in the analysis of research data. In their views on the contributions of the outdoor learning environments, prospective teachers seemed to concentrate on the issues of gaining new information, concretizing the knowledge, learning in the natural environment, and learning by doing and living. It was understood that the codes of “following the guide/teacher”, “acting in a planned manner” and “practice” came to the fore in the opinions of the prospective biology teachers regarding the things to be done during the implementation phase of the outdoor learning environments. While the codes of “getting opinion” and “question-answer method” came into prominence in the prospective teachers' views on the things to be done in the evaluation of outdoor learning environments; especially due to its content, after the scientific field trip, prospective teachers expressed opinions about “the examination of the notes taken, pictures, samples, and so on.” It was also observed that codes emerged from the suggestions of prospective biology teachers regarding the use of outdoor learning environments focused more on these aspects of the process: “should be a well-planned trip”, “should be informative”, “time management” and “participant/ teacher characteristics”.
Türkiyenin doğusunda II. basamak bir devlet hastanesinin perkütan endoskopik gastrostomi deneyimi
Authors: PEKSÖZ Rıfat , BORAZAN Serkan
Published: April 2020

Giriş ve Amaç: Uzun süre beslenecek hastalarda enteral yol parenteral yola göre daha avantajlıdır. Perkütan endoskopik gastrostomi diğer gastrostomi yöntemlerine göre daha avantajlı bir enteral beslenme çeşididir. Bu çalışmada Türkiye’nin doğu kesiminde II. basamak bir devlet hastanesinde perkütan endoskopik gastrostomi takılan hastaları literatür verileri eşliğinde tartışmayı amaçladık.

Gereç ve Yöntem: Muş Devlet Hastanesi endoskopi ünitesinde Ocak 2017–Aralık 2019 tarihleri arasında perkütan endoskopik gastrostomi tüpü takılmış 30 hastaya ait veriler retrospektif olarak incelendi.

Bulgular: Çalışmaya yaşları 18 ile 95 arasında olan 32 hasta alındı ve hastaların yaş ortalaması 68 yıl idi. Hastalar azalan sırasıyla anestezi yoğun bakım, nöroloji servisi, palyatif bakım birimi, genel yoğun bakım, dahiliye servisi, göğüs hastalıkları biriminden perkütan endoskopik gastrostomi işlemi için konsülte edildi. Perkütan endoskopik gastrostomi takılan hastaların endikasyonları azalan sırasıyla; serebrovasküler olay, hipoksik iskemik ensefalopati, Alzheimer, Parkinson, demans, amiyotrofik lateral skleroz, özofagus kanseri, subakut sklerozan panensefalit, aspirasyon pnömonisi, miyokard enfarktüsü, beyin cerrahi ameliyatı sonrası, elektrik çarpması sonucu oral alamayan (quadriplejik) hastalar idi. Hastalarımızda işlem sonrası majör komplikasyon gözlenmedi. Minör komplikasyon oranı 7/30 (%23) idi.

Sonuç: Perkütan endoskopik gastrostomi uzun dönem beslenme gereksinimi olan hastalar için enteral beslenmenin en güvenilir yoludur. Perkütan endoskopik gastrostomi işlemi II. basamak hastanelerde de kolaylıkla ve güvenle yapılabilir.
Çimlendirilmiş Buğday Unundan Yapılan Tırnaklı (Düz Ekmek) ve Tava Ekmek Kalitesi Üzerine Bir Araştırma
Authors: ÜNSAL Ahmet Sabri , ATLI Ayhan , KÖTEN Mehmet
Published: April 2020

Bu çalışmada, çimlendirilmiş buğday ununun Şanlıurfa yöresine özgü düz bir ekmek olan tırnaklı ekmek ve hacimli bir ekmek olan tava tipi ekmeklere olan etkisi araştırılmıştır. Araştırmada Dariel ekmeklik buğday çeşiti kullanılmıştır. Buğdayın çimlendirilerek öğütülmesi sonucu elde edilen un, %20-40-60-80-100 oranlarında normal buğday unu yerine ikame edilmiştir. Çalışma kapsamında çimlendirilmiş buğdayda 1000 tane ağırlığı, hektolitre ağırlığı ve düşme sayısı analizleri yapılırken, tırnaklı ve tava ekmeklerde ise duyusal analizler yapılmıştır. Elde edilen sonuçlara göre, çimlenmiş buğdaylarda 1000 tane ağırlığı, hektolitre ağırlığı ve düşme sayısı değerlerinde düşüş belirlenmiştir. Tırnaklı ekmeklerde ekmek yumuşaklığı ile tat ve aroma dışında, tava tipi ekmeklerde ise ekmek içi rengi ile tat ve aroma dışındaki duyusal özelliklerin tamamı çimlenmiş buğday ununun kullanımına bağlı olarak düşüş gösterirken, tırnaklı ekmeklerde bu etki daha sınırlı kalmıştır.
A comparative study of effectiveness, safety and cost effectiveness of olanzapine, risperidone and aripiprazole therapy in schizophrenia
Authors: Kanani Pooja R. , Pillai Ajita
Published: April 2020

Background: Schizophrenia is the most common psychotic disorder and responsible for approximately half of long-term psychiatric hospitalizations. Antipsychotic medications reduce the psychotic symptoms and prevent relapses. The choice of drug for treatment of schizophrenia depends on many issues, including effectiveness, cost, side-effect burden, availability, and tolerability. Many studies have compared antipsychotic drugs with one another, but no broad consensus has been reached. Our study compares the clinical effectiveness, safety and cost effectiveness of atypical antipsychotics in our setting.Methods: This was an observational, prospective study in which schizophrenia patients receiving either olanzapine, risperidone or aripiprazole were enrolled. Patients were followed up for 3 months. Evaluation of effectiveness was done by analysing mean reduction in PANSS score. Analysis of ADRs was done using WHO causality scale and Hartwig and Siegel severity scale. Cost analysis was done by comparing all three groups in term of cost range of antipsychotic drugs per improvement in PANSS score during the study period.Results: In the present study, the average dose of antipsychotic drugs received by a patient per day was 8.83±2.98 mg in olanzapine group, 4.76±1.12 mg in risperidone group and 20.43±8.5 mg in aripiprazole group. Mean reduction in PANSS score from baseline to 12 weeks was 23.79% in olanzapine group, 25.41% in risperidone group and 24.65% in aripiprazole group. Conclusions: All the groups were equally effective in reduction in PANSS score while risperidone was the most cost effective.
Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score
Authors: Aggarwal Amulya , Mathur Alok V. , Verma Ram K. , Gupta Megha , Raj Dheeraj
Published: April 2020

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.
Serum lactate as a prognostic marker in patients with sepsis: a prospective study
Authors: Shetty Suhas T. , Biradar Dayanand S. , Balookar Ramakant , Kori Shreedevi
Published: April 2020

Background: A prospective study to estimate the serum lactate levels and as a prognostic marker in patients with sepsis.Methods: 170 patients admitted with sepsis in B.L.D.E. (Deemed to be University) Shri. B. M. Patil Medical College, Hospital and Research Centre, Vijayapur from October 2014 to June 2016.Results: In this study the mean serum lactate value of first sample in survivors (146 patients) is 3.8±1.2 and non-survivors (24 patients) is 6.2±1.9 with p value<0.001 which is significant. The serum lactate value of the second sample in survivors (146) is 2.7±1.0 and in non survivors (24) is 6.3±1.8 with p value<0.001 which is significant. The mean value of serum lactate 1st sample collected at the time of admission is 4.1±1.6 and the mean value of serum lactate second sample collected at 24 - 48 hours after admission is 3.1±1.6.Conclusions: Lactate level more than 4 mmol/l, patients are at highest risk of mortality and an aggressive resuscitation strategy shall be warranted. Hence serum lactate is considered as an independent and significant prognostic marker in patients with sepsis and evaluates the treatment outcome.
Study prevalence of risk factors and clinical presentation of ventral incisional hernia an observational study
Authors: Nigam Anjana , Nirala S. L. , Bhusakhare Niraj
Published: April 2020

Background: Incisional hernia is the second most common type of hernia after inguinal hernia. It is a complication of abdominal surgery, reported in up to 11% of patients generally and in up to 20% of those who developed post operative wound infection. The list of predictive factors associated with development of incisional hernia is obesity, diabetes mellitus, steroid, smoking, old age, malnutrition, COPD and type of incision.Methods: This was a hospital based cross sectional observational study carried out from February 2018 - October 2019 in surgery department of Dr. B.R.A.M. Hospital Raipur C.G, with diagnosis of incisional hernia. Total 100 patients were included in the study.Results: In present study the mean age of study subjects was 47.27±13.16 years. Around two-third 64% were females. 40% of perforation and 35% of LSCS cases later develop to Incisional hernia.  Risk factors profile showed that 31% were alcoholic, 27% smokers, 48% pre-obese and 5% were obese. 36% were hypertensive, 48% diabetic, and 12% had constipation. 25% had prolonged cough, 35% had surgical site infection, 45% had anemia. Clinical presentation of study subjects showed that 63% had swelling, 33% had swelling and pain and 4% had obstruction.Conclusions: Incisional hernia is more common in female than males and in cases above the age of 45 years. It is more common in patients who underwent the previous surgery on an emergency basis especially in perforation and obstruction and LSCS cases. Risk factors associated with incisional hernia are smoker, alcoholic, obesity, hypertension, diabetes, constipation, prolong cough and anemia.
Management of patients with forearm and hand injuries
Authors: Bisht Bhaskar , Rajan Manu , Dvivedi Sanjay , Rawat Kinnari A. V. , Konda Sireesha
Published: April 2020

Background: Injuries to the hand and the forearm, particularly crush injuries have always been a major challenge to even the best of surgeons, whether it is a major case of a mangled hand by a high pressure injury or even a small case as an injury to the tip of the finger by getting squashed in a closing door. Any injuries in the forearm and the hand requires a very meticulous and thoughtful approach towards coverage with the aim of maximal restoration of function as well aesthetic appearance.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over the period of 12 months. Subjects were recruited from patients presenting in emergency/surgery OPD, HIMS, Dehradun with a primary diagnosis of soft tissue injuries in the forearm and the hand. A total of 114 patients were included in the study.Results: 39.5% (45 patients) were treated with combined modalities, including debridement, grafting & flap coverage. 14.1% (16 patients) required some form of orthopaedics intervention. 21.1% (24 patients) needed neurovascular or tendon repair surgery. 37.7% (43 patients) faced some sort of early or late complications.    Conclusions: Proper assessment and management of complex injuries of hand and forearm is mandatory for a good functional and aesthetic outcome.
Phytobezoar induced small bowel obstruction: an uncommon cause of intestinal occlusion
Authors: Deftereos Savas P. , Effraimidou Eleni I. , Foutzitzi Soultana , Cristodoulou Panagiota , Aggelidou Maria , Liratzopoulos Nikolaos
Published: April 2020

A case of a 42-year-old female patient with a two-days diffuse colicky abdominal pain, nausea and three episodes of vomiting is presented. Furthermore, patient complained for inability to eat for almost a week. In addition, patient had a history of subtotal gastrectomy Billroth II-type, due to gastric ulcer six years ago. There were no other known co-morbidities. Except for a distended, somewhat painful abdomen and sluggish bowel sounds, the rest clinical examination was unremarkable. Plain abdominal X-ray and ultrasound findings agreed with the clinical suspicion of sub-acute small bowel obstruction probably due to post-operative adhesions. A conservative management was decided. However, the patient after an initial clinical improvement, had a relapse of symptoms with the first feeding attempt. A followed computed tomography of the abdomen revealed a well define, oval, mass-like containing mostly air bubbles lesion, occupying for approximately six centimeters long the jejunum lumen. The diagnosis of jejunal phytobezoar was set. In accordance of computed tomography diagnosis were the intra-operative findings and the post-operative histopathology.
A rare case of gastroduodenal artery aneurysm in a highly active antiretroviral therapy induced acute pancreatitis case presenting with lump in abdomen
Authors: Gupta Madhukar R. , Goyal Samridhi
Published: April 2020

Gastroduodenal artery (GDA) aneurysm is a rare but potentially fatal vascular disease, with chronic pancreatitis being reported as the commonest etiological factor. Rupture, which is not uncommon, carries a high risk of mortality. The typical patient with palpable epigastric mass, upper gastrointestinal bleeding and pain, may not present in the emergency and the lesion is often picked up incidentally on abdominal ultrasound or a computed tomography. We describe a critical case presenting with lump in abdomen which was found out to be gastroduodenal artery aneurysm on scanning, developing in a patient with recurrent highly active antiretroviral therapy (HAART) induced pancreatitis managed with transfemoral catheter embolization. The patient in question succumbed due to post procedure hepatic failure. The management of aneurysms since historic times have been challenging, the open procedures are being gradually replaced by endovascular techniques, which are yielding better results.
Wandering gallbladder
Authors: Kumar Neeraj , Ranjan Piyush , Panwar Rajesh , Kataria Kamal
Published: April 2020

Cholecystectomy preferably laparoscopy is gold standard treatment for symptomatic cholelithiasis. However for some anatomical and/or pathological reasons the procedure is converted to open. Conversion rates at high volume centres is <5%. We present a case report of 48 aged lady, previously operated multiple times for hydatid liver and lung with symptomatic cholelithiasis. She was planned for laparoscopic cholecystectomy. During the procedure, inadvertent anatomy of “the wandering gallbladder” was noted. Here we describe the management approach selected for this type of unusual presentation. We recommend noting down detailed past history (preferably surgical) and preoperative consideration of deviant anatomical location and findings of gallbladder. We should maintain a low threshold for conversion to open.
Adult idiopathic hypertrophic pyloric stenosis: an infrequent cause of gastric outlet obstruction
Authors: Khan Nida , Kumar Meena , Mahadik Abhishek , Singhal Pragati
Published: April 2020

Hypertrophic pyloric stenosis is a congenital disease, presenting within two weeks of birth. However adult idiopathic hypertrophic pyloric stenosis (AIHPS) presents in middle age, predominantly in males and usually without any antecedent cause. Secondary variant may be due to intra gastric causes or extra gastric post-operative adhesions. Patient presents with symptoms of gastric outlet obstruction. Diagnosis depends on clinical, radiological and endoscopic findings. Treatment is subtotal gastrectomy. Pyloroplasty and endoscopic dilatation may be tried in debilitated patients. We present a case of AIHPS presenting as gastric outlet obstruction in a 16 year old female, that was surgically managed with an antrectomy.
Study of glomerular filtration rate in patients with metabolic syndrome
Authors: G. Prakash K. , S. Rashmi
Published: April 2020

Background: Chronic kidney disease is a major risk factor for end stage renal disease, cardiovascular events and death. Various studies have shown an association between metabolic syndrome and CKD. Even mild renal insufficiency increases the risk for cardiovascular events. This study was conducted to detect CKD in its early stages which are characterized by mildly reduced GFR in patients with metabolic syndrome.Methods: This is a cross sectional study of 60 patients, 30 with metabolic syndrome diagnosed on the basis of IDF criteria and 30 controls. EGFR was calculated using the CKD-EPI formula and the results between the two groups was analysed using chi square test for statistical significance.Results: In this study conducted on 60 patients, age distribution was between 20 and 60 years. Male to female ratio was 1:1.06. 26.66% of the cases had normal GFR while among the controls, 46.66% had normal GFR. Out of the 30 cases, 53.33% had mildly reduced GFR while out of the controls, 23.33% had mildly reduced GFR. This association between metabolic syndrome and mildly reduced EGFR was found to be significant (p≤0.05).Conclusions: The results of this study showed that metabolic syndrome is associated with a mildly reduced GFR and hence early detection of these risk factors is essential for treatment and prevention of CKD.