bluuebunny/crossref_metadata_2025 huggingface dataset:
ESTILOS DE APRENDIZAGEM E ESTRATÉGIAS DE USO DE DICIONÁRIOS PARA O ENSINO DE PORTUGUÊS
Authors: MOREIRA Bruna Elisa da Costa
Published: May 2022

RESUMO Este artigo aborda, no contexto dos estilos de aprendizagem, como as preferências sensoriais podem orientar estratégias de uso de dicionários. Para a contextualização teórica, parte-se da literatura que investiga as quatro áreas primordiais de preferências sensoriais: visual, auditiva, cinestésica e tátil. O objetivo do trabalho é articular as características das preferências sensoriais e de suas estratégias de aprendizagem a diretrizes explícitas que otimizem o uso de dicionários no ensino de português tanto como língua materna (PLM) quanto como língua não materna (PLNM). Busca-se, assim, superar o consenso sobre a função e o uso dos dicionários atestado na literatura sobre o tema. O trabalho observa que aprendizes e professores podem sair do que se denomina ‘zona de conforto estilística’ e diversificar estratégias ao longo do processo de ensino e aprendizagem. Este trabalho apresenta como resultados diretrizes de uso de dicionários que contemplam a escolha da modalidade da obra (impressa, eletrônica, online ), a indicação de buscas mais consistentes com cada preferência e a sugestão de obras a serem adotadas. Além disso, o artigo aponta mais uma possibilidade de uso do Roteiro para avaliação de dicionários como forma de documentar quais obras lexicográficas seriam mais consistentes com os objetivos de ensino de vocabulário e com os estilos de aprendizagem dos estudantes.
Deslocamento não motorizado na área central de Paranaguá (PR) Brasil: uma contribuição à mobilidade na cidade
Authors: Garcia de Faria Gislaine , Luis Tonetti Emerson , Vanhoni Jorge Felipe
Published: May 2022

O Brasil obteve nas últimas décadas um avanço significativo das normativas sobre o planejamento urbano e ambiental. Alguns dos avanços são observados no campo do transporte e mobilidade na cidade. Paranaguá, localizada na planície costeira do Paraná, enfrenta problemas socioambientais voltados ao crescimento sem planejamento que afetam a potencialidade da mobilidade não motorizada. Nesse sentido, o objetivo da presente pesquisa foi avaliar a potencialidade do deslocamento não motorizado na área urbana do município. Todas as ruas da centralidade foram percorridas; as calçadas, as ciclovias e a arborização viária foram classificadas com qualidade alta, média ou baixa. Os dados foram lançados em bases cartográficas cedidas pela Prefeitura Municipal e utilizou-se softwares em rotinas de geoprocessamento. No geral, as calçadas e a arborização viária possuem baixa qualidade. A malha cicloviária, apesar da boa qualidade, é reduzida e atende principalmente a demanda dos trabalhadores relacionados ao Porto de Paranaguá. Conclui-se que predomina a potencialidade baixa para o deslocamento não motorizado na malha urbana do local de estudo. Os setores da funcionalidade da cidade demandam melhores condições para esse tipo de deslocamento.

 

PALAVRAS-CHAVE: Paranaguá. Planejamento urbano. Deslocamento não motorizado.
Repercussão do campo disciplinar do restauro arquitetônico e urbano no território brasileiro: o projeto da Estação Ferroviária de Mairinque
Authors: França Madeira Muzzi Heloísa , Paula Farah Ana
Published: May 2022

O artigo tem por objetivo investigar a repercussão da teoria contemporânea do restauro na prática arquitetônica brasileira, analisando o caso específico do projeto de restauro ainda não executado para a Estação Ferroviária de Mairinque, lançado em concurso pelo CONDEPHAAT-SP em 2014. A metodologia de pesquisa foi dividida em duas etapas. A primeira voltou-se para o levantamento e leitura dos referenciais teórico-críticos do campo, investigando sua assimilação no território brasileiro. A segunda voltou-se para a análise técnico-operacional da intervenção proposta para a estação, diante de sua relevância cultural e documental para o país. Como resultado, foi verificado em que medida o projeto de restauro responde às demandas impostas ao edital do concurso e à deontologia do campo disciplinar. Obteve-se uma conclusão satisfatória, sendo observado um resultado projetual a par das discussões contemporâneas acerca ao campo.

 

PALAVRAS-CHAVE: restauro arquitetônico e urbano; patrimônio ferroviário; vertentes contemporâneas do campo disciplinar.
Prolongations of G-structures related to Weil bundles and some applications
Authors: Kouotchop Wamba P.M. , Wankap Nono G.F. , Ntyam A.
Published: May 2022

Let M be a smooth manifold of dimension m ≥ 1 and P be a G-structure on M , where G is a Lie subgroup of linear group GL(m). In [8], it has been defined the prolongations of G-structures related to tangent functor of higher order and some properties have been established. The aim of this paper is to generalize these prolongations to a Weil bundles. More precisely, we study the prolongations of G-structures on a manifold M , to its Weil bundle TAM (A is a Weil algebra) and we establish some properties. In particular, we characterize the canonical tensor fields induced by the A-prolongation of some classical G-structures.
Perturbation Ideals and Fredholm Theory in Banach Algebras
Authors: Lukoto Tshikhudo , Raubenheimer Heinrich
Published: May 2022

In this paper we characterize perturbation ideals of sets that generate the familiar spectra in Fredholm theory.
Adapted TRI Reagent RNA Extraction Protocol for Golden Mussel's gonads v1
Authors: Amaral Danielle
Published: May 2022

TRI Reagent RNA Extraction Protocol, with optimized steps for Golden Mussel's gonads tissue. Consisting of tissue homogenization, chloroform separation and ethanol precipitation.
[RETRACTED] K1 Keto Reviews (Works Or Hoax) Does Really Works? Read Updated Report! v1
Authors: not provided officialniamh
Published: May 2022

[RETRACTED]

People are searching for ways and means to decrease the fats accumulated in the body. Are you searching for ways and means to tone down your body weight? The good news is, K1 Keto can do that tremendous work leading you to have a fit and healthy life.
[RETRACTED] ACV 10X Keto Gummies Reviews Read All Ingredients? v1
Authors: keto Gummies Acv
Published: May 2022

[RETRACTED]

ACV 10X Keto Gummies Reviews Read All Ingredients?
[RETRACTED] K1 Keto Life Weight Loss Supplement Is It Safe & Effective To Burn Fat Quickly? v1
Authors: not provided robiniwall
Published: May 2022

[RETRACTED]

K1 Keto Life Reviews
[RETRACTED] Steve Harvey CBD Gummies | What Is The Truth Behind Steve Harvey CBD Gummies and How Its Works? v1
Authors: not provided SteveHarveyGummies
Published: May 2022

[RETRACTED]

These CBD chewy desserts treats will help with the success and flourishing of clients overall.
[RETRACTED] Keto Control (Scam Pills Or Legit) Full Detailed Review! v1
Authors: Control Keto
Published: May 2022

[RETRACTED]

MUST CHECK: *Special Discounted Pricing Available For The First 50 Customers Only! (ORDER Keto Control)
[RETRACTED] Optimal Max Keto Shark Tank: Reviews, Pills, Price v1
Authors: not provided optimalmaxosharkprice
Published: May 2022

[RETRACTED]

Optimal Max Keto Shark Tank: Reviews, Pills, Price
СЕЙСМИЧЕСКАЯ ОПАСНОСТЬ УРБАНИЗИРОВАННЫХ ТЕРРИТОРИЙ НА ЮГЕ СИБИРСКОЙ ПЛАТФОРМЫ Часть 2. Комплексная оценка сейсмической опасности
Authors: Джурик В.И. , Ескин А.Ю. , Серебренников С.П. , Брыжак Е.В.
Published: May 2022

В первой части работы подробно описаны методы натурных наблюдений для получения данных при сейсмическом микрорайонировании изучаемой территории. Во второй части исследования приводятся расчеты сейсмической опасности грунтов, слагающих участок наблюдения. Кроме того, выполнены теоретические выкладки сейсмических воздействий для стандартных грунтов, представленных на участке исследования, и реализованы расчеты оценки сейсмической опасности грунтов по максимальным ускорениям для возможных сильных землетрясений.
Osteosynthesis with arthroscopic control in fractures of tibial condyles
Authors: Lazishvili G. D. , Kuzmenko V. V. , Girshin S. G. , Dubrov V. E. , Grishin S. M. , Novikov O. E.
Published: May 2022

Modern opportunities of the arthroscopic surgery in intra-articular knee injuries (including fractures) are described; the advantages of arthroscopic method are shown. Authors give the precise description of reposition and osteosynthesis technique in various types of tibial plato fractures. Principles of postoperative and rehabilitation management are given. Authors consider the restoration of knee ligament tears in intra-articular fractures. Meniscus repair and collaterall ligaments reconstruction should be done in acute period of injury. Arthroscopic autoplasty of anterior cruciate ligament should be performed not earlier than 4 months after injury and prior ostheosynthesis. The results of the treatment of 27 patients allow to recommend the osteosynthesis of the tibial condyle with arthroscopic control for the wide clinical practice.
Removal of taiga ticks from human skin
Authors: Zolotov A. S.
Published: May 2022

The problem of removing taiga ticks at first glance may seem unimportant. However, in the Far East, in Siberia, in the Urals, the bites of these insects remain a mass phenomenon. It is not always easy to remove a tick, and this explains the frequent visits of affected patients to a traumatologist.
Enumerating Plausible Multifault Ruptures in Complex Fault Systems with Physical Constraints
Authors: Milner Kevin R. , Shaw Bruce E. , Field Edward H.
Published: May 2022

We propose a new model for determining the set of plausible multifault ruptures in an interconnected fault system. We improve upon the rules used in the Third Uniform California Earthquake Rupture Forecast (UCERF3) to increase connectivity and the physical consistency of ruptures. We replace UCERF3’s simple azimuth change rules with new Coulomb favorability metrics and increase the maximum jump distance to 15 km. Although the UCERF3 rules were appropriate for faults with similar rakes, the Coulomb calculations used here inherently encode preferred orientations between faults with different rakes. Our new rules are designed to be insensitive to discretization details and are generally more permissive than their UCERF3 counterparts; they allow more than twice the connectivity compared with UCERF3, yet heavily penalize long ruptures that take multiple improbable jumps. The set of all possible multifault ruptures in the California fault system is nearly infinite, but our model produces a tractable set of 326,707 ruptures (a modest 29% increase over UCERF3, despite the greatly increased connectivity). Inclusion in the rupture set does not dictate that a rupture receives a significant rate in the final model; rupture rates are subsequently determined by data constraints used in an inversion. We describe the rupture building algorithm and its components in detail and provide comparisons with ruptures generated by a physics-based multicycle earthquake simulator. We find that greater than twice as many ruptures generated by the simulator violate the UCERF3 rules than violate our proposed model.
Вызовы и перспективы изучения Большого Средиземноморья
Authors: Ильин Михаил , Нечаев Владимир
Published: May 2022

В статье выдвинут и обоснован междисциплинарный эволюционный подход к изучению пульсирующих и расширяющихся пространственно-временных феноменов социального развития, или месторазвитий, на примере Большого Средиземноморья. Анализируются способы объединения пространственных и временных подходов в региональных исследованиях, получивших – после броделевского поворота к междисциплинарному изучению цивилизационных комплексов в расширенном диапазоне большой длительности – дальнейшее развитие в рамках мир-системного анализа, в роккановском концептуальном картировании и в новом регионализме. Предложена собственная методология комплексной регионалистики на примере Большого Средиземноморья. Для изучения регионов как ключевой разновидности земных миров эпохи антропоцена, сходных, с одной стороны, с планетными сферами, а с другой – с малыми месторазвитиями, авторы используют принципы фрактального самоподобия. Эта методология позволяет изучать не только интегральную эволюцию пульсирующего и расширяющегося регионального пространства-времени, но и его отдельные слои и параметры. В частности, авторы предлагают три возможные аналитические проекции целостного пространственно-временного феномена: шурф во времени, моментальный снимок и дерево событий. Статья завершается рассмотрением возможностей использования концепции Большого Средиземноморья и методо- логии нового регионализма в конкретных политических исследованиях, включая политическое самоопределение Крыма, государственное строительство Федерации Боснии и Герцеговины и послевоенную реконструкцию на Украине.
А поговорить? Социально-организационные характеристики коллективных действий в современной Москве
Authors: Бедерсон Всеволод
Published: May 2022

В центре внимания статьи – мобилизация и коллективные действия современных москвичей. Автор выявляет социально-организационные факторы, влияющие на коллективные действия москвичей. Исследование основывается на теориях доверия и социального капитала, а также теориях организационной плотности и мобилизации ресурсов. Работа базируется на результатах массового репрезентативного социологического опроса в 30 районах Москвы, а также данных о зарегистрированных в этих районах некоммерческих организациях. На основе анализа научной литературы автор выдвигает теоретическое ожидание связи между характеристиками взаимодействий и коммуникации людей, а также организационными структурами, с одной стороны, и вовлеченностью граждан в различные типы коллективных действий: как политические, так и неполитические, – с другой. Разработанные формальные модели, базирующиеся на методе логистической регрессии, частично подтверждают гипотезы. Ожидания в отношении связи формы управления домом, частоты межперсональных соседских взаимодействий, наличия собственности на недвижимость, а также срока резидентства не показали статистически значимой связи с участием граждан в коллективных действиях. Напротив, факторы коммуникации – вовлеченность в дела дома (участие в собраниях и подобное) и вовлеченность в соседские/районные социальные сети и мессенджеры – оказались значимыми и показали положительную связь с участием в коллективных действиях всех типов. Организационные факторы также показали положительную связь: плотность гражданских ассоциаций оказалась связана с участием москвичей в коллективных действиях. Результаты фиксируют, что общение в институциональных формах – важное условие для мобилизации москвичей к участию в коллективных действиях разных типов: одновременно и политизированных в виде публичных протестных акций, и неполитизированных в виде благотворительности или субботников.
La realidad contable en el siglo XXI comprendida desde la filosofía y la ontología
Authors: Enríquez-Martínez Andrés Felipe , Cardona-Sánchez Daniela , García-Semanate Juan David , Narváez-Grisales Julián Andrés
Published: May 2022

Por mucho tiempo se ha estudiado la contabilidad como un sistema estático de normas a seguir que representan una realidad definida. Pero han aparecido críticas sobre si la contabilidad representa fielmente la realidad que conocemos, debido a que se suman conceptos a su campo de estudio, lo que ratifica su significado como ciencia social que continuamente construye su conocimiento, por lo que la realidad que representa la contabilidad no es una sola, y el conocimiento debe incluir otras representaciones para tener una mejor comprensión de las cosas. De ahí que varios autores hayan recurrido a disciplinas como la filosofía y la ontología para crear explicaciones alternativas al pensamiento contable tradicional, más si se tiene en cuenta que el siglo XXI tiene dinámicas sociales particulares para las cuales la contabilidad debe responder con representaciones adecuadas.
enseñanza de la econometría
Authors: Gómez-Mejía Alberto
Published: May 2022

Todos los autores de libros de econometría coinciden en lo difícil que es enseñar econometría para los estudiantes de economía en pregrado, especialmente por la deficiente preparación de estos en la matemática estadística y álgebra matricial. La experiencia también culpa la deficiente información sobre los estudios de economía y econometría. La econometría se puede enfocar en tres niveles dependiendo del grupo interesado. Los cursos para pregrado deben ser exigentes en estadística, algebra matricial y casos aplicados al contexto del estudiante. Los profesores deben ser economistas para que expliquen las aplicaciones del contenido en diversas áreas de práctica; la falla en este objetivo, produce apatía y deserción. Otras causas del problema pueden ser los profesores, el enfoque del plan de estudios, el negocio de la educación, etc.
Riesgos ergonómicos de carga física y lumbalgia ocupacional en una institución de educación superior en Cartagena, Colombia
Authors: Escudero-Sabogal Irina del Rosario , Borre-Ortíz Yeis Miguel
Published: May 2022

Se pretende identificar la relación de los riesgos ergonómicos de carga física y la aparición de lumbalgia en un grupo de trabajadores administrativos de una Institución de Educación Superior, Cartagena, Colombia, mediante un estudio descriptivo, transversal, y correlacional, realizado entre mayo 2016 y mayo de 2017. Para la recolección de la información se utilizó una encuesta sociodemográfica y el Cuestionario Nórdico de Kourinka; los resultados sociodemográficos fueron analizados con herramientas de Excel 2.5 y el análisis bivariado con SPSS 2012;  la mayoría de la población pertenece al género femenino (62%), en el rango de edades de entre los 20 y 29 años); molestias osteomusculares: a nivel de cuello (51%), dorsolumbar (69%) y muñeca/mano (27%); éstas molestias han estado presentes desde los últimos 12 meses, incluso, los últimos siete días; los datos de correlación muestran una ligera asociación entre la postura sedente y la presencia de malestar muscular lumbar (r= -,343; p= ,021; IC= 95%); la investigación indica que existe una relación entre el riesgo ergonómico de carga física y lumbalgia, sin embargo, se requiere un análisis estadístico de mayor profundidad, como un estudio de causa-efecto, que explique el comportamiento y variabilidad de los datos de manera predictiva.
Propuesta de Modelo de Competitividad Sistémica de los Espacios Rurales
Authors: Vinasco-Guzmán Martha Cecilia
Published: May 2022

El sector rural en Colombia ha sido tradicionalmente desatendido por los gobiernos locales y nacionales, evidenciado en la inequidad en la calidad de vida de los campesinos con los habitantes de áreas urbanas y que parte de la desarticulación de las propuestas en los planes de desarrollo.  El objetivo es validar el Modelo de Competitividad Sistémica de los Espacios Rurales, a partir del análisis de los planes de desarrollo departamentales, para la identificación de problemáticas y oportunidades de investigación que contribuyan a solucionar las necesidades locales, regionales y nacionales, en tres categorías: político - sustentable, competitiva - productiva y ambiental - social, que luego se dividen en subcategorías orientadas desde la visión de la multiactividad de la agricultura.  El modelo es dinámico, puede ser utilizado para cruzar un número muy amplio de variables y dar un panorama de la interacción de las diversas actividades, recursos, necesidades y actores involucrados en el desarrollo del campo.  La metodología utilizada fue la Teoría Fundamentada, utilizando el software Atlas ti, con el que se hizo la revisión y codificación de los 33 planes de desarrollo de los departamentos de Colombia.  Se evidencia en los resultados la falta de articulación de los planes y programas de los gobiernos departamentales en torno a las problemáticas del sector rural, pues no se plantean acciones particulares para el campo, lo que es crítico en aspectos como el de política de tierras, transferencia tecnológica, educación para el sector rural, mecanismos de protección social o seguridad alimentaria.  El metaanálisis realizado a partir de la lectura, revisión, codificación y análisis de los planes de desarrollo, evidencia las falencias en la formulación de muchos de estos documentos, que se vuelven más críticas puesto que no contemplan acciones particulares para atender a las necesidades del campo colombiano.
Brote de enfermedad transmitida por alimentos en una población especial. Cali, Colomd transmitida por alimentos en una población especial. Cali, Colobia 2021
Authors: Osorio Merchan May Bibiana , Rizo-Tello Victor Zein , Sánchez León Edna Margarita , Arturo Quiroga Gabriela Lizeth , Prieto-Alvarado Franklyn Edwin , Gómez Ortega Luis Carlos
Published: May 2022

Introducción: Las Enfermedades Transmitidas por Alimentos tienen un alto impacto en poblaciones confinadas y con deficientes condiciones en la preparación y distribución de alimentos. En mayo de 2021, el Sistema de Alerta Temprana del Instituto Nacional de Salud detectó un brote en Cali en una población cerrada. Objetivo: Caracterizar el brote de ETA en una población de Cali, e identificar fuente, agente y mecanismo de trasmisión con el fin de orientar las medidas de control. Métodos: Investigación de brote mediante a encuesta de consumidores y análisis con metodología de casos y controles. Se realizó análisis de inocuidad de alimentos y toma de laboratorio a alimentos cocidos. Se crearon tres definiciones de caso. Se utilizó Epi info 7.4.2 y las tres definiciones fueron contrastadas mediante OR contra alimentos, lugar de consumo, turno de consumo, edad y sexo. Resultados: Se identificaron 140 casos de 1,600 personas expuestas, tasa de ataque de 8.8%. Periodo de incubación medio de 11.7 (2.5 a 23 h). Se identificó que entre más tarde se consumían los alimentos más enfermos había. La cena, causó la mayor proporción de enfermos, con OR 8.19 IC 95%: 1.8-36.1. Conclusión: Se considera que la fuente fue la cena, el agente una toxina de E. coli y el mecanismo más probable de transmisión la contaminación cruzada. Mantener la estrategia de vigilancia comunitaria permite la detección posibles brotes, la estandarización en los procedimientos por los operadores de alimentos, así como las estrategias de prevención y un sistema de seguridad alimentaria con enfoque de riesgo.
Increased serum citrullinated histone H3 levels in COVID-19 patients with acute ischemic stroke
Authors: Bayar Muhammet Duran , Şişman Aysel Büşra , Koral Gizem , Çirak Selen , Tüzün Erdem , Günaydin Sefer , Baştan Birgül
Published: May 2022

Prevalence of acute ische­mic stroke (AIS) is increased in patients with coronavirus disease 2019 (COVID-19). A proposed hypothesis is increased virus-induced propensity to hypercoagulation resulting in arterial thrombosis. Our aim was to provide evidence regarding the involvement of neutrophil extracellular trap (NET) formation (NETosis) in COVID-19 related AIS. Twenty-six consecutively enrolled COVID-19+ pneumonia patients with AIS, 32 COVID-19+ pneumonia patients without AIS and 24 AIS patients without COVID-19 infection were included to the study. Clinical characteristics of recruited patients were collected. Serum levels of citrullinated histone H3 (H3Cit; a factor of NETosis), IL-8 and C5a (mediators associated with NETosis) were measured by ELISA (enzyme-linked immunosorbent assay). H3Cit levels were significantly higher in COVID-19+ AIS patients, whereas all study groups showed comparable IL-8 and C5a levels. There were no significant differences among etiological subgroups of AIS patients with or without COVID-19. AIS patients with COVID-19 showed relatively increased white blood cell, lymphocyte, neutrophil, D-dimer, C-reactive protein and procalcitonin levels than control groups. H3Cit levels did not correlate with clinical/prognostic features and inflammation parameters. H3Cit and IL-8 levels were correlated in COVID-19 patients without stroke but not in COVID-19 positive or negative AIS patients. Increased levels of inflammation parameters and H3Cit in COVID-19 related AIS suggest that NETosis may cause susceptibility to arterial thrombosis. However, H3Cit levels do not correlate with clinical severity measures and inflammation parameters diminishing the prognostic biomarker value of NETosis factors. Moreover, the link between IL-8 and NETosis appears to be abolished in AIS.
A Theoretical Framework for the Adoption of Web-Based Learning Management Systems in Saudi Higher Educational Institution
Authors:   Department of Computer and Information Science, Applied Collage, Taibahu University, Al-Madinah Al-Munawwarah 20012, Saudi Arabia, Abogamous Asmaa Hatem Rashid
Published: May 2022

This article describes the development of a theoretical framework for factors that influence adoption of web-based Learning Management Systems (LMS) in Saudi Higher Educational Institutions (SHEI). LMSs help such institutions manage the information required for planning and making informed decisions. LMSs also facilitate effective and efficient information management, allowing SHEI to improve their abilities in teaching and learning experience. However, higher learning institutions remain hesitant to adopt LMS projects. Such systems are relatively recent additions to educational institutions; thus, there are certain roadblocks to adoption. Thus, a framework is proposed to facilitate LMS adoption in SHEIs. The proposed framework considered 17 factors collected from relevant literature, with unified theory of acceptance and use of technology and technology-organisation-environment serving as the foundation. The proposed framework is expected to help SHEIs identify and comprehend the various individual, technological and environmental factors that must be considered when implementing an LMS.
Technological Integration Factors in Parental Involvement during Distance Learning
Authors:   the Faculty of Education, Universitas Negeri Yogyakarta, Indonesia, Herwin Herwin , Dahalan Shakila Che
Published: May 2022

During the pandemic, all learning activities are carried out remotely from home with the integration of technology. Teachers no longer directly interact with students so that the involvement of parents at home becomes an additional variable in student learning activities. This study aims to examine the technology integration factor on parental involvement in distance learning. This is a quantitative study using a survey design. The research subjects were elementary school students who participated in distance learning during the COVID-19 pandemic. Data were collected using a questionnaire technique. The data analysis technique used is path analysis. The research findings show that student request is the variable that has the highest effect on technology integration carried out by parents. Furthermore, technology integration is also influenced by parents' understanding of technology. The structural model shows that teacher performance and school support do not have a direct effect on technology integration by parents. However, these two variables have an indirect effect through the student requests variable.
Taste dysfunction in type 2 diabetes mellitus patients with autonomic neuropathy and its relation with HbA1C level and disease duration
Authors: Singh Archana , Kushwaha J. S. , Giri Richa
Published: May 2022

Background: Type 2 diabetes mellitus (T2DM) is a multifactorial, complex disease associated with chronic hyperglycemia, resulting from the interplay of genetic, environmental, and epigenetic factors. T2DM can causes various disabling complications. Diabetic autonomic neuropathy (DAN) is one of the common complications in diabetes. The taste threshold affected by various factors such as age, ethnic backgrounds, drugs, local and systemic diseases, consumption of alcohol, smoking, and tobacco chewing.Method: The present study is undertaken with the objectives to compare the taste dysfunction of four primary sensations in Type 2 DM with autonomic neuropathy and its relation with glycemic control. The 60 patients of T2DM with autonomic neuropathy and 60 healthy controls were taken for the study. Autonomic neuropathy was assessed clinically. Chemical taste test using four solutions of basic tastes (sweet, sour, salty, bitter) were done.Results: Taste dysfunction for sweet was significant in T2DM with uncontrolled hyperglycemia. The taste dysfunction in T2DM patients was not related to gender, disease duration, and type of treatment taken. The study found a significant correlation between taste dysfunction, HbA1C level and blood sugar fasting level in T2DM patients.Conclusions: The taste dysfunction was mainly for sweet. Sour and bitter did not show any difference in case groups compared to controls.
A clinical study of management of wounds using vacuum assisted dressings
Authors: Patra Sanat Kumar , Mohapatra Minati , Panda Srikant , Sarangi Ashok Kumar , Babu K. Kiran , Sarangi Anshuman
Published: May 2022

Background: The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. Vacuum assisted closure (VAC) has proved its efficacy for wound dressing leading to faster wound healing and shorter hospital stay. The aim of the study was to determine the advantage of vacuum assisted closure over conventional dressing in SCBMCH hospital.Methods: The study was conducted at general surgery wards of SCB Medical College hospital. After debridement of the wound vacuum assisted dressing was applied. Control group was given conventional dressing.Results: In the study sample 10% patients were less than 40 years, 76% belonged to 41-60 age group and 7% were more than 61 years of age, 60% male and 40% female. Wounds were located in the foot 27 (54%), leg 19 (38%), sole 2 (4%) and forearm 2 (4%). Patients with sterile pre (VAC), culture and sensitivity was not turning non sterile after VAC, but 90% non-sterile turns sterile after vacuum assisted dressing. In 5 days 25% of granulation tissue formed in VAC dressing whereas only 10% in case control. Similarly, in 10 days it was 40% for VAC and 25% in case of control. Finally, in 15 days it was 70% in case of VAC and 40% in case of control.Conclusions: VAC results in better healing, with few serious complications, and a promising alternative for the management of various wounds.
Incidence of infections in patients with pemphigus vulgaris
Authors: Narain Upma , Kant Tejas , Kant Arun
Published: May 2022

Background: Pemphigus is a rare, chronic autoimmune blistering disease of skin and mucous membranes. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Therefore, the objective of this study was to isolate and identify the pathogens in admitted patients suffering from pemphigus vulgaris.Methods: This was a retrospective observational study based on 68 diagnosed cases of pemphigus vulgaris (PV) admitted during January 1999 to April 2018 in SRN hospital, MLN medical college Prayagraj. Patients who had PV  and required admission owing to development of severe symptoms were included while patients with mild symptoms were excluded from the study. These admitted patients, along with routine and radiological examination, were also examined for microbiological examinations of sputum, throat swab, blood, body fluids, skin scrapings, stool and urine when necessary.Results: Out of the 68 patients, 66.17% patients developed bacterial infections while 33.83% developed fungal infections. The prevalence of bacterial and fungal pathogens in urinary tract is 72.42% and 27.58%, pneumonitis is 29.42% and 70.58%, septicaemia is 81.82% and 18.18% and skin and soft tissue is 87.50% and 12.50% respectively. In meningitis and pulmonary tuberculosis no traces of fungi were recorded. Mortality was seen in 7.35% patients, which was due to bacterial meningitis, septicaemia and fungal pneumonitis.Conclusions: The present study clearly states that the occurrence of the disease is uncommon but secondary infections are associated with worse prognosis. Therefore, the best regimen for each type of patients should base on the extent of disease and patient’s comorbidities.
A study on causes of chronic kidney disease in patients without diabetes mellitus and systemic hypertension in a tertiary care hospital
Authors: J. Praveen , A. Tumbanatham , M. Sivashankar
Published: May 2022

Background: Chronic kidney disease is an increasing health problem worldwide Thus apart from the well-established risk factors for CKD such as diabetes and systemic hypertension, the possibility that environmental, demographic, and various other risk factors an influence in developing chronic kidney disease has been assessed in several studies. Hence, the present study aimed to study the clinical and laboratory profile of chronic kidney disease in non-diabetic and non-hypertensive patients Methods: The study was enrolled 100 patients diagnosed with chronic kidney disease without diabetes and systemic hypertension in the department of general medicine and department of nephrology in a tertiary care hospital, Pondicherry for 1 year. The baseline data such as socioeconomic status, history of self-consumption of natural medicine and NSAIDs, their occupations, location of their living place, and routine laboratory parameters were collected and analysed. Results: The socioeconomic status of the present study revealed that upper lower class was the predominant status and the majority of the patients were housewives and farmers. 38% of the patients were exposed to insecticides that were associated with CKD (p=0.0327). 40% of the study population was victims of NSAID consumers (p=0.0236). 42% was consumed natural medication on their own for their illness 46 without any consultation (p=0.0324). The patients came from Cuddalore predominantly (22%). Conclusions: Insecticide exposure, self-consumption of NSAIDs, and natural medicine are the main causes that progress to CKD in the present study.
Pain assessment and clinical profile of burn patients
Authors: Banotra Ankush , Kumari Monika , Wani Mumtaz Din , Banotra Pankaj
Published: May 2022

Background: Burn injuries are a major global public health concern with up to 52% of burn patients suffering from chronic pain. The aim of the study was to asses clinical profile and management of pain in burn patients.Methods: The study was a prospective hospital-based study on a total of 300 patients admitted in burn unit of the department of surgery over a period of two years. BSA burns was determined by Wallace's rule of nine in adults and in children by Lund and Browder chart. Pain was assessed using Wong-Baker FACES pain rating scale. Statistical analysis was done using SPSS program.Results: In the present study, most of the burns i.e., 46.7% were seen in <20 years age group, and more in male (58.7%) subjects. Accidental burns and superficial burns were the most common. There were 113 (53.3%) patients with pain score of 2 followed by 160 (53.3%) with pain score 3, 22 (7.3%) pain score 4 and 5 (1.7%) with pain score of 1. For pain management, 171 (57%) patients were given NSAIDS, 78 (26%) needed opioid and NSAIDs and 51 (17%) needed opioid only. Complications in our studied patients on follow up revealed 29 (9.7%) had PTSD, 22 (7.3%) had post burn contracture, 16 (5.3%) had post burn pain, 15 (5.0%) were having anxiety.Conclusions: Pain in burn victims is present throughout the rehabilitation and so should be dealt with multimodal specialties.
Cardiovascular manifestations of acute aluminium phosphide poisoning and their impact on survival
Authors: K. Nithyapriya T. , Giri Richa , Sachan Mohit , Khan Aadil Mahmood
Published: May 2022

Background: Aluminium phosphide (AlP) is a common suicidal poison with a high mortality rate due to its cardiovascular impact and lack of antidote. The aim of the study was to describe the electrocardiographic changes and other cardio-vascular manifestations in acute AlP poisoning and evaluate its impact on survival outcomes.Methods: A prospective cross-sectional study was conducted in a tertiary care hospital including patients who presented with acute AlP ingestion in any form. Patients’ vitals and ECG at the time of admission were taken and outcomes of survival were identified. A descriptive study of echocardiography was also done. The clinical parameters were correlated with the survival outcomes.Results: Fifty patients were included with 30 males and 20 females. The consumption of AlP in tablet form caused more hemodynamic compromise (hypotension and high anion gap metabolic acidosis) as compared to the powder form. ECG changes were seen in 42% of the cases, the most common finding was prolonged QTc interval (26%). The mortality was 30%. Hypotension, bradycardia, and QRS widening were found to be significant predictors of mortality (p<0.05). Echocardiography was performed for 10 patients, of which, one had right ventricular dysfunction and two had left ventricular dysfunction.Conclusions: AlP tablets are more lethal and hemodynamically compromising than AlP powder. Hypotension, bradycardia, and QRS widening are significant predictors of mortality. Direct cardiotoxicity leads to ECG changes, of which, QTc prolongation is the most common.
Evaluation and correlation of clinicopathological and radiological findings of axillary node positivity in clinically node negative carcinoma breast
Authors: Kand Himanshu Sekhar , Mohapatra Minati , Panda Srikant , Sarangi Ashok Kumar , Babu K. Kiran , Sarangi Anshuman
Published: May 2022

Background: In 2015, there will be an estimated 155,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. By the time a breast lump becomes palpable for clinical detection, it is usually advanced. We conducted a study to compare the status of axillary lymph node between the radiological and histopathological finding with the clinically negative lymph mode in carcinoma breast in order to limit the axillary lymph node dissection.Methods: This prospective study 50 female patients of carcinoma breast freshly detected and those with non-palpable axillary lymph admitted in S.C.B M.C.H, Cuttack, were included in the study.Results: The mean age of the patients was 51.26 years with standard deviation of 12.26 years with a range of 20 to 80 years. All 50 cases included in the study was done mammography of both breast and among them BIRADS IV 18 cases, BIRADS V 19 cases, BIRADS VI 5 cases and 08 cases were benign. 44 (88%) patients had Karnofsky performance score of 90-100 and 6 (12%) patients had score of 80-90. None (0.00%) of the patients had <80 performance score. Out of the 50 cases enrolled in the study, 04 were underwent wide local excision, 09 were breast conservation surgery and 37 were modified radical mastectomy along with axillary clearance.Conclusions: Higher sensitivity due to axillary ultrasound helps to reduce surgery time as patients with positive axillary lymph nodes directly get an Axillary Lymph Node Dissection (ALND) without preceding Sentinel lymph node biopsy (SLNB).
Systemic lupus erythematosus patient on steroid therapy that develop to a Stevens-Johnson syndrome: a case report
Authors: Suardamana Ketut , Kurniari Pande Ketut , Winangun I. Made Arya
Published: May 2022

Stevens-Johnson syndrome (SJS) is a cutaneous immunity reaction involving the skin and mucosa and is an emergency condition that can be fatal. The incidence of this disease is relatively rare in the range of 1-2 per 1.000.000 population. The pathogenesis of SJS involves the immune system response of antigenic drug to body tissues but it still cannot be fully explained to date. We reported a woman, 35 years old with systemic lupus erythematosus (SLE) who had been on steroid therapy and in the course of treatment developed into SJS after administration of anti-epileptic drug. Steroids have anti-inflammatory effects mainly due to decreased syntheses or suppression of inflammatory mediators. SJS still can develop in patient with SLE who had been on steroid therapy. Giving steroid that indicated for the treatment of a disease including SLE, cannot prevent the occurrence of an allergic event including SJS. The presence of steroid can extend the duration of starting the drug with the occurrence of SJS and reduce the severity of the disease. Steroid still have a role in treatment that can be used both in SJS and SLE.
Endomyocardial fibrosis in a 7-year-old Nigerian child: a case report and review of the literature
Authors: Bassey Kevin , Okpokowuruk Frances Sam , Oghenedoro Osafugbe
Published: May 2022

Endomyocardial fibrosis (EMF) is a poorly-understood idiopathic disorder characterized by the development of restrictive cardiomyopathy. It is a disorder of the tropics and subtropics and was once the second commonest cause of acquired heart disease in Nigeria. Its diagnosis is often made when the disease is advanced and the prognosis is invariably poor at this stage. Reports of EMF have become increasingly rare in recent years and it is frequently misdiagnosed. This report seeks to highlight EMF as a still present and potentially important cause of heart failure in Nigerian children. A 7-year-old male referred to the pediatric cardiology clinic with complaints of abdominal and facial swelling, with no difficulty in breathing and exercise intolerance. Examination revealed a classic “egg-on-stick” appearance. Apex was not displaced and heart sounds were distant. Liver was enlarged but non tender and there was demonstrable ascites. A 2D echocardiography showed massive right atrial enlargement with severe tricuspid regurgitation and fibrosis within the right ventricular cavity which was small. There was a moderate-sized pericardial effusion. Electrocardiogram showed right atrial enlargement with low-voltage complexes. Full blood count showed eosinophilia (20% total white blood cell count). Total serum protein and albumin were reduced. EMF, though increasingly rare, remains an important cause of childhood cardiac morbidity and mortality. A high index of suspicion is critical as the prognosis remains poor.

 
Inclusión financiera en Panamá. La importancia de la calidad institucional y las brechas territoriales, de ingreso y de género
Authors: Garcimartín Carlos , Astudillo Jhonatan A. , Schneider Christian
Published: May 2022

La inclusión financiera ha venido adquiriendo un interés creciente, tanto a nivel académico, como por parte de las autoridades, el sector privado y la sociedad civil. Es así porque la inclusión financiera favorece el desarrollo económico, la reducción de la pobreza, el aumento de la equidad y ayuda a cerrar las brechas de género. El primer objetivo de este trabajo es elaborar un índice de inclusión financiera que permita analizar la situación relativa de Panamá. Los resultados muestran que la inclusión financiera de los hogares panameños es relativamente menor a lo que cabría esperar, dado el nivel de desarrollo alcanzado por el país. En segundo lugar, hemos estimado el índice por grupos sociales, encontrando que existe un sesgo de género, de nivel de ingresos y en contra de las áreas rurales en la inclusión financiera. Posteriormente, hemos analizado los factores que explican que la relativamente baja inclusión financiera en Panamá. De acuerdo con nuestros resultados, las principales causas son el peso relativo del empleo en la agricultura, la desigualdad de ingresos, la brecha de género, la calidad institucional y los desequilibrios territoriales que existen en el país; factores que remiten a desafíos estructurales que enfrenta Panamá. Por último, hemos analizado la inclusión financiera digital, encontrando que, al igual que sucede con la general, los resultados de Panamá son inferiores a lo que se esperaría, dado su nivel de desarrollo, siendo las causas similares a las anteriores, junto al bajo nivel educativo promedio y el escaso desarrollo de las industrias fintech. Todo ello pone de manifiesto que aumentar la inclusión financiera pasa por seguir mejorando en esos desafíos estructurales del país: equidad de género, distribución del ingreso, calidad institucional, equilibrio territorial y educación, además de las fintech en el caso digital. Panamá ha realizado avances en estos ámbitos a lo largo de los últimos años. Seguir progresando permitirá la inclusión financiera de un mayor número de panameños y, especialmente, de panameñas que aún no tienen acceso a los servicios financieros, lo cual, a su vez, contribuirá no solo al crecimiento económico, sino, además, a que éste sea más inclusivo.
Linfedema: de la fisiopatología al tratamiento actual
Authors: Zambrano-Ferreira José Alonso , Pérez-Fonseca Silvia Viviana , Caro-Becerra Andrea Carolina , González-Rocha Yilmar Fabriani , Gelvez-Díaz Julian Mateo , Rueda-Gutiérrez Jorge Andrés , Mallarino Gonzalo
Published: May 2022

El linfedema es la acumulación de líquido rico en proteínas en el intersticio debido a una incompetencia de los canales linfáticos. Se clasifica en primario cuando es ocasionado por anormalidades estructurales congénitas en los canales linfáticos, mientras que el secundario está causado por disrupciones en la integridad anatómica, que pueden acontecer después de trauma, infecciones (filariasis linfática), posterior a vaciamientos ganglionares, o iatrogénica. Objetivo: describir los aspectos más importantes del tratamiento del linfedema entendiéndose este desde la fisiopatología. Metodología: se incluyeron artículos publicados en idiomas español e inglés, la mayoría entre 2011 y 2021 que tuvieran contenido relacionado con el objetivo del presente manuscrito. Conclusiones: el linfedema se ha convertido en un reto para los profesionales de la salud debido a su complejo tratamiento multidisciplinario, pero gracias al avance de la microcirugía, el manejo quirúrgico se convertido en una creciente alternativa efectiva, especialmente gracias a su enfoque fisiopatológico de la enfermedad. MÉD. UIS.2021;34(3): 61-70.
Hernia diafragmática congénita posterolateral derecha sin herniación hepática: presentación de caso con tratamiento exitoso
Authors: Rubio-Duarte Andrés Felipe , Angarita Daniel Ricardo , Zarate-Suarez Luis Augusto
Published: May 2022

La hernia diafragmática congénita es un defecto en la formación del diafragma con una alta mortalidad y morbilidad para el recién nacido. La ubicación en el lado derecho corresponde a solo el 10% de todos los casos y se asocia con una menor supervivencia, especialmente cuando hay una herniación hepática. No se conoce con precisión el porcentaje de casos de hernia diafragmática congénita derecha que no implican una herniación hepática. Aun no hay certeza del tiempo estimado para obtener el mayor beneficio de la corrección quirúrgica, en nuestro caso realizado con éxito a los 2 días de vida, logrando previamente una adecuada estabilidad hemodinámica y ventilatoria. El manejo perioperatorio en unidad de cuidado intensivo neonatal, es fundamental para reducir la morbimortalidad asociada. Se presenta un caso de hernia diafragmática congénita derecha tratado con éxito y se exponen los aspectos más relevantes del manejo médicoquirúrgico de esta patología. MÉD.UIS.2021;34(3): 71-7.
Mamoplastia de reducción oncoplástica en paciente con cancer de seno y macromastia: reporte de caso
Authors: Rueda-Gutiérrez Jorge Andrés , Ascencio-León María Stefany , Meléndez-Flórez Genny Liliana , Corso-Restrepo Diego Fernando
Published: May 2022

El cáncer de mama es la patología maligna más frecuente en la población femenina, su tratamiento ha evolucionado progresivamente en dirección a la conservación del seno a través del desarrollo de la cirugía Oncoplástica de seno, que consiste en manejo conservador con mastectomía parcial y reconstrucción inmediata. Las pacientes que presentan de manera concomitante cáncer de seno y macromastia, representan un reto mayor en el tratamiento debido a la dificultad de generar simetría con el seno contralateral y que además presentan sintomatología específica relacionada con la macromastia que disminuye su calidad de vida. El objetivo de este artículo es reportar el caso de una paciente que se maneja de manera exitosa y simultánea el cáncer de seno y macromastia, mediante cirugía oncoplástica de seno derecho y en el mismo tiempo quirúrgico, mamoplastia de reducción bilateral, obteniendo adecuado control oncológico y mejoría significativa en su calidad de vida medida por cuestionario BREAST-Q. MÉD.UIS.2021;34(3): 93-101.