bluuebunny/crossref_metadata_2025 huggingface dataset:
Hubungan Pijat Bayi Dan Riwayat Kelahiran Prematur Dengan Kemampuan Motorik Kasar Pada Bayi Usia 3 – 6 Bulan
Authors: Haryanti Ita , Retno Wulan
Published: April 2023

Proses tumbuh kembang anak merupakan hal penting yang harus diperhatikan sejak dini, mengingat bahwa anak merupakan generasi penerus bangsa memiliki hak untuk mencapai perkembangan yang optimal, sehingga dibutuhkan  anak dengan kualitas baik demi masa depan bangsa yang lebih baik. Penting untuk melatih kemampuan motorik kasar anak sejak dini, karena dapat mempengaruhi masa depan nya. Beberapa factor yang dapat mempengaruhi perkembangan bayi  selain dari  factor lingkungan berupa stimulasi /Pijat bayi, factor lingkungan  post natal berupa kondisi anak pada saat lahir  premature juga dapat mempengaruhi perkembangan bayi. Tujuan penelitian adalah untuk mengetahui hubungan pijat bayi dan riwayat kelahiran prematur dengan kemampuan motorik kasar bayi usia 3-6 bulan di kelurahan sekar Jaya Kab OKU tahun 2022. Jenis penelitian yang digunakan adalah Observasional Analitik  dengan desain penelitian Cross sectional study. Populasi dalam penelitian ini bayi usia 3-6 bulan sebanyak 145, dengan sampel sebanyak 107 tehnik sampling menggunakan accidental sampling. Analisis bivariat dengan uji chi square menunjukkan ada hubungan antara pijat bayi dengan kemampuan motorik kasar dengan nilai p value 0,000<0,0005 dan ada hubungan antara riwayat kelahiran prematur dengan kemampuan motorik kasar.
Aplicación de las Nuevas Tecnologías al Análisis de la Táctica en el Tenis
Authors: Sanz David , Terroba Antonio
Published: April 2023

En el proceso de entrenamiento deportivo se pretende llevar al jugador a su máximo nivel de desempeño y este objetivo, que implica a numerosos componentes de un equipo de trabajo (técnico, preparador físico, médico, fisioterapeuta, psicólogo, familia,…), debe ser cuidadosamente supervisado y secuenciado. De hecho, podemos decir que el rendimiento deportivo está determinado por la relación óptima de componentes como la condición física, la táctica, la técnica y, nos atrevemos a incluir, sobre todo en nuestro deporte, la condición psicológica del jugador (Sanz, 2011). De esta forma, entendemos que en el proceso de desarrollo de un jugador de tenis, un elemento clave que nos ayudará a ir pautando las actuaciones que llevemos a cabo, lo constituye el análisis y evaluación de cualquiera de estas áreas de trabajo, utilizando las herramientas tecnológicas que nos permitan acceder a la mayor cantidad de información y que sean fácilmente interpretables por el técnico. El presente artículo presentará las nuevas tecnologías que se están aplicando al análisis de la táctica en el tenis, pasando por los diferentes trabajos que se han ido publicando al respecto de éste tópico.
El Aascenso a los 100 Primeros Puestos Transición de las 10 Mejores Juniors de la ITF a las 100 mejores del Circuito de la WTA (1996 – 2005)
Authors: D. McCraw Peter
Published: April 2023

Muchos estudios describen el perfil y edad promedio de los tenistas hombres y mujeres mejor clasificados (Tennis Canada 1993ª, 1993b; Treleven y Miley; 1996a, 1996b). El presente estudio investigó la transición de la clasificación entre las 10 Mejores Juniors de la ITF a las 100 mejores del Circuito de la WTA durante un período de 10 años entre 1996 y 2005. La intención de este estudio fue establecer un rango de marcas estadísticas que los entrenadores y las Federaciones puedan utilizar para los jugadores que desean hacer una carrera en el Circuito WTA.
Perception of Purchase Decisions at Indonesia Marketplace
Authors: Suryani Wan , . Lusiah
Published: April 2023

The results of this study indicate that simultaneously online customer review (X1) and online customer rating (X2) have a significant effect on purchasing decisions (Y) at Tokopedia. Partially, online customer review (X1) has no effect on purchasing decisions (Y), while online customer rating (X2) has a partial effect on purchasing decisions (Y). The results of this study indicate that simultaneously online customer review (X1) and online customer rating (X2) have a significant effect on purchasing decisions (Y) at Tokopedia. Partially, online customer review (X1) has no effect on purchasing decisions (Y), while online customer rating (X2) has a partial effect on purchasing decisions (Y).

Keywords: [Online Customer Review, Online Customer Rating and Purchase Decision]
Use of ICT in Language Learning
Authors: Mohanta Ramkrishna , Mahato Ramesh Chandra , Sutradhar Aniket
Published: April 2023

Human existence is reflected in language, which also helps to define it. Language is an individual’s voice. In contemporary society, it acts as a cosmic channel for information transfer. English and ICT have evolved into vital tools for a range of non-datum and emotions in daily life. English has developed into a global language as a result of its many applications and popularity relative to many other languages worldwide. English is presently the world’s primary language. The present study focuses on the use of ICT in different areas like e-learning, flipped classroom, internet dependency, internet addiction, artificial intelligence, technology integration etc. for language learning.

Keywords: e-learning, flipped classroom, internet dependency, internet addiction, artificial intelligence, technology integration.
Positive Correlation of Plasma Interleukin-6 Levels with Immunoglobulin M (IgM) Anti Phenolic Glycolipid-1 (PGL-1) Levels in Household Contacts of Multibacillary Leprosy Patients
Authors: Pratama Nevristia , Mas Rusyati Luh Made , Vibriyanti Karma Ni Luh Putu Ratih
Published: April 2023

Background/aim: Leprosy is a chronic infectious disease that can be cured but causes high morbidity because it causes disability. Leprosy is caused by the bacterium Mycobacterium leprae, an obligate intracellular virulence factor in the form of phenolic glycolipid-1 (PGL-1), a capsule component in M. leprae. This study aims for known Increased IL-6 correlation with IgM anti PGL-1 level in household contacts of multibacillary leprosy patient.
Methods: Analytical observational study with a cross-sectional approach. The sample consisted of 42 household contact persons and 22 non-contact samples aged 18-65 years who were selected through consecutive sampling according to the inclusion and exclusion criteria. Samples of 3 millilitres of venous blood were taken, which would then be examined for PGL-1 and IL-6 with the ELISA kit. Data analysis with SPSS version 23 and p-value <0.05 was significant
Results: The average anti-PGL-1 IgM level in the household contact group was 636.76±288.45 u/ml, while in the non-contact group, it was 211.00±237.43 u/ml. The average IL-6 level in the household contact group was 20.28 ± 12.54 pg/ml, while in the non-contact group, it was 8.29 ± 2.88 pg/ml. There was a significant difference in the levels of IL-6 and anti-PGL-1 IgM in the household contact and non-contact groups (p<0.001). This study found a strong positive relationship (r=0.620, p<0.001) between IL-6 levels and anti-PGL-1 IgM levels.
Conclusion: IgM anti-PGL-1 and IL-6 levels in household contacts were higher than in non-contacts, with a significant difference. There is a significant positive relationship between IL-6 and anti-PGL-1 IgM levels.

Keywords: leprosy, contacts, IgM anti-PGL-1, IL-6
Improving English Achievement Through “Bengkel Inggris” Program on Elementary School Students in Klambir Lima Kebun Village
Authors: Ayu Fitri , Anggriani Devi , . Nizamuddin
Published: April 2023

This research is conducted because there is a problem seen when it is surveyed in Klambir Lima Kebun Village. It is found that the students in elementary school age do not understand about English. They thought that English as a big problem in their head so that they dislike English so far. Realizing this fact, “Bengkel Inggris” program is offered to be one solution. This program will investigate further about the cause of their difficulties in English. Then, the activities will be made based on the problem they have. In addition, this “Bengkel Inggris” program is not only the place for learning English but also as the place for doing consultation and sharing about English. Then, they are grouped in two groups namely basic English and middle English. As the result, there are improvement for both classes seen from the score in pre-test, cycle 1 test and cycle 2 test. In basic English class, the scores are 65, 73,5 and 89,5 while in middle English class the scores are 65,83, 73 and 88,75. Therefore, it is concluded that Bengkel Inggris is a program that improve English achievement of children on elementary school students in Klambir Lima Kebun.

Keywords: English Achievement, Bengkel Inggris Program, Elementary School Students.
Beneficios de la semilla de Persea americana Millo (Palta)
Authors: Gómez Ugarte Magaly , Escalera Cruz David Ángel , Rojas Navi Patricia , Andrade Valeriano Michel , Lopez Rojas Anna Faviola , Muruchi Suarez Adelaida
Published: April 2023

La Persea americana Mill. (conocida también como palta y aguacate) es un fruto carnoso de tipo baya, característico de zonas tropicales, originario de México, perteneciente a la orden de los laureles. Es un fruto rico en agua, grasas vegetales y carbohidratos, recomendable para una dieta balanceada que debe consumirse moderadamente por sus altos valores calóricos. Es conocido en América Latina por su abundante inclusión en la gastronomía de estas regiones, además de su uso como cosmético natural.

Estudios realizados por la Revista de la Sociedad Brasileña de Medicina Tropical demuestran que la semilla de Persea americana Mill. tiene propiedades larvicidas, antifúngicas, antibacteriales, antioxidantes y antinflamatorias que ayudan en el tratamiento de enfermedades infecciosas; además, estas propiedades le confieren actividades anticancerígenas debido a la presencia de P-sitosterol en su composición química.

Las patologías cardiovasculares son reducidas gracias a la acción de los ácidos grasos saludables de la palta. Su gran contenido de taninos de la palta ayuda en cuadros diarreicos. La palta es Ideal para niños, deportistas y personas que desean tener músculos firmes.

El presente artículo es producto de una investigación en aula, realizada por un equipo multidisciplinario formado por docentes y estudiantes de las asignaturas de Computación Aplicada y Botánica.

El objetivo de este artículo es describir las propiedades medicinales de la semilla de Persea americana Miller incentivar su consumo.
Odontología Holística-Biológica: ¿un nuevo paradigma de salud?
Authors: Flores Zamorano Lidia
Published: April 2023

En esta revisión bibliográfica se presenta en forma resumida los comienzos de la Odontologia Holistica, las instituciones que la apoyan, los miembros que tienen registrados via online, asi como las principales caracteristicas de este enfoque en el campo de la Odontologia. Por otra parte, se presenta el punto de vista de la Odontologia como Ciencias de la Salud, mencionando a la Asociación Dental Americana (ADA) y a otras organizaciones y autores de libros dentales ampliamente conocidos en el campo cientifico para comparar algunas propuestas que sehala la Odontologia Holistica; en especial se puntualiza quizás 10 más controvertido entre ambas posiciones, 10 cual es el uso de la amalgama dental en las obturaciones dentales. Al mismo tiempo, se señalan algunos ejemplos de mala praxis que han cometido algunos odontólogos holisticos y las acciones disciplinarias a las que han sido sometidos. Finalmente, se presenta la posición actual de la Odontologia como parte de las Ciencias de la Salud en 10 que respecta a la amalgama dental, asi como las últimas conclusiones a las que Ilegaron los odontólogos holisticos como parte de la Academia Internacional de Toxicologia y Medicina Oral (IAOMT) contra el mercurio dental, dejando elegir al lector el criterio que prefiera seguir.
Trasplante renal de donante con muerte encefálica: a propósito de un caso
Authors: Espinoza Dávila Elvy Hael
Published: April 2023

El trasplante renal mejora la supervivencia de pacientes con Enfermedad Renal Crónica (ERC), en comparación con otras modalidades de terapias de reemplazo renal. El Trasplante Renal con Donante Vivo (TRDV) tiene ventajas frente a los Trasplantes Renales de Donantes con Muerte Encefálica (TRDME). Sin embargo, la diferencia en la supervivencia del paciente y del injerto entre ambas modalidades a corto plazo ha disminuido en los últimos años.

Se trata del primer TRDME realizado en el Hospital Universidad Privada del Valle. La beneficiaria fue una paciente de sexo femenino de 46 años, con antecedentes de ERC E 5 de etiologia desconocida, en terapia de reemplazo renal (Hemodiálisis) desde julio del año 2015. El 12 de septiembre 2017 se realizó el trasplante renal con donador de muerte encefálica secundaria a traumatismo encefalocraneano severo, de sexo masculino de 28 años.

Después de la implantación del injerto renal presentó una función inmediata del injerto, con diuresis inmediata y descenso de creatinina del pre trasplante de 8 mg/dl a 4 mg/dl el dia 1, alcanzando niveles de creatinina de 0.9 mg/dl al dia 4.

Se empleó una terapia de mantenimiento con Tacrolimus 6 mg diarios, Micofenolato de Mofetil 2 gramos dia y Prednisona con disminución progresiva de dosis. Se asocia el tratamiento profiláctico contra infecciones virales, micóticas y bacterianas.

Con evolución favorable y función del injerto dentro de parámetros normales, la paciente fue dada de alta hospitalaria el 29 de septiembre.
Implementasi Kebijakan Sistem Informasi Manajemen Pelaporan Wajib Pajak Berbasis Online Pada Hotel Dan Restoran Di Kabupaten Garut
Authors: Fauzan Hasbi Shiddiq
Published: April 2023

Perpajakan merupakan salah satu aspek penting dalam proses pendukung penyelenggaraan serta pembangunan secara berkelanjutan dan meningkatkan perekonomian bangsa. Pajak hotel serta restoran yang ada di Kabupaten Garut merupakan sumber pajak daerah, dan Pemerintah Kabupaten Garut menggunakan pajak untuk meningkatkan pelayanan. Hotel dan restoran menyumbangkan donasi yang besar terhadap keuangan daerah Kabupaten Garut, pada hal ini dibutuhkan suatu sistem menjadi alat monitoring bagi Pemerintah Daerah. Pada penelitian ini, menggunakan data kualitatif dan deskriptif yang didapat dari wawancara serta observasi. Tujuan penelitian ini ialah buat mengetahui penggunaan sistem informasi manajemen pelaporan wajib pajak berbasis online pada hotel dan restoran di Kabupaten Garut, apa kendalanya dan bagaimana mengatasinya. Hasil penelitian bahwa penggunaan sistem sudah dilaksanakan, namun hambatan dalam penggunaannya masih ada, sumber daya daya peralatan yang tidak mencukupi serta pengawasan yang tidak efektif oleh Badan Pendapatan Daerah Kabupaten Garut terhadap operator hotel serta restoran.
Romanian national heritage at the universal exhibition in Barcelona (1929)
Authors: Boda Gherghina
Published: April 2023

Since the 18th century, universal exhibitions have undergone a wide development, each aiming to bring to the public’s attention not only the most special and innovative exhibits but, at the organizational level, the most varied and unique attractions, usually the latest technical innovations or using what is already known in a whole new way. Romania was one of the participating countries, the inauguration of the Romanian Pavilion in Barcelona, on an area of 400 square meters, taking place on October 4, 1929, in the presence of King Alfonso XIII of Spain. Th e layout of the Pavilion provided for two major groups: a cultural one and an economic one, with sections dedicated to peasant art, modern painting and sculpture, decorative art, household industries. Following the judging, the products on display, received 62 Grand Prix, 51 honorary diplomas, 49 gold medals, 14 silver medals, 8 bronze medals and 21 collaborator diplomas. Th is shows the special value of the exhibits, as well as the international recognition of the national art and economy.
Traditional nutrition. Case study — Th e Romanian community in Greece
Authors: Cuciureanu Ana-Maria
Published: April 2023

The act of “eating” is part of the ritual and ceremonial acts that have a great capacity for social transformation with a well-marked symbolic eff ectiveness. Th e history of nutrition cannot be seen as detached from the history of humanity, as they are identifi ed in the stages of their evolution. Factors that play an important role in this regard, infl uencing and sizing specifi c meanings and connotations, are the natural environment, climatic conditions, the socio-economic structure of communities, spiritual beliefs. Migration has been an acute phenomenon of the Romanian society in the last 30 years. If in the second half of the last century, during the communist period, the phenomenon of migration focused on moving the population from rural to urban areas, the liberalization of borders, entering EU structures, NATO, etc., facilitated and even encouraged, in a way or another, the migration of Romanians. Th e Romanian communities have grown signifi cantly, reaching a signifi cant place in the population of migrating countries, and even a representative minority in certain European states (Italy, Spain, Great Britain, etc.). Statistically speaking, Greece does not have a concrete record of the Romanian community, the last census dating from 2007 and the one from the end of 2021 not being centralized yet. In Greece, based on the information provided by the Romanian associations, there are a number of approximately 80,000 — 100,000 Romanians from several areas of Romania, mainly from Moldova, Bucovina and Maramureș, most of them living in Athens and a smaller part on the islands. Th is paper presents a case study, conducted within the Romanian community in Greece, having as main element traditional food. Starting from the idea that this community is part of the mobility diaspora, not being clearly defi ned for a period of time, we will notice, however, that the traditional food is an extremely important element in preserving the national identity. Th e Romanian communities, be they historical or mobility, follow an authentic Romanian social pattern, with few foreign influences, determined by several factors.
Uluslararası Politikada Sistem Düşüncesi
Authors: ELİK Süleyman
Published: April 2023

Sistem teorisi hem sosyolojinin hem de uluslararası siyasetin en önemli çalışma alanlarından biri olmuştur. Sistem teorisini en kapsamlı şekilde ele alan ilk siyaset bilimci Morton Kaplan, gelenekselci metodun karşısında yer alarak çalışmalarını davranışsalcı akımın içinde yürütmüştür. Buna karşın Hedley Bull düzen kavramını üretmiştir. İngiliz okulu teorisyenlerinden Barry Buzan ve Richard Little’ın sistem tarihi yazımı denemesi ise alternatif bir sistem analizi sunmuştur. Morton Kaplandan sonra uluslararası siyasete üst seviyeden bir bakış, Kenneth Waltz tarafından yapılmıştır. O dünya siyasetinde Soğuk Savaş dönemini açıklayarak tepeden bir bakış açısı sunmuştur. Fakat Soğuk Savaş sonrası dönemde Sosyal İnşacılık yaklaşımının yapı ve yapan ilişkisini açıklaması, uluslararası siyasete dair yeni bir kuramsal deneme sunmuştur. Onların yaklaşımı, bir tarih yazımında kullanılmaktan ziyade sistem içindeki değişimi açıklamaya yöneliktir. Diğer taraftan Haas’ın sistem yaklaşımı ise uluslararası örgütlerin sistem içinde oynadığı role dikkat çekmektedir. Onun sistem yaklaşımı, sistemin bir parçası olan yapı konusunda bir öngörü sunmasına rağmen siyasi bir tarih yazımına bir katkısı söz konusu değildir. Buna karşın Resocrance’ın denemesi, en başarılı sistem tarihi yazımlardan biri olarak değerlendirilebilir.
Antimicrobial activity of Biosynthesized Silver Nanoparticles of Bauhinia racemosa leaf extracts
Authors: Riazunnisa K.
Published: April 2023

Increased wettability or solubility of nanoparticles (NPs) can greatly improve their antibacterial activities. The effect of the stabilising agent on the solubility of silver NPs (AgNPs) and their antibacterial and antifungal properties were examined in this study. Aqueous and methanolic solutions of Bauhinia racemosa plant leaf extracts were used as bioreductants for making silver NPs. The synthesised AgNPs were first identified by a change in colour from pale green to dark brown and further confirmed by surface plasmonic resonance (SPR) band at 430 nm for aqueous and 360 nm for methanolic extracts using UV-Visible spectroscopy. The size distribution of generated AgNPs in solution was examined using a DLS particle size analyzer, and it was found to be 114 and 122 nm for aqueous and methanolic extract respectively. Bauhinia racemosa AgNPs exhibited significant antibacterial and anti-fungal activities against E. coli, K. pneumonia, P. aeruginosa, S. aureus and Aspergillus niger, demonstrating that they may be utilized in the biomedicine field.
The Surface Structure, Chemical Molecules, and Thickness of Aggregatibacter actinomycetemcomitans biofilms by Different Inducers Agent
Authors: Listiana Kriswandini Indah , Tantiana Tantiana , Ariffany Mahardhika Aulya , Sjuhada Oki Aqsa
Published: April 2023

Aggregatibacter actinomycetemcomitans caused oral infection in recent years. It requires advancements in health technology, such as infection and sickness detection kits. This study purposed to provide data to aid in the detection kits. Aggregatibacter actinomycetemcomitans was prepared to be biofilm cultured sample. Then the samples were induced by glucose, lactose, soy protein, and iron. Scanning Electron Microscopy Energy Dispersive X-Ray, Confocal Laser Scanning Microscopy, and Olympus FluoView ver 4.2a were used to analyze the ultrastructural dimension of biofilms. The surface structure of biofilm induced by iron differed from that of biofilms induced by other inducers. O(78.65±10.32) and Cl(1.28±0.21) were the most abundant chemical compounds induced by glucose; S(14.67±4.56) and Fe(37.46±59.62) were induced by lactose; C(25.41±16.36) and N(13.49±9.37) were induced by soy protein; and P(58.53±17.80) was induced by iron. Iron induced the highest amount of polysaccharides (605.641±71.66). Lactose (857.877±70.86) induced the greatest number of bacterium cells. Iron (11.000±1000)nm caused the thickest layer. The biofilm of Aggregatibacter actinomycetemcomitans induced by glucose, lactose, soy protein, and iron are all different.
Formulation and Optimization Peel-Off Gel Mask with Polyvinyl Alcohol and Whey Protein-Based using Factorial Design from Ethanolic Extract of Mangosteen Peel (Garcinia Mangostana) as Antioxidant
Authors: Miksusanti Miksusanti , Fitria Apriani Elsa , Aprida Nita
Published: April 2023

Mangosteen peel (Garcinia mangostana) contains xanthone compounds that have high antioxidant activity so it can be used as active ingredients in cosmetic preparations. This study aims to make a peel off-gel mask preparation of mangosteen peel ethanol extract using a factorial design and to test the antioxidant activity of the optimum formula. Mangosteen peel was extracted with 96% ethanol solvent and then formulated into a peel-off gel mask. The peel-off gel mask formulation was designed using a factorial design of 23 where the factors and levels used were mangosteen peel ethanolic extract (1 and 2%), whey protein (2.5 and 5%), and PVA (12 and 14%), and whey protein (2.5 and 5%). The physical properties of the mask were analyzed using an expert design in order to obtain the optimum formula for continued antioxidant testing. Based on the results of statistical analysis, there was a significant influence between the factors and the response to adhesion (p<0.05) but not significant on the dispersion and drying time (p>0.05). Formula 6 was chosen as the optimum formula and had an IC50 value of 3.82ppm while vitamin C as a positive control was 13.98ppm and has the potential to be developed into cosmetic preparations.
Delayed Structure – function alterations in Pancreas and Liver of Rodent Diabetic Model treated with Salacia oblonga.
Authors: M. Bhat Bhagyajyothi , Raghuveer C.V. , D’Souza Vivian , Ilanthodi Sandhya , A. Manjrekar Poornima
Published: April 2023

Salacia oblonga (S. oblonga) is a component of several antidiabetic medications in alternative and folklore medicine. An evaluation of the hydroalcoholic root extract of S.oblonga (SOE) on the hepatocellular and pancreatic environment in the diabetic (Streptozotocin) rodent model was designed. SOE was fed in two doses for a period of 16 weeks. Regeneration of endocrine pancreas, significant increase in hepatic and pancreatic Vitamin C, reduced Glutathione (GSH), Protein thiols (PT) and decrease in Malondialdehyde (MDA measured as TBARS) and Carbonyl proteins (CP) were observed on treatment with SOE. Conversely, there was also an increase in alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT). Corroborating the above findings, histopathological examination of the liver and pancreatic tissue showed disrupted architecture in treated rats. It may be suggested that SOE has a sustained hepatic antioxidant effect and improved β-cell structure and function in diabetic rats, but the higher dose was mildly toxic to hepatocytes necessitating an exercise of caution in using SOE for therapy for prolonged periods.
Kamu İşletmelerinin Tarife Düzenleme Yetkisi ve Sınırları
Authors: KİREMİTCİ Orçun
Published: April 2023

Kamu işletmeleri, kamu kaynaklarıyla kurulsalar da kısmen veya tamamen özel hukuk hükümlerine tabidirler. Dolayısıyla, kamu işletmelerince görülen hizmetlerin bedelinin niteliği ve sınırları açısından kesin bir yargıya varılamaz. Çalışmada, kamu işletmelerinin fiyat tarifesi belirleme yetkileri, bu yetkinin sınırları, aynı hizmetin farklı bedeller karşılığında görülüp görülemeyeceği idare hukuku esasları çerçevesinde irdelenmiştir. Verimlilik ve kârlılık esasıyla örgütlenen iktisadi kamu hizmetlerinin bedeli kâr içerebilir. Ancak kârın hangi düzeyde olacağı somut durumun özelliğine bağlıdır. Somut durum kamu işletmesinin piyasada tekel konumunda olup olmaması kıstas alınarak belirlenmiştir. Kamu işletmesi tekel değilse rekabet ihlaline yol açmamak için piyasa düzeyinde kâr etmelidir. Kamu işletmesi, piyasada tekelse de kâr edebilir fakat kâr miktarı; bakım, onarım, yenileme, Ar-Ge gibi kalemlerden ibaret olacağından, bu tutarlar kâr olarak adlandırılsa da geniş anlamda maliyettir. Tekelli ve tekelsiz hizmetlerin bedeli her yararlanandan eşit miktarda alınır. Ancak, bir pozitif statü hakkı kapsamında kanuni dayanak bulunuyorsa, eşitlik ilkesine istisna olarak kamu işletmesi tarifeyi farklılaştırabilir veya kademelendirebilir.
Rekabet İlkesi Kapsamında Kamu Alım Usullerinin Değerlendirilmesi
Authors: POLAT Sedat , ÖZTUNÇ İhsan
Published: April 2023

Kamu alımlarında rekabet ilkesi; alım sürecinin eşit, adil, saydam ve yarışmaya elverişli bir ortamda geçmesini ifade etmektedir. Söz konusu sürecin tesisinde rol oynayan önemli faktörlerden biri alım usulleridir. Bu çalışmanın amacı, rekabet ilkesi çerçevesinde Türkiye’deki kamu alım usullerinin değerlendirilmesidir. Bu kapsamda 2011-2021 yılları arasındaki kamu alımlarının dağılımı ve seyrine yönelik incelemelerde bulunulmuştur. Araştırma sonucunda açık ihale usulünün ihale usulleri içerisindeki payının yüksekliğinin rekabet açısından olumlu olduğu ancak 2017 sonrasında bu usulün payındaki azalışın dikkat çekici boyutlara ulaştığı tespit edilmiştir. Buna karşılık rekabetçi olmayan pazarlık ihalelerinin payı ise yükseliş eğilimine girmiştir. Tenzilat miktarları göz önüne alındığında son dönemdeki seyrin rekabet ve kamu yararı açısından tartışılması gerekmektedir. Ayrıca genel ihale sistematiğinin dışında olan doğrudan temin ve istisna alımların payındaki seyir
de 2016 yılı sonrasında rekabet ilkesiyle ters yönde hareket etmektedir. Bu kapsamda ilana dayanmayan ve katılımcı sınırlaması içeren alım usullerinden mümkün olduğu kadar kaçınılması gerekmektedir.
Repercussões envolvidas na miomectomia pelas técnicas de histeroscopia cirúrgica, videolaparoscopia e laparotomia
Authors: Dantas Rebeca Fernandes de Azevedo , Conforto Mariana Eiras Cardoso , Alves Luana Gola , Santos Ana Carolina Kuntz Couto dos , Monteiro Daniela Pereira , Bekierman Hannah Barboza Vianna
Published: April 2023

Introdução: O mioma uterino é uma neoplasia benigna responsável por causar diversos obstáculos na qualidade de vida da mulher, como: dor pélvica, infertilidade e sangramento uterino anormal (SUA). Atualmente, existem várias técnicas cirúrgicas capazes de minimizar as intercorrências relacionadas com o mioma uterino. Objetivo: Avaliar as repercussões das técnicas cirúrgicas da videolaparoscopia (LM), histeroscopia (HM) e laparotomia (OM). Materiais e métodos: Foi realizada uma revisão sistemática da literatura com artigos publicados entre 2015 a 2022 nas plataformas United States National Library of Medicine (PubMed), Scientific Eletronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MedLine) e Cochrane Library. Resultados e conclusão: Foram obtidos 22 artigos selecionados, dos quais 13 foram incluídos neste estudo. De acordo com os dados estudados, viu-se que a indicação mais comum na miomectomia entre as técnicas de videolaparoscopia, histeroscopia cirúrgica e laparotomia é o sangramento uterino anormal (SUA), sendo a primeira e a última para a remoção de miomas submucoso, intramural e subseroso. Já na histeroscopia cirúrgica, a intervenção é feita nos miomas submucosos. Vale ressaltar que a histeroscopia cirúrgica é a indicação padrão-ouro para mulheres em idade reprodutiva e que desejam engravidar após a cirurgia. Além disso, o tempo médio de cirurgia foi maior nas técnicas de videolaparoscopia e histeroscopia cirúrgica; já para o tempo de internação hospitalar e as taxas de complicações foi percebido um aumento significante na laparotomia, por ser uma técnica invasiva, na qual o risco de trauma, como perfuração de alça intestinal e hemorragia, é mais frequente. Por conseguinte, a videolaparoscopia é considerada a opção mais eficaz para a miomectomia quando comparada à laparotomia e à histeroscopia, isso por ser uma técnica que abrange vários tipos de miomas e ter melhor segurança no quesito de internação hospitalar e prevalência de complicações. No entanto, é uma técnica desafiadora, que precisa ser realizada por cirurgiões experientes.
Avaliação de complicações da aspiração intrauterina a vácuo sob técnica modificada de baixo custo em pacientes pós-abortamento
Authors: Sabadin Hohanna , Chiminacio Igor , Obrzut Carolina
Published: April 2023

Introdução: O abortamento é a mais comum intercorrência obstétrica. Até 20% das gestações evoluem para aborto antes de 20 semanas. O esvaziamento uterino está indicado no abortamento incompleto, inevitável, retido ou infectado, gestação anembrionada, mola hidatiforme e interrupção legal da gestação. Para esvaziamento uterino, existem as técnicas convencionais de curetagem uterina e aspiração manual intrauterina (AMIU). Utilizamos técnica modificada de esvaziamento uterino por aspiração de baixo custo, realizada por sonda nasogástrica. Objetivo: Analisar a ocorrência de complicações de pacientes submetidas a aspiração uterina pós-abortamento por meio de técnica inovadora e de baixo custo em hospital do interior do Paraná. Materiais e métodos: Trinta pacientes foram submetidas a aspiração uterina pós-abortamento de até 14 semanas com tubo de cloreto de polivinila (PVC) nº 20 (sonda nasogástrica curta) associado a vácuo clínico. As pacientes são submetidas ao procedimento após a dilatação do colo do útero com velas de Hegar ou misoprostol, sob sedação, com o uso de sonda nasogástrica nº 20 com orifício ampliado na lateral da sonda e conectada a vácuo clínico para a aspiração de restos ovulares via colo uterino. As variáveis analisadas foram: ocorrência de complicações. As pacientes foram avaliadas clinicamente no pós-operatório imediato, 14 e 28 dias após o procedimento. Resultados e conclusão: Todas as pacientes tiveram êxito no esvaziamento uterino completo, nenhuma complicação do método aplicado foi observada no grupo estudado. Não houve registro de complicações transoperatórias (laceração cervical, perfuração uterina e hemorragia) ou pós-operatórias (ao fim do 28º dia pós-operatório, nenhum episódio de febre, dor abdominal ou hemorragia foi verificado). A aspiração intrauterina com sonda nasogástrica pelo método de baixo custo é eficaz e segura, apresentando custo reduzido comparativamente ao método estabelecido (AMIU por seringa de vácuo), podendo-se melhorar a disponibilidade desse método em todos os serviços de saúde no Brasil.
Descolamento prematuro de placenta: relato de caso
Authors: Magalhães Maria Regina Marques , Couto Lorena Moreira
Published: April 2023

Introdução: O descolamento prematuro de placenta (DPP) é a separação da placenta normoinserida antes do nascimento do feto. Os principais achados clínicos são sangramento vaginal e dor abdominal, comumente seguidos de contrações uterinas hipertônicas. A grande maioria dos casos acontece antes de 37 semanas, sendo importante causa de prematuridade e morbimortalidade materna e perinatal. A fisiopatologia do DPP pode ser explicada pela ruptura dos vasos maternos na decídua basal. O sangue acumulado atinge a zona de clivagem decíduo-placentária e inicia a separação. Os principais fatores de risco (FR) do DPP incluem DPP em gestações anteriores, síndromes hipertensivas, idade materna avançada e uso de cocaína. Relato de caso: Paciente M.S., do sexo feminino, 41 anos de idade, gestante com idade gestacional de 34 semanas, G4 P2 A1 (dois partos cesáreos), negra, doméstica, droga adicta (faz uso de cocaína), natural e moradora de São Gonçalo. Deu entrada na emergência com queixa de dor abdominal intensa, súbita e sangramento vaginal escurecido. Negava comorbidades. Ao exame físico, apresentava estado geral regular, anictérica, acianótica, afebril, eupneica, hidratada, corada e com frequência cardíaca de 90 bpm. Ausculta cardiopulmonar normal, extremidades bem perfundidas e edema bilateral de membros inferiores (1+/4+). Ao exame físico obstétrico, batimentos cardíacos fetais (BCF) de 130 bpm, altura de fundo de útero de 34 cm e dinâmica uterina ausente. Colo firme, fechado, posterior. Estática fetal: atitude de flexão generalizada, situação longitudinal e apresentação cefálica. A conduta inicial foi de internação hospitalar, estabilização hemodinâmica e coleta de exames laboratoriais. Posteriormente, optou-se por interrupção da gestação por hipótese diagnóstica de DPP. Conclusão: O DPP é uma hemorragia que ocorre na segunda metade de gestação, representando mais de 30% de todas as hemorragias do terceiro trimestre. Pode ser definido como a separação completa ou parcial da placenta normoinserida. Cerca de 80% dos casos ocorrem antes do início de trabalho de parto. Sua etiologia é multifatorial, sendo os principais FR hipertensão, idade materna avançada e DPP em gestações prévias. O diagnóstico é clínico, com presença de sangramento vaginal escurecido associado a dor abdominal súbita e de forte intensidade. A ultrassonografia obstétrica é importante para o diagnóstico de óbito fetal e para excluir diagnóstico de placenta prévia (PP), que é o principal diagnóstico diferencial do DPP. Quando normal, não afasta DPP, já que possui sensibilidade muito baixa. O tratamento consiste em estabilização hemodinâmica materna, reposição volêmica, se necessário, e interrupção da gestação. Em caso de feto viável, avaliado pelos BCF, deve-se prosseguir pela via mais rápida, na maioria das vezes o parto cesáreo. As complicações mais comuns no DPP são a coagulação intravascular disseminada e útero de Couvelaire.
Distribuição das malformações fetais em gestações em centro de referência em alto risco fetal no Rio de Janeiro
Authors: Silva Fernanda Cristina Vasconcellos , Izzo Aline Silva , Jesus Guilherme Ribeiro Ramires de , Peixoto Filho Fernando Maia
Published: April 2023

Introdução: As gestações de feto com anomalias e malformações congênitas têm incidência de 7,9 milhões de casos com nascidos vivos a cada ano, representando importante parcela das gestações. Estão descritas, atualmente, diversas malformações e anomalias fetais, com prevalências distintas entre os nascidos vivos. Objetivo: O estudo pretende avaliar a distribuição dos principais grupos de malformações fetais em um centro de referência em medicina fetal no Rio de Janeiro, além dos resultados de cariótipo fetal nessas gestações. Materiais e métodos: Estudo de coorte retrospectiva observacional de mulheres cujo parto ocorreu no período de julho de 2015 a abril de 2016 em um centro de referência em medicina fetal no Rio de Janeiro. Foram selecionadas as pacientes com gestação de feto único malformado, cujo parto tenha ocorrido com mais de 20 semanas. Resultados e conclusão: A população foi distribuída em oito grupos de malformações: as do sistema nervoso central, as renais e de vias urinárias, as cardíacas, as torácicas, as de parede abdominal, as de musculoesquelética, as múltiplas e outras. A distribuição encontrada na amostra foi: 22,35% malformações de sistema nervoso central, 8,82% malformações renais e de vias urinárias, 9,41% de malformações cardíacas, 2,94% torácicas, 14,71% de parede abdominal, 2,94% de musculoesquelética, 29,41% múltiplas e 9,41% outras. Apenas 21,18% (36) das pacientes realizaram teste invasivo para a determinação de cariótipo fetal. Dentre elas, 15 fetos apresentaram cariótipo normal, um apresentou cariótipo pendente (resultado não encontrado no prontuário), três apresentaram trissomia do 21, oito tiveram resultado de trissomia do 18, enquanto cinco tiveram de trissomia do 13 e um, amostra insatisfatória. Os outros exibiram resultados como translocação, encurtamento do braço de cromossomo e mosaicismo. Observou-se, na população estudada, maior prevalência de malformações múltiplas, seguidas por sistema nervoso central, parede abdominal e cardíaca. Outros estudos nacionais demonstram maior prevalência de malformações de parede abdominal, seguida por malformações de membros e sistema nervoso central. No entanto, trata-se de uma amostra limitada, sendo necessários estudos com amostras populacionais maiores para melhor avaliação dessa distribuição.
Economic Analysis of Factors Affecting Sudanese Live Sheep Exports to Kingdom of Saudi Arabia
Authors: Ahmed Awadelkarim Hamid , El-Sammani Mohamed Ahmed Hassan , Babiker Babiker Idris
Published: April 2023

The major objective of this paper was to analyze the effects offactors responsible for the exported quantity of Sudanese live sheep to themarket of the Kingdom of Saudi Arabia (KSA). For this end, data onexported quantities, import prices, competitors' prices, exchange rate andSaudi chilled mutton imports was used. Multiple regression analysis wasused for estimating the effect of these factors via a transformedgeneralized Cobb-Douglas function. Among the four hypothesizedvariables, only import price and exchange rate were having significanteffect on exported live sheep quantities. Consistent with the economiclogic, the former was having an elastic effect while the latter had aninelastic effect. The other two variables with insignificant effect werecompetitors' price and KSA imported chilled mutton. All four variablesexerted increasing returns to scale to the Sudanese exported live sheepquantity. To increase live sheep exports to the Saudi market, the paperrecommends improvement of quality control measures, reduction ofproduction cost as well as minimizing the tax margins levied by thedifferent local governments involved, adopting long term contracts infuture markets and have Sudan Central Bank adopt exchange rate policymeasures to encourage investments in this foreign trade business.
Assessment of Litter Input, Decomposition and Elements Dynamics in Yatta Tropical Forest in Western Equatoria State, South Sudan
Authors: M.A Daldoum , J.E. Lagure
Published: April 2023

This study characterized soils, assessed litter input, litter decomposition and elements release in Yatta forest, Western Equatoria State, South Sudan during May 2008 and March 2010. The soil was described and sampled. Litter was collected weekly from plots of 16 m2 under the forest cover with forty replicates. Seventy five litter bags were buried at 15-30 cm soil depth to assess decomposition and elements' release. Twenty fife bags were withdrawn at every 6, 12 months periods   Fallen litter, remaining decomposed litter and soil samples were analyzed in the Laboratory of the Department of Soil and Environment Sciences, Faculty of Agriculture, University of Khartoum. The soil was characterized as Oxisols, sandy clay loam, acidic, rich in organic matter, and amply furnished with nutrients. Litter input was 1791 kg/ha/year; with concessive seasonal maxima and minima in dry and wet months. Losses of dry matter were high, ranging of 52.2 % to 96.8 % during the tested periods. The elements K, N, P, Ca, Mg were rapidly released with successive rates ranges of 37 %-62 %, 56 %-72 % and 62 %-90 % during 6, 12 and 18 months observation periods. The results showed a high potential fertility of this natural forest site which will support the sustainability of the growing stock and utilization of the forest for high yielding food crops.
Pancreatitis aguda. Diagnóstico y enfrentamiento inicial en la práctica clínica
Authors: Uribe V Navor , Berger F Zoltán
Published: April 2023

Acute pancreatitis is a prevalent disease, with variable clinical course: several patients recover quickly and uneventfully, while others require treatment in critical care units with long hospital stay and even with a considerable mortality. The patient’s symptoms, laboratory tests and radiological images allow diagnosis without major difficulties. However, early identification of more severe cases can be difficult, and it determines the adequate selection of the hospitalization unit and the quick initiation of the appropriate therapy. In this paper we give some practical treatment guidelines for the everyday clinical practice: immediate severity stratification, fluid replacement and pain control. Early enteral nutrition, monitorization of severe cases in critical care units, adequate therapeutic but no prophylactic use of antibiotics assures the best treatment results.
Respuesta inmune innata y adaptativa frente al SARS-CoV-2. Diagnóstico: PCR y serología
Authors: Hunt P Nicole , Bastías O Carla
Published: April 2023

SARS-CoV-2 infection in the people has been characterized by great variability in the clinical manifestations, ranging from an asymptomatic infection in some individuals to a fatal disease in others. Recently, the importance of human genetics in determining clinical response has been highlighted. Within this context there are patients who don’t become infected despite viral exposure and others who, being young without comorbidities, develop a severe disease. On the other hand, it’s under constant investigation whether the presence of a concomitant primary or secondary immunodeficiency determines a different clinical course.
Alergia y Covid-19
Authors: Isler I Dayanne , Guzmán M Mª Antonieta
Published: April 2023

Atopic diseases, especially asthma may confer increased susceptibility to viral infections, however, such patients have been largely unaffected in the current Covid-19 pandemic. This favorable course could be explained by a protective role of cytokines and cells involved in an immune response with a T2 profile. In spite of the favorable course observed, it is a priority to maintain with its basic treatments to ensure a good control of the pathology. With respect the immunization process being carried out in patients with a history of allergic reactions in different degrees, the recommendation of the type of vaccine and the protocol for its administration should be individualized according to a risk stratification prior to its administration.
Obtención de plasma rico en plaquetas (PRP) en el Laboratorio de Terapia Celular para uso como herramienta terapéutica en medicina regenerativa
Authors: Pérez N Claudio , Escobar A Gisselle , Soto B Pablo , Ibarra C Camila , Larrondo L Milton , Alfaro L Jorge
Published: April 2023

Platelet rich plasma (PRP) is used to speed up tissue repair. Despite its widespread use, the therapeutic application of PRP generates controversies in clinical results due to the variability in methods of obtaining the different preparations and differences between the components of different types of PRP, so it’s recommended to mention the type of platelet preparation used. In this article, we describe technical and biologics characteristics of our platelet product, and we compare them to different commercial preparations described in order to validate their clinical use. Our results determine that the preparation can be considered a platelet rich plasma with biological activity in vivo and in vitro, which supports its use as a valid therapeutic tool, alternative to products currently available in Regenerative Medicine.
Falla hepática aguda sobre crónica (ACLF), síndrome subdiagnosticado con alta mortalidad
Authors: García N Daniela , Poniachik T Jaime
Published: April 2023

Acute on chronic liver failure is an increasingly recognized syndrome characterized by acute decompensation of chronic liver disease associated with organ failure and high short-term mortality. ACLF is frequent, affecting between 24 and 40% of patients admitted for complications of cirrhosis. Sepsis, active alcoholism, and relapse of chronic viral hepatitis are the most frequent precipitating factors. However, in up to 40%–50% of the cases of ACLF have no identifiable trigger. The stage of severity of Acute on chronic liver failure is very important because it allows us to stratify patients according to their prognosis, evaluate therapeutic response, determine transplant urgency, deciding intensive care unit admission, and also have a basis on which to decide therapeutic futility.
Cáncer de piel: melanoma. Revisión de la literatura
Authors: Oyarzún S Juan , Gac E Patricio , Rodríguez M Francisco , Cabané T Patricio , Rappoport W Daniel
Published: April 2023

Skin cancer is usually classified into melanoma (SCM) and non-melanoma (SCNM), with different cell origins; being the SCM responsible for the highest mortality. In Chile, an incidence (2008) of 434 new cases is estimated, obtaining a standardized rate of 2.2 cases per 100,000 habitants. There are multiple associated risk factors, the main ones being exposure to UV radiation and sunburn. The strategies to prevent this pathology fall on these same factors. The clinical evaluation of the lesions with ABCD mnemonics added to the use of dermoscopy increases the diagnostic sensitivity and specificity; however, the definitive confirmation is through biopsy, which must include the necessary parameters to define prognosis of disease. The definitive treatment is Surgical. There are alternatives such as the use of the sentinel lymph node to define lymph node dissections. Regarding systemic therapies, the use of immunotherapy has shown results that improve survival in these patients.
Tendencias en procedimientos meniscales y reconstrucción de ligamentos de rodilla en Chile: estudio transversal entre 2004-2019
Authors: Barahona V. Maximiliano , Palet B. Miguel , Zamorano C. Álvaro , Barahona V. Macarena , Infante C. Carlos , Hinzpeter C. Jaime
Published: April 2023

Purpose: The aim of this study was to describe the incidence rate per 100,000 inhabitants (IR) of knee arthroscopic procedures and knee ligament reconstruction in Chile, between 2004 and 2019. Methods: Cross-sectional study. Patients who underwent a meniscal surgery and patients undergoing knee ligament reconstruction were identified in the database of the Chilean department of statistics and health information (DEIS) between 2004 and 2019. Results: The DEIS reported 149,734 patients, 169244 arthroscopic procedures with a significant upward trend in the IR, from 24.61 in 2004 to 80.6 in 2019. Related to knee ligament reconstruction, 42,026 procedures were found in 38,171 patients, with a significant upward trend in the IR, from 4.08 in 2004 to 24.62 in 2019. Conclusions: Knee arthroscopy and ligament reconstruction are in an upward trend in Chile. An evident inequity in access was found public insurance needs to improve the quality and access to both procedures. An updated, national registry is urgently needed to improve data, allowing better health policies.