bluuebunny/crossref_metadata_2025 huggingface dataset:
Yetişkinlerin Beslenme Bilgisi ve Besin Tercihleri ile Beden Kütle İndeksi Arasındaki İlişki: Kesitsel Bir Çalışma
Authors: KESKİN Yaren , AKAR Yusuf , ERDEM Özden , EROL Saime
Published: April 2022

Giriş: Beslenme bilgisinin yeterli olması sağlıklı besin tercihleri için önemlidir. Amaç: Bu çalışmada yetişkin bireylerin beslenme bilgisi ve besin tercihleri ile Beden Kütle İndeksi arasındaki ilişkiyi belirlemek amaçlandı. Yöntem: Aralık 2019 – Mart 2020 tarihleri arasında kesitsel tasarımla yürütülen çalışmanın evrenini, İstanbul ilinin iki farklı ilçesindeki Aile Sağlığı Merkezlerine kayıtlı yetişkin bireyler oluşturdu. Örneklem, oransız tabakalı örnekleme yöntemi ile belirlendi. Aile Sağlığı Merkezlerine başvuran yetişkinlerden bir kadın, bir erkek olacak şekilde sistematik olarak alınan 444 birey örneklemi oluşturdu. Araştırmanın gücü Temel Beslenme bilgisi bölümü için 0,89, Beslenme tercihi bölümü için 0,99 bulundu. Veriler Yetişkinlerin Beslenme Bilgi ve Besin Tercihleri Ölçeği, anket formu ve boy, kilo ölçümleri alınarak toplandı. Tanımlayıcı istatistikler, Pearson korelasyon analizi ve Ki kare analizi ile değerlendirildi. Bulgular: Araştırmaya katılan yetişkinlerin %49.5’i kadın, %50.5’i erkek olup, yaş ortalaması 41.01±13.67’tir. Çalışma grubunun %56.1’i gibi büyük çoğunluğunun fazla kilolu ve obez olduğu ve beden kütle indeksi ortalamaları 25.81±4.37 bulundu. Bireylerin %45.9’unun beslenme bilgi düzeyleri orta, %36.5’inin iyi ve bireylerin %45.3’ünün besin tercihleri orta, %30.2’sinin iyi düzeyde olduğu bulundu. Yetişkinlerin medeni durum, gelir ve eğitim durumu değişkenleri ile Beden Kütle İndeksi arasındaki fark istatistiksel olarak anlamlı bulundu (p<.05). Beden Kütle İndeksi ile Temel Beslenme Bilgisi ve Besin Tercihi puan ortalamaları arasında istatistiksel olarak anlamlı ilişki saptanmadı (p>.05). Sonuç: Yetişkinlerin beslenme bilgi ve tercihleri yeterli olmasına rağmen büyük çoğunluğunun fazla kilolu/obez olması, besinlerin ihtiyaçtan fazla tüketilmesi ya da inaktif olmaları ile ilişkili olabileceği düşünüldü.
Digital Currency Alert System Using IOT
Authors: R DEEPIKA.R , R Keerthika , P Amrutha , K Valarmathi
Published: April 2022

Assume a client needs to put his cash in Bitcoin market and he/she would be more than once checking for Bitcoin esteem in current market. So rather than customary checking, the python program in this task proves to be useful. In this the program requests that the client enter the money from which he/she need to put resources into bitcoin market, then the program requests his/her ideal selling cost. In the wake of taking the selling value the program stores it and afterward it checks for current bitcoin esteem in the market in his/her given money. For this the program utilizes the API of worth of bitcoin which we have embedded in our program. Assuming it observes that the current market worth of bitcoin is not exactly the selling value, the program naturally as an indication of caution rings ringer and furthermore the LED as advance notice. Yet, in the event that guess the client not ready to hear alert. This program checks for bitcoin value in every 30 seconds online it also gives the latest transaction of bitcoin which helps the investor to know how many people made a transaction and how much they invest in bitcoin. If people made many transactions between two periods of time, investors may come to a conclusion that the bitcoin price has decreased time.
Educação Física e o mundo do trabalho no âmbito das adequações produtivas do capital
Authors: Scapin Gislei José , Souza Maristela da Silva
Published: April 2022

Objetiva-se compreender a função que o Conhecimento em Educação Física assumiu no movimento histórico de (re)produção do capital a partir das mudanças no Mundo do Trabalho. Foi realizada uma investigação bibliográfica, de base Marxista. Teoricamente: apresenta-se a organização da Escola Capitalista; e situa-se o lugar do Conhecimento em Educação Física, compreendendo sua função pedagógica no processo de formação básica dos educandos para dar continuidade à (re)produção do capital. Se compreende, enfim, que a função do Conhecimento (escolarizado) em Educação Física esteve atrelada ao projeto histórico de sociedade burguesa, na qual demandou demasiado cuidado com a educação dos corpos.
REPRODUCTIVE POTENTIAL OF TWO SPECIES OF ENTOMOPATHOGENIC NEMATODES ON GRATE WAX MOTH LARVAE (GALLERIA MELLONELLA)
Authors:   University of Banja Luka, Faculty of Agriculture, Bosnia and Herzegovina, Đekanović Radijana , Nježić Branimir
Published: April 2022

Local populations of two species of entomopathogenic nematodes Steinernema carpocapsae andS. feltiaewere tested in laboratory conditions with the aim to evaluate their reproductive potential on the larvae of grate wax moth (Galleria mellonella). The optimal productivity of infective dauers was obtained with the dose of 60 and 120 nematodes per larva, of 285.283,3 and 114.018 nematodes per cadaver, or 1.506 and 546,7 nematodes per mg of an insect. Both strains revealed high virulence and good reproducibility and present potential for application as biological control agents.
DETERMINATION OF ANTIBACTERIAL POTENTIAL OF AGARICUS MACROSPORUS AND RUSSULA VESCA MUSHROOM EXTRACTS
Authors:   1University of Ss. Cyril and Methodius, Faculty of Agricultural Sciences and Food, Skopje, Stojanova Monika , Djukic Dragutin , Todor Stojanova Marina , Şatana Aziz , Lalevic Blazo
Published: April 2022

The aim of this research was to determine the antibacterial potential ofaqueous and ethanolic extract of wild mushroom species: Agaricus macrosporus and Russulavesca. Extracts from R.vesca were characterized with higher values for total carbohydrates and total proteins. Both aqueous extracts had higher antibacterial activity compared to ethanolic extracts. Aqueous extract from R.vesca showed higher antibacterial activity against B. cereus (13.6mm), E.faecalis (12.1 mm), E. coli(16.7 mm) and P.aeruginosa (10.5 mm) compared to gentamicin or neomycin. This study represents a novel starting point for future researchin which mushroom extracts can be used in various industry fields.
Peningkatan Keaktifan Belajar Menggunakan Video Tutorial dalam Materi Tendangan Samping Pencak Silat Siswa SMA 5 Kendari
Authors: Suryani  , Resky Ana Abadi
Published: April 2022

Penelitian ini disusun dengan tujuan untuk meningkatkan keaktifan belajar peserta didik menggunakan Video Tutorial pada siswa kelas XI SMA 5 Kendari pada materi ajar tendangan samping, Pencaksilat tahun ajaran 2020/2021.Jenis penelitian ini adalah Penelitian Tindakan Kelas (PTK), di mana guru sebagai pelaksana pembelajaran sedangkan peneliti sebagai pengamat. Desain Penelitian yang digunakan pada penelitian ini adalah penelitian model Kemmis dan Mc. Taggart dengan menggunakan dua siklus. Penelitian ini dilaksanakan pada semester ganjil tahun ajaran 2020/2021, Subjek penelitian ini adalah peserta didik kelas XI SMA 5 Kendari yang terdiri dari 32 peserta didik yang terdiri dari 17 siswa laki-laki dan 15 siswa perempuan. Objek penelitian adalah keaktifan belajar peserta didik. Teknik pengumpulan data menggunakan teknik tes, observasi dan Dokumentasi. Data dianalisis secara kuantitatif dan disajikan dalam bentuk tabel dan grafik. Hasil penelitian menunjukkan adanya peningkatan keaktifan belajar peserta didik, yaitu pada siklus I sebesar 46,00% (kategori kurang), kemudian pada siklus II meningkat menjadi 93,75% (kategori sangat baik). Hal ini berarti terjadi peningkatan sebesar 47,75% Dengan demikian penggunaan video tutorial dapat meningkatkan keaktifan belajar peserta didik kelas XI SMA 5 Kendari.
Complex Treatment for Analaplastic G3 Meningioma- Clinical Case with Literature Review
Authors:   Medical Oncology Clinic Department of Radiation and Metabolic Brachytherapy UMHAT “Queen Joanna” Sofia, Bulgaria, Marinova Lena , Vassileva Vaska ,   Medical Oncology Clinic Department of Radiation and Metabolic Brachytherapy UMHAT “Queen Joanna” Sofia, Bulgaria, Petrov Viktor ,   Medical Oncology Clinic Department of Radiation and Metabolic Brachytherapy UMHAT “Queen Joanna” Sofia, Bulgaria, Gabrovski Iliya ,   Medical Oncology Clinic Department of Radiation and Metabolic Brachytherapy UMHAT “Queen Joanna” Sofia, Bulgaria, Vulchev Galin ,   Medical Oncology Clinic Department of Radiation and Metabolic Brachytherapy UMHAT “Queen Joanna” Sofia, Bulgaria
Published: April 2022

Anaplastic meningiomas are rare aggressive brain neoplasms that are followed by recurrences, despite a gross total surgery. We present a 45-year-old woman with an anaplastic meningioma recurrence two years after surgery, which is not followed by postoperative raditherapy. Through this clinical case, we emphasize the required diagnostics and complex treatment in analaplastic meningiomas as well as the current optimization options of imposing surgical intervention, radiotherapy and drug treatment. Тhe standard care is maximum safe resection followed by adjuvant raditherapy (RT) for grade 3 meningiomas. Radiosurgery (RS) is an effective therapeutic alternative for intracranial and spinal meningiomas up to 3.5 cm. Hypofractionated radiosurgery (HFRS) is administered postoperatively in analaplastic meningiomas with a diameter of more than 3.5 cm. After re-operation of recurrences and after 6 months of the previous radiotherapy, it is possible to conduct HFRS re-irradiation, followed by targeted therapy
Adaptive Behaviour Empowerment of Children with Disabilities in Pertubuhan Pemulihan Dalam Komuniti (PPDK)
Authors: Jamaluddin Zakiyah , Mohd Ali Hanafiah Norzalinda , Sayuti Rusimah
Published: April 2022

Adaptive behaviour is a conceptual, practical, and social skill that each individual uses in daily life. This study focuses on the empowerment of adaptive behaviour among children with disabilities in the Pertubuhan Pemulihan Dalam Komuniti (PPDK) or Community Rehabilitation Organisation in the district of Kubang Pasu, Kedah, Malaysia. The objective of the study is to examine the differences in the adaptive skills of children with disabilities based on the category of People with Disabilities (PWDs). This is a quantitative study using a survey method that involves parents or guardians of children at PPDK. A total of 95 respondents were involved in this study from the total population of 137 disabled trainees. The questionnaire was based on and modified from the Inventory for Client and Agency Planning (ICAP) which covered adaptive behaviours based on motor skills, social and communication skills, personal life skills, and community life skills. The analysis found that motor skills, communication and social skills, and personal life skills are different for all categories of PWDs. Only community life skills are similar for all categories of PWDs. Overall, this study found that PPDK can enable the adaptive behaviour of children with disabilities for participating in formal education.
In secondary schools: problem, analysis, and recommendations
Authors: Badalova Maksuda
Published: April 2022

The article is devoted to the research work carried out in secondary schools of Mingbulak, Namangan, Uchkurgan districts of Namangan region, and Ulugnor district of Andijan region.
The text of the article focuses on the activities, problems, and solutions of secondary schools analyzed the results of interviews and questionnaires with school principals and teachers and made appropriate recommendations and conclusions.
Social Cognition Interventions in Neuro-Rehabilitation: An Overview
Authors:   Buckinghamshire Healthcare Trust, UK, Yeates Giles
Published: April 2022

This article provides an overview of interventions developed and trialled in the embryonic field of social cognition neuro-rehabilitation. Interventions are categories under the headings of explicit skills training, embodied/relational interventions, and relational approaches. The assessment and treatment of social neuropsychological impairments have received comparably less attention and development than other domains of cognition. These include difficulties in representing the intentions and perspectives of others (mentalising), recognising emotions, inferring nuanced social communications such as sarcasm and deceit, accessing social knowledge, and emotion-based decision-making. Founded on distributed neuroanatomical substrates, impairments of these functions have been found to be present and enduring across major sub-groups of acquired brain injury (for review see [1]). The theoretical richness of the social neuroscience revolution has not been matched by the translation of concepts and findings into rehabilitation practice. This article will review the embryonic field of social cognition rehabilitation, categorised into three intervention clusters: a) explicit skills training, b) embodied and affective interventions and c) relational approaches.
Freud, forgotten Neurologist
Authors:   Hull Royal Infirmary, Hull, UK, Pearce JMS
Published: April 2022

For a five-year period, before Sigmund Freud embarked on his original studies of psychological mechanisms, nomenclature, and psychoanalysis, he had extensive neuropathological training under von Brücke and executed research into neuronal cytoarchitecture and neural tracts. Influenced by Charcot and Theodor Meynert he carried out and published important clinical studies on aphasia and cerebral diplegia. He strived to carry his scientific discipline into his psychoanalytical work. As a Neurologist his role is underestimated.
Disease modifying treatments for Parkinson’s disease – an update
Authors:   Institute of Neurological Sciences, Glasgow, UK, Chandran Vijay , Grosset Donald G ,   Institute of Neurological Sciences, Glasgow, UK
Published: April 2022

An improved understanding of the pathological processes leading to neurodegeneration in Parkinson’s disease (PD) is leading to the development of a number of disease modifying agents. These include both novel and repurposed drugs. Some of these disease modifying therapies act on cellular targets that have been identified by genetic mutations, while others act on other cellular process which we know are affected in PD. This review provides an update on the progress in the field, and highlights some areas of special interest.
An expert opinion: Vocational rehabilitation after stroke
Authors:   National Hospital Queen Square, London, UK, Leary Siobhan , Hurford Joanne ,   National Hospital Queen Square, London, UK, Shanahan Niamh ,   National Hospital Queen Square, London, UK
Published: April 2022

Less than half of people return to work following a stroke. For those who do, their return is often complicated by residual ‘invisible’ symptoms. It is important to ask about work and to provide intervention early in the rehabilitation process. Specialist vocational rehabilitation services can support more complex and long-term interventions, but there is a paucity of service provision which needs to be addressed. One in four strokes occur in people of working age. Return to work is often a key goal for the person with a stroke and important for maintaining quality of life and wellbeing. However, less than half of those in employment return to work after a stroke.
Dietary restriction in multiple sclerosis: evidence from preclinical and clinical studies
Authors:   University of Sydney, Australia, Liao Eileen , Ghezzi Laura ,   Washington University, US, Piccio Laura ,   Washington University St Louis, US
Published: April 2022

Dietary restriction (DR) interventions, which encompass both chronic and intermittent reductions in energy intake, are emerging as potential therapeutic approaches for dampening neuroinflammation and demyelination in multiple sclerosis (MS). Mechanisms mediating the beneficial effects of DR include the regulation of pro- and anti-inflammatory signalling molecules and gut microbiome remodelling. This article summarises the preclinical evidence supporting the role of DR in attenuating disease in animal models of MS and the developing clinical evidence indicating the safety and feasibility of such DR interventions in people with MS (pwMS).
Hansen’s bacillus
Authors:   Hull Royal Infirmary, Hull, UK, Pearce JMS
Published: April 2022

Because of its gradually declining incidence, many UK physicians rarely encounter leprosy which is thus easily overlooked. Hansen’s discovery of mycobacterium leprae, the first identified human bacterial infection, was of crucial importance. He struggled to find acceptance, and arguments about the priority of his discovery were rife until his vital role was established in the Leprosy congress in Berlin in 1897.
Putative autoimmune mechanisms for Acute Disseminated Encephalomyelitis (ADEM) and Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 infection
Authors:   University College London Medical School, UK, Massey Flavia
Published: April 2022

The novel coronavirus severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, responsible for the ongoing COVID-19 pandemic, is associated with a broad manifestation of neurological disease, including Acute Disseminated Encephalomyelitis (ADEM) and Guillain-Barré Syndrome (GBS), amongst other forms of autoimmune encephalitis, stroke, encephalopathy, delirium, and cranial neuropathies. These phenomena are not limited to human coronaviruses but are also seen in a minority of patients in response to other viral infection. There is good evidence that an autoimmune mechanism hypothesis is likely. The final pathology is probably the culmination of mixed mechanisms such as vascular and immune dysregulation as well as direct viral invasion of neurons – though there is little if any evidence of viral invasion in the literature to date. The aim of this review is to elucidate the emerging evidence about this subset of COVID-19-associated neurological disease. This unique opportunity to study the interactions between virus and host immune and central nervous system (CNS) to gain novel insights applicable to other probable autoimmune neurological disease. I have conducted a literature search as well as drawn on my own observations from the COVID-19 and encephalitis multidisciplinary meetings at Queen Square National Hospital for Neurology and Neurosurgery, London, UK.
CICLOFOSFAMIDA COMO DROGA INDUTORA DE REMISSÃO EM PACIENTE LÚPICA: RELATO DE CASO
Authors: Dias Filho Ulisses , Mituiassu Alexandre Mitsuo
Published: April 2022

Lúpus Eritematoso Sistêmico é definido como uma doença autoimune, de caráter inflamatório crônico, mais frequente em mulheres em idade fértil e que, tipicamente, apresenta acometimento multissistêmico, manifestando-se por períodos de atividade e remissão, com grande variabilidade fenotípica1.  Dentre as diversas possibilidades de acometimento renal no LES, a Nefrite Lúpica (NL) é a forma de lesão renal mais comum, acometendo aproximadamente 50% dos pacientes1. Essa manifestação ganha importância impar pelo fato de ser a principal indicação para o uso de altas doses de corticoides e imunossupressores, bem como o principal fator relacionado à mortalidade1. O tratamento de portadores de NL tem como objetivo atingir a resposta clínica completa à terapia imunossupressora, visto que essa é diretamente proporcional à sobrevida renal à longo prazo. Na atualidade, existem diretrizes como a da Sociedade Brasileira de Reumatologia e Sociedade Internacional de Nefrologia que norteiam a prática médica, quanto ao diagnóstico e tratamento da NL. Entretanto, é evidente que o surgimento de novas medicações e novos protocolos terapêuticos abrem espaço para discussões e estudos sobre o manejo destes doentes. O presente estudo tem como objetivo, portanto, discutir a terapia indutora de remissão com o uso de ciclofosfamida em uma paciente de 35 anos, do sexo feminino, com LES grave, associado à NL e acometimento cutâneo, seroso, hematológico e sobreposição com Síndrome do Anticorpo Antifosfolípide (SAAF).
Assessing the Impact of a Physician Resiliency and Wellness Program to Physician Burnout Levels in a Pediatric Department of a Tertiary Hospital: A Pilot Study of the I-CARE Program
Authors: Tan-Lim Carol Stephanie C. , Dumagay Teresita E. , Dahildahil Roy O. , Del Castillo Ronald T. , Carasco Maria Arla Andrea G.
Published: April 2022

Background. Physician burnout is a growing problem worldwide. Several interventions aimed at lowering burnout rates among physicians have been implemented. To date, there is no established structured program to combat burnout in the Philippine General Hospital. This study evaluated the effectiveness of the I-CARE program, a physician resilience and wellness program which adapted the different components of the international programs for the Philippine setting.

Objective. To evaluate the effectiveness of the I-CARE program in reducing medical residents’ burnout level.

Methods. After key components of the I-CARE program were identified, the program was implemented in 2 phases. The first phase involved training of consultants to hone their facilitation skills. The second phase was a before-and-after study of the I-CARE program. The participants’ burnout level was measured before and after the program using the Maslach Burnout Inventory.

Results. The I-CARE program was implemented in the Department of Pediatrics from March to August 2020. There was no significant change in the overall burnout levels of 59 pediatric residents after the I-CARE implementation (p=0.32). This may be due to several challenges encountered during the implementation, such as time constraints, the increased workload caused by the COVID-19 pandemic, and the lack of physical meetings due to the restrictions of the pandemic. However, the feedback of the administrators, facilitators and residents was generally positive. All the interviewed participants recommended the continuation of the I-CARE program in the Department of Pediatrics.

Conclusion. The I-CARE program shows potential in promoting mental health and emotional wellness among physicians in training.
Functional Outcomes among Geriatric Fragility Hip Fracture Patients in a Developing Country: A Comparative Study between Complete and Incomplete Post-operative Rehabilitation
Authors: Peña Maria Antonia Rosanna G. , Tabu Irewin A. , Ching Bing-Agsaoay Dorothy Dy
Published: April 2022

Objective. The study compared functional outcomes among post-operative geriatric fragility hip fracture patients who received complete and incomplete rehabilitation.

Methods. This is an ambispective cohort study of 50 acute fragility hip fractures over a 40-month period (October 2017 to November 2020) treated with either arthroplasty or internal fixation under the UP-PGH Orthogeriatric Fracture Liaison Service (FLS). Patients were contacted and interviewed through Telemedicine. They were asked to answer two questionnaires – the Modified Harris Hip Score (MHHS) and the EuroQol-5D-5L (EQ-5D-5L). The scores were tallied and used to describe and compare the post-operative functional outcomes between the two rehabilitation pathways.

Results. Among the 50 patients included in this study, twenty-three (46%) patients underwent complete rehabilitation, while 27 (54%) underwent incomplete rehabilitation. The average corrected MHHS was at 82.5 suggesting good outcomes among all patients, with a higher-than-average outcome of 83.6 among patients who underwent complete rehabilitation, and an outcome of 75.9 among patients who underwent incomplete rehabilitation. Results to the EQ-5D—5L survey showed that a majority of patients who underwent complete rehabilitation reported having ‘no problems’ in terms of self-care, and anxiety or depression. However, the same group had more patients reporting ‘any problems’ in terms of mobility. On the other hand, a bigger proportion of patients from the incomplete rehabilitation group presented with ‘any problems’ in terms of usual activities. Proportions were similar for both groups in terms of pain or discomfort, with neither group having patients who reported extreme pain or discomfort.

Conclusion. In spite of the heterogenous nature of the hip fracture population, functional outcome measures show generally good outcomes of patients under the UP-PGH Orthogeriatric FLS, with no significant difference among patients who receive complete rehabilitation from those who undergo incomplete rehabilitation. Continuing this study may better describe and differentiate the functional outcomes in order to pave the way for evidence-based protocols dedicated to providing the highest quality of care for acute fragility fracture patients.
Rapid versus Slow Feeding Advancement in Preterm Low Birth Weight Neonates: A Systematic Review and Meta-analysis
Authors: Canlas-Gubat Iris G. , Gubat Johannes A. , Gaspi Sally Andrea D.
Published: April 2022

Objectives. To compare the clinical outcomes of rapid versus slow enteral feeding advancement in preterm low birth weight neonates.

Methods. Searches for randomized controlled trials evaluating the effect of rapid versus slow rate of enteral feeding advancement on the clinical outcomes of preterm, low birth weight neonates were performed in different databases. Two authors screened the articles for inclusion and statistical analysis was done using Review Manager Version 5.3 (RevMan) software.

Results. Six trials with a total of 680 subjects comparing enteral feeding advancement protocols were identified. The number of days to reach full feeds in rapid enteral feeding was shorter by 2.79 days (95% CI 1.39, 4.19) and time to regain weight by 3.72 days (95% CI 2.86, 4.59) compared to slow enteral feeding. There was no significant difference in the incidence of feeding intolerance (OR 0.69, 95% CI 0.42, 1.11) and NEC (OR 0.88, 95% CI 0.45, 1.72) between the two groups.

Conclusions. Rapid enteral feeding protocols reduce the time to establish full enteral feeds and to regain birth weight in preterm low birth weight neonates. Rapid enteral feeding may facilitate early discharge and help reduce hospital costs for the care of these neonates.
Critical Illness-Related Corticosteroid Insufficiency (CIRCI) among Patients with Refractory Shock at a Tertiary Hospital: A Look into Clinical Practices and Patient Outcomes
Authors: Arcellana Anna Elvira S. , Lim Kenneth Wilson O. , Arcegono Marlon S. , Jimeno Cecilia A.
Published: April 2022

Introduction. A significant number of critically ill patients, as high as 60% among patients with septic shock, suffer from critical illness-related corticosteroid insufficiency (CIRCI), which refers to an inadequate corticosteroid response to the level of stress.

Objectives. This study aimed to determine the strategies employed in managing patients with critical illness-related corticosteroid insufficiency and the outcomes of these patients at a tertiary hospital.

Methods. This was a single-center, mixed-methods study which consisted of a review of charts of patients 19 years old and above admitted for shock or developed refractory hypotension from January 2017-December 2019, and key informant interviews and focus group discussion among clinicians who have experience in managing CIRCI.

Results. A total number of 362 patient charts reviewed showed a relatively low rate of initiation of corticosteroids for patients with refractory shock, at just 28.57% of the entire population. After corticosteroids were initiated, patients were in shock for a median of just one day and the median blood pressure improved to 100/60 mm Hg. In this cohort, patients who were started on steroids had more severe illness, as measured by the Mortality Probability Model (MPM) score, which had a median of 43.65% for the group on steroids and just 25.0% for the non-steroid group (p ≤ 0.0001). Patients who were started on steroids had a statistically significant longer median days on a ventilator, 5 days vs. 3 days for the non-steroid group (p = 0.0297); longer median length of intensive care unit (ICU) stay, 8 days vs. 5 days for the non-steroid group (p = 0.0410), and a higher morbidity and mortality rate. The need for steroids, the presence of septic shock, and a higher MPM score were significant predictors of mortality.

Discussions among clinicians revealed significant variability in practices in the management of CIRCI.

Conclusion. The presence of clinical features of CIRCI is a poor prognostic factor. Timely recognition, work-up, and interventions to address CIRCI are paramount in critical care.
Time Intervals from the First Symptom to Surgery of Ovarian Malignancies in a Tertiary Government Hospital
Authors: Alfabeto Ma. Paula Rhove O. , Toral Jean Anne B.
Published: April 2022

Objective. This is a cross-sectional study aimed to determine the time intervals from the first symptom to surgery of 37 patients with ovarian malignancies who underwent surgery at a tertiary government hospital from June to October 2019.

Methods. Structured interviews of patients and chart reviews were conducted to identify the intervals and the reasons behind such. The data were analyzed using Stata/SE 14.1, with the time intervals presented as medians and the reasons as frequencies. Multinomial logistic regression analysis established the association of time intervals with the extent of surgery and final stage of ovarian malignancies.

Results. The median Total Time Interval from the first symptom to surgery was 214 days. The longest delay was the Total System Interval (from the first visit at the tertiary hospital to surgery) with a median of 70 days. This was followed closely by Patient Interval (from the first symptom to consult with the initial physician) with a median of 64 days. A distant third was the Initial Physician Interval (from the consult with the initial physician to the first visit at the tertiary hospital) with a median of 29 days. Most common reasons for the delays were the patients not acknowledging the gravity of their condition for the Patient Interval; choice to go to other hospitals, distance and laboratory works or diagnostics for the Initial Physician Interval; waiting for laboratory work-ups for the First System Interval; and waiting for other departments’ clearance for the Second System Interval. The most common first symptom was abdominal enlargement. The length of interval and the final stage (p=0.056 for Stage III and p=0.162 for Stage IV)) as well as extent of surgery (p=0.093) did not show significant association.

Conclusion. The time interval from first symptom to surgery showed a median of 214 days. The greatest delay is contributed by Total System Interval followed by Patient Interval due to varying reasons. Length of time intervals, however, was not found to be significantly associated with the extent of surgery and final stage
Risk Factors and Interventions: Fournier Gangrene in a Tertiary Hospital: A 10-year Experience
Authors: Alip Sylvia Karina L. , Lapitan Marie Carmela M.
Published: April 2022

Objective. The study aimed to describe the patient demographic characteristics, clinical factors, surgical interventions, and quality of care parameters in non-survivors and survivors of Fournier’s gangrene (FG).

Methods. A total of 131 cases of Fournier’s gangrene (FG) were included in a retrospective chart review in the Philippine General Hospital over 10 years using the Department of Surgery research database. We collected data for various direct and derived variables from the identified population. The primary outcome was mortality rate, while other factors studied were genital and colorectal manipulation, bowel diversion, laboratory parameters (white blood cell count, creatinine, hemoglobin).

Results. The mortality rate was 15%. Diabetes mellitus was common comorbidity among patients with Fournier’s disease. The following were statistically more common in the non-survivor group: female sex, concomitant bowel diversion surgery. Admission data in the non-survivor group showed a lower serum hemoglobin, a higher serum creatinine, and an increased percentage of patients with an abnormal white blood cell count; these did not statistically differ between cohorts, however. The median time to first antibiotic infusion was six hours. The median time to surgery was 13 hours.

Conclusions. Among patients with Fournier’s gangrene, the proportion of women and those undergoing bowel diversion was higher in those who did not survive. The time of infusion of antibiotics or time to surgery did not differ significantly between survivors and non-survivors.
Clinical experience of surgical repair left ventricular rupture after mitral valve replacement
Authors: Dung Van Hung
Published: April 2022

Background: Left ventricular rupture after mitral valve replacement is very rare but often leads to death. This study aimed to report one center experience.

Methods: Retrospective case series from 2001 to 2021 at the Heart Institute.

Results: There had 18 cases of left ventricular rupture after mitral valve replacement (0.2%). 94% of patients were female, the mean age at surgery was 57. Rheumatic mitral stenosis (11) or mitral disease (6) occurred in the majority of cases. 6/18 has posterior annulus calcification; 3/18 cases had reoperation after previous mitral valve replacement. The median valve size was 27 (25-29mm). Type I rupture 03; type II: 1 and type III: 14. Time of left ventricular rupture occurrence: early in 5; late in 2 and intermediate in 11 cases. The mortality rate was 61% (11/18). Regarding the repair technique, 8 cases of external repairs, without opening the heart and 10 cases of combined internal and external repairs, reinforced with bio-glue. 100% had supported by extracorporeal circulation and 15/18 cases had inserted intra-aortic balloon counterpulsation.

Conclusion: preserve the posterior valve as much as possible, gentle resection of the diseased valve, and no need for radical decalcification of the posterior annulus are measures to prevent left ventricular rupture. The combined technique of internal and external repairs with bio-glue coating has shown a good hemostatic and high success rate.
Imaging characteristics, and long term outcomes of surgical management for pannus overgrowth after mechanical aortic valve replacement
Authors: Dung Van Hung
Published: April 2022

Background: Endocardial proliferation or pannus is uncommon after aortic valve replacement. This study aimed to determine the imaging characteristics, the risk factors and evaluate the long-term results of surgical treatment for these patients.

Material and methods: a retrospective review of patients with confirmed intraoperative pannus diagnosis following mechanical aortic replacement.

Results: There have 102 patients (mean age 48 and 71 women) who were re-operated for pannus. The image of “pannus” seen on echocardiography and valve dysfunction on fluoroscopy is positive in over 90% of cases. Female sex (OR=2.1, P=0.01) and both aortic and mitral valve replacement at first surgery (OR=2.98; P = 0.001) have a higher risk of pannus. Surgical procedures included pannus resection only or aortic replacement with a new valve and resect pannus or resect pannus, aortic replacement with aortic annulus enlargement. 30-day mortality was 1 case; atrioventricular block required permanent pace marker: 2 cases. The mean follow-up time for the second operation was 55.3 ± 48.8 months (2 cases lost of follow-up), recurrent pannus occurred in 5 cases, and no late death.

Conclusion: The female patients and previously aortic combined with mitral replacement are a risks factor for pannus.  Echocardiography combined with fluoroscopy could be identified as the diagnosis of pannus. The long-term outcomes of surgery for pannus are very good. Completely resect the pannus and replace it with the new valve is the method of choice instead of simply resecting the pannus to prevent recurrent pannus.
Hemşirelerin Elektronik Bakım Planı Kullanımlarının Zaman ve Hasta Bakım Uygulamaları Yönünden Değerlendirilmesi: Özel Bir Hastane Örneği
Authors: ÖZTÜRK İlknur , VARLI Gamze , KOÇ ASLAN Saliha
Published: April 2022

Giriş: Hemşirelik süreci yaklaşımı kullanılarak oluşturulan “hemşirelik bakım planı” sağlıklı ya da hasta bireyin sağlıkla ilgili bireysel gereksinimlerinin tanımlanması ve tanımlanan bu gereksinimleri karşılamaya yönelik öz bakım verilmesini destekleyen, uygulamalara yön veren yazılı rehberlerdir. Amaç: Bu çalışma, hemşirelerin elektronik bakım planı kullanımları ile ilgili görüşlerini almak ve elektronik bakım planının zaman ve hasta bakım uygulamalarına etkisini değerlendirilmek amacıyla planlanmıştır. Yöntem: Tanımlayıcı tipteki araştırma 11 Şubat-29 Mayıs 2019 tarihleri arasında özel bir sağlık grubunun İstanbul, Kocaeli ve Bodrum’da bulunan dokuz farklı hastanesinde, 357 yatan hasta dosyası üzerinden hastanın primer hemşiresiyle yüz yüze görüşülerek gerçekleştirilmiştir. Araştırma verileri araştırmacılar tarafından literatür, prosedür ve talimatlardan yararlanılarak hazırlanan “Elektronik Hemşirelik Bakım Planı Kayıt İnceleme Formu” kullanılarak toplanmıştır. Veriler Microsoft Office Excel 2010 programında sayı ve yüzdelik dağılımlarına bakılarak değerlendirilmiştir. Bulgular: Araştırmada toplam 357 hasta dosyası ve 1066 hemşirelik tanısı incelenmiş, 168 hemşire ile görüşülmüştür. Elektronik bakım planının sistem üzerinden değerlendirilmesi, hemşirelerin elektronik bakım planı ile ilgili görüşleri ve sistemin gelişmesi gereken yönleri ve yaşanan güçlükler saptanmıştır. Sonuç: Sonuç olarak; elektronik bakım planlarının sisteme entegre edilmesi ile kurum içinde standart bakım uygulamaları oluşturduğu, yeni işe başlayan hemşirelere rehberlik ettiği, kayıt için harcanan zamanı azalttığı, güncel uygulamaların yayılımını hızlandırdığı, hemşireler için güvenilir bir veri tabanı oluşturduğu gibi olumlu görüşlerin yanı sıra sistemin sürekli güncellenmesi ve alt yapısının iyi olması gerektiği bununla birlikte sisteme ilişkin teknik sorunlar oluşabileceği sonucuna varılmıştır.
Exploring spatial patterns of environmental noise and perceived sound source dominance in urban areas. Case study: the city of Athens, Greece
Authors:   National Technical University of Athens, Greece, MARKOU Dimitris
Published: April 2022

The aim of the present study is to map spatial patterns related to noise pollution and the acoustic environment -in a broader context- in the urban area of Athens, Greece. The primary goal of this thesis is to present a comprehensive approach that combines elements of two basic methodologies related to acoustic environment studies: a) noise mapping and b) the soundscape approach. The main inputs are environmental noise measurements and perceptual sound source-related observations. The results feature three noise pollution maps (LAeq,30 sec, L10, and L90 indices) and three sound source maps which reflect the way in which the human ear perceives the presence of sounds. Additionally, the question of whether the spatial distribution of sound source dominance can be explained by the dispersion of environmental noise levels was examined using geographically weighted regressions (GWR). The GWR models showed that sound source-related observations are explained to a significant extent by all three indicators. Four important findings emerge from the analysis. Firstly, areas with high levels of noise pollution are characterized by high to moderate presence of technological and absence of anthropic and natural sounds. Secondly, regions, where there is a simultaneous presence of all sound sources, are characterized by moderate to low noise levels. Thirdly, the absence of technological sounds is observed in quiet areas. Finally, areas featuring a moderate presence of technological and natural sounds are mostly urban green spaces built-in proximity to the main road network.
Use of Computer Technology to Help Students with Special Needs
Authors: Mrs. A Mamatha  , Mrs. K. L. L. Lavanya  , Mrs. G. Radhika  , Ms. CH. Sai Leela Rani
Published: April 2022

Millions of students across the United States cannot benefit fully from a traditional educational program because they have a disability that impairs their ability to participate in a typical classroom environment. For these students, computer-based technologies can play an especially important role. Not only can computer technology facilitate a broader range of educational activities to meet a variety of needs for students with mild learning disorders, but adaptive technology now exists than can enable even those students with severe disabilities to become active learners in the classroom m alongside their peers who do not have disabilities. This article provides an overview of the role computer technology can play in promoting the education of children with special needs within the regular classroom. For example, use of computer technology for word processing, communication, research, and multimedia projects can help the three million students with specific learning and emotional disorders keep up with their nondisabled peers. Computer technology has also enhanced the development of sophisticated devices that can assist the two million students with more severe disabilities in overcoming a wide range of limitations that hinder classroom participation--from speech and hearing impairments to blindness and severe physical disabilities. However, many teachers are not adequately trained on how to use technology effectively in their classrooms, and the cost of the technology is a serious consideration for all schools. Thus, although computer technology has the potential to act as an equalizer by freeing many students from their disabilities, the barriers of inadequate training and cost must first be overcome before more wide- spread use can become a reality.
Review on Vedic Mathematics
Authors: Raksha  , Shravan Ravi Shetty  , Shravan Kumar  , Monisha M
Published: April 2022

Vedic mathematics is claimed by its founder to be a present given to the current by the traditional sages of Asian countries, although there is no historical evidence that for this claim. It is a system for limited computation and polynomial calculation which his easier and more convenient than the corresponding algorithm in present math. Vedic Mathematics is the ancient technique used to mentally solve add, subtract, and multiply. In this era of digitization, engineers are working to enlarge digital circuits’ speed while reducing the size and energy consumed. Arithmetic operations are the basic units of all the digital circuitry and hence rewriting these units increases the efficiency of the entire digital design. By using this technique answer any question in one line. Vedic Mathematics doesn’t get its due importance; it is a fantastic method. Vedic Mathematics is a great technique to master calculations, being more adequate and authentic. In this survey paper, we will come up with reader. An overview of Vedic mathematics, as well as some progressive works in space.
RASA Chatbot Using AI
Authors: Prof. Yogesh S Sapnar  , Dnyaneshwari P Kodlinge  , Sakshi B Jogde  , Kimaya V Bhosale  , Simran S Kudale
Published: April 2022

The growth of technologies like Artificial Intelligence (AI), Big Data & Internet of Things (IoT), etc. has marked many advancements in the technological world since the last decade. These technologies have a wide range of applications. One such application is “Chatterbot or “Chatbot”. Chatbots are conversational AIs, which mimics the human while conversing & eliminates the need of human by automating mundane tasks. In the study undertaken, we have created a chatbot in education domain & it is named as “College Enquiry Chatbot”, This chatbot is a web-based application that analyses and understands user's queries and provides an instant and accurate response. Rasa technology is used to construct this chatbot. It's an open-source technology, which uses its two main packages i.e., Rasa Core & Rasa Natural Language Understanding (NLU) in order to build a Contextual AI Chatbot. NLU is used to infer the intent and to extract the necessary entities from user input & the Rasa Core provides the output by building a probabilistic model with the help of Recurrent Neural Network (RNN). Evaluation of the model is done by getting a confusion matrix and performance measures like Precision, Accuracy & F1 Score which come out to be 0.628, 0.725 and 0.669 respectively on average basis. This chatbot's accuracy, lack of dependability on human resources, 24 x 7 accessibility and low maintenance creates various opportunities for its implementation. This conversational agent can not only be used in educational institutions but also in places where enquiry becomes a tedious task.
A influência do Sistema Renina-Angiotensina no prognóstico de pacientes hipertensos com COVID-19
Authors: Braga Maria Clara Biccas , Brandão Gabriel Andreata
Published: April 2022

Introdução:A pandemia de COVID-19 é uma grande preocupação para a saúde mundial, sendo importante destacar os fatores de risco para pior prognóstico, como a hipertensão. Para isso, é importante entender como o sistema renina-angiotensina, alterado terapeuticamente ou não, pode afetar o prognóstico dessa doença.Objetivo: Verificar a influência do sistema renina-angiotensina no prognóstico da infecção por SARS-CoV-2 em pacientes com hipertensão. Metodologia: Cruzou-se os descritores“Renin-Angiotensin System”, Progno-sis, Hypertension, “Coronavirus Infections”na Biblioteca Virtual em Saúde e PubMed, sele-cionando somente textos em inglês, português, publicado nos últimos dois anos, disponível completo gratuitamente. Após, foram adicionadas três referências complementares, elimina-das as duplicatas e excluídos os que tinham o título, resumo ou texto não condizentes com o enfoque do estudo, resultando em um total de 16 artigos.Resultados: O SARS-CoV-2 é um vírus que se liga à enzima conversora de angiotensina II para infectar células humanas e se replicar. Especialistas se preocuparam em relação aos pacientes hipertensos, já que muitos fazem uso de medicamentos antihipertensivos que aumentam a expressão dessa enzima, o que poderia trazer um pior prognóstico caso essas pessoas contraíssem o vírus. Entre-tanto, muitos estudos encontrados são inconclusivos, sendo que alguns demonstravam queesses fármacos não tinham efeito na mortalidade e outros que demonstravam diminuiçãona mortalidade dos pacientes hipertensos.Conclusão:Conclui-se que o sistema renina-an-giotensina pode exercer influência no prognóstico da COVID-19 em pacientes hipertensos,principalmente quando este é modulado por medicamentos inibidores do sistema, porémmais estudos são necessários para uma conclusão definitiva.