bluuebunny/crossref_metadata_2025 huggingface dataset:
Arbres humanitzats i altres obres amb vegetals
Authors: Bosch Glòria
Published: August 2023

Peintre, sculpteur, poète, traducteur, historien de l’art, commissaire et critique d’art, illustrateur, graphiste et dramaturge, Narcís Comadira est sur le point d’inaugurer au Teatre Nacional de Catalunya la pièce L’hort de les oliveres, un titre proche de la thématique de l’anthologie picturale Obres amb arbres i altres vegetals, non chronologique, présentée à la Fundació Vila Casas de Barcelone et qui, maintenant, arrive en petit format au Centre d’Etudes Catalanes de Paris. Ce voyage à travers le temps ne pouvait être chronologique, comme il ne peut être non plus le reflet de l’arbre comme protagoniste absolu, mais au contraire il agit souvent en contrepoint pour entrer dans d’autres mondes comme celui de l’architecture, les structures, les fruits, les végétaux… jusqu’à arriver à créer différentes atmosphères.
Estrategias utilizadas por el nuevo conservadurismo religioso en las elecciones presidenciales de Costa Rica en 2018
Authors: León Carvajal Arantxa
Published: August 2023

El objetivo del presente artículo es el identificar las estrategias utilizadas por el nuevo conservadurismo religioso en las elecciones presidenciales de Costa Rica en el 2018. Por medio de la revisión bibliográfica de fuentes primarias y secundarias se aborda el tema de los derechos humanos, y más específicamente el matrimonio igualitario, dentro de un estado confesional. Se señalan algunas tendencias dentro de la manifestación electoral, así como elementos nuevos encontrados en el 2018 producto del fallo de la Corte Interamericana de Derechos Humanos a favor del matrimonio igualitario. A su vez se plantean los desafíos a la democracia visibilizados en la contienda electoral. Se concluye que la volatilidad del voto, la capacidad incorporar argumentos propios de la democracia y el populismo, fueron las principales estrategias utilizadas tanto en la primera como en la segunda ronda electoral por el PRN.
Evaluation of Multidisciplinary Treatment Relationship between Orthodontics and Periodontology Departments by Examining Inter-Departmental Consultation Notes
Authors: Kurem I , Topsakal U , Ozturk T
Published: August 2023

Aims:

The aim of this study is to evaluate the multidisciplinary treatment relationship between the two specialties of Dentistry, Departments of Periodontology and Orthodontics, by examining consultation request notes between the two departments.

Materials and Methods:

The consultation request notes of 1685 patients who were treated at Erciyes University Faculty of Dentistry were included in the study. All notes were analyzed retrospectively and divided into categories. While the consultation request notes of 446 patients from the Department of Periodontology (DP) to the Department of Orthodontics (DO) were evaluated, the consultation request notes of 1239 patients from DO to DP were evaluated. Pearson's Chi-Squared test was used in the cloud-based TURCOSA statistical software for the statistical analysis of the obtained data.

Results:

The highest number of requests for consultation from DP to DO was due to “Evaluation of the patient for orthodontic treatment (n = 203; 45.5%),” and the highest number of requests from DO to DP was “Gingival/Periodontal Treatment and Providing Motivation of Oral Hygiene (n = 558; 45.0%)“. It was observed that most patients for whom consultation was requested were women (P < 0.05).

Conclusions:

This study determined the most common reasons for consultation requests between DP and DO and the sex which was the most prevalent. It was concluded that requests were made for the expertise of the other department for problems that could not be solved by the first department.
Evaluation of Dual Trigger with Combination of Gonadotropin-Releasing Hormone Agonist and Human Chorionic Gonadotropin in İmproving Oocyte-Follicle Ratio in Normo-Responder Patients
Authors: Gurbuz AS , Deveer R , Gode F
Published: August 2023

Objective:

Our aim was to compare the efficacy of two triggering method one with dual triggering with gonadotropin-realising hormon (GnRH) agonist plus standard dosage human chorionic gonadotropin (hCG) and the other with hCG only for final oocyte maturation on oocyte/follicle ratio and pregnancy rates in normoresponders in GnRH antagonist cycles in invitro fertilization-intrastoplasmic sperm injection (IVF-ICSI).

Material Methods:

In this retrospective study, all patients underwent GnRH antagonist protocol. When at least ≥3 follicles reached ≥17 mm diameter, 116 patients received dual trigger with GnRH agonist plus hCG (1mg Leuprolide acetate plus 10.000 IU uhCG) and 178 patients received uhCG (10.000 IU u hCG) for final oocyte maturation. All follicles ≥10 mm diameter were aspirated. Number of oocytes and metaphase II oocytes retrieved per aspirated follicles, implantation rate, and clinical pregnancy rate per cycle was recorded.

Results:

There was no statistically significant difference in terms of metaphase II oocyte ratio per aspirated follicle, implantation rate and clinical pregnancy rate between the dual trigger group and hCG only group (45.7% vs. 51%; 35.4% vs.30.3% and 45%vs. 40% respectively). Oocyte/ follicle ratio was significantly higher in dual trigger group (68.2%vs 63.8% p=0,028).

Conclusions:

Dual triggering in normal responders with a GnRH-agonist and a standard dosage of hCG is superior to hCG only protocol in terms of oocyte/follicle ratio but does not improve metaphase II oocyte, implantation and clinical pregnancy rates in GnRH-antagonist cycles. Dual triggering method may be beneficial in patients with immature oocytes and emty follicle syndrome.
Comparison of intracranial pressure prediction in hydrocephalus patients among linear, non-linear, and machine learning regression models in Thailand
Authors: Trakulpanitkit Avika , Tunthanathip Thara
Published: August 2023

Background: Hydrocephalus (HCP) is one of the most significant concerns in neurosurgical patients because it can cause increased intracranial pressure (ICP), resulting in mortality and morbidity. To date, machine learning (ML) has been helpful in predicting continuous outcomes. The primary objective of the present study was to identify the factors correlated with ICP, while the secondary objective was to compare the predictive performances among linear, non-linear, and ML regression models for ICP prediction. Methods: A total of 412 patients with various types of HCP who had undergone ventriculostomy was retrospectively included in the present study, and intraoperative ICP was recorded following ventricular catheter insertion. Several clinical factors and imaging parameters were analyzed for the relationship with ICP by linear correlation. The predictive performance of ICP was compared among linear, non-linear, and ML regression models. Results: Optic nerve sheath diameter (ONSD) had a moderately positive correlation with ICP (r=0.530, P<0.001), while several ventricular indexes were not statistically significant in correlation with ICP. For prediction of ICP, random forest (RF) and extreme gradient boosting (XGBoost) algorithms had low mean absolute error and root mean square error values and high R2 values compared to linear and non-linear regression when the predictive model included ONSD and ventricular indexes. Conclusions: The XGBoost and RF algorithms are advantageous for predicting preoperative ICP and establishing prognoses for HCP patients. Furthermore, ML-based prediction could be used as a non-invasive method.
Radiomic analysis of abdominal organs during sepsis of digestive origin in a French intensive care unit
Authors: Boutin Louis , Morisson Louis , Riché Florence , Barthélémy Romain , Mebazaa Alexandre , Soyer Philippe , Gallix Benoit , Dohan Anthony , Chousterman Benjamin G
Published: August 2023

Background: Sepsis is a severe and common cause of admission to the intensive care unit (ICU). Radiomic analysis (RA) may predict organ failure and patient outcomes. The objective of this study was to assess a model of RA and to evaluate its performance in predicting in-ICU mortality and acute kidney injury (AKI) during abdominal sepsis. Methods: This single-center, retrospective study included patients admitted to the ICU for abdominal sepsis. To predict in-ICU mortality or AKI, elastic net regularized logistic regression and the random forest algorithm were used in a five-fold cross-validation set repeated 10 times.Results: Fifty-five patients were included. In-ICU mortality was 25.5%, and 76.4% of patients developed AKI. To predict in-ICU mortality, elastic net and random forest models, respectively, achieved areas under the curve (AUCs) of 0.48 (95% confidence interval [CI], 0.43–0.54) and 0.51 (95% CI, 0.46–0.57) and were not improved combined with Simplified Acute Physiology Score (SAPS) II. To predict AKI with RA, the AUC was 0.71 (95% CI, 0.66–0.77) for elastic net and 0.69 (95% CI, 0.64–0.74) for random forest, and these were improved combined with SAPS II, respectively; AUC of 0.94 (95% CI, 0.91–0.96) and 0.75 (95% CI, 0.70–0.80) for elastic net and random forest, respectively.Conclusions: This study suggests that RA has poor predictive performance for in-ICU mortality but good predictive performance for AKI in patients with abdominal sepsis. A secondary validation cohort is needed to confirm these results and the assessed model.
Awake prone positioning for COVID-19 acute hypoxemic respiratory failure in Tunisia
Authors: Ismail Khaoula Ben , Essafi Fatma , Talik Imen , Slimene Najla Ben , Sdiri Ines , Dhia Boudour Ben , Merhbene Takoua
Published: August 2023

Background: In this study, we explored whether awake prone position (PP) can impact prognosis of severe hypoxemia coronavirus disease 2019 (COVID-19) patients. Methods: This was a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. Patients were divided into two groups: group G1=patients who benefited from a vigilant and effective PP (>4h minimum/24) and group G2=control group. We compared demographic, clinical, paraclinical and evolutionary data. Results: Three hundred forty-ninepatients were hospitalized during the study period, 273 met the inclusion criteria. PP was performed in 192 patients (70.3%). The two groups were comparable in terms of demographic characteristics, clinical severity and modalities of oxygenation at ICU admission.The mean PaO2/FIO2ratios were respectively 141 and 128 mmHg, (P=0.07). The computed tomography scan was comparable with a critical >75% in 48.5% (G1) versus 54.2% (G2). The median duration of the daily PP session was 13±7 hours per day. The average duration of spontaneous PP days was 7 days [4–19]. Use of invasive ventilation was lower in the G1 group (27% vs. 56%, P=0.002). Healthcare-associated infections were significantly lower in G1 (42.1% vs. 82%, P=0.01). Duration of total mechanical ventilation and length of ICU stay were comparable between the two groups. Mortality was significantly higher in G2 (64% vs. 28%, P=0.02). Conclusions: Our study confirmed that awake PP can improve prognosis in COVID-19 patients. Randomized controlled trials are needed to confirm this result.
Mobilization phases in traumatic brain injury
Authors: Nazwar Tommy Alfandy , Triangto Ivan , Pringga Gutama Arya , Bal’afif Farhad , Wardana Donny Wisnu
Published: August 2023

Mobilization in traumatic brain injury (TBI) have shown the improvement of length of stay, infection, long term weakness, and disability. Primary damage as a result of trauma’s direct effect (skull fracture, hematoma, contusion, laceration, and nerve damage) and secondary damage caused by trauma’s indirect effect (microvasculature damage and pro-inflammatory cytokine) result in reduced tissue perfusion & edema. These can be facilitated through mobilization, but several precautions must be recognized as mobilization itself may further deteriorate patient’s condition. Very few studies have discussed in detail regarding mobilizing patients in TBI cases. Therefore, the scope of this review covers the detail of physiological effects, guideline, precautions, and technique of mobilization in patients with TBI.
Etiologic Investigation of Patients Diagnosed with Bacteriologically Unconfirmed Tuberculosis in Tanzania
Authors: Maze Michael J. , Nyakunga Gissela , Sakasaka Philoteus A. , Kilonzo Kajiru G. , Luhwago Elisha , Chelangwa Manase , Crump John A. , Kisonga Riziki M. , Madut Deng B. , Rogath Josephine , Sadiq Adnan , Thiessen Rennae , Rubach Matthew P.
Published: August 2023

Globally, half of patients with pulmonary tuberculosis (PTB) are diagnosed clinically without bacteriologic confirmation. In clinically diagnosed PTB patients, we assessed both the proportion in whom PTB could be bacteriologically confirmed by reference standard diagnostic tests and the prevalence of diseases that mimic PTB. We recruited adult patients beginning treatment of bacteriologically unconfirmed PTB in Moshi, Tanzania, in 2019. We performed mycobacterial smear, Xpert MTB/RIF Ultra, and mycobacterial culture, fungal culture, and bacterial culture on two induced sputum samples: fungal serology and computed tomography chest scans. We followed participants for 2 months after enrollment. We enrolled 36 (63%) of 57 patients with bacteriologically unconfirmed PTB. The median (interquartile range) age was 55 (44–67) years. Six (17%) were HIV infected. We bacteriologically confirmed PTB in 2 (6%). We identified pneumonia in 11 of 23 (48%), bronchiectasis in 8 of 23 (35%), interstitial lung disease in 5 of 23 (22%), pleural collections in 5 of 23 (22%), lung malignancy in 1 of 23 (4%), and chronic pulmonary aspergillosis in 1 of 35 (3%). After 2 months, 4 (11%) were dead, 21 (58%) had persistent symptoms, 6 (17%) had recovered, and 5 (14%) were uncontactable. PTB could be bacteriologically confirmed in few patients with clinically diagnosed PTB and clinical outcomes were poor, suggesting that many did not have the disease. We identified a high prevalence of diseases other than tuberculosis that might be responsible for symptoms.
Heterogeneity of Mycobacterium tuberculosis Strains Circulating in Panama’s Western Region
Authors: Acosta Fermin , Saldaña Ricardo , Miranda Sara , Candanedo Daniela , Sambrano Dilcia , Morán Mitchelle , Bejarano Saily , De Arriba Yeraldine , Reigosa Angel , De Dixon Elizabeth , Atencio María , Castillo Ramón , Goodridge Amador
Published: August 2023

Tuberculosis remains a challenge in both rural and urban areas. Although a majority of countries display a higher burden in urban areas compared with rural areas, Panama continues to report the highest mortality rate in Central America. Urban areas, such as Panama City, report a high tuberculosis burden, whereas Panama’s western region, including the provinces of Chiriquí, Bocas del Toro (both semiurban) and Ngäbe-Bugle (rural), show a lower burden. We aimed to identify highly transmitted Mycobacterium tuberculosis strains within rural and semiurban settings of Panama’s western region during a 3-year period (2017, 2019, 2021). We randomly selected 87 M. tuberculosis isolates from a biobank from Panama’s western region and analyzed them using allele-specific oligonucleotide polymerase chain reaction and 24-mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR). Our results show only 11.7% (10/85) of M. tuberculosis strains identified as prevalent A-Beijing, B-Haarlem, or C-LAM Strains. We found a low prevalence of A, B, and C M. tuberculosis strains in both rural and semirural settings compared with isolates collected from the Eastern Colon Province. MIRU-VNTR genotyping revealed a high degree of diversity with no clusters with single loci variation of ≥ 2 loci. These results support the notion that tuberculosis prevalence in the rural and semiurban western region of Panama are not due to previously described highly transmitted strains but is influenced instead by other health determinants, including poor health system access and a lack of systematic transmission chain monitoring. For remote rural and semiurban settings, we recommend allocating resources to reinforce efforts to prevent tuberculosis spread.
Low Prevalence of Soil-Transmitted Helminth Infections among Children in the States of Chhattisgarh and Himachal Pradesh, India, 2018
Authors: Campbell Suzy J. , Shanmugasundaram Devika , Ganguly Sandipan , Sehgal Rakesh , Karmakar Sumallya , Sanga Prerna , Stephen Hannah Nirmala , Kaur Hargobinder , Kihara Jimmy , Minnery Mark , Nath Srabani , Sen Shrabanti , Bundy Donald A. , Mishra Neeraj , Batra Gunjan , Shah Hemang , Balasubramaniam Sudharsunam , Dutta Shanta , Khera Ajay , Murhekar Manoj
Published: August 2023

Large-scale impact assessments of soil-transmitted helminth (STH) programs are essential for determining the frequency of mass drug administration (MDA). In baseline surveys, the prevalence of STHs in the Indian States of Chhattisgarh and Himachal Pradesh was 80.2% in 2015 and 29.0% in 2016, respectively. In 2018, we estimated the prevalence and intensity of STHs after six rounds of biannual MDA in Chhattisgarh and annual MDA in Himachal Pradesh. We conducted multistage cluster sampling surveys in preschool-age children (PSAC), school-age children (SAC), and adolescent cohorts. Stool samples from 3,033 respondents (PSAC, n = 625; SAC, n = 1,363; adolescents, n = 1,045) in Chhattisgarh and 942 respondents (PSAC, n = 192; SAC, n = 388; adolescents, n = 362) in Himachal Pradesh were examined for presence of STH infection using the Kato-Katz method. The overall cluster-adjusted prevalence in Chhattisgarh was 11.6% among all age groups (95% CI, 5.6–22.4)—an 85.5% reduction in the prevalence since 2015. Prevalence was not significantly different across cohorts (PSAC, 11.0% [95% CI, 5.0–22.6]; SAC, 10.9% [95% CI, 5.2–21.6]; adolescents, 12.8% [95% CI, 6.2–24.5]). Ascaris lumbricoides was the most common helminth, with most infections of light intensity. In Himachal Pradesh, only three STH infections were detected in 2018, resulting in a cluster-adjusted prevalence of 0.3% (95% CI, 0.1–1.7)—a 99.0% reduction in prevalence since 2016. All infections were of light intensity. Both states showed substantial improvements in socioeconomic and water, sanitation, and hygiene (WASH) indicators since the baseline surveys. Extensive reductions in prevalence and intensity are linked to sustained, high deworming coverage, as well as socioeconomic WASH indicators.
Case Report: Relapsing Leptospirosis in an Immunocompromised Host
Authors: Prasad Ritika , Narsana Niyati K. , Ajayi Antonette A. , Wang Hannah , Patel Jayna , Ho Dora Y. , Banaei Niaz , Blackburn Brian G.
Published: August 2023

Leptospirosis is typically a self-limited febrile illness; when it occurs, meningitis usually develops early in the course. Here, we describe a patient who had engaged in freshwater activities in Kauai that was immunocompromised due to a history of mantle cell lymphoma, autologous hematopoietic cell transplant, and hypogammaglobulinemia. He developed leptospiral meningoencephalitis 11 weeks after illness onset and persistently detectable Leptospira DNA in blood and cerebrospinal fluid along with ongoing clinical illness, despite appropriate treatment.
Perceptions Associated with Noncompliance to Community-Wide Mass Drug Administration for Soil-Transmitted Helminths
Authors: Sindhu Kulandaipalayam Natarajan , Aruldas Kumudha , Kaliappan Saravanakumar Puthupalayam , Mahendran Elavarasan , Walson Judd L. , Means Arianna Rubin , Ajjampur Sitara Swarna Rao
Published: August 2023

Mass drug administration (MDA) is a key strategy for the control of soil-transmitted helminths (STHs). Within MDA programs, poor and non-random compliance threaten successful control of STHs. A case-control study was conducted comparing perceptions among non-compliant participants with compliant participants during a community-wide MDA (cMDA) with albendazole in southern India. Common reasons cited for non-compliance were that the individual was not infected with STH (97.4%), the perception that he/she was healthy (91%), fear of side-effects (12.8%), and dislike of consuming tablets (10.3%). Noncompliance was associated with poor awareness of intestinal worms (odds ratio [OR]: 9.63, 95% CI: 2.11–43.84), the perception that cMDA was only required for those with worms (OR: 2.14, 95% CI: 1.06–4.36), and the perception that the drug is not safe during pregnancy (OR: 2.19, 95% CI: 1.18–4.07) or when on concomitant medications (OR: 3.14, 95% CI: 1.38–7.15). Understanding of perceptions driving noncompliance can provide valuable insights to optimize participation during MDA for STHs.
Preferences of Patients and Providers in High-Burden Malaria Settings for Long-Acting Malaria Chemoprevention
Authors: Scarsi Kimberly K. , Sayles Harlan , Kapungu Kelvin , Sifuna Peter , Ippolito Matthew M. , Furl Renae , Anderson Matthew J. , Ofimboudem Joelle Dountio , Chongwe Gershom , Hutter Jack , Rannard Steven P. , Owen Andrew , Swindells Susan
Published: August 2023

Antimalarial medications are recommended for chemoprevention as part of malaria control programs to decrease the morbidity and mortality related to more than 200 million infections each year. We sought to evaluate patient and provider acceptability of malaria chemoprevention in a long-acting formulation. We administered questionnaires to patients and providers in malaria endemic districts in Kenya and Zambia. Questions explored preferences and concerns around long-acting antimalarial formulations compared with oral formulations. We recruited 202 patient respondents (Kenya, n = 102; Zambia, n = 100) and 215 provider respondents (Kenya, n = 105; Zambia, n = 110). Long-acting injection was preferred to oral pills, whereas oral pills were preferred to implant or transdermal administration by patient respondents. Of 202 patient respondents, 80% indicated that they ‘definitely would try’ malaria chemoprevention offered by injection instead of oral pills. Of parents or guardians, 84% of 113 responded that they ‘definitely would’ have their child age < 12 years and 90% of 88 ‘definitely would’ have their child ≥12 years receive an injection for malaria prevention. Provider respondents indicated that they would be more likely to prescribe a long-acting injectable product compared with an oral product for malaria chemoprevention in adults (70%), adolescents ages 12 years and older (67%), and children <12 years (81%). Potential for prolonged adverse effects with long-acting products was the highest concern for patient respondents, while higher medication-related cost was cited as the most concerning barrier to implementation by providers. Overall, these findings indicate enthusiasm for the development of long-acting injectable antimalarials to provide individual delivery method options across age groups.
Severe Hemolysis during Primaquine Radical Cure of Plasmodium vivax Malaria: Two Systematic Reviews and Individual Patient Data Descriptive Analyses
Authors: Yilma Daniel , Groves Emily S. , Brito-Sousa Jose Diego , Monteiro Wuelton M. , Chu Cindy , Thriemer Kamala , Commons Robert J. , Lacerda Marcus V. G. , Price Ric N. , Douglas Nicholas M.
Published: August 2023

Primaquine (PQ) kills Plasmodium vivax hypnozoites but can cause severe hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We conducted two systematic reviews. The first used data from clinical trials to determine the variety of definitions and frequency of hematological serious adverse events (SAEs) related to PQ treatment of vivax malaria. The second used data from prospective studies and case reports to describe the clinical presentation, management, and outcome of severe PQ-associated hemolysis necessitating hospitalization. In the first review, SAEs were reported in 70 of 249 clinical trials. There were 34 hematological SAEs among 9,824 patients with P. vivax malaria treated with PQ, nine of which necessitated hospitalization or blood transfusion. Criteria used to define SAEs were diverse. In the second review, 21 of 8,487 articles screened reported 163 patients hospitalized after PQ radical cure; 79.9% of whom (123 of 154) were prescribed PQ at ≥ 0.5 mg/kg/day. Overall, 101 patients were categorized as having probable or possible severe PQ-associated hemolysis, 96.8% of whom were G6PD deficient (< 30% activity). The first symptoms of hemolysis were reported primarily on day 2 or 3 (45.5%), and all patients were hospitalized within 7 days of PQ commencement. A total of 57.9% of patients (77 of 133) had blood transfusion. Seven patients (6.9%) with probable or possible hemolysis died. Even when G6PD testing is available, enhanced monitoring for hemolysis is warranted after PQ treatment. Clinical review within the first 5 days of treatment may facilitate early detection and management of hemolysis. More robust definitions of severe PQ-associated hemolysis are required.
Use of intravascular lithotripsy in non-coronary artery lesions
Authors: Umeh Chukwuemeka Anthony , Stratton Ashley , Wagner Tifani , Saigal Shipra , Sood Krystal , Dhawan Raghav , Wagner Cory , Obi Jessica , Kumar Sabina , Ching Tsung Han Scottie , Gupta Rahul
Published: August 2023

Aspirin, other antiplatelet agents, and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases. A concomitant proton pump inhibitor (PPI) treatment is often prescribed in these patients, as gastrointestinal complications are relatively frequent. On the other hand, a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs; in particular, it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel, due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism. Previously, the concomitant use of clopidogrel and omeprazole or esomeprazole has been discouraged. In contrast, it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel, new P2Y12 receptor antagonists. Current guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding, including advanced age, concurrent use of anticoagulants, steroids, or non-steroidal anti-inflammatory drugs, and Helicobacter pylori (H. pylori ) infection. In patients taking oral anticoagulant with risk factors for gastrointestinal bleeding, PPIs could be recommended, even if their usefulness deserves further data. H. pylori infection should always be investigated and treated in patients with a history of peptic ulcer disease (with or without complication) treated with antithrombotic drugs. The present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors, anticoagulants, and PPIs, discussing consequent clinical implications.
Spontaneous coronary artery dissection-associated takotsubo syndrome: A systematic review of case reports
Authors: Bhanushali Aditi , Kohli Muskan , Prakash Ananya , Sarvepalli Svaapnika Rao , Pandey Anchal , Odugbemi Olufemi , Reyaz Nafisa , Trambadia Bansi , Reddy Sadhu Aishwarya , Chauhan Shaylika , Desai Rupak
Published: August 2023

Aspirin, other antiplatelet agents, and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases. A concomitant proton pump inhibitor (PPI) treatment is often prescribed in these patients, as gastrointestinal complications are relatively frequent. On the other hand, a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs; in particular, it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel, due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism. Previously, the concomitant use of clopidogrel and omeprazole or esomeprazole has been discouraged. In contrast, it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel, new P2Y12 receptor antagonists. Current guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding, including advanced age, concurrent use of anticoagulants, steroids, or non-steroidal anti-inflammatory drugs, and Helicobacter pylori (H. pylori ) infection. In patients taking oral anticoagulant with risk factors for gastrointestinal bleeding, PPIs could be recommended, even if their usefulness deserves further data. H. pylori infection should always be investigated and treated in patients with a history of peptic ulcer disease (with or without complication) treated with antithrombotic drugs. The present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors, anticoagulants, and PPIs, discussing consequent clinical implications.
Mr. Feige, I don’t feel so good … Copyright ownership, creators’ rights, and the Marvel Cinematic Universe
Authors: Dixon Alicia
Published: August 2023

The Marvel Cinematic Universe is the highest grossing franchise of all time. What happens when the creators of some of the characters that have made Earth’s Mightiest Heroes such an onscreen success attempt to reclaim their ownership of those characters? This article discusses the relationship of the MCU to copyright disputes in phases.

First, the history of copyright contests over Marvel characters is discussed, starting with the licensing disputes surrounding the 1998 film Blade. Former attempts by creators to reclaim ownership of their comic book characters are then analysed and compared to the current claims for ownership of MCU characters. The article then speculates on the possible effects of character ownership becoming split in the MCU and suggests ways that the MCU might move forward by taking an approach to shared character ownership informed by past Marvel licensing and character agreements.
MEDIA PEMBELAJARAN ANIMASI TIGA DIMENSI DENGAN METODE DISCOVERY LEARNING DALAM MENINGKATKAN KETERAMPILAN MENULIS TEKS DESKRIPSI SISWA SMP
Authors: Khairunnissah Khairunnissah , Utami Sintowati Rini , Suhartini Suhartini
Published: August 2023

This study aims to improve the writing skills of description text using Discovery Learning Method through Three-Dimensional Animation media for students of class VII G SMP Negeri 7 Jakarta. The subjects in this study consisted of 30 students. This research consisted of three cycles. Each cycle consists of four stages, namely planning, implementation, observation, and reflection. Data collection techniques used in this study were observation, questionnaires, interviews, tests, and documentation. The collected data were analyzed using qualitative descriptive analysis techniques supported by quantitative data. The results of this study indicate that students of class VII G have the ability based on the results of learning activities and student scores. Thus, the application of Discovery Learning method through Three-Dimensional Animation media has been designed and used to improve description text writing skills in detailing objects. The increase obtained from the pre-cycle stage to cycle 3 with an average of 66.87 pre-cycle, 71.83 cycle 1, 77.87 cycle 2 and 86.57 cycle 3. Based on the results of the study, it can be concluded that the Discovery Learning Method through Three-Dimensional Animation Media can improve the ability to write description texts in class VII G students of SMP Negeri 7 Jakarta.AbstrakPenelitian ini bertujuan untuk mengetahui peningkatan keterampilan menulis teks deskripsi dengan Metode Discovery Learning  melalui Media Animasi Tiga Dimensi pada siswa kelas VII G SMP Negeri 7 Jakarta. Subjek pada penelitian ini terdiri dari 30 siswa. Hasil penelitian ini menunjukkan bahwa siswa kelas VII G memiliki kemampuan berdasarkan hasil aktivitas belajar dan nilai siswa. Dengan demikian, penerapan Metode Discovery Learning melalui media Animasi Tiga Dimensi telah dirancang dan digunakan untuk meningkatkan keterampilan menulis teks deskripsi dalam merincikan objek secara detil. Adapun peningkatan yang diperoleh mulai dari tahap prasiklus hingga siklus 3 dengan rata-rata prasiklus 66,87, siklus 1 71,83, siklus 2 77,87 dan siklus 3 86,57. Berdasarkan hasil penelitian, dapat disimpukan bahwa Metode Discovery Learning melalui Media Animasi Tiga Dimensi dapat meningkatkan kemampuan menulis teks deskripsi pada siswa kelas VII G SMP Negeri 7 Jakarta.
From Anti to Pro: An Imperious Non-Resistance to Heteronormativity in The Writer
Authors: AZAKLI Ayşegül
Published: August 2023

Heteronormativity, a sub branch of queer theory, has emerged as the legitimisation of heterosexual practices with privilege over sexual fluidity by various institutions. The unequivocal acceptance of heteronormativity embedded in society overshadows less-favoured sexual orientations, hindering these minority groups’ representation and reflection in society. Theatre as a form of art production serves as a medium to appreciate the diversity of sexual orientations by performing related plays on stage or, at least, giving voice to the concerns of individuals with so-called abnormal sexual tendencies. Still, heteronormativity subjugates to the end of appealing to the spectator, which is to be criticised by playwrights as in The Writer. In this metadrama, the power struggle between the female Writer with homosexual tendencies and the male Director with a conventional mindset induces turbulence and aggravates the communication between the two. Despite the Writer’s efforts to denaturalise heterosexuality through staging a homosexual scene in a mystic sphere, her attempt faces difficulties from the Director, and she finds her scene on stage in an implicitly heteronormative form. Hence, the imposition of gender binaries on the Writer’s lesbian couple displays how heteronormativity is embedded in the ending of both Hickson and the Writer’s plays and how it predominates the Writer’s deep convictions who has been opposing the heteronormative formations.
Ahmet Mithat Efendi’nin Esrâr-ı Cinâyât ve Jön Türk Romanlarında Hafiyelik
Authors: YEŞİLYURT Şamil
Published: August 2023

Roman ve hikâyelerinin esin kaynağı olarak sosyal hayattaki tecrübe ve gözlemlerini kullanan Ahmet Mithat, devleti ayakta tutmak esas gayesiyle devlet aleyhinde faaliyette bulunanları tespit etmek, suçluların yakalanmalarını sağlamak ve onlara gerekli cezaları uygulatmak maksatlarıyla oluşturulan; ancak daha sonra amacından uzaklaşan hafiye teşkilatlarını bu yaklaşımla kurmaca dünyaya taşır. Hatta kendisinin de İbret gazetesinde yayımlanan bir tenkit yazısından ötürü 6 Nisan’da tutuklanıp 10 Nisan’da Rodos’a sürgüne gönderilmesine sebep olan faktörlerden biri Genç Osmanlılar ile kurduğu yakın ilişki ise diğeri de bu ilişkiyi farklı biçimlerde yorumlayarak rapor düzenleyen hafiyeler olmuştur. İstibdat döneminin oluşturduğu baskı dolu, siyasi ve politik atmosferde bile asıl mesleği olarak gördüğü gazeteciliği bırakmayan Ahmet Mithat, sansüre “sansar” ismini verir. Hatta hafiyelerin faaliyetlerine karşı önlem almak maksadıyla matbaada çalışanlarına sürekli olarak dikkatli olmalarını ve kümeste sansar girecek delik kalmaması gerektiğini söylemesi yaşanan dönemin sıkıntı ve zorluklarını işaret etmektedir. Gördüğü, duyduğu, okuduğu her şeyi roman konusu hâline getirmeye çalışan bir sanatçının bunları da romanlarında işlememesi elbette düşünülemez. Bu maksatla Taine’in muhit, ırk, zaman teorisi bağlamında Ahmet Mithat’ın romanlarındaki hafiyelik olgusuna bakmak çalışmanın esasını oluşturmaktadır.
Histopathology lesions in red deer (Cervus elaphus) from Idanha-a-Nova and Lousã (Portugal): preliminary results
Authors: Jota Baptista Catarina , Oliveira Paula A, , Gonzalo-Orden José M. , Fernandes Gilberto , Seixas Fernanda
Published: August 2023

The red deer (Cervus elaphus) is a wild ungulate and game species with a broad distribution in Portugal. In Idanha-a-Nova (Castelo Branco) there is a particular interest in studying these populations due to the importance of the hunting industry to the regional economy, and the recognised role of ungulates as reservoirs of infectious agents to livestock and humans. This histopathology survey aimed to compare deer lesions from Idanha-a-Nova (n=16) and Lousã (n=4). Samples from the lung, liver and kidney of animals were collected during the hunting season. The results reveal a high prevalenceof parasitic bronchitis (13/20; 65%), especially in Idanha-a-Nova (11/16; 68.8%). Moreover, many animals presented non-purulent nephritis (8/20; 40%). No statistically significant differences were found between regions or genders for any lesion. This survey provides an overview of the health status of the red deer populations in these regions. Further studies are crucial to better know the sanitary situation of these populations and under the One Health perspective, to apply protective measures for animal, hunter and consumer health.
INVESTIGATION OF MECHANICAL PROPERTIES OF SAND CASTING MOLDS PRODUCED BY BINDER JETTING 3D PRINTER
Authors: ASLAN İbrahim , CAN Ahmet
Published: August 2023

The use of the additive manufacturing method in the casting industry is increasing day by day. The production of reverse angled and complex shaped casting parts, which cannot be produced with the classical modeling technique, can also be produced very easily with this method. On the other hand, it is very fast, especially in terms of rapid production of prototype castings, which can be directly molded without the need for model production. In this study, a 3D Printer with binder jet was designed and produced firstly. 3D Printer; It consists of 3 parts, the main chassis, the sand spreader and the spraying part. In this printer, which was produced afterwards, sand molds were produced with different nozzle advance speeds, different catalyst ratios and sand grain sizes. The consumables used in the production of sand molds are silica sand, furan resin and catalyst. The mechanical properties of the produced samples were determined by performing compression and gas permeability tests. Afterwards, it was determined which of the produced samples were more suitable for a sand casting mold by comparing the results obtained from similar studies in the literature. In this study, a new printer was designed with direct spray technique without using cartridges and preliminary studies were carried out successfully.
Differential Harm
Authors: Di Liberto Yuri
Published: August 2023

This essay opposes the idea that contemporary critical events like pandemics, global warming, environmental deterioration, et cetera, are to be considered as affecting humanity in a uniform way. Instead of seeing these phenomena like abstract universal threats, I propose to look at them through the lens of my concept of differential harm. By drawing on interdisciplinary sources, this concept aims at covering a series of processes that are best described in differential, rather than absolute, terms. By the same token, differential harm is a matter of scale. Moreover, this essay also suggests that macroscopic critical processes are better understood as instances of harm, rather than violence. Instead of framing macroscopic disruptive phenomena as simple calamities or crises, my approach also aims at acknowledging their social, political, and psychological dimensions.
Determinar los niveles de ruido ocupacional en agentes de tránsito de Cuenca - Ecuador
Authors: Vazques Sanchez Domenica Jissenia , Manzano Merchán Fredy Omar
Published: August 2023

El ruido es un factor de riesgo físico que se presenta en casi toda actividad laboral, es así como para la elaboración de este artículo se ha propuesto como objetivo principal determinar los niveles de ruido ocupacional para prevenir la sobreexposición en los agentes de tránsito de Cuenca, Ecuador. Para el desarrollo de este estudio se empleó un diseño metodológico de acuerdo con el alcance de la investigación, y los métodos utilizados fueron cualitativos y cuantitativos, mientras que el tipo de investigación fue explicativa y exploratoria, se utilizó un dosímetro de ruido, además como técnicas e instrumentos se optó por la observación directa y análisis de los datos utilizando el software casella. En el estudio se encontró que, de las 17 mediciones realizadas, el 41.17% se encuentra expuesto a niveles menores de 85 dB, mientras que los 58.82% superando los 85 dB de ruido, sobrepasando lo que expresa la normativa ecuatoriana, también de acuerdo con las dosis en estas zonas sobrepasan el 100%. Con los resultados obtenidos se concluye que se debería realizar un control de este factor de riesgo en la fuente a través de capacitación a los conductores o entrega de información a los mismos.
“Connecting Better and Wider”: A Constructivist Grounded Theory and Situational Analysis Exploration of Community Resilience in the Anthropocene Among the Transition Network
Authors: Boisvert Deanne M. , Suransky Carolina
Published: August 2023

For decades qualitative researchers have used grounded theory methodologies in their investigations. Although the grounded theory literature is extensive, less well documented are qualitative studies which incorporate complementary grounded theory approaches into their designs; or studies that validate the use of grounded theory strategies for applied research projects. This paper seeks to add to both margins of the grounded theory literature. First, it provides a detailed methodological account of how constructivist grounded theory and grounded theory situational analysis were used in a Ph.D. study exploring how ecologically concerned networks understand community resilience and respond to current and anticipated challenges of the Anthropocene, the idea that humans are now the primary influencers of global environmental changes. This account is based on a constructivist grounded theory analysis of nine interviews with Europeans active in the Transition Network at the community or regional level; and a grounded theory situational analysis of the network’s written discourse based on twenty-two English-language texts produced by prominent Transitioners, such as founders, headquarters staff, or national hub teams. Furthermore, while the wider Ph.D. study focused on theory building, analysis activities yielded practical insights into addressing real world problems, such as creating and sustaining collective action at the local level. Hence, the paper also discusses a framework that neighborhoods, towns, or other types of communities could adapt for their own collective purposes.
Formas de relación intergeneracional que potencializan la neuroplasticidad en extremos de la vida
Authors: Lemus Mayra Nineth
Published: August 2023

PROBLEMA:   alrededor del mundo el adulto mayor al convertirse en abuelo desarrolla un vínculo intergeneracional en la familia, según estudios favorece su capacidad afectiva cognitiva y social. Por ello se pretende determinar las formas de relaciones intergeneracionales que potencializan la neuroplasticidad en el adulto mayor. OBJETIVO: determinar los beneficios de relaciones intergeneracionales que potencian la neuroplasticidad en el adulto mayor. MÉTODO: se realizó un estudio cuantitativo a 81 adultos mayores (abuelos) en el municipio de Asunción Mita, Jutiapa. RESULTADOS: se demostró el rango etario más frecuente fue de 60 a 70 años de edad con un 55.6% (N=45), encontrando el género femenino como predominante en un 69.1% (N=56), su estado civil casadas con un 53.1% (N=43) se estableció que los beneficios de las relaciones que obtienen los adultos mayores de los nietos son las visitas frecuentes, la comunicación y la relación afectiva es positiva, en cuanto a las competencias emocionales un 97.5% (N=72) cumplen sus funciones como abuelos CONCLUSIÓN: en la escala de factores socioemocionales evaluada el factor con mayor predominancia fue el sentirse un buen abuelo con un 97.5% siendo un factor protector.
Uso de redes sociales y salud mental en adolescentes
Authors: Linares Pinto Ingrid Estefanía
Published: August 2023

PROBLEMA: profundizar en la investigación de la relación entre las redes sociales y la salud mental de los adolescentes en grupos urbanos, de la región oriental del país. OBJETIVO: el objetivo de la investigación fue evaluar el uso de redes sociales y su efecto en la salud mental de los adolescentes del área urbana de los municipios de Esquipulas y Quezaltepeque, departamento de Chiquimula, Guatemala. MÉTODO: se realizó un estudio descriptivo, de metología mixta con predominancia cualitativa en 80 adolescentes acerca del uso de redes sociales y su efecto en la salud mental. RESULTADOS: Se encontró que los adolescentes con una frecuencia de uso de más de 2 horas al día de las redes sociales, reflejaban mayor presencia de problemas interpersonales, baja autoestima y bienestar, ansiedad y depresión, identificando que el mayor uso de redes sociales se encuentra en individuos muy jóvenes, con mayor predisposición en el sexo femenino. CONCLUSIÓN: se concluye por medio de los hallazgos encontrados que la mayoría de los adolescentes pasan más de 2 horas conectados a las redes sociales por lo que existe el desafío en Guatemala de implementar normas o políticas a nivel educativo que orienten a la prevención sobre el manejo adecuado de las redes sociales en adolescentes y evitar en alguna medida, el posible desarrollo de trastornos psicológicos.
Factores que intervienen en el aprendizaje de Lengua de Señas en Guatemala
Authors: García García Clara Marcela
Published: August 2023

PROBLEMA: en Guatemala se observa un creciente interés de las personas oyentes por el aprendizaje de la lengua de señas, como una forma de establecer comunicación con las personas sordas y por la aprobación de la ley de lengua de señas. Surge entonces el interés por conocer los factores que influyen en ese aprendizaje OBJETIVO: identificar los factores que intervienen en el aprendizaje de Lengua de Señas en Guatemala, en personas oyentes. MÉTODO: fue un estudio exploratorio con metodología mixta y con una muestra de 144 personas. RESULTADOS: el perfil predominante es que la mayoría de la muestra es de sexo femenino 88.19% y el rango etario predominante estuvo comprendido entre las edades de 21 a 30 años con un 35.42 %. Se analizaron los factores que intervienen en el aprendizaje de la lengua de señas en personas oyentes: personales, familiares, ambientales / inclusivos y económicos. CONCLUSIÓN: entre los factores personales está la motivación para comunicarse con personas sordas. Entre los factores familiares, la familia es esencial ya que estimula a los alumnos y brinda el ambiente adecuado para aprender lengua de señas. En cuanto al factor ambiental / inclusivo, las redes sociales son cruciales para obtener información, fortalecer el nivel de empatía y consciencia hacia las personas con discapacidad auditiva. En cuanto al factor económico cabe destacar que aprender lengua de señas no es costoso, y esto constituye un incentivo para que en los últimos años haya aumentado el interés para estudiarlo.
Terapia asistida con perro para la reducción de cortisol en adulto mayor
Authors: Moscoso Figueroa Ana Lucia
Published: August 2023

PROBLEMA: pocas herramientas generadas para que el adulto mayor disfrute de esta etapa con una mejor salud. OBJETIVO: determinar cómo la terapia asistida con perro puede reducir el cortisol en adulto mayor. MÉTODO: descriptivo transversal con una muestra de 80 sujetos entre 65-90 años de edad,  que fueran dueños de perros en Guatemala y sus alrededores.  RESULTADOS: el 63% de las personas entrando a la etapa de adulto mayor siendo el 55% su mayoria del sexo femenino, 76% permitiendo que su mascota les ayude a ser creativas e independientes. 80% logran sentirse emocionalmente estables. CONCLUSIÓN: se ha logrado evidenciar que la terapia guiada por un perro, genera un impacto positivo en las personas adulto mayor a un 80%, permitiendo sentir emociones de manera segura el 67% de ellos, ayudando a que el cortisol no se eleve y pueda disfrutar de esta etapa junto a un fiel amigo el 80% de los participantes.