bluuebunny/crossref_metadata_2025 huggingface dataset:
Encephalopathy and Delirium
Authors: Qazi Alliya S. , Barr Juliana
Published: January 2021

Delirium occurs commonly in critically ill patients. ICU delirium is associated with increased short-term and long-term mortality, increased ICU length of stay, and long-term cognitive deficits in these patients. There are significant health-care costs associated with ICU delirium. Delirium is often overlooked in patients when assessed by clinicians based on clinical judgment alone. The use of a validated delirium assessment tool increases delirium detection rates in patients. ICU delirium is a multifactorial process. Nonmodifiable risk factors include age, dementia, prior coma, emergency surgery or trauma, and a high severity of illness. Modifiable risk factors include benzodiazepine use and blood transfusions. There is no evidence to support the use of any pharmacologic agent for either the prevention or treatment of ICU delirium. Antipsychotics should only be used for symptom management in ICU patients with delirium, and then discontinued when no longer needed. The mainstay of delirium management should be a multi-component, non-pharmacologic strategy aimed at minimizing risk factors. One such multimodal strategy, the ABCDEF Bundle, can significantly decrease the incidence of ICU delirium. Additional research is needed to better understand the pathophysiology and management of ICU delirium.

This review contains 5 figures, 7 tables, and 51 references
Keywords: Delirium, Encephalopathy, Intensive Care, Outcomes, ABCDEF Bundle, ICU Liberation.
Tertiary Hyperparathyroidism
Authors: Beck Anna C , Sugg Sonia L
Published: January 2021

The definition, pathophysiology, and diagnosis of tertiary hyperparathyroidism is reviewed. Parathyroidectomy is the mainstay of management, and the indications and timing of surgery are explained. The operative approach is described.

 This review contains 1 figure, 1 table, and 19 references.
Key Words: cinacalcet, hungry bone syndrome, parathyroid adenoma, parathyroidectomy, parathyroid hyperplasia, renal transplantation, tertiary hyperparathyroidism
Recurrent and Persistent Hyperparathyroidism
Authors: Beck Anna C
Published: January 2021

Persistent and recurrent hyperparathyroidism is defined. Key components of preoperative planning including imaging modalities are discussed. Indications for surgery and emerging techniques to aid identification of abnormal parathyroid tissue in the reoperative neck are described.
This review contains 2 figures, 2 tables and 22 references
Key Words: indocyanine green fluorescence angiography, methylene blue injection, near-infrared autofluorescence imaging, parathyroid cryopreservation, parathyromatosis, persistent hyperparathyroidism, recurrent hyperparathyroidism, selective parathyroid hormone venous sampling
Colorectal Cancer
Authors: Eng Cathy
Published: January 2021

Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States. Although environmental factors, including diet and lifestyle, clearly play a role in the etiology of colorectal cancer, as many as 25% of patients with colorectal cancer have a family history of the disease, which suggests the involvement of a genetic factor. Inherited colon cancers can be divided into two main types: the well-studied but rare familial adenomatous polyposis (FAP) syndrome, and the increasingly well-characterized, more common hereditary nonpolyposis colorectal cancer (HNPCC, a.k.a. Lynch Syndrome). The prevention, screening, diagnosis, and treatment of cancers of the colon and rectum are covered in this chapter. Figures illustrate various forms of adenomatous polyps, the tumor, node, metastasis (TNM) staging system for colorectal cancer, and the five-year survival rate in patients with colorectal carcinoma. Tables describe risk factors; possible chemopreventive agents; evidence supporting the effectiveness of screening tests; features and usage issues with different fecal occult blood tests; recommendations for early detection, screening, and surveillance for patients at different levels of risk; colorectal cancer staging systems; indicators of poor prognosis; and chemotherapeutic and biologic agents in the treatment of colorectal cancer. This chapter contains 197 references.
Management of Depression, Part 1: Identification and Diagnosis
Authors: Banov Michael
Published: January 2021

Clinical depression is a commonly occurring and profoundly disabling condition that affects approximately 4%, or nearly 350 million people, worldwide. Depression has been identified as the world’s leading cause of disability and a major contributor to overall global burden of disease. In the United States alone, estimates of economic burden are greater than 200 billion dollars, including costs of direct medical care, suicide-related mortality, and lost work productivity. Managing depression is challenging due to the marked variability in biological contributors, the heterogeneity of the illness, psychosocial history, current stresses exacerbating the condition, medical and psychiatric co-occurring conditions, lifestyle, and motivation and willingness to accept and engage in treatment recommendations. This review discusses diagnosis, depression screening and workup, neuroimaging, differentiation among depression types, patient safety, and treatment initiation in patients with depression. Tables list DSM-5 versus ICD-10 classification of depression and DSM-5 updates with respect to depression.
 
This review contains 5 tables and 60 references
Key words: bipolar depression, clinical depression, depression, depression screening, psychiatric neuroimaging, unipolar depression
Management of Depression, Part 2: Treatment Options
Authors: Banov Michael
Published: January 2021

Clinical depression is a commonly occurring and profoundly disabling condition that affects approximately 4%, or nearly 350 million people, worldwide according to the World Health Organization. Managing depression is challenging due to the marked variability in biological contributors, the heterogeneity of the illness, psychosocial history, current stresses exacerbating the condition, medical and psychiatric co-occurring conditions, lifestyle, and motivation and willingness to accept and engage in treatment recommendations. Mental health professionals such as master-level counselors, psychologists, or psychiatrists are specially trained to identify and treat depression; however, a significant amount of depression presents in primary care medical settings. This review covers treatment of depression with psychotherapy, complementary and alternative medicine (CAM), and antidepressant medication, as well as treatment course and long-term depression treatment. Tables list CAM depression treatments, nonnutraceutical CAM therapies, managing antidepressant side effects, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, norepinephrine dopamine reuptake inhibitor, alpha2 antagonists, serotonin-2 antagonist/reuptake inhibitors, monoamine oxidase inhibitors, food restrictions with monoamine oxidase inhibitors, managing partial response/treatment-resistant depression, and serotonin receptor modulators.
 
This review contains 15 tables and 98 references
Key words: antidepressant medication, clinical depression, depression, monoamine oxidase inhibitors, nonpharmacologic depression treatment, omega-3 fatty acids, S-adenosylmethionine, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, St. John’s wort, tricyclic antidepressants
Disorders of Water and Sodium Balance: Hyponatremia
Authors: Carmona Matos Danilea M. , Chen Herbert
Published: January 2021

Disorders of water and sodium balance are common in clinical practice. To better assess them, we must have a clear understanding of water-electrolyte homeostasis and renal function. The following review goes over practical equations necessary for electrolyte balance analysis as well as the foundations of renal physiology. Emphasis is placed on the understanding of sodium transport and its physiologic and pharmacologic regulation. In addition, we explore the most common electrolyte imbalance affecting up to 28% of hospitalized patients: hyponatremia (ie, low sodium concentration). Hyponatremia has been found in several acute and chronic clinical scenarios including postoperative, drug-induced, and exercise-associated hyponatremia. However, it is not uncommon to find this disorder coexisting with other diseases such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH), acquired immunodeficiency syndrome (AIDS), cancer, and in rare cases, hypothyroidism. To better understand this disorder, the etiology, diagnosis with clinical manifestations and laboratory values, and treatment options are explored.
This review contains 9 figures, 6 tables, and 52 references.
Key Words: aldosterone, antidiuretic hormone, body fluids, electrolyte balance, hyponatremia, hypovolemia, osmolality, sodium transport, vasopressin
Resurgence and Recurrent Outbreaks of COVID-19: Prospects for Assimilation of hCoV-19 into Human Genome
Authors: Nikhra Vinod
Published: January 2021

The Outbreaks and Resurgence: The disease which reportedly began in the Chinese city Wuhan in November-December 2019, soon spread to various parts of the world, and was named and declared a pandemic disease by WHO. While the European countries were recovering from the epidemic, the disease took hold in the USA, the South American countries, Arabian countries, and South Asian countries, predominantly affecting India. Presently, most of the European countries are witnessing resurgence and recurrent outbreaks of COVID-19. Spread and Evolving New Insights: Whereas there is workplace-related infection rise as people are returning to their offices, in other places the outbreaks are related to the people crowding and partying care-freely and trying to resort back to their earlier way of life. The reopening the educational facilities across the continents may make matters worse. Impact on Health and Healthcare: Most cases of COVID-19 infections go unnoticed and are followed by self-recovery. But what may appear good from the clinical perspective, appears to complicate epidemiological efforts to contain the outbreak. With the evolving information about the disease, there seem to be certain possible outcomes such as control and containment, or the persistence of the disease as global endemic accompanied with outbreaks and resurgent episodes. Gnetic Factors Linked to Disease Severity: With the COVID-19 pandemic, not all infected patients develop a severe respiratory illness. Further, there is a large variation in disease severity, which may be due to the genetic factors underlying the variable response to the virus. It is becoming clear that apart from the advanced age and pre-existing conditions, certain genetic constituent factors render some patients more vulnerable to the more severe forms of the diseases. Integration of Virus into Human Genome: A significant part of the human genome is derived from viruses especially the RNA viruses. In fact, about 8 percent of the human genome is made up of endogenous retroviruses (ERVs), which are viral gene sequences that have become a permanent part of the human lineage after they infected our ancient ancestors. With this background, an emerging novel concept holds that if COVID-19 persists for several generations, its genetic material is projected to be integrated or assimilated into human genome. The involved mechanisms are conceptualised through the transposons or transposable elements of the SARS-CoV-2.
In Vitro Anti-Collagenase Activity and Total Phenolic Content Of Five Selected Herbs: A Review
Authors: Shukri Siti Maisarah , Pardi Faezah , Jaafar Sidik Norrizah
Published: January 2021

Etlingera elatior, Persicaria odorata, Centella asiatica, Senna alata and Phyllanthus emblica were reviewed for their in vitro anti-collagenase activity and its total phenolic contents. Plant herbs play a vital role to promote the production of collagen which is the component of the skin. Different solvents during plant extraction and various plant parts were used to determine anti-collagenase properties and total phenolic content. Generally, anti-collagenase assay and Folin-Ciocalteu method were used to determine the anti-collagenase activity and total phenolic content, respectively. The extracts of these herbs have the potential of inhibiting collagenase activity and they possess total phenolic content. The total phenolic was found to be important elements in collagenase inhibition activity other than flavonoid. The selected herbs are popular in Malaysia and this review can be a useful reference or information for future application in pharmaceutical, food and cosmetics fields.

Keywords: Anti-collagenase activity, total phenolic contents; plant Extraction; flavonoids
100 Months Experiences With VenaSeal® Vein Glue: Long Time Follow - Up Study Conducted On 2912 Truncal Saphenous Veins In 1509 Cases
Authors:   Saphenion Vein Care Centers, Berlin, Germany, Zierau Ulf Th
Published: January 2021

The paper is about long - time experiences in treatment of truncal varicose veins with the vein glue VenaSeal®: 100 months - follow up of 1509 cases and 2912 truncal varicose veins. Since 1999 years by now, varicosis has been increasingly treated endovenously. At the start, the rather inconvenient VNUS® Closure plus - procedure and the more convenient linear laser procedure were used, and these were followed in 2007 by the bipolar RFITT® catheter, the VNUS® Closure Fast system and the radial laser. These endovenous treatment techniques were followed by the Clarivein System and the VenaSeal® System in 2011/2012. Thus, in the course of the last few years, plenty of experience has been gathered with endoluminal therapy, quality criteria have been defined and standards for the different techniques have been developed. The presented actual paper sheds light on the advantages and disadvantages of the vein glue VenaSeal® and presents the 100-months results of a single-center praxis study with prospective design. We will report about our experiences and results of a prospective comparative study of VenaSeal® - Closure in the treatment of 2512 saphenous veins (1949 GSV, 731 SSV, VSAL in 110 cases, VSAM in 87cases, femoropopliteal vein in 33 cases and Giacomini’s vein in 2 cases). Also ulcera crures were included in 17 cases (Figure 1).
Do The Oncologists Systematically Follow Treatment Recommendations And Protocol Adaptations Suggested By Prior Comprehensive Geriatric Assessment In Older Patients With Colorectal Cancer?
Authors:   European Hospital, Retornaz Frédérique
Published: January 2021

In order to assess the ability of older patient with Colorectal Cancer (CRC) to receive chemotherapy, a Comprehensive Geriatric Assessment (CGA) is recommended before the final therapeutic decision.
Evaluation Of The Diagnostic Value Of Electromagnetic Navigational Guided Targeted-Bronchoalveolar Lavage In The Diagnosis Of Lung Cancer
Authors:   Helen F. Graham Cancer Center And Research Institute, Matus Ismael
Published: January 2021

Electromagnetic Navigation Bronchoscopy (ENB) is recommended for the evaluation of Peripheral Pulmonary Nodules (PPNs). Current diagnostic bronchoscopy and pulmonary nodule evaluation guidelines do not establish recommendations regarding the role of individual tissue acquisition techniques, the ideal combination or sequence of executing them to optimize diagnostic yield.
Sexual Dysfunction In Women Who Are Human Papillomavirus Positive
Authors:   Dokuz Eylul University, Ilgen Orkun
Published: January 2021

Female Sexual Dysfunction (FSD) is a prevalent disorder among women that has negative impacts on life quality. Human Papillomavirus (HPV) infection is the most common sexually-transmitted disease and has a negative emotional effect on women because of causing cervical cancer.
Baker's asthma in bread factory workers
Authors: Aydın Ömür , Sözener Zeynep Çelebi , Demirel Yavuz Selim , Seçil Derya , Mungan Dilşad
Published: January 2021

Background: Baker's asthma (BA) is one of the most common causes of occupational asthma. Prevalence of BA varies from 3 to 24% in various studies; however, in our country, there are not enough data on its prevalence. Objective: The aim of this study was
to evaluate wheat flour sensitivity and to determine the rate of BA in workers at a large bread factory in Ankara. Methods: All steps of the study were carried out in the workplace by the research team who made regular visits to the bread factory. A questionnaire was used
to determine the presence of respiratory symptoms and its relation with the occupation. Skin-prick tests and specific immunoglobulin E measurements were performed. Pulmonary function tests and specific inhalation challenges (SIC) were performed to confirm the BA diagnosis. Results:
A total of 162 workers (women/men, 3/159; mean ±standard error age, 38.25 ± 7.8 years) were included in the study. Of the 99 workers who described symptoms, 88 (88.8%) had nasal and 57 (57.5%) had lower respiratory symptoms. Sensitivity to wheat flour was present in 23 of
the workers (14.2%) among all the workers. Among all the workers, seven (4.32%) were diagnosed with BA and SICs were positive in four (2.46%). Conclusion: Wheat sensitivity was high among the bakers who were exposed to wheat flour; however, the prevalence of BA was quite
lower than the previous data in the literature.
Crescimento e qualidade de mudas de faveleira em função do substrato e níveis de água
Authors: Sousa Rosilvam Ramos de , Freire Antonio Lucineudo de Oliveira
Published: January 2021

Diante do cenário atual de degradação dos ecossistemas brasileiros, faz necessária a produção de mudas de qualidade visando à recuperação dos mesmos. No entanto, para atender a essa finalidade é necessário que se cause o mínimo de impacto ambiental possível. Nesse sentido, o uso de materiais alternativos na composição do substrato, bem como redução na quantidade de água na fase de viveiro são aspectos que devem ser considerados. Dessa forma, conduziu-se o presente trabalho com o objetivo de avaliar substratos e níveis de água no crescimento e na qualidade de mudas de faveleira, foram avaliados quatro misturas, sendo duas entre solo e esterco (2:1 e 3:1) e duas entre solo e rejeito de vermiculita (2:1 e 3:1) combinados com quatro níveis de água (100, 75, 50 e 25% da capacidade de vaso) no esquema fatorial 4 x 4. Os tratamentos foram distribuídos em delineamento inteiramente cazualizado com quatro repetições por tratamento. Foram avaliados altura das plantas; diâmetro do coleto; as massas secas da parte aérea, das raízes, das folhas, do caule e total; taxa de crescimento absoluto; a razão altura/diâmetro e o Índice de Qualidade de Dickson. O substrato composto de solo + esterco bovino proporciona a obtenção de mudas de melhor qualidade. Recomenda-se o nível de água entre 75% e 100% da capacidade de vaso para a a produção de mudas de faveleria, por proporcionar maior crescimento.
Defining Mental Health Practitioners’ LGBTIQ Cultural Competence in Thailand
Authors:   Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Thailand, Ojanen Timo Tapani , Phukao Darunee ,   Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Thailand, Boonmongkon Pimpawun ,   Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Thailand, Rungreangkulkij Somporn ,   WHO CC Centre for Research and Training on Gender and Women’s Health, Faculty of Nursing, Khon Kaen University, Thailand
Published: January 2021

This study investigated what competencies are crucial for mental health practitioners’ culturally competent practice with LGBTIQ clients in Thailand. The study used two-round Delphi methodology to aggregate views of mental health practitioners with expertise on LGBTIQ issues (n = 14), and of LGBTIQ individuals who had used mental health services (n = 13). Participants proposed competencies in Round 1 through interviews or an online questionnaire, and rated these competencies’ importance in another online questionnaire in Round 2. Forty-one knowledge competencies, 35 awareness/attitude/belief competencies, 14 skill competencies and 35 action competencies were rated. Among key themes were understanding gender/sexual diversity as well as issues affecting LGBTIQ people and their families, and being able to assist on these issues; accepting gender/sexual diversity, respecting clients’ self-determination, and communicating this to clients; being aware of the impact of one’s beliefs, attitudes, identities and values; recognizing and rejecting stereotypes; being open, humble, and willing to learn more; knowing how to use feminist counseling techniques and other specific techniques; refraining from offending actions; social justice action; and obtaining information sensitively. Developing these competencies is likely to improve mental health services’ appropriateness for LGBTIQ clients and should be included in mental health practitioners’ training in Thailand.
USPJEŠNOST PROGRAMA EUROPSKE UNIJE U POTICANJU I FINANCIRANJU KULTURNOG I KREATIVNOG SEKTORA U REPUBLICI HRVATSKOJ
Authors: Bestvina Bukvić Ivana , Bjelić Kristina , Šain Marija
Published: January 2021

The cultural and creative sectors are highly ranked by the number of employees at the European Union (EU) level and they represent an economic force that proved its resilience to economic changes due to rapid and easy adaptations to market and innovation trends. In order to achieve the objectives of the Europe 2020 Strategy, in 2013 the Regulation (EU) No 1295/2013 was passed by the European Parliament and the Council to establish the Creative Europe Programme (2014–2020) for support to cultural and creative sectors. However, it was found that the Republic of Croatia lacked systematic monitoring of the cultural and creative sectors (including the IT sector) as they are not sufficiently and well positioned in national policies and strategies. The research has been conducted into the level of success of the EU and its regulatory framework in stimulating cultural and creative sectors in developing countries. The paper analyzes the extent to which the Republic of Croatia adopted and applied the opportunities offered by the European Union programmes in financing the projects in cultural and creative sectors based on the results of the Creative Europe Programme, the Culture Sub-programme. The authors conducted the comparative analysis into the official programme results achieved in the Republic of Croatia, Slovenia and other EU member states. The research results show the position of the Republic of Croatia in relation to other countries, the influence of EU membership length and the level of innovation on the total number of positive applications evaluations in this field.
A study to assess the knowledge on psoriasis among adults
Authors: Parimala L  , Jothimeena B
Published: January 2021

Psoriasis was viewed as just as a skin issue; nonetheless, it is currently best portrayed as an intricate, multifactorial and inflammatory illness. Psoriasis is an interminable skin sickness and the epidemiology shows its event more a few nations than India. Psoriasis is thought to influence somewhere in the range of 2% and 4% of the populace in Westernized nations and in spite of the fact that not perilous, it is related with a noteworthy debilitation of personal satisfaction, influencing work, family and sexual relations, just as physical and mental prosperity. Both genders are influenced similarly and, for most of the patients (75%), psoriasis first presents between the ages of 15 years and 25 years, with the rest of those influenced encountering side effects between the ages of 55 years and 60 years. The aim of the study is to assess the knowledge regarding psoriasis among adults. Quantitative research approach with pre experimental research design was adopted for the study. Convenient sampling technique was used to select the 100 adults who attend dermatology outpatient in Saveetha Medical College and Hospital. The demographic variable data was collected by structured questionnaire, and the level of knowledge on Psoriasis was assessed by psoriasis knowledge scale. The pretest level was assessed by psoriasis knowledge scale, and then health education on psoriasis was given for seven days, followed by a posttest. The data were analyzed using descriptive and inferential statistics. Additionally, Wilcox on rank sum test was performed to assess the effectiveness of the study.
Assessment of Prevalence, Knowledge and Practice of Over-the-Counter Medications Use among General Population
Authors: Cecyli C  , Kavitha K  , Manjula A
Published: January 2021

The rate of use of over the counter (OTC) drugs is radically expanding step by step. Over the counter medications are drugs sold easily to consumer without a physician’s instruction. A cross sectional descriptive design was adopted for this study to assess the prevalence, knowledge and practice of over-the-counter medications use among general population. A sum of 440 people was selected utilizing probability cluster sampling by evaluating individuals who met the inclusion criteria. The participants were collected data on knowledge and practice of over-the-counter medications use with a self-structured questionnaire through structured interview method. An aggregate of 500 people were met with respect to their utilization of OTC medications, among which 440 were selected. The commonness of self-medicine with OTC medications in our examination was seen as 88%. Among which 97% of them had adequate knowledge on OTC meds and just 3% had inadequate knowledge. With respect to level of Practice, it was discovered that 67.7% of them had low practice, 31.1% had moderate practice and 1.13% had high practice. There was a feeble negative connection existed among knowledge and practice (r=-0.244) which was significant at p<.001. There was likewise a measurably statistically significant affiliation noted between the degree of knowledge with medicinal professionals in their family at p<0.01 and source of awareness at p<0. 001. Correspondingly, an affiliation was found between the degree of practice with educational qualification at p < 0.01, OTC medicine utilization in years at p < 0.01and source of awareness at p <05.
An analytical study on effect of constitutional homeopathic medicines for single arm disability patients in age group of 6-15 years
Authors: Satyanarayana P  , Rajesh P  , Ravi P  , Rajamuthiah N
Published: January 2021

Learning disability is a disorder of the basic physiological processes involved in using or understanding language written or spoken which manifest itself in imperfect ability to listen, speak, read, write, spell or do mathematical calculations. In this study, homeopathic medicine was prescribed to the 30 children having learning disability of age group 6 to 15. Synthesis repertory was used for repertorisation of cases and to find out constitutional medicine. Single dose of medicine was prescribed to every child at the interval of 10 to 15 days in required potency. Pre-assessment of each child was done with "Is It Dyslexia" free online evaluation by Davis Dyslexia Association. Visual Analogue Scale was used for before and after treatment analysis. Study showed significant result with mild to moderate improvement in 30 patients. Dyslexia and Dysgraphia come under category of specific developmental disorder. Dyslexia is characterized by failure to develop adequate reading skills and delay in learning to read which become apparent between the ages of 6 to 9 years. The clinical feature includes omission, distortions or substitutions of words, long hesitations, reversal of words or simply slow reading, writing difficulties are often coexisted with dyslexia. Clinical features include difficulties with spelling, syntax grammar and composition.
A Prospective Evaluation of Asthma Management: Emergency and Continuing Care for Asthma
Authors: Sai Sravanthi T  , Donthu Raj Kiran  , Sundaravadivel V P  , Kayalvizhi E
Published: January 2021

Previous assessments of asthma management have demonstrated huge consideration holes in the administration of intense asthma. As a major aspect of potential “Global Survey of Asthma Practice (GASP)” we tentatively assessed an associate of asthma patients who went to a University subsidiary hospital “emergency department (ED)”. Patients going to ED with intense asthma were tentatively assessed with normalized evaluation apparatus. Pattern attributes, pre affirmation asthma the executives, examinations done in the ED just as release drugs were completely recorded. In this investigation, we have indicated that patients going to the ED have an unnecessary utilization of salvage medicine with a background marked by continuous earlier ED visits and hospitalizations with intense asthma. This information recommends there keeps on being a huge consideration hole both in-network and Emergency Department regarding ideal administration of intense asthma. Asthma is a long term inflammatory sickness of lungs airways. It is portrayed by feature and repeating suggestions, reversible wind stream impediment, and simply triggered bronchospasms. The appearances include scenes of hacking, wheezing, windedness, & chest snugness. These might occur rare times every day or every week. Rely on an individual, asthma indications might turn out to be more terrible around evening time or with practice.
Knowledge effect on postnatal mothers regarding Baby Friendly Hospital Initiative
Authors: Kalabarathi S  , Aarthi A
Published: January 2021

Breastfeeding is the “Gold standard” for infant feeding. There are several areas of biological superiority of breastfeeding and breast milk over artificial (formula) milk. Exclusive breast milk feeding is the suggested diet for term and untimely children to give ideal baby nourishment, basic immunological and mitigating advantages, and prevention from ailment and illnesses. The Baby-Friendly Hospital Initiative dispatched in1991, is an exertion by UNICEF and WHO to guarantee that all maternities, whether detached or in a medical clinic, become focuses of breastfeeding support. The present study aims to assess knowledge effect on postnatal mothers regarding baby friendly hospital initiative. A one group pretest posttest research design was conducted among 60 postnatal mothers. Convenient sampling technique was used to select samples. Structured knowledge questionnaire was used to assess the effectiveness of information booklet regarding Baby-Friendly Hospital Initiative among postnatal mothers. The present study attempted to evaluate the effectiveness of information booklet on Baby-Friendly Hospital Initiative among postnatal mothers of SMCH and found that 6(10%) had adequate, 9(15%) had moderate adequate knowledge and also 45(75%) had inadequate knowledge in pretest and 42(70%) had adequate, 12(20%) had moderate adequate knowledge and 6(10%) had inadequate knowledge in posttest and concluded that there was a significant improvement after administration of information booklet. Thus, information booklet was effective in improving the knowledge on Baby Friendly Hospital initiative among postnatal mothers.
Analysis on Overweight and Inadequate Physical Activity by Nutritional Behaviors such as Obesity
Authors: Venu Gopal Raju S  , Satyanarayana P  , Sriram V  , Umapathi P
Published: January 2021

We study all the review article related to Obesity. The  Obesity is the disease in which  imbalance between the calorie intake and  its use. Obesity has  touched widespread levels in established as  well as  in developing countries. It progressively existence experiential by altering  the lifestyle of the  family. The  mechanism of  Obesity is the unusual calorie convert into fat in adipose tissue. Adipose  tissue consists of  an adipose cell and unusual  calorie accumulate into the adipose cell  they swell increase their Weight and  increase the bodyweight of  the body.  Universally in an investigation of 199 nations, 1.46 billion grown-ups are assessed to actuality overweight, and 502 million are assessed as existence stout. Individuals are commonly viewed as fat when their weight file (BMI) an estimation developed by segmentation an individual load by the rectangular of the separate tallness is more than 30 Kg/m2, by the reference range 25-30 kg/m2 considered as overweight. Weight Index (BMI) is commonplace uses to clarify the overweight and heftiness in the study of disease transmission contemplates. In any case, BMI has low affectability and there is bigger entomb singular changes in the percent muscle versus fat for some random BMI esteem, somewhat trait to age sex and nationality. Causes of  Obesity, both genes and  environmental factor participate in Obesity. However, by  the large, genes are now thought  to set  only the stage and provide  the background, against which  the decisive effects and provide effects  are eventually driven by the natural and conduct factors.
Impact of Functional Food Mixes on Serum Calcium and Phosphorous Level – An Interventional Study
Authors: Usharani R
Published: January 2021

Agriculture is the main occupation of the people. Further cultivation, public occupied themselves in weaving, tanning and metallurgy. Among the various occupations weaving is one of the second major occupations in India next to agriculture. A long tradition of excellence in its craftsmanship, Indian Handloom is said to have dated back to the ancient ages. 15th August 1947, noticeable turnings face for the country's handloom weavers. Weavers are the main population in India who suffer from major health problems such as respiratory problems, musculoskeletal disorders and chronic diseases like hypertension as well as disabilities such as everlasting ears hot failure due to revelation to sound. For the interventional study interview schedule was used and screened 90 subjects based on the health problems, subjects divided into 3 groups such as EM – 30, EMS-30 and CM-30. Functional food mixes prepared and formulated soya based health mixes and assessed the nutrient content of health mixes, and supplemented to the experimental groups. There is no supplementation for the control group. Then the impact was evaluated by using biochemical parameters. After the supplementation revealed, the soya based health mixes are reduced the risk of osteoporosis.
Utilization and analyzation of pregabalin tablets for easy dissolving for diabatic neuropathy treatment using simple γ-amino butyric corrosive
Authors: Donthu Raj Kiran  , Sai Sravanthi T  , Ramakrishnan V  , Naveen P
Published: January 2021

Pregabalin (PRE) has been considered as a basic simple of γ-aminobutyric corrosive, which is utilized to treat unmanageable incomplete seizures, diabetic neuropathy, post-remedial neuralgia, and social tension problems. Its fundamental site of activity has all the earmarks of being the α2-δ subunit of the voltage-subordinate calcium channels that are broadly dispersed all through the fringe and focal sensory system. The idea of detailing quick tablets dissolving comprising of PRE delivers a reasonable & commonsense methodology in the wanted goal of quicker crumbling & disintegration attributes with expanded bioavailability. Quick tablets of PRE have been placed through direct pressure techniques & mix has been assessed for pre-pressure boundaries, for example, mass thickness, compressibility, point of rest and so on the tablets were set up by utilizing Croscarmellose sodium, Crospovidone and sodium starch glycolate, as super disintegrants in various focus alongside phosphate cushion pH 6.8 at 75 rpm by paddle technique. Generally, the definition F4containing of Croscarmellose sodium was discovered to be fascinating &has demonstrated a crumbling 45 sec.Moreover, solidness reads have been performed at a very long time (quickened considers) according to ICH rules. The improved plan (F4) indicated no critical varieties aimed at the tablets boundaries and it was steady for the predefined time-frame. Consequently, outcomes indisputably exhibited fruitful covering of taste & quickest deterioration of figured tablets.
Evaluation of Connective Tissue Grafts Versus Free Gingival Grafts
Authors: Keerthana Baskar  , Nashra Kareem  , Sreedevi Dharman
Published: January 2021

Root coverage is one of the important aims of periodontal therapy. The aim of the study was to evaluate the connective-tissue grafts (CTG) and free gingival grafts (FGG) in root coverage procedures. A retrospective study of sample size 32 was conducted. These patients underwent a root coverage procedure done using grafts. The details on which graft was obtained from patient records were reviewed and analysed between June 2019 to March 2020. Excel tabulation was done, analysed and transferred to SPSS for statistical analysis. The p value was set at 0.05. In the study, it was found that CTG was used in 56.25% of the patients and FGG was used in 43.75% of the patients undergoing root coverage procedure.  It was found that Free gingival grafts (25%) were placed more commonly in females when compared to connective tissue grafts (18.75%). However, in males, connective tissue grafts (37.5%) were placed more commonly than free gingival grafts. (18.75%) The prevalence of connective tissue graft was more when compared to free gingival graft at 36-55 years of age. Connective tissue graft was done more commonly in the age group of 15-35 years. Prevalence of connective tissue grafts was more in males than in females. Within the limits of the study, it was found that connective tissue graft (CTG) procedures performed more than free gingival graft (FGG) procedures following the gold standard for root coverage in gingival recession treatment.
Effects of Blended Simulation Applied for Respiratory System Assessment in Undergraduate Nursing Education
Authors: Miran Eom  , Sun Kyung Kim  , Oe-Nam Kim
Published: January 2021

The importance of undergraduate nursing education has never been higher due to the aging population and complexity of patients. The blended simulation combined two and more educational methods and is an effective strategy in nursing education. This study was to evaluate the effectiveness of blended simulation using standardized patients and patients simulation. Using a convenience sampling, a quasi-experimental study was conducted. Forty undergraduate nursing students enrolled and were allocated to the experimental group (n=20) or the control group (n=20). CPX (clinical performance examination) was used to evaluate physical assessment skills. Self-reporting questionnaires were used for communication skill and learning satisfaction. χ2-test/Fisher's exact test and Mann-Whitney U test were conducted for statistical analysis. After completing the educational program, there were statistically significant higher levels of physical assessment and communication skills in the blended simulation group (p<.001) compared with the control group. Regarding learning satisfaction, there were also statistically significant differences with a higher level of satisfaction among students in blended simulation group (p=.002). This blended simulation has high potential to successfully achieve learning outcomes in undergraduate nursing education. Providing students with diverse educational methods ensure an optimal learning experience.
宫颈癌放疗患者阴道冲洗的研究进展
Authors: 魏 秀丽
Published: January 2021

宫颈癌是女性生殖系统常见的恶性肿瘤，发病率占所有恶性肿瘤的首位。中、晚期患者有阴道出血、排液，尿频尿急、贫血等症状，预后差，放疗是宫颈癌治疗中重要的手段，近80%的患者需要接受放疗，包括术后辅助放疗、根治性放疗以及姑息性放疗。在取得显著疗效的同时，放疗引发的并发症也不容忽视，放疗期间肿瘤组织坏死、脱落会导致阴道分泌物增多、感染，给患者造成巨大的心理压力，影响放疗疗效。因此，在放疗期间给予阴道冲洗、护理干预对改善患者预后有重要作用。论文就宫颈癌放疗患者采取阴道冲洗的临床观察及护理应用效果进行综述
SPK Evaluasi Kompetensi Instruktur Lembaga Kursus Bahasa Inggris Menggunakan Metode PROMETHEE Berbasis Android
Authors: Utiarahman Siti Andini , Yusuf Muh. Fitra
Published: January 2021

Bahasa inggris merupakan salah satu bahasa internasional yang digunakan oleh banyak negara. Bahasa inggris juga sebagai bahasa komunikasi internasional yang sangat penting untuk berbagai sektor yang ada. Hal ini menjadikan My Liberty hadir sebagai lembaga kursus bahasa inggris yang telah banyak menghasilkan lulusan terbaik sejak 9 tahun terakhir, baik untuk sekolah tingkat International English School dan Kids School. Tentu hal tersebut tak lepas dari peran instruktur (tenaga pengajar) yang berkompeten. Sehingga diperlukan adanya evaluasi kompetensi terhadap para instrukturnya secara lebih objektif per periode. Saat ini pelaksanaan evaluasi kompetensi instruktur di My Liberty masih bersifat komprehensif sehingga mengakibatkan kurang terukurnya tingkat kualifikasi kemampuan instruktur. Sehingga perlu adanya Sistem Pendukung Keputusan sebagai solusi untuk mengevaluasi kompetensi instruktur berdasarkan tingkat kualifikasi kemampuan instruktur. Metode PROMETHEE digunakan dalam penelitian ini untuk menghitung bobot setiap kriteria agar dapat memilih alternative terbaik. SPK ini diterapkan pada aplikasi android sehingga memudahkan instruktur leader dalam melakukan penilaian nantinya. Dari hasil penelitian disimpulkan bahwa SPK berbasis android ini mempermudah penilaian evaluasi kompetensi instruktur yang dilaksanakan setiap tahun dengan hasil yang efektif.
Aplikasi Pengenalan Alat Kesehatan Berbasis Android
Authors: Julianto Rudi , Lestari Mei , Parwati Ni Wayan
Published: January 2021

— Kesehatan merupakan salah satu hak dasar manusia di Indonesia yang diakui dalam konstitusi UUD 1945. Sebagai perwujudan dari perlindungan hak dasar tersebut, Negara bertanggung jawab atas penyediaan fasilitas layanan kesehatan yang layak termasuk ketersediaan obat. Ketersediaan perbekalan kesehatan ini dilakukan melalui kegiatan pengadaan alat kesehatan. Alat kesehatan pada rumah sakit di suplai oleh banyak pabrik pembuat alat kesehatan khusus rumah sakit. Banyaknya jenis alat kesehatan membuat beberapa masyarakat dan para siswa sulit untuk mengenali serta memahami jenis alat kesehatan dengan mudah dan praktis. Media belajar berbasis aplikasi android dapat mempermudah sarana kegiatan dalam proses pembelajaran dan menambah wawasan tertentu. Ditinggalkannya gaya membaca pada media buku cetak saat ini membuat masyarakat beralih dalam mencari pengetahuan berbasis aplikasi android. Dengan dibangunnya aplikasi pengenalan alat kesehatan berbasis android diharapkan mampu membantu masyarakat dan para siswa untuk mempelajari jenis alat kesehatan secara interaktif. Para siswa dapat mengasah pengetahuan mereka dengan adanya kuis yang tersedia pada aplikasi. Untuk metode penelitian ini menggunakan metode prototyping. Hasil penelitian ini diharapkan agar pemahaman dan pengetahuan tentang jenis-jenis alat kesehatan dapat lebih mudah dimengerti serta difahami dengan baik dalam bentuk aplikasi berbasis android mobile.
THE HIGHEST TERRESTRIAL OFFICIALS OF CHERNIHIV VOIVODESHIP (1696-1733s)
Authors: Shymanskyi Yevhen
Published: January 2021

The article is based on academic biographical and genealogical literature with involvement of published legislative sources of the Polish-Lithuania Commonwealth Diet (Sejm). The researching instruments are represented by the method of the prosopography and ruled by principles of objectivity, chronology and historicism. This paper reveals the history of a nobleman group which occupied highest posts (voivode and castellan) in Chernihiv Voivodeship terrestrial office hierarchy during the reign of the king August II (1696-1733). It has been studied out that highest terrestrial officials were represented by people that came from rich magnate nobleman families from the different parts of the country. This group of noblemen were related to the different centers of political power and their careers were built on dependence not only on the land possession of their families but also on the great role of their political relationships with the king and various opposing political forces. Chernihiv Voivodeship can be named as “titular”or “exulant” due to absence of lands in its possession in contradistinction to real voivodeships of the Polish-Lithuania Commonwealth. This circumstance reduces the role of a highest terrestrial official of an “exulant” voivodeship only to the senator’s
mission in a republican Diet. It has been found that terrestrial official’s titles can be characterized as “sinecurial” and they also were the instruments for a power increasing of large political fractions in the Diet. The narrower relationships between Chernihiv’s highest officials (senators) and Chernihiv Voivodeship exulants nobleman community grouped over Volodymyr dietine (sejmik) can be found on a wider material of different historical archival sources hiding a various data of political and parliamentarian processes.
Obtención de fase ferroeléctrica en cerámicos base BaTiO3 doblemente dopados con tierras raras
Authors: Martínez Ricardo , Hernández-Lara Juan Pablo , Pérez-Labra Miguel , Barrientos-Hernández Francisco Raúl , Reyes-Pérez Martin , Reyes-Cruz Víctor E. , Juarez Tapia Julio César
Published: January 2021

Los materiales cerámicos con una estructura tipo perovskita como el titanato de bario ya sea sin dopar o dopado han sido de gran interés gracias a sus variadas aplicaciones eléctricas, entre ellas; capacitores dieléctricos, resistores, sensores térmicos, capacitores multicapa, etc. Las características de este tipo de materiales son determinadas por su microestructura y su composición química, estas variables son determinadas por el proceso de síntesis, la calidad de materiales precursores y la adición de dopantes. El presente trabajo tiene por objetivo sinterizar soluciones solidas tipo Ba1-3XGd2XTi1-3XEu4XO3, utilizando precursores de alta pureza en las concentraciones de x igual a 0.1%, 0.15%, 0.3% y 0.6% en peso, con el fin de obtener una fase ferroeléctrica dopada con 〖Gd〗^(3+) y 〖Eu〗^(3+). Las mezclas de polvos se sinterizaron a 1300°C por 6 horas. La evolución microestructural fue caracterizada por difracción de rayos X y microscopia electrónica de barrido. Los resultados mostraron evidencias de la evolución estructural, en las cuatro composiciones, de una fase ferroeléctrica (tetragonal).
Reseña sobre el libro “La anti-productividad. Así como estamos funcionando no está funcionando”
Authors: Elizalde Rivera Brenda
Published: January 2021

En el libro “La anti-productividad. Así como estamos funcionando no está funcionando” Schwartz, Gomes y McCarthy describen como la adecuada implementación de un sistema de motivación laboral en las organizaciones figura como el aporte más innovador para obtener resultados de alto rendimiento
Identificación de problemas en el departamento automotriz en una empresa de telecomunicaciones mediante herramientas de mejora continua
Authors: Romero-Fuentes Diana A. , Mendoza Gómora César , Borja-Soto Carlos E.
Published: January 2021

Las Herramientas de Mejora Continua (HMC) se han vuelto importantes en el ámbito laboral, ya que permiten analizar situaciones actuales, identificando los principales problemas que afectan la eficiencia en las empresas. En el caso de una empresa de telecomunicaciones se implementaron las HMC en el departamento automotriz, ya que presentaba una serie de inconsistencias, que ocasionaba una serie de reclamos, baja eficiencia en el departamento y gastos mayores en los mantenimientos correctivos. Algunas herramientas que se implementaron fueron el ciclo PHVA, diagrama de Pareto y diagrama causa-efecto. Lo anterior permitió identificar el problema raíz que afecta a la empresa, el cual radica en la falta de un adecuado programa de mantenimiento.
Industria 4.0 en zonas rurales.
Authors: Gress Bautista Sergio , Pérez Castañeda Suly Sendy
Published: January 2021

¿La infraestructura tecnológica y las condiciones educativas de las zonas rurales impactan positivamente en el desarrollo de competencias digitales de la población para implementar tecnología digital en actividades productivas? Bajo esta pregunta se lleva a cabo el presente estudio, que tuvo como objetivo hacer un estudio exploratorio de las características que tiene el estado del arte en este tema, donde se identificó que el área de estudio principal es el sector el educativo y las principales variables abordadas son las condiciones educativas y el acceso a la infraestructura. La metodología empleada fue documental, a través de la revisión de 20 artículos científicos de Elsevier.