bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial mucocele and brain complications: diagnostic priorities
Authors: Sigüenza González Rebeca , Pérez Fernández Santiago , Jiménez Cuenca Isabel , Castañeda Cruz Carlos
Published: June 2019

We present the case of a male with a history of nasal polyposis underwent bilateral nasosinusal endoscopic surgery. He went to the emergency department because of having behavioral changes and left frontal headache. An emergency CT showed nasal-sinus polyposis and several nodular lesions with a characteristic “ring” enhancement and perilesional edema. These findings were compatible facial mucocele complicated with rupture of the bone wall of the left frontal sinus and frontal abscess. Urgent surgery was performed, with left frontal craniectomy and drainage of the abscesses. Mucoceles are benign slowly growing lesions which can associate important complications. The most frequent are abscesses and the invasion of neighboring structures. It is very important to remember that frontal mucoceles can cause intracranial invasion when there is an erosion of the internal osseous table.
The Towneley 'First Shepherds’ Play': Its ‘Grotesque’ Feast Revisited
Authors: Gerhardt Ernst
Published: June 2019

With few exceptions, criticism of the Towneley ‘First Shepherds’ Play’ maintains that the food consumed by the shepherds in their feast-scene must have been imaginary and that performed consumption of this imaginary food must have been mimed. This essay counters this view, arguing that the shepherds’ menu includes food commonly served at English medieval Christmas feasts, and that, given the play’s theme, the play itself was likely performed in conjunction with — or even during — the actual Christmas feast. The play offers evidence of performance practices that integrated audience food consumption with the play itself.
Philip Butterworth and Katie Normington, eds. Medieval Theatre Performance: Actors, Dancers, Automata and their Audiences. Cambridge: D. S. Brewer, 2017. Pp 296. Hardback £60.00 ISBN: 9781843844761.
Authors: Brazil Sarah
Published: June 2019

This review considers Medieval Theatre Performance: Actors, Dancers, Automata and their Audiences.
Laurence Publicover. Dramatic Geography: Romance, Intertheatricality, and Cultural Encounter in Early Modern Mediterranean Drama. Oxford: Oxford University Press, 2017. Pp. xiii, 204. Hardback £50.00. ISBN: 9780198806813.
Authors: Das Nandini
Published: June 2019

This review considers Dramatic Geography: Romance, Intertheatricality, and Cultural Encounter in Early Modern Mediterranean Drama.
Matteo A. Pangallo. Playwriting Playgoers in Shakespeare’s Theater. Philadelphia: University of Pennsylvania Press, 2017. Pp 248. Hardback USD $59.95. ISBN: 97808122494415.
Authors: Ellinghausen Laurie
Published: June 2019

This review considers Playwriting Playgoers in Shakespeare’s Theater.
Margaret Jane Kidnie, ed. A Woman Killed with Kindness, by Thomas Heywood. London: Bloomsbury, 2017. Pp xviii, 301. Paperback £14.99. ISBN: 9781904271581
Authors: Lowe Eleanor
Published: June 2019

This review considers A Woman Killed with Kindness.
Sarah Dustagheer and Gillian Woods, eds. Stage Directions and Shakespearean Theatre. London: Bloomsbury, 2018. Pp. xvi, 350. Hardback £80.00. ISBN: 9781474257473.
Authors: Thomson Leslie
Published: June 2019

This review considers Stage Directions and Shakespearean Theatre.
Фльоринка – лемківскє місце памяти
Authors: Duć-Fajfer Helena
Published: June 2019

Florynka: A Lemko Realm of MemoryThe article refers to the concept of realm of memory (les lieu de mémoire) developed and popularized by Pierre Nora. The notion of realm of memory is presented and then utilized for symptomatic reading and interpretation of the workings of memory as it develops around a topographical location. The author shows the essentialization and sacralization of names and concepts referring to the political activity of the Lemkos, such as Florynka, the Rusyn National Republic of the Lemkos and the national council. It is demonstrated that similar processes of memory are affecting names and personal traces located in the Florynka realm of memory. Furthermore, following Jan Assmann, the article distinguishes between two manners in which memory is preserved: either by means of ritual coherence, characteristic of oral tradition, or by means of textual coherence, implemented in written form. Finally, a question is posed about the goals and needs of a community built on memory, in this case of the Lemko community, namely to whom memory belongs to and whom it serves. A tentative answer to these questions indicates identity-related goals, which would be a direct and indirect continuation of certain currents of thought and action that were being developed in the years 1918‑ 1921. The entire article emphasizes the activist form of collective memory, which negotiates with established stereotypes and at the same time contributes to preserve them.
Progress on the introduction of supervisory ward manager roles since the Francis report recommendations
Authors: Regan Paul , Shillitoe-Kehoe Sarah
Published: June 2019

Recommendation 195 of the Francis report suggested that the introduction of supervisory ward managers into clinical practice could improve the quality of patient care in England. The Department of Health and NHS Commissioning Board's vision and strategy Compassion in Practice in 2012 restated the recommendation in action area four, with trusts required to publish progress. With the aim of identifying whether the lessons of the Francis report had been learned, a review of the published literature since 2012 retrieved only five articles on the subject, with many anecdotal accounts of its implementation in local trusts. The three subsequent update reports of Compassion in Practice stopped backing recommendation 195 and promoted black and ethnic minority leadership, a laudable initiative, but not a recommendation of the Francis report. The authors suggest recommendation 195 and Compassion in Practice's original action area four should be promoted again to ensure public safety and address the notion that lessons learned are less likely to be repeated.
Prescribing in end-of-life care
Authors: Armstrong Amanda
Published: June 2019

End-of-life care aims to support a person in the last stages of a life-limiting condition to live as well as possible until they die. Prescribing at the end-of-life presents many challenges. Advanced care planning can be carried out so that health professionals are aware and supportive of the patient's and their family's wishes. This article discusses the care and management of patients as they receive care at the end of their life as well as any anticipatory medication that may be needed.
My experience as a non-medical prescriber from 2012–2019: are we still facing the same problems?
Authors: Hubbard Kevin
Published: June 2019

This article is a reflective account of one non-medical prescriber and discusses everyday prescribing issues that have affected him since qualifying as a non-medical prescriber and reflects on the influences on prescribing practice.
What does an inadequate practice look like?
Authors: Frankova Helena
Published: June 2019

Knowing some of the common ways in which GP practices have been found to be inadequate can help develop understanding of how to improve. Helena Frankova summarises some of the information the CQC provides on the matter
Testing of Various Monochromatic LED Lights Used in Supplemental Irradiation of Lettuce in Modern Urban Rooftop Polytunnels
Authors: Chang Chung-Liang , Chang Kuang-Pi , Fu Wei-Lun
Published: June 2019

Abstract. Urban farming could provide both vegetable growers and urban dwellers with more direct access to various fresh vegetables. Nevertheless, certain challenging problems associated with urban farming, including a lack of cultivation space and the effects of urban heat islands, must still be solved. Relatedly, a grower must, in some cases, also know how to utilize various forms of technology, such as lighting systems, as well as factors such as water availability. In this study, an original rooftop polytunnel design for lettuce ( cv. Lollo Rosso) cultivation equipped with a hydroponic system and light emitting diodes (LEDs) is proposed. Various monochromatic lights were also tested for their effects on different quality parameters of lettuce. Specifically, supplemental red (655 nm), blue (445 nm), green (520 nm), and ultraviolet (380 nm) LED lights were used at night to apply photon fluxes of 150, 150, 150, and 20 µmol.m-2.s-1, respectively. The resulting effects of these different colored LEDs on the pigment concentration and growth response of the lettuce grown inside the roof polytunnel were then investigated. The experiment was then repeated several times with different environmental parameters in order to compare the effects of the different light wavelengths under higher temperatures and higher natural irradiation conditions.The results indicated that supplemental red or blue light at night could be strategically employed to maintain low nitrate levels and enhance the nutritional value and growth of lettuce grown in roof polytunnels. Keywords: Light emitting-diodes, LEDs, Hydroponic, Red lettuce, Rooftop polytunnel, Urban agriculture.
Moisture-dependent Physical and Thermal Properties of Sericea Lespedeza Seeds
Authors: Mahapatra Ajit K , Ekefre Daniel E , Degala Hema L , Punnuri Somashekhar M , Terrill Thomas H
Published: June 2019

Abstract. The bioactivity of Sericea lespedeza (SL) condensed tannins, including suppression of gastrointestinal nematodes, has contributed to a surge in interest of use of this plant in livestock production systems worldwide. Physical and thermal properties of SL seeds (AU Grazer™ and Serala cultivars) were determined as a function of moisture content for a moisture range from 8.57% to 26.53%, wet basis. The length, width, arithmetic mean diameter, geometric mean diameter, surface area, volume, and 1000 seed mass of both the seeds increased as the moisture content increased. Bulk density and unit density decreased as the moisture content increased. The sphericity of SL seeds decreased with increasing moisture content. Serala seeds were characterized by a higher aspect ratio than AU Grazer™. The angle of repose of SL seeds increased, while the compressibility index decreased in the moisture range. For color, the L* values of SL seeds decreased while the a* values increased with the increase in moisture content. A decrease in the b* values was insignificant. The thermal conductivity and specific heat of SL seeds decreased, whereas, thermal diffusivity increased as the moisture content of SL seeds increased. Serala seeds were characterized by higher values of thermal conductivity and volumetric specific heat than AU Grazer™. Keywords: Engineering properties, Moisture content, Physical properties, Seeds, Thermal properties.
Species composition and role of exotic invasive pioneers in vegetation establishment on Mount Merapi Volcanic Deposits in Java, Indonesia
Authors: SUTOMO SUTOMO
Published: June 2019

Sutomo. 2018. Species composition and role of exotic invasive pioneers in vegetation establishment on Mount Merapi Volcanic Deposits in Java, Indonesia. Trop Drylands 2: 59-64. The volcanic deposits found in Mt Merapi are relatively new in terms of years since last known eruption. The objective of this study was to make use of the chronosequence method to describe changes in the species composition patterns in vegetation establishment, and to conduct observations on whether pioneer species, especially exotic and perhaps also invasive species, are decreasing or increasing species diversity in the succession. Results showed that the younger deposits were dominated by Athyrium macrocarpum, Polygonum chinense, Paspalum conjugatum and Cyperus flavidus. The older deposits were dominated by Anaphalis javanica, Imperata cylindrica, Polytrias amaura and Eupatorium riparium. Invasive (native and exotic) pioneer species such as Imperata cylindrica, Anaphalis javanica, Calliandra callothyrsus, Polyosma ilicifolia, and Eupatorium riparium showed positive correlation with species diversity. It is important to understand the role of non-native, invasive alien species in the recovery process. Early recovery generally depends on these species to boost the succession, but in the longer term invasive species may affect the successional trajectory.
Maize bioengineering with c-repeat binding factor 1 (CBF1) as a technique for desiccation toleration
Authors: KURIA ERIC KIMANI , MACHUKA JESSE , RUNO STEVEN
Published: June 2019

Abstract. Kuria EK, Machuka J, Runo S. 2019. Maize bioengineering with c-repeat binding factor 1 (CBF1) as a technique for desiccation toleration. Trop Drylands 3: 1-10. Africa is a desiccation inclined continent leading to riskful cultivation particularly to small-scale cultivators who rely on rain-fed agriculture. Maize is the most widely cultivated main crop in Africa with more than 300 million people relying on it as their principal dietdiet fount. Desiccation causes crop fiasco, famine and poverty and this is being aggravated by climate change. There is therefore an obligation to flourish desiccation tolerablish maize. Traditional propagation techniques have been implementedcarried out in the establishment of desiccation tolerablish plants but are restricted by their requirement for labour, time and space, suggesting a limited genetic diversity within genotypes and transition of undesired traits along with the wanted ones. These restrictions are handled by utilizing these techniques along with bioengineering. Desiccation triggers a range of physiological and biochemical reactions in plants at cellular and molecular levels. These reactions include initiation of genes with several usefulness. Plant alteration for expanded desiccation toleration is generally based on the administration of either transcription and/or signaling factors or genes that directly secure plant cells contra water shortage. C-repeat binding factor (CBF) is a transcriptional factor that interacts with the desiccation responsive element (DRE), a cis-acting promoter element that governs gene expression in reaction to desiccation, brine and freezing stress. Over expression of these transcription factors, escalates stress toleration to freezing, desiccation and high brininess. In this study, three maize inbred lines and one hybrid were altered with CBF1 gene and appointed with mannose utilizing the Phosphomannose isomerase (PMI) gene. Genetic alteration was conducted through Agrobacterium tumefaciens and PCR was utilized to ascertain altered plants. Alteration frequency, alteration effectiveness and regeneration effectiveness were equated among the distinct genotypes altered. There were no remarkable dissimilarities in alteration frequency among the four maize genotypes. CML216 had the highest alteration effectiveness and regeneration effectiveness followed by A188. No alleged transgenic plants were regenerated from TL27 and A188×TL18 under the circumstances implemented on acount of their low regenerability. Further molecular analysis and desiccation stress tentatives on the expanded transgenic maize are significant prior to commercial release. Availability of desiccation tolerablish maize would bear a considerable positive collision contra famine particularly in Africa.
CISTERNA DE POLIETILENO X CISTERNA DE PLACA: DO COMBATE À SECA A CONVIVÊNCIA COM O SEMIÁRIDO.
Authors: Santos Kamilla Ferreira
Published: June 2019

O artigo aborda duas políticas públicas de acesso à agua para consumo humano e suas implicações socioeconômicas. Ambas tem a mesma finalidade de captar e armazenar água da chuva para as famílias residentes da zona rural do semiárido baiano, no entanto, a gênese e a implementação das políticas públicas diferem, pois, a cisterna de polietileno pode ser considerada como uma tecnologia tradicional voltada para a concepção do combate à seca, enquanto a cisterna de placa, idealizada pelas comunidades rurais e adotada movimentos sociais, que originou o Programa Um Milhão de Cisternas (P1MC) gerenciado pela Articulação do Semiárido Brasileiro (ASA), é uma tecnologia social. Os projetos executados em parceria entre a ASA e o Estado surgiram a partir de processos de mobilização e organização social, de articulação política dos/as agricultores/as familiares, das comunidades rurais, e, principalmente, dos Movimentos Sociais numa releitura do Semiárido, ou seja, da adoção da ideia de convivência com o semiárido. Portanto, este artigo propõe avaliaro surgimento e execução dessas políticas abordando a transformação espacial que resulta em novas territorialidades.
DINÂMICA INDUSTRIAL E FORMAÇÃO DA VILA DE HUMILDES, EM FEIRA DE SANTANA/BA
Authors: Anjos Vanessa Conceição dos
Published: June 2019

Este artigo busca compreender a formação da vila Humildes e as mudanças que ocorreram em função do desenvolvimento da atividade industrial nas suas imediações, com base na leitura sobre processos sociais, econômicos e ações políticas. Com o desenvolvimento da atividade industrial, do campo o homem foi atraído para novas relações de trabalho, iniciadas com o aparecimento de algumas indústrias instaladas às margens da BR 101 e da BR 324, o que modificou a dinâmica espacial do distrito. Humildes está vinculado a Feira de Santana e compreende parte de seu recorte urbano-industrial. Sua urbanização pretérita foi marcada pela atuação da Igreja, pelos interesses dos grupos dominantes e pela dinâmica rural, até o início do século XX. No contexto da Segunda Guerra Mundial, somou-se a isso uma incipiente atividade manufatureira. Todavia, tal lógica, em parte, foi modificada. A implantação do polo industrial influenciou o crescimento econômico de Humildes e decorreu em transformações socioespaciais, tais quais alterações na dinâmica demográfica e a expansão da vila, mudanças que atestam o aprofundamento das diferenças entre o campo e a sede distrital. Essa expansão que ocorreu na vila, nos últimos anos, foi também decorrente do êxodo rural e da fixação de pessoas na área urbana, fatores outrossim relacionados à industrialização.
Modernism and reforms in contemporary Ghanaian art education
Authors: Bodjawah Edwin K. , Nortey Samuel , Kissiedu Kwaku Boafo
Published: June 2019

This study addresses the issues of art, art education and globalization and its implications for reforms in art education in Ghana. It examines the hold colonial education has had over art and its education in Ghana. In Ghana, there is scepticism among artists and art educators who appear to be at ease with western traditional formats and media, with relics of colonial arts education epitomized by ‘hand and eye’ training by rote. The study contextualizes art education and incorporates historical, regional, and global perspectives to dissect the intersections between Ghanaian art education and other contexts. Discussions revealed the need to design a curriculum that affords students and teachers a better understanding of the colonial education system, its objectives and implications, highlighting the need to embrace and utilize a wide range of media, formats and criticality of content which ought to penetrate teaching, learning and making art at all levels.
Utilizing contemporary art forms in the primary after-school: An artist-teacher-researcher perspective
Authors: Blagoeva Nadezda
Published: June 2019

This article discusses the application of the integrative approach to teaching art to primary-school students in after-school activities from the teacher’s perspective. The described case study is based on the theoretical assumption that contemporary art forms are integrative in their nature and are therefore a suitable tool for knowledge integration because they have potential to make the relations between different objects and phenomena more visible. The research questions, addressed in the article, are related to the role of the artist-teacher-researcher in the teaching-learning process in the visual arts classroom and the pedagogical outcomes of applying artistic action research to teaching visual arts through contemporary art forms. An action research was conducted by the artist-teacher-researcher in an international primary after-school environment, and semiotic analysis of the collected verbal and visual data was performed to demonstrate how conceptualization of artistic ideas leads to knowledge construction.
Creative convergent culture: Practice to profession
Authors: Rosner Terre Layng
Published: June 2019

Two aims stem from the neopragmatist perspective employed in this research. The first is identifying and defining a creative convergent culture embedded in contemporary professions blossoming from visual communication technological improvements. The second is the challenges faced by creative educators trying to keep pace with this culture populated by technologically, organically educated students and incorporating both into their curricular and higher education structures. By collecting and interpreting data gleaned from creative professional interviews and a nationally (United States) distributed, post-secondary, creative educator survey, I was able to unravel the ideologies in disparate but intimately related academic fields, such as graphic design and mass communication. I found that the meta-disciplinary space of media arts (MA) encompasses student learning to navigate and produce informed aesthetics. Consequently, graduates who enter the creative professions are most successful if they are able to research problems, competently write and ethically design.
In the flow of art making: Seniors improve their well-being
Authors: Mugambi Lucy , Lin Ching-Chiu
Published: June 2019

This visual essay documents activities conducted during a workshop in an independent living facility in Vancouver, British Columbia. The workshop provided seniors with an opportunity to create sock monkeys as an avenue to engage with various materials in space and time. We illuminate the impact that the visual art making activity had among seniors in this retirement centre. We observe that completion is not an end of learning, instead it is a state of continuing change that invites the seniors to explore possibilities.
Discentes com Deficiência Visual: Estudo de Caso com Cálculo Diferencial e Integral Adaptado / Students with Visual Disabilities: A Case Study with Adaptive Differential and Integrated Calculation
Authors: Brandão Jorge Carvalho , Silva Miguel Ângelo Da , Magalhães Elisângela Bezerra
Published: June 2019

O presente trabalho mostra as estratégias utilizadas em uma disciplina de Fundamentos de Cálculo para Engenharias, a qual é equivalente ao Cálculo Diferencial e Integral com uma variável, contemplando em uma das disciplinas duas discentes com baixa visão. Como metodologia, usou-se a eclética, isto é, dependendo do conteúdo a ser abordado e das especificidades de cada discente (com necessidades educativas especiais – NEE) em determinadas situações iniciava-se apresentação de conteúdos por meio de problemas, analisando erros, intermediado pelo método Van Hiele. As avaliações passaram a ser contínuas e continuadas e o docente precisou reaprender a ensinar. Uma psicopedagoga auxiliou nas intervenções com discentes, fazendo leitura facial destes e analisando gestos e expressões e um colega matemático auxiliava ações usando WhatsApp. Como conclusões parciais, a mais significativa foi que demais discentes sem aparentemente ter NEE, e muitos sendo experientes (tendo pelo menos uma reprovação na referida disciplina), conseguiram entender a essência dos conceitos de derivação e integração.
Material approaches to exploring the borders of paratext
Authors: Ruokkeinen Sirkku Inkeri , Liira Aino
Published: June 2019

This article examines the relationship of material text (text of the document) and paratext in light of fourteenth to sixteenth century evidence. Despite the wealth of interest generated by paratexts and paratextuality in recent years, especially in the fields of literary studies, book history, and translation studies, theoretical approaches to paratexts and paratextuality remain scarce. The paratextual status of an element is typically determined by its function, in combination with its distance from the material text: elements within the codex which do not share space with the text are part of the paratext. Less studied, however, is the gray area of elements which are located within the codex and share the space with the text. We examine this border between text and paratext through an analysis of late medieval and early modern initials, typeface, script and notes. While the form and function of the element are a good starting point, we propose that gauging the optionality of the element, in relation to the abstract text of the work and the material text of the document, is a better indicator of its paratextual status. Optionality should therefore be taken into consideration as evidence of a type of contemporary paratextual understanding.
How To Think About EEBO
Authors: Gavin Michael
Published: June 2019

Provides a revisionist history of the history of Early English Books Online and the TEI.
Magnets and school turnarounds: Revisiting policies for promoting equitable, diverse schools
Authors: Ayscue Jennifer B. , Siegel-Hawley Genevieve
Published: June 2019

This case study examines how magnet school and school turnaround processes can work together to promote desegregation and improvement. Based on cross-case analysis of three magnet schools undergoing turnarounds, this study draws on data from the 2010 federal Magnet Schools Assistance Program grant and qualitative fieldwork through observations, interviews, and focus groups. In academically struggling schools with high concentrations of students of color and low-income students, successful magnet turnarounds involve changes across many aspects of the schools. While the local context is essential for shaping the magnet turnaround process, these three schools reveal common ways in which participants viewed their schools as successful turnarounds, the elements that supported success, and the challenges that magnets undergoing a turnaround are likely to face. Participants’ perceptions of a successful turnaround were based on increasing family interest and increasing racial and economic diversity, as well as improvements in curriculum and instruction, school culture, and academic achievement. This study helps broaden our definition of a school turnaround beyond higher test scores and reminds us of the origins of the concept, which revolved around desegregation. Lessons from the sites suggest that rather than closing underperforming or under-enrolled schools, districts should consider magnet schools as a turnaround approach.
Sozial-ökologische Forschung international: Forschung für nachhaltige Gesellschaften als globale Aufgabe
Authors: Thorn Michaela
Published: June 2019

Der Wandel hin zu einer nachhaltigen Lebens- und Wirtschaftsweise erfordert globales Handeln. Das Bundesministerium für Bildung und Forschung (BMBF) beteiligt sich deshalb an europäischen und internationalen Initiativen und Programmen und stärkt die internationale Vernetzung
und Anschlussfähigkeit im Förderschwerpunkt Sozial-ökologische Forschung (SÖF). Der Beitrag gibt einen Einblick, wie diese bilateralen und multilateralen Forschungsprogramme funktionieren, welche Themen im Vordergrund stehen und welche Chancen sie der Wissenschaft
bieten.
Manajemen Anestesi Operasi Total Tiroidektomi Menggunakan Target Controlled Infusion (TCI) Propofol dan Blok Pleksus Servikal Superfisial pada Pasien Karsinoma Tiroid dengan Metastasis Paru
Authors: Fachrian Dedy , Istanto Widya , Harahap Mohamad Sofyan
Published: June 2019

Latar Belakang : Keganasan pada tiroid jarang terjadi, namun kanker tiroid merupakan keganasan endokrin yang paling sering terjadi. Kanker paru-paru muncul ketika terjadi mutasi genetik pada sel normal dalam paru-paru yang dapatbermetastasis ke seluruh tubuh atau juga dapat diakibatkan metastasis dari tempat lain, seperti payudara, tiroid, atau usus besar. Keganasan tiroid menimbulkan beberapa tantangan dalam tindakan anestesi yaitu kemungkinan kesulitan dalam pengelolaan jalan nafas dan kemungkinan terjadinya badai tiroid.Adanya massa pada paru menjadikan pengelolaan anestesi pada pasien ini menjadi lebih kompleks.Kasus : Wanita usia 36 tahun dengan karsinoma tiroid metastasis paru direncanakan tindakan total tiroidektomi. Dari pemeriksaan pra operasi didapatkan keluhan benjolan pada leher kanan sebesar bola bekel. Pasien berada dalam Kondisi eutiroid secara klinis dan laboratoris. Dari foto dada didapatkan massa dengan opasitas bentuk bulat, batas relatif tegas dengan kalsifikasi di tepinya pada hemithoraks kiri.Manajemen anestesi diawali dengan midazolam 2 mg sebagai premedikasi dilanjutkan dengan TCI Propofol target plasma 6 mcg/ml, Fentanyl 100 mcg dan Rocuronium 30 mg untuk induksi kemudian pasien diintubasi tanpa gejolak hemodinamik. Setelah itu, dilakukan blok pleksus servikal superfisial dengan bupivacaine konsentrasi 0,25% volume 10 cc di setiap sisi leher.Untukrumatantarget plasma TCI diturunkan menjadi 4 mcg/ml dan rocuronium intermiten.Ventilator dengan setting Pressure Cycle untuk menghindari hiperinflasi paru dengan O2 dan Air dengan perbandingan 1:1 tanpa menggunakan N2O dan Agen Anestesi Volatile. Operasi berlangsung selama 4 jam dengan hemodinamik stabil.Pada akhir operasi TCI Propofol diturunkan secara bertahap dan pasien diekstubasi setelah pernapasan spontan adekuat kemudian pasien kembali ke ruang perawatan.Ringkasan : Penggunaan kombinasi anestesi umum dengan intubasi menggunakan TCI Propofol dan blok servikalis superfisial dapat menjadi teknik anestesi pilihan pada kasus struma disertai tumor paru. Analgesi melalui blok pleksus servikal superfisial terbukti cukup memuaskan selama operasi.
Manajemen Anestesi pada bayi prematur dengan asosiasi VACTERL
Authors: Wibowo Primartanto , Yahya Corry Quando
Published: June 2019

Latar Belakang : Sindrom VACTERL merupakan kelainan kongenital yang melibatkan malformasi vertebra, atresia anal, anomali kardiovaskular, malformasi ginjal dan kelainan struktur pada tungkai. Manajemen anestesi pada pasien tersebut memiliki risiko mortalitas tinggi karena adanya anomali jantung dan ginjal yang dapat mempengaruhi status hemodinamik.Kasus : Dilaporkan penanganan anestesi pada bayi prematur berusia 28 minggu berat 1,795gr menjalani operasi kolonostomi atresia ani.  Frekuensi nadi 157x/menit, frekuensi napas 40x/menit, terdapat ronki pada kedua lapang paru dan murmur sistolik. Saturasi oksigen pasien 98% menggunakan nasal continuous positive airway pressure (NCPAP) fraksi inspirasi oksigen 40%.Induksi menggunakan 0,2 mg midazolam, 2 mg ketamin, 2 mcg FentanylR . Rapid sequence intubation diberikan ventilasi dengan oksigen 100% menggunakan sirkuit Jackson-Rees frekuensi pernapasan 50-60 kali/menit. Rumatan anestesi dilakukan menggunakan oksigen 100% 4 liter per menit dan 1 volume percent isofluran. Setelah penggunaan isofluran, pasien mengalami desaturasi hingga 92% dan bradikardia hingga 125 kali per menit. Isofluran dihentikan diganti denganketamin. Setelah hemodinamik stabil, insisi dimulai. Selama prosedur operasi, denyut jantung berkisar di 125-155 kali per menit dengan saturasi oksigen 98-100%. Lama operasi 95 menit. Post operasi dirawat di NICU. Pasien meninggal pada hari ke-12 perawatan pasca operasi di NICU.Ringkasan : Tata laksana anestesi pada pasien VACTERL terutama di fokuskan pada kelainan kardiovaskuler yang ada  dengan memperhatikan keseimbangan antara SVR dan PVR.
Peran Deksmedetomidin Sebagai Protektor Otak Yang Dinilai Dengan Kadar Il-6 Dan Cox-2 Pada Tikus Model Cedera Otak Traumatika
Authors: Harahap Mohammad Sofyan , Wargahadibrata A. Himendra , Bisri Tatang , Rehatta Nancy Margarita
Published: June 2019

Latar belakang: Proteksi otak sangat penting dalam penanganan cedera kepala sehari hari, agar tidak terjadi cedera sekunder. Proteksi otak terdiri dari metode dasar dan farmakologik yaitu dengan menggunakan obar-obatan. Sampai saat ini belum ada hasil proteksi otak yang konsisten dari berbagai metode farmakologi, sehingga masih terus menjadi bahan kajian.Tujuan :  Penelitian ini untuk mengetahui peran deksmedetomidin sebagai protektor otak yang dinilai dengan kadar IL-6 dan COX-2.Metode : Penelitian eksperimental di laboratorium dengan rancangan acak terkontrol, dilakukan pada 24 tikus wistar jantan, usia sekitar 3 bulan, kondisi aktif, yang mendapat perlakuan cedera kepala buatan derajat sedang. Setelah mendapat persetujuan komite etik, hewan coba dibagi dalam 3 kelompok secara random yaitu kelompok K1(NaCl) (n=8), kelompok P (deksmedetomidin) (n=8) dan kelompok K2 (kontrol) (n=8), kemudian dilakukan anestesi dengan Ketamin 80 mg/kgBB ip dan diambil sampel darah, selanjutnya kelompok K1 dan kelompok P dilakukan kraniektomi dan diberi trauma diikuti dengan pemberian deksmedetomidin 60 µgr/kgBB ip untuk kelompok P dan NaCl dengan volume dan cara sama untuk kelompok K1. Kelompok K2 tidak dilakukan cedera dan tidak mendapat terapi apapun. Pemberian deksmedetomidin atau NaCl diulang pada jam ke-3, ke-12 dan ke-24, pengambilan sampel darah berikutnya untuk pemeriksaan dengan metode ELISA dilakukan pada jam  ke-12 dan jam ke-24. Data yang diperoleh kemudian dianalisis dengan uji ANOVA dan Friedman serta uji korelasi Spearman.Hasil :  Kadar IL-6 pada kelompok K1 meningkat secara bermakna dibanding kelompok P, pada 12 jam dan 24 jam pasca trauma. (160±15,57) vs (140,5±17,65) dan (172,6±19,07) vs (124,2±23,6). Sedangkan Kadar COX-2 pada kelompok K1 meningkat secara bermakna dibanding kelompok P pada 12 jam dan 24 jam pasca trauma. (1491,41±341) vs (803,62±215,73) dan (1048,45±170,43) vs (588,93±198,57). Kadar COX-2 menunjukkan proses inflamasi yang terjadi.  Analisis Spearman’s menunjukkan adanya korelasi positif antara IL-6 dan COX-2 (ρ=0,71), yang terjadi pada 12 jam pasca trauma pada kelompok yang mendapat NaCl.Simpulan:  Deksmedetomidin mempunyai peran sebagai protektor otak dengan menurunkan kadar IL-6 dan COX-2. Ada korelasi positif pada perubahan kadar antara  IL-6 dan COX-2 setelah trauma.
Perbandingan Efektifitas Antara Tramadol Dan Meperidin Untuk Pencegahan Menggigil Pasca Anestesi Umum
Authors: Sasongko Himawan
Published: June 2019

Latar belakang : Menggigil pasca anestesi merupakan komplikasi yang cukup sering terjadi. Menggigil menimbulkan keadaan yang tidak nyaman dan berbagai resiko terutama bagi pasien dengan kondisi fisik yang tidak optimal, pasien dengan penyakit paru obstruktif menahun yang berat, atau pasien dengan gangguan kerja pada jantung. Karena itu menggigil harus segera dicegah atau diatasi. Sampai saat ini obat yang paling sering digunakan adalah meperidin.Tujuan : Membuktikan bahwa pemberian tramadol 2 mg/kgBB intra vena menjelang akhir operasi lebih efektif daripada meperidin 0,5 mg/kgBB intra vena menjelang akhir operasi untuk mencegah kejadian menggigil pasca anestesi umum.Metode : Merupakan penelitian eksperimental dengan desain “randomized post test only controlled group” pada 72 pasien usia 16 – 60 tahun, status fisik ASA I – II, berat badan normal yang menjalani operasi dengan anestesia umum. Pasien dipuasakan 6 jam dan diberikan premedikasi midazolam 0,07 mg/kgBB dan fentanil 1,5 µg/kgBB intra vena 2 menit sebelum induksi. Tekanan darah diastolik, tekanan darah sistolik, tekanan arteri rerata, laju jantung dan SaO2 diukur 5 menit sebelum induksi. Induksi anestesi dilakukan dengan thiopental 5 mg/kgBB. Setelah reflek bulu mata hilang, diberikan atrakurium besilat 0,5 mg/kgBB dan dilakukan intubasi endotrakea. Rumatan anestesi menggunakan isofluran 0,8 – 1,7 vol%, N2O 70% dan O2 30%. Atrakurium intermiten diberikan dengan dosis 0,2 mg/kgBB. Temperatur esofagus diukur segera setelah induksi. Lama operasi dibatasi antara 2 – 3 jam. Pada akhir operasi, obat inhalasi dihentikan. Setelah nafas spontan adekuat, reflek laringeal positip dilakukan randomisasi. Pasien dibagi menjadi tiga kelompok yaitu kelompok T (mendapat tramadol 2 mg/kgBB), kelompok M (mendapat meperidin 0,5 mg/kgBB) dan kelompok K (mendapat NaCl 0,9%).  Ekstubasi dilakukan 5 menit setelah perlakuan. Tekanan darah diastolik, sistolik, tekanan arteri rerata, laju jantung dan SaO2 diukur dan dicatat segera setelah ekstubasi dan tiap lima menit selama 30 menit. Suhu tubuh diukur segera dan 15 menit setelah ekstubasi. Pasca ekstubasi pasien diberi oksigen 6L/menit. Uji statistik menggunakan One-way ANOVA, dengan derajat kemaknaan  p < 0,05.Hasil : Data dasar, data karakteristik klinis sebelum induksi, perbandingan pengukuran tekanan darah diastolik, tekanan darah sistolik, tekanan arteri rerata, laju jantung dan SaO2 berbeda tidak bermakna (p>0,05) kecuali laju jantung 30 menit pasca ekstubasi antara kelompok tramadol dan kontrol berbeda bermakna (p<0,05). Kejadian dan derajat menggigil kelompok tramadol dan meperidin berbeda tidak bermakna (p>0,05). Perbedaan suhu tubuh kelompok tramadol dan meperidin 15 menit pasca ekstubasi dan efek samping obat yang timbul berbeda bermakna (p<0,05).Kesimpulan : Tramadol dan meperidin mempunyai efektifitas yang sama dalam mencegah menggigil pasca anestesi umum, tetapi tramadol mempunyai efek samping obat yang lebih rendah dibandingkan meperidin.
Dasar-Dasar Perancangan Alat Pemanggil Ikan
Authors: Sugiyanto Sugiyanto , Setiawan Joga Dharma , Nugraha Faryan , Yuwana Rizkia Wira
Published: June 2019

Alat pemanggil ikan merupakan suatu alat yang menggunakan prinsip akustik bawah air. Akustik merupakan ilmu yang membahas tentang gelombang suara dan perambatannya dalam suatu medium. Jadi, Alat pemanggil ikan ini akan menghasilkan suatu gelombang suara yang akan merambat pada medium air. Perambatan gelombang suara di dalam air dipengaruhi banyak faktor, diantaranya suhu, salinitas dan kedalaman. Penelitian ini bertujuan untuk mendapatkan suatu dasar perancangan alat pemanggil ikan menggunakan metode gelombang suara. Permasalahan utama pada perancangan alat pemanggil ikan adalah terjadinya penyerapan air laut terhadap gelombang akustik sehingga memperpendek jarak jangkau pemanggilan. Metode yang digunakan pada penelitian adalah dengan membuat alat yang dapat menghasilkan suatu gelombang suara dengan frekuensi yang dapat diatur sesuai dengan frekuensi ikan yang dipakai sebagai uji coba pemanggilan, selanjutnya dilakukan pengujian pemanggilan ikan di laboratorium. Dengan mengamati perubahan prilaku ikan dapat dibuat suatu kesimpulan apakah ikan tersebut terpengaruh oleh frekuensi suara apa tidak. Berdasarkan hasil perancangan diperoleh alat pemanggil ikan ini menggunakan lampu LED dan ICL8038 lalu diperkuat dengan OP-AMP 741untuk mengeluarkan frekuensi yang diinginkan. Selanjutnya alat tersebut diuji terhadap ikan kakap merah yang memiliki frekuensi suara 1000 Hz, hasilnya menunjukkan bahwa ikan kakap merah merespon pemanggilan tersebut, hal ini ditunjukkan terjadinya perubahan perilaku ikan yang bergerak memutari alat tersebut, sebanyak 70 kali putaran dalam kurun waktu 1 jam pengujian.
Pengaruh Waktu Tahan Proses Pack Carburizing Baja AISI 3115 dengan Menggunakan Calcium Carbonat dan Batubara Sub Bituminous dan Mendapatkan Perlakuan Panas Quenching Media Pendingin Air
Authors: Satria Dhimas , Setiawan Ipick , Rosyadi Imron , Listijorini Erny , Haryadi Haryadi , Lusiani Rina , Ariesmunandar Ariesmunandar
Published: June 2019

Perkembangan material di dunia industri semakin menuntut untuk rekayasa terhadap material tersebut sehingga dihasilkan material yang kuat dan ulet sesuai dengan kebutuhan. Salah satu metode untuk meningkatkan sifat fisik dari material adalah dengan carburizing atau proses karburisasi. Metode penelitian yang digunakan dalam penelitian ini adalah proses karburisasi yang diikuti dengan perlakuan pendinginan cepat (quenching) untuk meningkatkan kekerasannya sehingga permukaan logam menjadi lebih tahan aus, kemudian menambahkan energizer atau bahan pengaktif kalsium karbonat dan batu bara sub bituminous yang akan mempercepat terbentuknya gas CO rendah. Penelitian ini bertujuan mencari solusi perlakuan panas yang baik pada baja AISI 3115 maka dilakukan perlakuan panas (heat treatment) pada variasi suhu 750°C, 850°C, 950°C. Disusul dengan pendinginan cepat menggunakan cairan berupa air dalam suatu wadah, yang diharapkan dapat meningkatkan kekerasan baja AISI 3115. Hasil penelitian adalah proses karburasi yang diikuti proses perlakuan panas dan pendinginan cepat, serta penambahan bahan pengaktif kalsium karbonat dan batubara sub bituminous mempunyai pengaruh untuk meningkatkan tingkat kekerasan pada baja karbon rendah AISI 3115. Semakin tinggi temperatur pada proses heat treatment maka kekerasan semakin meningkat dan nilai tingkat karbon juga ikut meningkat berdasarkan parameter suhu yang tinggi, dikarenakan peningkatan nilai karbon pada baja menggunakan karbon berupa batubara subituminus dengan pengikat berupa calsium karbonat. Fungsi dari calsium karbonat juga sebagai media untuk mempercepat proses karburasi. Pengaruh temperatur terbaik terdapat pada suhu 950°C. Pada penelitian ini didapatkan nilai kekerasan tertinggi sebesar 38,14. dan memiliki laju korosi terlambat dengan nilai 2,86 mpy dan foto struktur mikro terbaik terdapat pada suhu 850°C dikarenakan ferrit yang bewarna terang pada baja menandakan bahwa baja bersifat tidak keras, sedangkan pearlit yang bewarna gelap bersifat keras karena titik hitam lebih banyak dibandingkan titik putih maka nilai kekerasan terbaik di dapat pada suhu 850°C.
Helicobacter Pylori Eradication with Beta Carotene, Ascorbic Acid and Allicin
Authors: Koçkar Cem , Öztürk Mustafa , Bavbek Nüket
Published: June 2019

In this study,in vivoeffectiveness of ascorbic acid (AA), beta carotene (BC) and allicin in HP eradication were evaluated. 210 patients who are HP positive in biopsy were involved in this study. The patients randomised to seven treatment groups (each group consisting of 30 patients). The first group was given standard eradication treatment (lansaprasol 30 mg bid, clarithromycin 500 mg bid, amoxicillin 1 g bid for 14 days). Second group received AA 1000 mg/day in addition to the standard treatment. Third group received only AA 1000 mg/day for 14 days. Fourth group was treated with standard regiment plus 120 mg/day BC. Fifth group was given only BC 120 mg/day for 14 days. Sixth group was given standard regiment and allicin 4200 μg/day. Seventh group received only Allicin 1200 μg/day for 14 days. The eradication was achieved in 20 (66.6 %) in group I, 15 (50 %) in group II, 3 (10 %) in group III, 15 (50 %) in group IV, 0 (0 %) in group V, 27 (90 %) in group VI and 7 (23.3 %) in group VII. Allicin seemed to be potentially effective agent for HP eradication but ascorbic acid, beta caroten was found to be ineffective.
Small Bowel Permeability in Diagnosis of Celiac Disease and Monitoring of Compliance of a Gluten-Free Diet (Gut Permeability in Celiac Disease)
Authors: Kohout Pavel
Published: June 2019

Background & Aim: Celiac disease is an autoimmune disease with the damage of the intestinal barrier. The aim of study was to measure gut permeability in patients with untreated celiac disease and during treatment with a gluten free diet. Methods: 30 patients with celiac disease before and during treatment with gluten-free diet were investigated, 30 patients without organic damage of the gastrointestinal tract served as control. Small bowel permeability was measured using lactulose/mannitol and lactulose/D-xylose ratios. The saccharides were examined in the 5 hours collected urine using capillary gas chromatography. Results: Small bowel permeability (indices lactulose/mannitol and/or lactulose/xylose) increased significantly in patients with untreated celiac disease. 23 patients were followed up before and during treatment with a gluten-free diet 2-6 months after beginning of this treatment and small bowel permeability (measured as indices lactulose/ mannitol and/or lactulose/xylose) significantly decreased. Conclusion: Small bowel permeability test is a non-invasive test suitable for the diagnosis of celiac disease and monitoring of compliance to a gluten-free diet in these patients.
Importance of the Anorectal Manometry in Chronic Anal Fissure
Authors: Šimkovič Dušan , Šmejkal Karel , Široký Milan , Hladík Pavel , Pospíšil Ivo
Published: June 2019

This publication presents the results of postoperative manometric investigations of 77 patients with anal fissure treated within the time span 1985-1997 by lateral sphincterotomy (LS). Results of manometric investigations are compared with digital anal examinations and subjective complaints of patients. Digital anal examination correlated with manometry results in 52 cases (68%). The correspondence between these two results was proved in 48 cases when normal finding was present. An increased sphincter tonus was found in 3 patients, all of them having the anal fissure recurrences. A marked sphincters` insufficiency, which had been manifested by stool and gas incontinence was found in one case. When searching for the reason of this complication we found out that this operation procedure had been performed by an unexperienced team of surgeons. In 25 cases (32%) the digital anal assessment and manometric measurement were different. Nevertheless, the clinical symptoms in this group of patients were rather poor. To conclude we may state that manometry provides important data for preoperative evaluation of anal sphincter function and should be performed prior to lateral sphincterotomy operation at least in women.
Wolfram Syndrome in a Family with Variable Expression
Authors: Kadayifci Abdurrahman , Kepekci Yalcin , Coskun Yavuz , Huang Ying
Published: June 2019

Wolfram syndrome is a rare neurodegenerative disorder with autosomal recessive inheritance. The main characteristic features of this disorder are diabetes mellitus and optic atrophy. However, diabetes insipidus, sensorineural deafness, renal tract and neurologic abnormalities are seen in majority of patients. In this study, we describe a family in which two members had the main features of the syndrome while a third sibling had only sensorineural deafness. DNA analysis revealed that the fully affected siblings were homozygote for a pointmutation on chromosome 4p whereas the third sibling with deafness was a heterozygote carrier for the same mutation. The characteristics of disease and phenotypic variations that possibly related to heterozygote carrier state were discussed.
The End of Plato’sPhaedoand the End(s) of Philosophy
Authors: Werner Daniel
Published: June 2019

The ending of the Phaedo is one of the most powerful and memorable moments in the entire Platonic corpus. It is not simply the end of a single dialogue, but a depiction of the end of the life of the man (Socrates) who is a looming presence in nearly everything that Plato wrote. In this article I offer an in-depth analysis of the final scene of the Phaedo. I argue that Plato very carefully constructs the scene for the sake of specific philosophical, dramatic, and political ends. Plato uses it to unify the Phaedo as a singular text, while also provoking us to reflect on the nature of our lives, our deaths, and the possibilities and limits of philosophy itself.
Friendship, Knowledge and Reciprocity inLysis
Authors: Giménez José Antonio
Published: June 2019

Plato’s characterization of philia in Lysis, on one hand, as one-sided belonging to the ultimate object of our desire and, on the other, as interpersonal reciprocal belonging appears problematic. Yonesawa has recently claimed that one can make sense of both uses of “belonging” if we assume that one is the other’s friend when each one coincides in being the ultimate object of the other’s desire. This paper proposes instead that Lysis’ ‘reciprocity’ of friendship results from friends’ right wanting, which presupposes their souls are well-disposed to a true object of desire. To prove this, I will argue that (i) the action and the argument of the dialogue exhibit this kind of reciprocity, (ii) there is a ‘unique’ ultimate object of desire (‘teleological monism’), that consists of a ‘knowledge about the good life’ and (iii) only the common longing for such knowledge can make possible friends’ reciprocal belonging.