bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSOCIATION OF CRP AND D-DIMER WITH CT SEVERITY SCORING IN COVID-19 PATIENTS
Authors: Patel Sunil Kumar , Adhikari Shital , Gauli Basanta , Bhattarai Madhur Dev , Paudel Bigyan , Adhikari Deepak , Gurung Sailesh , Wagley Pratik , Puri Niraj , Regmi Bibek
Published: April 2022

Background: Corona virus disease 2019 (COVID-19) has become a global public health issue with significant impacts upon the healthcare delivery systems. Previous studies have consistently found elevated levels of C-Reactive Protein and D-dimer with disease severity. In this study, we aimed to investigate the relationship between C-Reactive Protein, D-dimer level and Computed Tomography severity score in patients with SARS-COV-2 pneumonia.
Methods: Our study included 76 patients with COVID-19, admitted in COVID Unit of Chitwan Medical College and Teaching Hospital from June 2020 to December 2020. We included COVID-19 cases confirmed by a RT-PCR test and those undergoing High resolution Computed Tomography of chest and having C-Reactive Protein and D-dimer levels done on admission. A semi-quantitative CT score was calculated based on the extent of lobar involvement (0:0%; 1, < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5, > 75%; range 0–5; global score 0–25.
Results: Overall the median CTSS was 15. Mild, moderate and severe CT severity scoring was reported in 5.3%, 60.5% and 34.2% respectively and D-dimer progressively increased across the CTSS severity groups. The difference was significant for CRP, P = 0.007 but not for D-dimer, P = 0.42. Moreover, higher CTSS scores were significantly associated with higher ICU stay, lower recovery rate and higher O2 requirement at discharge.
Conclusions: Radiological severity of COVID-19 pneumonia has significant association with elevated C-Reactive Protein level but not with D-dimer level and other routine laboratory parameters.
KNOWLEDGE ON DRUG ABUSE AMONG MBBS FIRST YEAR STUDENTS OF CHITWAN MEDICAL COLLEGE
Authors: Paudel Gita , Chaurasia Lokeshwar , Bhurtyal Karma Murti , Karki Sirisa
Published: April 2022

Background: Currently, drug abuse is booming in developing countries including Nepal, which may directly affect personal as well as socioeconomic condition of individual and community. Teenage, being the most crucial stage of life, is the age when teenagers want to explore a lot of things and is curious about new experiments. So, they think that, drugs assist them to overcome all the problems they face in day to day life. Therefore, the aim of this study was to assess the knowledge regarding drug abuse among MBBS first year students of Chitwan Medical College.
Methods: A cross-sectional study was carried out to determine the knowledge regarding drug abuse among MBBS first year students of CMC. A self-administered questionnaire was used to collect information, which was adopted from previous studies. Study participants were briefed about the nature of the study and the procedure of completing the questionnaire was explained. After completion of the questionnaire, data was collected, reviewed, organized and expressed as counts/percentages and statically analyzed using SPSS version 20.
Results: The current study showed that, majority 81.3% of the participants had satisfactory whereas 18.8% of the participants had unsatisfactory level of knowledge about drug abuse.
Conclusions: Majority of the MBBS first year students had satisfactory knowledge regarding drug abuse and only few had unsatisfactory knowledge. So, for them it is deemed necessary to update their knowledge regarding drug abuse, as it is one of the crucial matters of concern these days.
FUNCTIONAL AND RADIOLOGICAL OUTCOME OF LOCKING PLATE IN DISPLACED FRACTURE OF DISTAL END RADIUS
Authors: Bidary Suraj , Pandey Suresh , Gupta Hemant  Kumar , Das Manoj , Aryal Roshani , Ghimire Pradeep , Bhattarai Kushal
Published: April 2022

Background: Distal radius fracture is the most common fracture of upper extremity. There are wide variety of treatment options including plaster, ligamentotaxis, percutaneous pinning and plating for the treatment of displaced distal end radius fracture in the adult. Each option has got its own pros and cons. This study was designed with an objective of assessment of functional and radiological outcome of displaced distal end radius fracture treated with volar locking plate.
Methods: This was a retrospective study of closed displaced fracture of distal end radius managed with volar locking plate from January 2018 to September 2020. Data were collected from the case chart and included patient’s demography, fracture characteristics, radiological parameters, range of motion and complications. Data analysis was done using Statistical package for social science 20.0 software. Descriptive statistics for categorical variable was used and mean of the continuous data was compared using student’s t-test.   P-value <0.05 was considered as statistically significant.
Results: The mean age of patient was 35.87 years after analysis of total of 30 patients with mean follow up of 12.87 months. Road traffic accident (76.7%) was the most common mode of injury. There were 36.7% Association of Osteosynthesis (AO) type B and C injuries, each. The mean Quick Disabilities of Arm, Shoulder and Hand (DASH) score was 1.13 (range 0 - 6.81) at the final follow up. The mean union time of the fracture was 6.6 weeks. One patient had stiffness and one developed reflex sympathetic dystrophy.
Conclusions: Functional and radiological outcome of the displaced distal end radius in adult treated with open reduction and internal fixation with locking plate was found good to excellent in most of the cases.
ACUTE GLOMERULONEPHRITIS IN CHILDREN: A HOSPITAL-BASED STUDY IN A TERTIARY CARE CENTRE IN NEPAL
Authors: Adhikari Sudhir , Sitaula Deekshanta , Regmi Shanti , Parajuli Biraj , Poudel Sumita
Published: April 2022

Background: Acute glomerulonephritis is a common pediatric kidney disease which places a huge burden in developing countries. This study aimed to evaluate causes, clinical manifestations, laboratory findings and complications of acute glomerulonephritis in children presented to a tertiary care center of Nepal.
Methods: This was a retrospective review of records of children admitted with acute glomerulonephritis at Chitwan Medical College from April 2018 to February 2021. Socio-demographic data, clinic-laboratory profile and outcomes were obtained from medical records and descriptive analysis was carried out.
Results: Among 48 recruited children with acute glomerulonephritis, 60.4% were male and the mean age was 9.5 ± 3.7 years. Post infectious glomerulonephritis including post streptococcal glomerulonephritis (48%) was the main cause of acute glomerulonephritis. The major clinical features were edema (81.3%), hypertension (72.9%), dyspnea (29.2%) and hematuria (25%). ASO titer was positive in 45.8%. The complications noted were acute kidney injury (6.3%), hypertensive emergency (6.3%) and congestive cardiac failure (2.1%).
Conclusions: Most of the patients were above 5 years of age and presented most commonly during autumn and summer season.  The complications of acute glomerulonephritis were acute kidney injury, hypertensive emergency and congestive cardiac failure.
DENTAL STUDENTS’ PERCEPTION TOWARDS INTERNAL MEDICINE
Authors: Shrestha Deepak Sundar
Published: April 2022

Background: A qualified dental surgeon is expected to be well versed in the essentials of medicine. However, many factors may affect their interest level, which may determine how well they learn to be a competent practitioner. This study aimed at understanding the interest of students towards internal medicine and to explore ways for enhancing their interest.
Methods: It was cross-sectional study conducted amongst students from third year, fourth year and internship at People’s Dental College and Hospital after Institutional Review Committee approval. The study took place during February 2021 to March 2021. SPSS version 21 was used to perform Chi square test to see association of different variables.
Results: Most students (93.7%) were interested in internal medicine. Cardiovascular and respiratory system were most interesting topics. Total 86.7% students agreed that learnings in medicine will be useful. However, 47.6% and 49.7 % didn’t think that the knowledge and skills they acquire would be enough for them. Most favored combining different teaching learning methods to increase understanding and interaction. Overall, 65% of students felt time allotted for internal medicine was inadequate and 40.2% proposed to include it in third and fourth years. Majority (51%) recommended more emphasis on practical classes and demonstration.
Conclusions: Combining different teaching learning methods appealing to the participants should be used to enhance their understanding and to increase interaction. Revision at the end of lecture is necessary. Increased years of teaching with focus on applied knowledge, enhanced clinical exposure and practical placements during internship would be helpful.
CONSERVATIVE VERSUS OPERATIVE MANAGEMENT OF MID-CLAVICULAR FRACTURES
Authors: Dahal Saurav , Shrestha Shriraj , Bhandari Parash , Bajracharya Suraj , Bajracharya Aayush , Maharjan Basanta
Published: April 2022

Background: Mid-clavicle fractures were traditionally managed by non-operative means which led to stiffness and painful shoulder. Surgical treatment on the other hand had the advantage of reducing malunion and allowing early shoulder movements, but also had incidences of infection. This study was carried out with the objectives of comparing functional outcome, fracture union rates, patient satisfaction rates and complications of both treatments.
Methods: In this observational study done from October 2020 to September 2021 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Nepal, 40 patients with mid-clavicle fractures were treated either conservatively or operatively according to their choice. 20 patients in each group were assessed functionally in each follow-up using the Constant and Murley score and union and complications were also assessed. Data collection and entry was done using the statistical package for social science version 22 and analyzed by using statistical tools like mean, frequency and Independent samples t-test.
Results: At 6 months, there was no statistical difference in the Constant and Murley score between the two groups, but the scores were statistically better in the operative group at 6 weeks. Mean fracture union time in operative group (12.67 weeks) was statistically better than that in conservative group (14.89 weeks). Complications in operative group were mainly hardware related while stiffness was more common in conservative group.
Conclusions: Operative treatment led to earlier fracture union, regain of shoulder function and return to work, but had the disadvantage of high cost and risk of infection as compared to conservative treatment.
KNOWLEDGE, ATTITUDE AND PRACTICE RELATED TO DIABETES MELLITUS IN DENTISTS OF NEPAL
Authors: Joshi Bishal , Pokhrel Buddhi Raj , Shrestha Laxmi , Kar Sanjit  Kumar , Mahotra Narayan Bahadur
Published: April 2022

Background: Diabetes mellitus (DM) is one of the most common systemic diseases encountered by dentists in daily practice. The present study aimed to assess the knowledge, attitude, and practice of dentists regarding diabetes mellitus.
Methods: This cross-sectional study was conducted among the dentists of Nepal from August to December 2020. A total of 345 dentists throughout the country took part in this study. A set of 27 self-designed questions was used as the study tool, among which 11 questions were about knowledge, seven were about attitude, and nine were about practice related to DM. The result was expressed in frequency and percentage. Chi square and Spearman’s correlation analysis were performed with SPSS version 16.
Results: The mean knowledge score was 8.15 ± 1.54 with 11 being the highest possible score. Of the total participants, 252 (73%) had good knowledge regarding DM. The mean attitude score was 4.68 ±1.19, where seven was the highest possible score. Of the total respondents, only 190 (55.1%) had a positive attitude. The mean practice score was 7.19 ± 1.19, with nine being the highest possible score. A majority of the respondents (N = 320, 92.8%) had good practice habits regarding diabetic patients. Correlation analysis showed a weak positive but significant correlation among knowledge, attitude, and practice.
Conclusions: There was good knowledge and practice in dentists though there were frequent areas of improvement in attitude. Various trainings like continuing medical educations (CME) may be beneficial to improve personal beliefs.
PATIENTS’ SATISFACTION TOWARDS EYE CARE SERVICES AT TERTIARY EYE HOSPITAL IN WESTERN PART OF NEPAL
Authors: Khadka Thapa Saraswati , Thapa Hari Bahadur , Upadhyay Hari Prasad
Published: April 2022

Background: Patient satisfaction is the level to which the patients’ experience that their needs and expectations are being met by the service provided. The aim of the study was to measure and improve the quality of eye care services at Lumbini Eye Institute and Research center (LEIRC)/Shree Rana Ambika Shah Eye Hospital (SRASEH) both pediatric and adult groups.
Methods: A cross sectional study with descriptive analysis was done from November 2018 to April 2019 at LEIRC, Bhairahawa Nepal.  Five hundred seventeen (517) patients were enrolled by systematic random sampling, segregating 201- In patients, 205 – adult and elder patients and 111 pediatric patients. Interview was taken from the patients using the questionnaire which was already used in Arvind Eye Care System, India after validating in our context. Data was entered and analyzed using IBM SPSS -20 version.
Results: Among 517 respondents Female (54%) respondents were more than male. Overall patient satisfaction was almost ninety-eight percent were satisfied. Similarly, more than eighty (83.94) percent felt the reasonable cost in service charge and almost sixty five percent respond the reasonable waiting time. Ninety percent patients expressed their interest to recommend their friends or relatives to the hospital.
Conclusions: Majority of the patients were satisfied with the overall services of the LEIRC. However, there is need to reduce longer waiting time of the patients.
OVERVIEW OF OPTIC NEURITIS AND VISUAL OUTCOME IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL
Authors: Dahal Polina , Bastola Pradeep
Published: April 2022

Background: Optic neuritis is a visually debilitating and usually painful condition of the eye. As per the Optic neuritis treatment trial (ONTT) intravenous methylprednisolone has shown to accelerate recovery in Optic neuritis and has also been proven to somewhat decrease recurrence. This study was aimed to provide demographics of patients, clinical findings and features, investigative findings in cases of optic neuritis and the outcome of treatment for future references.
Methods: This prospective observational study was carried out in Chitwan Medical College, Department of Ophthalmology from 16 August 2021 to 15 October, 2021. Newly diagnosed cases of Optic neuritis were included in the study for treatment with intravenous methylprednisolone and oral steroids. SPSS version 26 was used to analyze the data entered in a specified proforma.
Results: Fourteen 63.6% of the study participants were females. Mean age of presentation of the study subjects was 51.45 years (Range 33-78, +- 13.0). Commonest presenting complaint was sudden onset diminution of vision (100%). Radiographic findings were present in 36.3 %. All study subjects had varying grades of relative afferent pupillary defect (RAPD), 45.4% participants had color vision defect, and visual field changes were detected in 36.6% (8) study subjects.
Conclusions: Optic neuritis presents with sudden onset diminution of vision usually in one eye. The treatment outcome with IV steroids followed by oral steroids when initiated early in cases of optic neuritis have an excellent visual outcome.
CESAREAN SCAR ENDOMETRIOSIS – A RARE AND UNDERESTIMATED COMPLICATION
Authors: Pandey Chandani , Shrestha Junu , Subedi Anjali , Rana Apariharya
Published: April 2022

Endometriosis is defined as the presence of the endometrium outside the uterine cavity. Around 8- 15 % of women of the reproductive age group have been affected by it. Abdominal scar endometriosis is a rare complication of the cesarean section and can be often misdiagnosed. We present a 39-year-old woman who has been complaining of pain and edema at the location of her cesarean incision for the past two years. The pain began on the first day of the menstrual cycle and only continued for the duration of the cycle. Swelling, which started as tiny but grew in size over time, was linked to pain. She had a similar background four years ago. Her vitals were stable during examination, as were her general and systemic examinations. There was a scar mark over the hypogastric region, as well as a 5 x 3 cm swelling in the left lateral angle of that scar. The swelling was tender. Scar endometriosis was seen on USG. Scar endometriosis was removed, and tissue was sent for histopathological examination. Now she is on injection Leuprolide 3.75mg intramuscular every monthly for a period of six months.We present this case as it is very rare complication and being underestimated by patient.
PATTERN, MANAGEMENT AND OUTCOME OF ACUTE INTESTINAL OBSTRUCTION AT CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL
Authors: Bhattarai Abhishek , Devkota Pragya , Shrestha Anup , Chand Manoj , Timalsina Santosh , Tamrakar Kishor Kumar , Neupane Harish Chandra
Published: April 2022

Background: Acute intestinal obstruction is one of the commonly encountered emergencies in surgical practice. Gynecological surgery, especially adnexal surgery and hysterectomy has a higher incidence of bowel obstruction as compared to bowel surgery. Conservative management can be done in patients with post-operative adhesive bowel obstruction if there is no evidence of ischemia, bowel necrosis, or perforation. Therefore, a correct diagnosis is essential for appropriate management. We conducted a study to evaluate the etiology, clinical presentation as well as management and outcome of patients presenting with Acute intestinal obstruction at our center.
Methods: This was a retrospective study of all the patients with a diagnosis of Acute intestinal obstruction from January 2015 to December 2019. The diagnosis of Acute intestinal obstruction was made by a combination of clinical and radiological parameters. The data were analyzed using Statistical Package for Social Sciences (SPSS) for Windows version 16. The  data  were  expressed in  number and percentage.
Results: During the study period, 178 patients were admitted with the diagnosis of Acute intestinal obstruction. Abdominal pain and vomiting were the main complaints seen in 98.3% (n=175) and 84.8% (n=151) respectively. Hernia (n=49, 27.5%) was the most common cause of acute intestinal obstruction in adults, and Intussusception (n=15, 8.4%) was the leading cause of Acute intestinal obstruction in a pediatric age group. Majority of the patients’ needs (n=148,83.1%) operative intervention to relieve the obstruction. The overall mortality rate was 6.7% (n=12).
Conclusions: Hernia was the most common cause of Acute intestinal obstruction in adults while intussusception was the commonest in the pediatric age group.
CLINICAL CHARACTERISTICS AND CHEST X-RAY AND COMPUTED TOMOGRAPHY FINDINGS IN DIFFERENT CLINICAL SEVERITY GRADING OF COVID-19 PATIENTS
Authors: Gurung Sailesh , Adhikari Shital , Bhattarai Madhur Dev , Gauli Basanta , Adhikari Deepak , Poudel Bigyan , Puri Niraj , Wagley Pratik , Patel Sunil
Published: April 2022

Background: Clinical assessment, chest X-ray (CXR) and high-resolution computed tomography (HRCT) are used in the Corona virus disease-19 (COVID-19) management. The aim of the study was to determine the clinical characteristics and CXR and HRCT findings in COVID-19 patients with different clinical severity.
Methods: This was a hospital-based cross-sectional study conducted at Chitwan Medical College, Department of Pulmonary and Critical Care Medicine from September to December 2020. Data from sixty adult patients with moderate (non-severe), severe, and critical COVID 19 disease having both CXR and HRCT were collected and were analyzed using SPSS version 16.
Results: Median age of patients in our hospital-based study was 59.9 years and 76.7% were male, 30% had diabetes, and 35% had hypertension. Respiratory rate (p=0.001) and shortness of breath (p= 0.011) significantly increased and oxygen saturation (SpO2) (p<0.001) decreased with increase in clinical severity of COVID-19 disease. Among the moderate, severe and critical clinical severity groups, there was significant difference in the HRCT findings like ground-glass opacity (GGO), consolidation, septal thickening, crazy paving pattern, bronchiectasis and fibrosis (p<0.05). GGO was the most common finding. Bilateral consolidation in CXR and multiple lobes in both lungs involvement in HRCT were similar across the moderate, severe and critical clinical severity (p>0.05).
Conclusions: There was no difference in CXR and HRCT findings across moderate, severe and critical clinical severities of COVID-19; future study performing CXR whenever HRCT is done for any indication may similarly indicate the situation in mild COVID-19 disease.
SELF-PERCEPTION OF DENTAL APPEARANCE AND AWARENESS TOWARDS ORTHODONTIC TREATMENT AMONG UNDERGRADUATE STUDENTS AND INTERNS OF DENTISTRY
Authors: Acharya Gaurav , Shrestha Rosha , Shrestha Parikshya , Ghimire Luna
Published: April 2022

Background: Patient’s perception of own facial appearance is also an important contributing factor for treatment planning. Also, knowledge and attitude of patients to orthodontic treatment is becoming more important in orthodontics these days. The study aimed to assess self-perception, awareness and attitude towards orthodontic treatment among dental students and interns.
Methods: Data was collected through cross-sectional survey conducted among the dental students and dental interns in KIST Medical College through online google form. Study duration was from August 2021 - October 2021. The data was entered in SPSS software 20. Frequency distribution was generated for all variables. Categorical variables were evaluated using Chi-square test.
Results: About 96.7% of the participants believe that orthodontic treatment will improve facial appearance. 61.5% believe that orthodontic treatment is a lengthy and painful procedure. 44.5% does not think orthodontic treatment weakens the teeth. 50% of female believe that orthodontic treatment will give the promising result. Statistically significant difference was obtained with respect to preference of different types of braces among students of different years. 54.9% of the participants are satisfied with the arrangements of their teeth, 20.9% had avoid smiling and 22.5% felt lack of confidence because of the appearance of their teeth. Almost half of the participants (50.5%) think they should have orthodontic treatment and 76.2% readily agree to orthodontic treatment if suggested by the dentist.
Conclusions: Dental students and interns had a good knowledge about orthodontic treatment and positive attitude towards it. Gender difference exists regarding the awareness of orthodontic treatment. Statistically significant difference was found in preference of different types of braces in students of different years and interns.
PROFILE OF BREAKTHROUGH INFECTION OF COVID-19 IN A TERTIARY CARE HOSPITAL: A DESCRIPTIVE CROSS-SECTIONAL STUDY
Authors: Pokharel Khilasa , Dawadi Bishwa Raj , Aryal Binod , Shrestha Lok Bahadur
Published: April 2022

Background: While reports of vaccine induced immunity against COVID-19 have been around, frequency of breakthrough infections is also being reported. The study aimed to analyze breakthrough infections after a complete dose of COVID-19 vaccination.
Methods: Individual who was fully vaccinated with COVID-19 were included in this study. Nasopharyngeal and Oropharyngeal swab was collected and transported to the laboratory as soon as possible for the diagnosis of COVID-19. The specimens were transported in a viral transport medium maintaining cold chain of 2-8°C. Statistical Package for the Social Sciences (SPSS) version 20 was used for data entry and analysis.
Results: Of 8350 samples received 5494 (65.79%) were vaccinated and 2856 (34.20%) were non vaccinated. Among fully vaccinated individuals, 694 (12.63%) are post vaccination COVID-19 cases. Among the post vaccinated COVID-19 cases 264(14.15%), 95(12.70%), 44(3.19%), 28 (1.86%) breakthrough infections are seen among individuals who received Sinopharm, Oxford-Astrazeneca, Johnson and Johnson, other vaccines Pfizer, Moderna, Sputnik V respectively which were tested positive for SARS-CoV-2 RNA on reverse transcriptase polymerase chain reaction.
Conclusions: Laboratory-confirmed COVID-19 cases among vaccinated individuals after complete dose of vaccination indicates that there is still risk of COVID-19. Therefore, regular COVID-19 testing should be conducted even after vaccination.
Karia Stratonikeia Territoriumu’ndan Figürlü Mangal Tutaçları
Authors: SÖĞÜT Bilal , DURNAGÖLÜ Nihal
Published: April 2022

Antik Çağ yemek pişirme kültürünün bir parçası olan mangallar aynı zamanda ısınma amaçlı kullanılan dekoratif ocaklardır. Mangal kenarına aplike edilmiş kalıp yapımı figürlü tutaçların özellikle Hellenistik Dönem içerisinde sakallı başlarla, boğa ve keçi gibi hayvan protomlarıyla tasvir edildiği görülmektedir.
Karia bölgesi sınırları içinde yer alan Stratonikeia, Hellenistik ve Roma İmparatorluk dönemlerinde terrakotta figürin üretiminde önemli bir merkezdir. Terrakotta üretimine ek olarak yapılan Hellenistik Dönem mangallara ait parçalar, bu çalışmanın konusunu oluşturmaktadır. Çalışma kapsamında 27 adet figürlü mangal tutacı ve 3 adet gövdeye ait parça değerlendirmeye alınmıştır. İncelenen örnekler, Stratonikeia kent merkezi ile Börükçü ve Yeldeğirmentepe yerleşmeleri ve Lagina Hekate kutsal alanındaki kazılarda bulunmuştur. Stratonikeia koroplastik sanatı içinde farklı ve özel bir grubu oluşturan mangal tutaçları aynı zamanda Akdeniz Bölgesi’ndeki ticari ağlar hakkında ek bilgi sunan önemli bir buluntu grubudur. Kente ait bulgular, mangal tutaçlarının üretim yerleri konusunda da bazı yeni görüşler sunmamıza imkan sağlamaktadır. Bunların bazıları, tipolojik olarak Ege kıyılarında Knidos, Myndos ve Halikarnassos kentlerindeki örneklerden ayrılarak Stratonikeia’da yerel bir üretimin varlığına işaret etmektedir.

Portable stoves were not only part of culinary arts but also decorative stoves for heating purposes in Antiquity. Molded figural panels appliqued on the edges depict especially bearded faces, protomes of animals such as bull and goat in the Hellenistic period.
Stratonikeia in Karia was an important terracotta figurine production center during the Hellenistic and Roman Imperial periods. Pieces produced for stoves in addition to the figurines in the Hellenistic period constitute the scope of this article. The present study covers 27 figural panels and three body fragments. The pieces were uncovered in the city center of Stratonikeia, settlements at Börükçü end Yeldeğirmentepe as well as at the Sanctuary of Hekate. The figural panels not only constitute a special and different group within the coroplastic art of Stratonikeia but also shed extra light onto the commercial networks in the Mediterranean Region. Finds from the city allow us to propose new ideas regarding the manufacturing sites of the stove panels. Some of them differing from the examples from Knidos, Myndos and Halikarnassos on the Aegean littoral suggest local production at Stratonikeia.
The Self-Regulation of Electronic Commerce: An Appraisal in Accordance to the Chilean Law of Unfair Competition
Authors: David López Jiménez
Published: April 2022

Electronic commerce or e-commerce constitutes a commercial activity on the rise. Although it has many advantages, there are several lingering factors that prevent its consolidation, such as the lack of trust of the potential consumer/user. In order to overcome that obstacle, instruments of self-regulation were created in the field of advertising. Firms that wish to distinguish themselves favorably against their competitors have the option of adopting those instruments, which play a praiseworthy role regarding the target audience and constitutes a considerable improvement of consumer rights. However, on occasions, problems arise in the market when those systems of self-regulation bind third parties that did not voluntarily enter into a contract. This paper tackles the question of if self-regulation of advertising in the net can be put in place should it affects the honor of the third party not committed with the fair-practices document. In this article, we will refer to the particularities that arise from a case concerning the Chilean Law no. 20,168, of 2007, on unfair competition and self-regulation of advertising in the Internet pertaining WOM, Movistar, Entel, Claro and Virgin. The Chilean Law no. 20,168, of 2007 contributes to the goal of discouraging conduct contrary to good faith or good practices in advertising in conjunction with codes of conduct that have been approved in the field related to the systems of self -regulation.
Responsividade do Sistema Sancionatório da Radiodifusão Brasileira
Authors: Marcelo Barros
Published: April 2022

O propósito deste artigo foi avaliar a responsividade do sistema sancionatório aplicável aos concessionários, permissionários e autorizatários de serviços de radiodifusão no Brasil. A pesquisa se utilizou da teoria responsiva da regulação de Ayres e Braithwaite como parâmetro para a análise crítica do sistema sancionatório da radiodifusão brasileira. A pesquisa revelou que o sistema sancionatório não incentiva o cumprimento de obrigações legais, contratuais e normativas, uma vez que as penalidades não estimulam o diálogo entre regulador e regulado, há obstáculo legal para a aplicação da punição máxima, a cassação, e já ocorreu a prescrição de multas no passado. Os resultados desta pesquisa poderão subsidiar os reguladores brasileiros no desenvolvimento de um sistema sancionatório mais responsivo e eficaz para os serviços de radiodifusão. A pesquisa introduz a discussão sobre responsividade no modelo regulatório brasileiro de radiodifusão.
Clinical related factors to neuroendocrine tumors in Ecuadorian patients: a logistic biplot approach
Authors: Montes Escobar Karime , Vicente Villardón José Luis , Alarcón Cano Daniel Fabricio , Siteneski Aline
Published: April 2022

Neuroendocrine tumors (NETs) are relative rare, affecting neuroendocrine cells throughout the body. Most tumors are diagnosed at advanced stages. NETs prevalence has increased in the last years but there is little data available in developing countries. The aim of this study was to describe symptoms associated with NETs in patients of the Society for the Fight Against Cancer (SOLCA) in Ecuador from 2005 to 2020; using logistic biplots, in a hospital database, generating binary responses (presence/absence) relevant to this study. The results showed that the mean age was 59 and the study showed no difference in prevalence between genders. NETs were mainly found in lungs (19%), followed by stomach (18%) and skin (9%). Most patients had pathological diagnosis G2 and G3 (30% and 70%, respectively). Symptoms as cough, dyspnea, weight loss, diarrhea, constipation, abdominal pain, dyspepsia, hypertensive crisis, distended abdomen and intestinal obstruction had p values <0.05. Additionally, the statistical analysis showed that cough and intestinal obstruction were also common, bearing in mind that patients had most frequent NETs in the lungs and skin. In summary, our results indicate that symptoms of NETs patients were positively associated with lung and skin. Further investigation is needed focusing on the type of NETs and their symptoms in order to establish an early marker for diagnosis.
A new approach of immunotherapy against Crotalus snakes envenoming: ostrich (Struthio camelus) egg yolk antibodies (IgY-technology)
Authors: Bello Carlos , Torrico Fátima , Jiménez Juan C. , Cepeda Mariana V. , López Miguel A. , Rodríguez-Acosta Alexis
Published: April 2022

Crotalid envenomation is a neglected collective health problem involving many countries in America, which need secure and inexpensive snake anti-venom treatments. Here, high antibody titers (IgY) were raised in the Ostrich (Struthio camelus) egg yolk by immunizing with the venom of Venezuelan venomous Crotalus snakes. Ostriches were immunized with a pool of venoms from common rattlesnake (Crotalus durissus cumanensis), Uracoan rattlesnake (Crotalus vegrandis), Guayana rattlesnake (Crotalus durissus ruruima) and black rattlesnake (Crotalus pifanorum). The anti-snake venom antibodies were prepared from egg yolk by the water dilution method, enriched by the addition of caprylic acid (CA) and precipitation with ammonium sulfate at 30% (W/V). The purity and molecular mass of the final product was satisfactory, yielding a single ∼ 175 kDa band in SDS-PAGE gels ran under non-reducing conditions. In the immunoblot analysis, specific binding of the antivenom was observed with most venom proteins. The LD50 was 16.5 g/mouse (825 µg/kg body weight). High titers of IgY against Crot/pool venom were shown by ELISA. The median effective dose (ED50) was 19.66 mg/2LD50. IgY antibodies neutralized efficiently the Crot/pool venom lethality. As far as we know, this is the first anti-snake venom produced in ostriches, which could make this technology an affordable alternative for low-income countries, since it is likely to produce about 2-4 g of IgY per ostrich egg. Hence, almost 400 g of IgY can be purified from only one ostrich during a year. In addition, there are enormous differences in the cost of investment in the maintenance of horses, from the points of view of infrastructure, feeding and veterinary care, in which the cost can reach USD 100 per animal per day, compared to a maintenance cost of USD 146 per month per producing bird. These results are encouraging and could easily be extrapolated to the manufacturing of other antivenoms and antitoxins as well, as they could be applied to the manufacturing of potential diagnostic tools.
ANÁLISE DA COBERTURA VEGETAL DOS BAIRROS CENTRO E SÃO BRAZ EM UNIÃO DA VITÓRIA (PR)
Authors: Rocha Mariane Félix da , Oczust Daniel
Published: April 2022

Essa pesquisa teve como intuito analisar a vegetação de dois bairros de União da Vitória (PR), o Centro e o São Braz, a partir da quantidade e distribuição da cobertura vegetal, da quantidade e localização das áreas verdes e do histórico e planos de ocupação dos bairros. Assim, pode-se traçar um comparativo entre um bairro central e um bairro periférico em termos de acesso à vegetação pelos habitantes de cada bairro. Para isso, foi necessária uma etapa cartográfica para quantificar e localizar os fragmentos de cobertura vegetal, uma etapa de campo para localizar as áreas verdes dos bairros e uma consulta ao Plano Diretor Municipal, para compreender a ocupação de ambos os bairros. Como resultado, o Centro apresentou 12,14% de cobertura vegetal, distribuídos de forma sobretudo isolada, enquanto o São Braz dispunha de 72% de cobertura vegetal, distribuída de forma conectada na parte sul do bairro e isolada em sua parte central. Todavia, o bairro Centro apresentou mais espaços de áreas verdes em comparação ao São Braz. A falta de áreas verdes coloca em risco o atual índice de cobertura vegetal deste bairro, uma vez que o Plano Diretor prevê o aumento da ocupação do São Braz nos próximos anos.
CUSTOS INTERORGANIZACIONAIS DE UMA CADEIA DE SUPRIMENTOS MOVELEIRA DO OESTE DE SANTA CATARINA
Authors: Pacassa Francieli , Zanin Antonio
Published: April 2022

Esta pesquisa teve por  objetivo identificar os fatores condicionantes da Gestão de Custos Interorganizacionais presentes em uma cadeia de moveleira do oeste de Santa Catarina. Metodologicamente caracteriza-se como uma pesquisa exploratória e descritiva, de estudo de caso e com abordagem qualitativa. Para a coleta de dados, foram utilizadas entrevistas semiestruturadas em diferentes empresas da cadeia de suprimentos. A análise de dados foi realizada através da técnica de Análise de conteúdo, com a utilização do software de análise de dados qualitativo Atlas TI. Os resultados evidenciaram fatores atrelados aos constructos gestão interna de custos, gestão de custos interorganizacionais e nível de interdependência incentivam a aplicação da GCI na cadeia de suprimentos, em contrapartida a questão da cooperação e da confiança mostram-se como fatores que inibem sua pratica. Como limitações da pesquisa, destaca-se impossibilidade de generalizar os achados a outros relacionamentos interorganizacionais e o fato de a pesquisa ter analisado apenas o ponto de vista de poucas empresas da cadeia a montante e a jusante. Para estudos futuros, sugere-se a utilização de mais de uma forma de coleta de dados a fim de confirmar os relatos dos respondentes.
INOVAÇÃO EM SERVIÇOS: UM PANORAMA DA PRODUÇÃO CIENTÍFICA NA BASE SCOPUS (1967-2017)
Authors: Souto Bolzan Medeiros Flaviani
Published: April 2022

O setor de serviços ocupa uma parcela expressiva da economia em boa parte dos países ao redor do mundo e para atender a sua demanda específica as organizações desse setor inovam. Deste modo, considerando a relevância do tema, o objetivo deste artigo é apresentar um panorama da produção científica na área de inovação em serviços nos últimos cinquenta anos considerando para tal análise a base de dados Scopus. Do ponto de vista metodológico, o trabalho tem como base um levantamento bibliométrico acerca da produção científica sobre a temática inovação em serviços na referida base, portanto, caracterizando-se como uma pesquisa qualitativa-quantitativa e do tipo descritiva. Os resultados obtidos nas análises revelam que apesar de o primeiro trabalho ter sido publicado em 1974 apenas nos últimos dez anos é que se observa certa regularidade em termos de publicações e tem na grande área do conhecimento Negócios, Gestão e Contabilidade o destaque do período. Concluiu-se que há espaço para a produção de novas pesquisas relacionadas, pois existe uma diversidade de áreas interessadas na temática.
PERSPECTIVAS DA INOVAÇÃO GERENCIAL NO CONTEXTO BRASILEIRO: UMA REVISÃO DA LITERATURA
Authors: Ribeiro Silva Mara Rosalia , Kumasaka Júlia Mitsue Vieira Cruz
Published: April 2022

O objetivo deste artigo é apresentar os resultados de uma revisão sistemática da literatura no contexto brasileiro sobre inovações gerenciais. A relevância da temática torna-se ainda mais evidente em crises como a pandemia do Covid-19, pois os gestores estão precisando implementar práticas e processos gerenciais inovadores adequados ao seu novo contexto. Inicialmente, tratou-se das principais concepções acerca das inovações de uma forma geral e das inovações organizacionais e gerenciais. Após a busca nas bases de dados Capes, Spell e Scielo, 24 artigos foram selecionados e analisados em relação ao período de publicação, campo empírico, abordagem de inovação gerencial, abordagem metodológica e teorias que os embasaram. Depois da análise detalhada dos artigos selecionados, a pesquisa contribuiu para o maior entendimento sobre o desenvolvimento empírico do constructo no país, além de propor um conceito de inovação gerencial. Possíveis pesquisas futuras foram sugeridas em três níveis de análise (individual, grupal e organizacional). Entre elas estão estudos relacionados com as competências que precisam ser desenvolvidas em gestores para a implementação de inovações gerenciais, como a organização pode promover uma cultura que permite o desenvolvimento de inovações gerenciais e o papel da cultural brasileira para o desenvolvimento das inovações gerenciais.
Emergency and Non-Emergency Vehicle Classification using Machine Learning
Authors: T G ASWATHY , D PROF. DR. GANESH
Published: April 2022

A highly populated country like India faces too much traffic jam. Sometimes emergency vehicles like ambulances, fire engine get stuck in the traffic causing threat to life in many cases. It is important to give priority to this vehicle and help to clear its path. But it is difficult or sometimes impossible for traffic police to handle this. So, differentiating a vehicle into an emergency and non-emergency category can be an important component intraffic monitoring as well as self-drive car systems can easy understand the emergency vehicle as reaching on time to their destination is critical for these services. In case of automatic vehicles, they need an alert input message like this to clear the path to emergency vehicles. on other hand, this is useful for all types of vehicle to get sudden alert to clear thepath to emergency vehicles. For this reason, we need an automated system that will be ableto detect an emergency vehicle in heavy traffic road, let the controller know or automatically navigate other vehicles to clear its path. In this work, we have proposed an automated system to detect emergency vehicle using the Machine Learning. KEYWORDS: Intelligent Transport System (ITS), Support Vector Machine (SVM), Convolutional Neural Network (CNN), Decision Tree, Recurrent Neural Network (RNN), space invariant artificial neuralnetworks (SIANN)
HUBUNGAN INISIASI MENYUSU DINI (IMD) TERHADAP SUHU BADAN BAYI BARU LAHIR (BBL) DI BPM FAUZIAH HATTA PALEMBANG TAHUN 2019
Authors: Sari Sagita Darma , Indriani Fitri
Published: April 2022

Hypothermia is a major cause of morbidity and mortality in newborns at developing countries. The World Health Organizations (WHO) has recommens  to maintain heat in newborns care, however hypothermia continues become a normal neonatal condition, which is unidentified, not documented and limited treatment. The purpose of this study was to determine the relationship between IMD and body temperature of newborns in 2019 BPM Fauziah Hatta Palembang. The method uses in this study was to uses descriptive analytical design, collecting samples using accidental sampling totaling 50 people respondent, data was collected by measuring temperature directly after birth and 1 hour after birth using a digital thermometer and recorded in the observation sheet. The results showed a ρ-value of 0,000 <ɑ (0,05) which means there is a significant relationship between the Initiation of Early Breastfeeding Against the Body Temperature of a Newborn. It is expected that the IMD method is implemented by health staffs, particularly midwives in order to assist the improvment of body temperature within the normal of newborns.
KARAKTERISTIK DEMOGRAFI IBU DENGAN KEMAMPUAN TOILET TRAINING PADA ANAK DI PAUD HARAPAN BUNGA BANGSA PALEMBANG
Authors: Febrianti Arly
Published: April 2022

Toilet training is an effort to train children to be able to urinate and defecate on their own, toilet training is an important aspect in the development of toddler age children that must receive parental attention in urinating and defecating. Demographic characteristics related to age, education and occupation can affect a child's development and ability to perform toilet training. The aim of the study was to determine the relationship between maternal demographic characteristics and the ability of toilet training in children. The research method is cross sectional and the research sample is taken using a total sampling technique with a total of 72 respondents who have children at PAUD Harapan Bunga Bangsa Palembang. This research was conducted on January 29, 2021 using research instruments in the form of a questionnaire and a check list. The results of the study using the Chi Square test showed that there was a relationship between education (p = 0.000), knowledge (p = 0.000), occupation (p = 0.002) and toilet training abilities in children. There is no relationship between age (p = 0.579) with toilet training ability in children. Health workers are expected to provide counseling to schools about the importance of toilet training in early childhood.
FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN TINGKAT PENGETAHUAN WANITA PEKERJA SEKS (WPS) TENTANG PENYAKIT MENULAR SEKSUAL (PMS) DI PROSTITUSI SEER KABUPATEN KARAWANG
Authors: Putri Vivi Dwi
Published: April 2022

According to WHO estimates in 2008, 499 million new cases of curable STI (syphilis, gonorrhea, chlamydia and trikomoniasis) takes place every year around the world in adults aged 15-49 years. These figures do not include extra health burden caused by HIV and other viruses such as HSV IMS. The design that was used in the preparation of analytical research methods is by using a Cross-sectional approach in simple random sampling, with the number of respondents to be 65. The research and discussion of the 65 respondents, a total of 20 respondents (30.8%) good knowledge level and 45 respondents (69,2%) level of knowledge. Of the 5 variables are examined, there is one variable that meaningful socio-economic value of the obtained p = 0.05  (≤0.05), and 4 other variables was not meaningfully. There is a meaningful relationship between the socioeconomic level of knowledge of women sex workers (WPS) against sexually transmitted diseases (STDS), whereas other characteristics such as age, experience, the status of residence and source of information on the absence of a meaningful relationship with the level of knowledge of female sex workers (WPS) against sexually transmitted diseases. Therefore this research as a basis to improve the quality of service type to the community in order to be able to empower communities especially the society became a target in the health establishments.

 Menurut 2008 WHO memperkirakan, 499 juta kasus baru IMS dapat disembuhkan (sifilis, gonore, klamidia dan trikomoniasis) terjadi setiap tahun di seluruh dunia pada orang dewasa berusia 15-49 tahun. Angka-angka ini tidak termasuk beban kesehatan tambahan yang disebabkan oleh HIV dan IMS virus lainnya seperti HSV. Desain yang digunakan dalam penyusunan ini adalah metode penelitian analitik dengan menggunakan pendekatan Cross Sectional secara simple random sampling, dengan jumlah responden sebanyak 65. Hasil penelitian dan pembahasan dari 65 responden, sebanyak 20 responden (30,8%) tingkat pengetahuan baik dan 45 responden (69,2%) tingkat pengetahuan kurang baik. Dari 5 variabel yang diteliti, terdapat satu variable yang bermakna yaitu sosial ekonomi diperoleh nilai p = 0,05 (≤0,05), dan 4 variabel lainnya tidak bermakna.Terdapat hubungan yang bermakna antara sosial ekonomi dengan tingkat pengetahuan wanita pekerja seks (WPS) terhadap penyakit menular seksual (PMS), sedangkan karakteristik lainnya seperti umur, pengalaman, status tempat tinggal dan sumber informasi tidak adanya hubungan yang bermakna dengan tingkat pengetahuan wanita pekerja seks (WPS) terhadap penyakit menular seksual. Untuk itu penelitian ini diharapkan sebagai bahan masukkan untuk meningkatkan kualitas pelayanannya terhadap masyarakat agar lebih bisa memberdayakan masyarakat terutama masyrakat yang menjadi binaan di instansi kesehatan tersebut