bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic evaluation in head and neck cancer patients: a clinicoimaging tertiary care center study
Authors: Keerthika N. Kavya , Veda D. Sri , Prabhat M. P. V. , Sarat G. , Maini Gunmeet
Published: September 2021

Background: The occurrence of the head and neck cancers (HNC) is increasing day by day. These have been associated with multiple etiological factors, and early diagnosis has a prime role in the patient's prognosis and overall survival. Prognostic evaluation in head and neck cancer patients utilizing clinical incidence and imaging outcomes.Methods: The study sample included 217 confirmed HNC patients’ data obtained from the tertiary cancer care centre were analysed to assess the prognosis and be subjected to statistical analysis.Results: Out of all HNC, cancer pertaining to the lip and oral cavity was the most common variety with 65.89% and most of the HNC occurred in men of about 97%, suggesting a strong association with adverse oral habits.Conclusions: We conclude that the current scenario of HNC’s progression and treatment modalities in Andhra Pradesh were in comparison to the World Health Organization (WHO) data suggests an increase in the awareness of the etiological factors and the disease progression. Though various advanced imaging and treatment modalities are available, the patients' prognosis is untethered due to low socio-economic status in this region.
Study of knowledge attitude and practice towards COVID-19 among patients attending a tertiary care hospital in Durg district of Chhattisgarh
Authors: Junaid Mohd , Shinkar Swapnil , Patil Amol
Published: September 2021

Background: Poor knowledge, attitude, and practice (KAP) patterns among patients might reflect the danger of possible high transmission of COVID-19 and the need for awareness campaigns. The need of the hour is to gauge the knowledge, awareness and practices of the people to help prevent the further outbreak of COVID-19.Methods: Questionnaire based cross sectional study was done for a period of 7 days to access the knowledge attitude and practice towards COVID-19 among patients attending a tertiary care hospital in Durg, Chhattisgarh.Results: A total of 288 people participated in the study, majority of respondents were males 53% mean age was 39±15.9 years. Overall, 80.4% of the participants had good knowledge, 68.6% of the participants had a positive attitude, 83.8% of the participants were following good practices. Gender and income influenced knowledge scores, being significantly higher in males and higher income individuals (p value <0.05) while attitude and practices scores had no significant association with gender and income group (p value >0.05).Conclusions: Though the population demonstrated decent knowledge, appropriate practice, and positive attitude towards COVID-19 at the time of outbreak there is still need of on-going health education and awareness campaigns and need of policies and intervention that are more person centred.
Knowledge and consumption of probiotics and prebiotics in India: a narrative review
Authors: Shireen Arshia , Aneesh Mitravinda
Published: September 2021

In this narrative review, we discuss existing literature on the knowledge, consumption, and factors influencing the consumption of probiotics and prebiotics in India. We also examined the current nature of the probiotics and prebiotics market in the country. There were only a handful of studies on the knowledge and consumption of probiotics and prebiotics among Indians, mainly conducted in urban areas and middle to high-income households. Limited research showed that the knowledge of probiotics had increased appreciably in the past decade, while there is still poor technical knowledge among Indians. Simultaneously, prebiotics is an unfamiliar concept to the general public. Younger individuals are more aware than their older counterparts. The probiotics market in India offers several milk-based beverages, yogurt, and curd, while few non-dairy beverages are available from overseas. The prebiotics market in India has several powder formulas and some chewable tablets. The consumption of probiotics and prebiotics is limited to popular foods like curd, probiotic drinks, buttermilk, and milk, wheat, onion, tomatoes respectively. The modern Indian diet lacks traditional probiotic and prebiotic sources despite their presence in several regional cuisines. Furthermore, awareness of these foods and the knowledge and belief in their health benefits are the most influential factors in their consumption. Contrarily, the perception of not requiring these foods for the maintenance of good health prevents their consumption. Improving awareness and knowledge while offering diverse gut-healthy foods in all strata of Indian society can increase the utilization of these foods and improve general health and prevent chronic diseases.
COVID-19 and thrombosis
Authors: Verma Kavita , Sharma Anjali , Bulsara Shahzad Sarosh
Published: September 2021

The first case of novel corona virus disease (COVID-19) was reported in China and undoubtedly today this disease has rapidly crossed borders, infecting people throughout the world. There are heaps of complications related to COVID-19 namely acute respiratory failure, acute liver and kidney injury, bacterial and fungal infections, and septic shock. Vascular thrombosis is another burden that COVID-19 is pilling on to the load of its complications. Venous thromboembolism namely deep vein thrombosis and pulmonary thromboembolism; pulmonary microvasculature thrombosis and systemic arterial thromboembolic events like limb ischemia, myocardial ischemia/infarction and cerebrovascular thrombosis are being increasingly reported in COVID-19 patients.
Our comprehensive experience with tracheostomy in tertiary multi-speciality hospital over four years
Authors: Kapadia Parth B. , Mandal Manit M. , Panchal Ajay J. , Kumar Rakesh , Parmar Neel , Shah Vidhi
Published: September 2021

Background: Tracheostomy is a common surgical procedure used to achieve a secure airway in patients in elective as well as emergency conditions. Our study accounts for our first-hand experience with the procedure in our tertiary multi-speciality hospital.

Methods: It is a four year (January 2017 to February 2021) retrospective study in which all the 246 cases of tracheostomies were taken into account which were performed during this study period in the department of otorhinolaryngology (ENT), Surat Municipal Institute of Medical Education and Research (SMIMER), Surat (India). The patients were thoroughly followed up until the final outcome of the tracheostomy was established.  

Results: A total of 246 tracheostomies were performed, 63.82% of which were in men. The mean patient age was 42 years. The majority (76%) were elective, performed for various indications, while the remaining 24% were emergency tracheostomies. All tracheostomies were performed by otorhinolaryngologists. Complications relating to tracheostomy were documented in 40 patients (16%) intra-operatively and/or post-operatively which included bleeding, surgical emphysema, granulations along the stomal site and rarely shock. The mean time to decannulation was 13.48 days.

Conclusions: Our study takes into account and discusses the findings of all the 246 tracheostomies which were performed during the study period of 4 years. Elective cases form the majority although there is a significant case series of emergency tracheostomies performed for a range of pathologies.

 
Políticas para el financiamiento de cadenas de valor: lecciones aprendidas para intervenciones frente al COVID-19
Authors: Demichelis Francisco , Curat Pablo , Fernández María Carmen , Matias Gago Roxana , Fernandini Manuel , Schneider Christian
Published: September 2021

La pandemia del COVID-19 ha provocado una profunda crisis macroeconómica mundial con caídas históricas en las actividades económicas. Esto ha llevado a la necesidad de ofrecer financiamiento inmediato a empresas para asegurar su supervivencia ante la crisis y para evitar la caída del empleo y la destrucción del tejido productivo de los países. En este escenario, se debe prestar particular atención a las políticas públicas de acceso al crédito y al mercado de capitales. El Banco Interamericano de Desarrollo (BID) introdujo en los últimos años un rasgo innovador en sus programas de cadenas productivas que ha traído resultados positivos. Dicho rasgo consiste en combinar diversos instrumentos de asistencia técnica dirigidos a clusters y sectores con fondos destinados a fomentar una mayor asistencia crediticia a las micro, pequeñas y medianas empresas (mipyme). Este documento aborda la problemática del diseño de políticas de desarrollo productivo, en particular aquellas orientadas al financiamiento de mipyme, para luego analizar las lecciones aprendidas de tres programas de financiamiento de cadenas productivas ejecutados por el BID. A partir de este análisis, y tomando en cuenta el impacto de la pandemia del COVID-19 tanto a nivel macroeconómico como entre sectores, este documento propone un conjunto de intervenciones defensivas y constructivas para facilitar el acceso al financiamiento de mipyme. De igual manera, se describen los instrumentos financieros más adecuados de acuerdo con las necesidades y perfil de riesgo de las cadenas involucradas.
Potencial de recuperación pospandemia: crédito bancario por sectores productivos en América Latina y el Caribe
Authors: Bebczuk Ricardo , Fernández Díez M. Carmen , Támola Alejandro
Published: September 2021

El crédito productivo puede jugar un papel relevante en las condiciones de recuperación tras la crisis provocada por la pandemia. Entender cómo se ha comportado el crédito en la región y los factores que influyen en su comportamiento por sectores es esencial para orientar a los formuladores de políticas sobre las capacidades de recuperación de los sectores y las alternativas de focalización de los esfuerzos y apoyos a sectores específicos. Esta nota técnica desarrolla un marco analítico enfocado en la recuperación del crédito bancario a nivel de sectores, formulando un índice específico de recuperación potencial, que puede utilizarse para mejorar el diseño de las políticas públicas de apoyo a la recuperación del crédito por sectores productivos. El presente estudio confirma que existen mejores condiciones de recuperación para aquellas industrias con mayor acceso al crédito previo (medido por su apalancamiento), menor participación en la cartera comercial de la banca antes de la pandemia y mejor desempeño productivo durante la pandemia. Estas condiciones de recuperación se fundamentan en características respaldadas por la evidencia empírica de aquellos factores relevantes que afectan al crédito bancario. Los dos sectores con mayor potencial de recuperación del crédito bancario en la región, sobre la base de las limitantes prepandemia y de la posición durante la pandemia, son el sector de agricultura, silvicultura y pesca seguido por el sector de actividades inmobiliarias; por su parte, los sectores con menor potencial de recuperación autónoma del crédito son el comercio y las industrias manufactureras. Se sugieren alternativas en cuanto al diseño de las políticas de focalización y apoyo para los sectores específicos en un contexto de escasez de información, restricciones fiscales y limitación de los recursos presupuestarios.
Social Framework of Collective Memory and Cognitive Problems of Historical Knowledge
Authors: Ionov Igor
Published: September 2021

The article demonstrates that the cognitive possibilities of historical memory and “living history”, which generates the agenda, questionnaires and source strategies of historians, are closely connected with the social framework of historical memory and, accordingly, with the self-identification of historians. They form cognitive maps that regulate the cognitive activity of a historian. It is shown that the social framework of historical memory within the crisis of globalization is changing rapidly, creating unusual, contradictory and sometimes absurd constellations. This topic is studied in the context of the history of discursive hegemony in historical memory by analyzing the ideas of A. Assmann, J. Laroche, A. Cento Bull and H. L. Hansen, who criticize the current state of historical memory and suggest new versions of it, based on the change of social frameworks and forms of discourse. The project of cosmopolitan memory created by the latter, its advantages and disadvantages are evaluated. The tools of analysis are N. Elias's theory of “civilization process”, G. Bateson's theory of schismogenesis, E. Erikson's theory of self-identification, E. N. Shulga's concept of pre-understanding. It is shown that cosmopolitan memory, while remaining within the framework of hegemonic discourse, reproduces antagonistic forms of memory. The most productive are the approaches of A. Assmann and S. Conrad, who carefully criticize the situation of cosmopolitan memory, seem to be the most productive. Cultural and historiographical processes in Germany, the British Empire and Southeast Asia served as the main material for the study. The works of N. Ferguson, close to the imperial historical school and the neo-Asianism (reorientalism) of Lee Kuan Yew, in which the values of empire, colonialism and traditionalism are defended in opposition to the ideal of human rights, have been analyzed. It is noted that historians strive to distinguish between the universalism of the idea of humanity and cultural pluralism in dialogue about human rights, which prevents criticism of alien or seemingly alien values outside a situation of cooperation and consensus. The ideal of cross historical memory as the historian's optimal cognitive tool is put forward.
The Establishment of Soviet Control over the Church of St. Louis in Moscow in 1947—1950 (According to the Documents of the the Council for Religious Cults Aﬀairs under the Council of Ministers of the Soviet Union)
Authors: Zhdanova Ekaterina
Published: September 2021

The Council for Religious Cults Aﬀairs, created in 1944, was in charge of control over the activities of all non-Orthodox religious organizations. At the same time, the transformation of the religious course of the Soviet regime in the 1940s, the increase in the number of Catholics at the expense of the newly annexed territories, the conditions of the Cold War, and a negative attitude towards the Vatican were the reasons for the Council's special attention to Catholicism. Church of St. Louis on Lubyanka remained the only active Catholic church in Moscow, and, surprisingly, the authorities could not fully control it, since many parishioners were foreigners, and the rectors of the temple were French and American priests who enjoyed the patronage of the French embassy and asked for help to the American embassy. In this regard, the Council for Religious Cults Aﬀairs decided to sever the existing ties between the temple and the embassies and establish control over its life. Based on documents deposited in the State Archive of the Russian Federation, the article reconstructs in detail the process of determining the rights of the Soviet state to the building of a church, forming the “twenty” from among Soviet citizens and appointing a priest — a citizen of the USSR.
Remembrance of the Past in a Digital Environment: Cognitive Landmarks for Historical Research
Authors: Zvereva Galina
Published: September 2021

Russian professional historians have long been working with “memory” in their disciplinary field. They study collective and personal memory of the past in a variety of forms of memories, evidences of experiencing the past, their documentation and storage. In the last third of the 20th — beginning of the 21th century, their research activities are increasingly influenced by the cognitive turns that take place in social sciences and humanities. At present, the object of increased attention of Russian historians is the qualitative and technological changes occurring in the methods and forms of the production of memory of the past, its storage, transmission, appropriation and consumption in the information society. The article examines the possibilities of updating theoretical and methodological tools in historical studies of memory based on innovations occurring in the interdisciplinary field of memory studies and, above all, in such intensively developing areas as media memory studies and digital memory studies. The key concepts of media memory, digital memory, algorithmic memory, and socio-technical connected memory introduced into the scholar circulation of memory studies can serve as important cognitive guidelines for historians to study the peculiarities of constructing memory of the past in a modern mediatized digital society, the specifics of its documentation, formats for saving, and transferring. The article discusses the scope of these concepts and their heuristic potential for identifying and investigating new properties of collective memory produced in a mediatized digital environment. The inclusion of such concepts in the arsenal of historical studies of memory as units of analysis opens up opportunities for complicating scientific perception, categorization and conceptualization of the phenomena of memory of the past.
Cognitive Mechanisms for Representing Global Risks in Recent History (Search for Ways of Interdisciplinary Research)
Authors: Zabotkina Vera
Published: September 2021

Interdisciplinary cognitive research is a hallmark of the 21st century. New clusters are being formed in the field of the humanities. This article explores ways of integrating cognitive history and cognitive linguistics. The point of contact is the desire of representatives of both sciences to explore the laws of thinking, mental models and knowledge structures. The method of integrated research is frame analysis, applicable both to texts of the past and to documents of recent history, the concept of RISK is analyzed. The perspectives of an integrated methodology for studying global risks are shown.
Micropolar Fluid Flow Along with an Inclined Riga Plate Through a Porous Medium
Authors: Islam Md. Rafiqul , Nasrin Sonia
Published: September 2021

This study presents the one-dimensional unsteady micropolar fluid flow set in a porous medium along with an inclined infinite Riga plate. This Riga plate is created an electric and magnetic field, where a transverse Lorentz force is generated that contributes a flow along with the plate. The explicit finite difference method is used to find the solution of the non-dimensional form of the governing equations and estimated results are analyzed in terms of Microrotation parameter, Suction parameter, thermal Grashof number, mass Grashof number, Permeability parameter, Hartmann number, Dufour number, Soret number, Schmidt number. Also, the effects of the pertinent parameters on the local and average shear stress, Nusselt number, and Sherwood number are reported numerically as well as graphically.
Experimental Study on Mixing Uniformity of Injection On-Line Mixer of Crop Protection Equipment
Authors: Shi Yixin , Jiang Ping , Wang Fujie , Zhou Shuxian
Published: September 2021

In order to promote pesticide application reduction and efficiency enhancement, to avoid the direct mixing of pesticides caused by secondary pollution and life safety risksand, further improve the mixing uniformity of on-line mixing system of crop protection equipment. The numerical simulation on structural parameters and fluid parameters of the mixer was performed by the CFD method to determine the best structural parameters of the mixer. And an injection online mixing system experiment platform was built. The experiments were carried out by high speed photography and spectrophotometry respectively. The experimental results show as following: The variable mixing ratio experiment was carried out in the case of pure reagents mixing test in the mixer. When the water flow is 140 L/min and the pesticide pressure is 1 MPa, the ratio of pesticide solution is controlled in the range of 1:300 ~ 1:3000, and the images of pesticide entering the mixer are collected respectively. The results of image analysis and processing show that the online mixing system has good mixing performance in qualitative analysis. When the mixing ratio is 1:300 to 1:300 and the normal pressure of pesticide is 0.1 MPa, the maximum mixing uniformity variation coefficient of the pesticide solution is 6.87%. When the mixing ratio is 1:300, the minimum mixing uniformity coefficient is 3.33%. It is proved that the overall trend of mixing uniformity variation coefficient increases with the increase of mixing ratio when the pesticide is mixed at normal pressure. When mixing under pressure, the mixing uniformity coefficient of variation is less than 5% and the maximum is 3.903%, which indicates that the mixing uniformity of the mixer is well when mixing under pressure. The results can improve pesticide utilization, safety of plant protection, reduce secondary pollution and reduce pesticide residues. Through the qualitative analysis of high-speed photography, it is found that the drug mixer has good time and space distribution uniformity in the process of drug mixing. The quantitative detection of spectrophotometry shows that the drug liquid has good time and space distribution uniformity after passing through the mixer. The conclusion of this paper has certain guiding function and reference value for plant protection technology and liquid on-line mixing in chemical and pharmaceutical fields.
Reverse Osmosis Desalination Plant Driven by Solar Photovoltaic System–Case Study
Authors: Kensara Muwaffaq , Dayem Adel M. Abdel , Nasr Abdelaziz
Published: September 2021

A case study of designing of a reverse osmosis (RO) desalination plant using a Solar Photovoltaic (PV) system is investigated in this work. The RO system is a desalination plant providing pure water to the Shoiaba power generation plant. The system consists of a PV array connected to an inverter for day time or batteries for night time. The PV is designed to meet the high-pressure pumps’ load that is about 13649 kWh a day. Because the plant is operated 24 hours a day the PV panels are divided into two parts, one to cover the day time load and the second to cover night load that is stored in batteries. Based on weather conditions of solar radiation of the shortest day and maximum ambient temperature the PV is sizing and a storage system is determined. The system is modeled by the TNSYS software to simulate the performance of the system during the year. The annual performance of system proves that the system is able to meet the required load during the year. It can be concluded that it is a great opportunity to install photovoltaic panels and increase the efficiency of Reverse Osmosis Desalination Plant.
Performance Analysis of an Adsorption Refrigeration System Working on Activated Carbon/Methanol Pair Using Finned Tube Type Adsorber Bed
Authors: Soni Palash , Lolalis Sruthi , Mazumdar Bidyut , Bhowmick Shubhankar , Gaba Vivek Kumar
Published: September 2021

Adsorption refrigeration, being a unique and eco-friendly technology, has gained popularity over conventional refrigeration systems. The present study is aimed at developing an annular finned tube adsorber model which serves as a thermal compressor in adsorption refrigeration systems. The mathematical model is addressed numerically using finite difference discretization method and explicit scheme was used for the solution. The generalized model has been simulated for activated carbon–methanol working pair. The system has an optimum cycle time of 1800s. It was found to have a highest refrigeration capacity of 260.66 kJ/kg at a regeneration temperature of 393 K and evaporator temperature of 283 K. The highest COP (Coefficient of Performance) achieved by the system is 0.3706 at a regeneration temperature of 353 K and evaporator temperature of 283 K. A highest SCP (Specific Cooling Power) of 144.8 W/kg was obtained at an evaporator temperature of 283 K and regeneration temperature of 393 K.
Investigation of Air Distribution in Mosque Rooms with Different Angles of Supply and Inlet Velocity
Authors: Harsito Catur , Permata Ariyo Nurachman Setiya
Published: September 2021

The HVAC (heating, ventilation, and air conditioning) systems utilization has increased in the last decade. It conducts global warming which has an impact on the rising of global temperatures. An excellent air conditioning system will make the room comfortable conditions. This paper aims to investigate the mosque space with a cooling model of wall-mounted air conditioning and the difference in inlet angle and air inlet velocity. The room design was constructed using SolidWorks software. Air distribution observations were created using ANSYS Workbench simulation software. The use of a supply angle of 90° results in an even distribution of air with a low inlet velocity, whereas in conditions of a supply angle of 60° requires a higher inlet speed. Thus, the uniform air distribution is able to be realized by the proper configuration which results an appropriately room temperature and saves energy usage.
Leveque-Type Similarity Transformation for a Thermally Developing Viscous Dissipative Flow in a Parallel Plate Channel
Authors: Chen Gooi Mee , Yip Yew Hau
Published: September 2021

Compared to the existing more elaborate eigenvalues-eigenfunction analytical solution where the solution of a thermally developing forced convection problem converges very slowly at the beginning of thermal entrant region, Leveque-type similarity transformation method provides a more convenient way to look into the insights of the problem. Assuming that the wall heat flux and viscous dissipation only has an effect within the thin thermal boundary layer at the beginning of the thermal entrance region, this study intends to solve the governing thermal energy equation for a thermally developing flow in a parallel plate channel, subjected to uniform heat flux, by means of Leveque-type similarity transformation. The resulting ordinary differential equation, is subsequently solved by a fourth order Runge Kutta method. A comparison of the Nusselt number along the axial direction, at the beginning of the thermally developing region with the literature, reveals less than 10% discrepancy for Brinkman number less than one, which is a commonly acceptable range for practical applications. Although its accuracy depletes downstream the channel, similarity transformation provides sufficiently accurate temperature distribution, and captures the heat transfer insights for a thermally developing viscous dissipative forced convection.
Metodología para evaluación de impacto ambiental de proyectos de infraestructura en Colombia
Authors: Viloria Villegas Margarita Inés , Cadavid Lorena , Awad Gabriel
Published: September 2021

La Evaluación de Impactos Ambientales (EvIA), requiere herramientas estándar con un marco establecido para la evaluación ambiental. En esto se ha avanzado en Colombia con la expedición de términos de refencia para la realización de estudios ambientales por sector productivo, sin embargo se sigue evidenciando poca calidad de los estudios ambientales, una gran diversidad de métodos con incosistencias metodológicas e incluso conceptuales, sumado al uso de juicios de valor que dependen del profesional que los ejecuta y a que las escalas de valoración cualitativas no son claras o adecuadas, lo cual sesga los resultados. Por lo anterior, el objetivo de este artículo es presentar un marco metodológico cualitativo para la evaluación del impacto ambiental de proyectos de infraestructura en el contexto Colombiano, considerando el ciclo técnico de proyectos. Este artículo está organizado como sigue. Inicialmente se presenta el soporte conceptual del que nace la propuesta metodológica; luego se indica la forma en que se desarrolló el trabajo, presentando los lineamientos que orientaron la selección de los criterios y atributos para la EvIA. Posteriormente se explora la metodología diseñada para llevar a cabo esta valoración, y se procede con la discusión de los hallazgos encontrados en la elaboración de la investigación. Como principal conclusión se tiene la necesidad de seguir profundizando en el escalamiento de atributos para EvIA con el fin se seguir reduciendo el sesgo en las evaluaciones ambientales, y generando mayor estandarización en los procesos que conllevan a determinar el impacto de proyectos de infraestructura en Colombia.
An Analytical Study of the Factors Affecting Hearing Improvement after Ossiculoplasty – A Retrospective Study, Mathura, Uttar Pradesh
Authors: Singh Piyush Kant , Saggu Samneet , Singh Preeti
Published: September 2021

BACKGROUND Otologists always yearn to improve the hearing outcome of their patients with chronic suppurative otitis media. There are different options for ossiculoplasty to choose from, depending on the extent of disease, condition of ossicular chain and availability of implant material and there has always been a quest to make appropriate decision with a predictable outcome. In this study, we have tried to analyse various factors which can affect hearing outcome after Ossiculoplasty. METHODS A retrospective study was done to study the effect of implant material, condition of ossicular chain and disease in the mastoid on post-operative hearing improvement on 200 patients, who underwent tympanoplasty or tympanomastoidectomy from January 2018 to January 2020, in Department of Otorhinolaryngology and Head and Neck Surgery, K.D. Medical College, Mathura. Decision of ossiculoplasty was made based on intra-operative findings. Autograft incus, Teflon TORP (total ossicular replacement prosthesis) and cartilage columella were used based on availability and feasibility. RESULTS Mean improvement in average air-bone gap of 200 patients was found to be 18.57 dB, with autograft incus, it was 19.99 dB, with Teflon TORP (total ossicular replacement prosthesis), 19.53 dB and with cartilage columella 16.73 dB (P = 0.023). Mean hearing improvement was 18.98 dB when handle of malleus was present and 15.59 dB when it was absent (P = 0.023). Mean hearing improvement was 19.42 dB when stapes superstructure was present and 16.92 dB when it was absent (P = 0.016). Even though the hearing outcome was better when mastoid was disease free (19.57 dB) compared to when it was diseased (18.30 dB), the difference was not statistically significant. (P = 0.177) CONCLUSIONS In our study, we found autograft incus to be the best material for ossiculoplasty and presence of handle of malleus and stapes superstructure improved postoperative hearing outcome significantly but involvement of mastoid by disease did not significantly affect the hearing outcome post-operatively. KEYWORDS Chronic Suppurative Otitis Media, Ossiculoplasty, Tympanoplasty, Ossicular Prosthesis, Autograft
Effectiveness of Remedial Teaching for Improving the Academic Performance of Poorly Performing Phase 1 Medical Students in Biochemistry Discipline at Government Medical College, Kozhikode, Kerala
Authors: Sreedhar Shaji , Appunni Sandeep
Published: September 2021

BACKGROUND Remedial teaching is an educational programme for increasing the academic performance of poorly performing students in a curriculum. Remedial teaching is finding specific learning difficulties in low achieving learners who are lagging behind in academics and providing them with necessary support and guidance to bring their academic performance closer to the required standard and to prevent them from occurring in future. METHODS This quasi-experimental study was conducted among first year medical students at Government Medical College, Kozhikode, Kerala from December 2019 to February 2020. All the sixty-four students who scored less than 50 % of marks in Biochemistry first internal examination were identified as poor performers. They were divided in to two groups, A and B, each consisting of thirty-two students by simple random method. The study skills of group A and group B students were assessed using study skills assessment questionnaire. They were also assessed on non-academic problems that affect their studies through open-ended interviews. Both the group students received academic support that included conceptual learning, logical thinking, reasoning skills and answering methods. In addition, group A students were given remedial teaching comprising study skills training, counselling sessions and motivation classes. At the end of eight weeks, a summative assessment was conducted for both the groups. A four-point Likert scale feedback questionnaire on remedial teaching was collected from group A students. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16. RESULTS The mean mark of group A that received remedial teaching was significantly higher (P < 0.0001) than group B. The difference in mean marks between pre-test and post-test in group A was statistically significant (P < 0.0001). CONCLUSIONS Remedial teaching sessions are effective for improving the academic performance of poorly performing students in the subject of Biochemistry. KEYWORDS Remedial Teaching, Academic Support; Study Skills; Counselling; Motivation
Spectrum of Multi-Organ System Involvement in Perinatal Asphyxia at a Tertiary Care Hospital in Southern India - A Descriptive Study
Authors: Satna Soumya , Devagudi Ramadevi , Pedada Ramu , Lunavath Narayana
Published: September 2021

BACKGROUND Perinatal asphyxia (PA) is an important cause of neonatal morbidity, mortality, and neurologic handicap in children. Dysfunction of organs other than central nervous system is often recognised after perinatal asphyxia and manifests as hypoxic ischaemic insults to heart, lungs, kidneys and bowel. The purpose of this study was to assess the spectrum of multi-organ system involvement in perinatal asphyxia. METHODS This observational, descriptive study was conducted at SVRRGGH (Sri Venkateswara Ramnarayan Ruia Government General Hospital) - Tirupati from October 2010 to September 2011 and has Institutional Ethics Committee approval (Regd. No: 58647, Dt: 20 / 11 / 2010). After considering the inclusion and exclusion criteria, 204 neonates diagnosed with perinatal asphyxia who got admitted in our newborn intensive care unit (NICU) were included in this study. RESULTS In the present study, we had 118 (57.89 %) male babies and 86 (42.11 %) female babies. The mean birth weight was 2640 +/- 460 grams. Infants of birth weight 2500 - 4000 grams (appropriate for gestational age - AGA) accounted for 202 (98.96 %). Major maternal risk factors in this study were MSAF (meconium-stained amniotic fluid (66/204, 32.4 %), PIH (pregnancy induced hypertension) and Eclampsia (26/204, 12.7 %) and PROM (premature rupture of membranes) (26/204, 12.7 %). In the present study, we found higher mortality (19/117, 16.2 %) in babies born to multiparous mothers. Respiratory system involvement was seen in 80 (39.2 %) infants. Renal involvement was observed in 58 (27.5 %) infants. Acute renal failure was diagnosed in 22 (10.8 %) cases. CVS (cardiovascular system) involvement was seen in 56 (27.5 %) cases where as GIT (gastrointestinal tract) involvement was found in 32 (15.68 %) cases. CONCLUSIONS Epidemiological research is needed to accurately estimate the contribution of birth asphyxia to perinatal morbidity and mortality, especially in community settings where the burden of disease, due to high proportion of unattended deliveries, is likely to be larger than the hospital setting. KEYWORDS Perinatal Asphyxia, Neonatal Intensive Care Unit, Hypoxic Ischaemic Encephalopathy, Multi Organ Dysfunction, Cardiovascular System
Study of Systolic and Diastolic Dysfunction among Normotensive Patients with Type 2 Diabetes Mellitus – A Cross–Sectional Study from Puducherry, India
Authors: I.S.S. Suman Babu , Shankar Sethu Prabhu , Reddy Harshavardhan , Nair Surya Usha Surendran
Published: September 2021

BACKGROUND Diabetes mellitus (DM) single-handedly accounts for 75 – 90 % of excess coronary artery disease (CAD) risk seen in persons suffering from it and it also enhances and amplifies the effects of other traditional cardiovascular risk factors. After adjusting for concomitant risk factors such as hypertension and hyperlipidemia, there still remains an excess risk for cardiovascular disease (CVD) in people with diabetics. In this study, we wanted to evaluate left ventricular (LV) systolic and diastolic dysfunction in normotensive diabetic patients. METHODS A cross sectional comparative study was performed from January 2016 to September 2017 on 50 diabetics and 50 age and sex matched healthy controls. Adult patients of both sexes with diabetes mellitus who are normotensive were included as cases. Patients with known heart disease, chronic kidney disease, thyroid disorders were excluded from the study. 2D transthoracic echocardiogram (ECHO) with M mode was used for assessing systolic and diastolic function. RESULTS Mean ejection fraction was lower in patients group (59.76) as compared to control group (64.74) with 8 % of cases with a value of< 50 %. Fractional shortening was also lower in patients (29.14) compared to controls (34.86) with 12 % patients having a value of < 25 %. E/A ratio was 1.12 in patients when compared to 1.36 in controls with 32 % of patients having value < 1. Mean isovolumic relaxation time was 96.52 in patients when compared to 87.42 in controls with 24 % patients having value > 100 msec. CONCLUSIONS Normotensive diabetics are prone to left ventricular dysfunction. Diastolic dysfunction is more common than systolic dysfunction. KEYWORDS Diabetes Mellitus, Systolic Dysfunction, Diastolic Dysfunction, Cardiovascular Disease
Identification of Risk Factors Associated With Mortality Among Patients With COVID-19 Using Random Forest Model: A Historical Cohort Study
Authors: Moghaddam-Tabrizi Fatemeh , Omidi Tahereh , Mahdi-Akhgar Masoomeh , Bahadori Robabeh , Valizadeh Rohollah , Farrokh-Eslamlou Hamidreza
Published: September 2021

There is conflicting evidence about factors associated with Clinical course and risk factors for mortality of adult inpatients. We aimed to identify the demographic, clinical, treatment, and laboratory data factors associated with mortality in the Khoy district. We performed a retrospective cohort study including COVID-19 infected patients who were admitted to Qamar-Bani Hashim hospital from 2 November 2020 to 4 December 2020. We used random forest methods to explore the risk factors associated with death. The applied method was evaluated using sensitivity, specificity, accuracy, and the area under the curve. Age, pulmonary symptoms, patients need a ventilator, brain symptoms, nasal airway, job were the most important risk factors for mortality of COVID-19 in the random forest (RF) method. The RF method showed the highest accuracy, 82.9 and 79.3, for training and testing samples, respectively. However, this method resulted in the highest specificity (89.5% for training and 95.7% for testing sample) and the highest sensitivity (91.9% for training and 94.5% for testing sample). The potential risk factors consisting of older age, pulmonary symptoms, the use of a ventilator, brain symptoms, nasal airway, and the job could help clinicians to identify patients with poor prognosis at an early stage.
Molecular Epidemiology of blaCMY-1, blaCMY-2, blaFOX Genes in K. pneumoniae From Elderly Patients in Tehran, Iran
Authors: Badamchi Ali , Namazi Shabestari Alireza , Etemadi Mohammad Reza , Tabatabaei Azardokht
Published: September 2021

The growth rate of the population aging is increasing worldwide. To assess antimicrobial susceptibility of extended-spectrum β-lactamase- (ESBL-) producing Klebsiella pneumoniae Isolated from Patients aging in Rasool Akram, Hospital, as well as to identify AmpC genes. 100 K. pneumoniae strain isolated from different clinical samples. Isolates resistant to oxyimino-cephalosporins and to cefoxitin evaluated to phenotypic ESBL production and to phenotypic AmpC production, respectively. Detection of resistance genes was then performed using primers specific for AmpC genes. Piperacillin/tazobactam and carbapenems remained the active β-lactam antibiotic against K. pneumoniae. ESBLs were detected among 40 (40%) of K. pneumoniae isolates. CMY-1 gene was detected in 34.3% of all AmpC-positive isolates, whereas CMY-2 and FOX genes were 14.2% and 28.6%, respectively. The consumption of Carbapenem family drugs is high in Iranian hospitals which are used as a first line of treatment without antibiotic susceptibility testing. Therefore, increase in antibiotic resistance to this family drugs is unavoidable in the near future. Therefore, it is necessary to take the necessary measures to modify the administration and use of antibiotics.
The Prevalence of Insulin Resistance and Its Association With Thyroid-Stimulating Hormone and Obesity in Infertile Women With Different Polycystic Ovary Syndrome Phenotypes
Authors: Azargoon Azam , Sadeghi Narges , Mirmohammadkhani Majid
Published: September 2021

The aim of this study was to investigate the prevalence of insulin resistance (IR) according to the phenotypic subgroups of polycystic ovary syndrome (PCOS) and to determine the associations of TSH levels and body mass index (BMI) with IR in infertile women with PCOS. In this cross-sectional study, we included 400 infertile women with a diagnosis of PCOS according to Rotterdam criteria who were referred to the infertility clinic of amir-al-Momenin University Hospital from April 2018- to January 2020. They were classified into four different phenotypic subgroups according to ESHRE guidelines. The homeostasis model (HOMA-IR) was used to measure IR. The prevalence of insulin resistance was 39.3% in infertile women with PCOS. Among women with PCOS, the commonest phenotype was type I (68%), with type II (18.2%), type III (8.8%), and type IV (5%), respectively. Furthermore, there was no significant difference in the prevalence of IR among different phenotypes of PCOS. Logistic regression analysis showed that the chance of insulin resistance was higher in overweight (OR: 1.76, 95% CI: 1.07, 2.88, P=0.024) and obese PCOS women (OR: 3.25, 95% CI: 1.86, 5.67, P<0.001) compared with those who were normal or underweight. Moreover, the chance of IR was higher in PCOS women with TSH ≥2.5 μIU/ml as compared with those who had TSH <2.5 μIU/ml (OR: 2.00, 95% CI: 1.18, 3.40, P<0.001). Insulin resistance is a prevalent disorder among infertile Iranian women with PCOS BMI, and serum levels of TSH ≥2.5 μIU/ml are independent predictors of IR.
Eficiencia municipal y servicios públicos en Michoacán, México
Authors: Morán Figueroa Julio Cesar , Ayvar Campos Francisco Javier
Published: September 2021

Este trabajo evalúa el uso de los recursos para proveer servicios públicos en el estado de Michoacán, en 2014, usando el análisis envolvente de datos y considerando los insumos (recursos) y productos (servicios públicos) del municipio. Los resultados indican que solo 22 municipios proporcionaron servicios públicos de manera eficiente, y aunque los recursos financieros de los gobiernos locales han aumentado se emplean de manera ineficiente.
La teoría del valor trabajo y el principio de máxima entropía
Authors: Jacobo Juan Esteban
Published: September 2021

En este artículo se utiliza el principio de máxima entropía para ilustrar algunos planteamientos de la economía política clásica relacionados con la teoría del valor trabajo. Primero muestra que la libre movilidad del trabajo puede dar lugar a una distribución de salarios que tiende a la media y que el trabajo universal es una propiedad emergente del sistema. De manera similar, el resultado de la libre movilidad del capital es la tendencia a una tasa de ganancia normal, aunque pueden existir periodos de crisis.
La reintegración económica de excombatientes de grupos ilegales en el Departamento del Meta
Authors: Sacristan Andrés Felipe
Published: September 2021

Este trabajo analiza la incidencia de la política colombiana de reintegración en el desarrollo de capacidades educativas, participación laboral y generación de ingresos. Emplea un método mixto que combina estrategias cualitativas y cuantitativas para examinar un grupo de 296 excombatientes en el departamento del Meta. Encuentra que si bien algunos beneficios llevan a ejercer ciertas capacidades, aún persisten retos de acceso educativo, mayor formalización laboral y mejores resultados en emprendimiento. Al final, se hacen recomendaciones para la reincorporación de las FARC y ajustar el modelo de reintegración actual.
Obtaining Resources for Improving the Finance Function: Ideas from Practice
Authors:   HPO Center, de Waal André , Bilstra Eelco , Bootsman Jacques
Published: September 2021

This research investigates the question ‘How can a finance function get approval and resources for an improvement that is mainly internally oriented (within the finance function) and where the benefits will mainly be indirect in nature?’ For the finance function to make the improvements necessary to provide a high-quality service to its customers and play a pioneering role in the transformation of the organization into a permanently high-performing organization, resources for making improvements are needed, but in practice may be difficult to obtain because operations often take precedence in the allocation of resources. Existing literature provides limited information with which to answer the research question, so this study uses experts from the financial field, employing two round table discussions and a Delphi study to identify courses of action that financial experts deemed most effective for obtaining resources for improvements. Ten effective courses of action were identified that, according to the financial experts, should be applied in combination and in a particular order to be most effective in obtaining resources for improvement.
Estágio curricular em educação especial na formação inicial docente em Educação Física. O caso de uma universidade pública brasileira
Authors: Munhoz Gomes Nilton , Both Jorge
Published: September 2021

Estudo objetivou analisar a percepção dos acadêmicos de Licenciatura em Educação Física frente à realização do estágio curricular na área da Educação Especial considerando seu processo de formação inicial bem como, identificar a opinião dos acadêmicos frente a uma proposta diferenciada do estágio convencional. Pesquisa é descritiva. Participaram 75 estudantes de licenciatura em Educação Física. Utilizou-se um instrumento com oito afirmativas com justificativa da opção de resposta. Os resultados mostraram que não se observou diferenças significativas entre os grupos controle e experimental antes do início do estágio. Observou-se que o grupo experimental apresentou melhora significativa em todas as questões, entre a pré e a pós intervenção. Conclui-se que o estágio proposto trouxe aos acadêmicos uma percepção positiva frente à sua efetividade na formação de professores para atuação na área EE.
Prácticas Pedagógicas Innovadoras Mediadas por las TIC
Authors: Parra Bernal Lina , Rengifo Rodríguez Karen
Published: September 2021

Este artículo presenta el analisis de las prácticas pedagógicas innovadoras mediadas por TIC, realizadas por los profesores de una institución educativa en Popayán – Cauca, (Colombia). La investigación es cualitativa, de diseño biográfico-narrativo, con alcance descriptivo y desarrollada a traves de entrevistas semiestructuradas aplicadas a tres profesores. Los resultados permiten establecer que los profesores aplican innovación incremental dentro del aula de clase, en función de las necesidades curriculares y la praxis cotidiana, pero no utilizan continuamente herramientas Web 2.0 y Entornos Virtuales de Aprendizaje, para articular el trabajo extra clase; entre las razones de esta situación se tienen los problemas de conectividad, la resistencia al cambio y la escasa gestión educativa institucional.