bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF STEP PATTERN TECHNIQUE TO SIDE AND MOVEMENT STEP STRAIGHT AHEAD TO SABIT KICKNESS
Authors: Julianur Julianur , Santoso Januar Abdilah , Jusuf Jeane Betty Kurnia , Raharja Andri Tria , Mahardhika Nanda Alfian
Published: May 2020

This study aims to determine the effect of exercise on stepwise pattern and exercise a straight forward move towards crescent kick agility in UKM PSHT students of Muhammadiyah University of East Kalimantan (UMKT). The population in this study were students who were still actively participating in the UKM PSHT UMKT. Sampling uses a random sampling system, divided into 2 groups, namely group A by practicing stepwise patterns and group B by practicing a straight forward step. Each group consists of 10 sample people, so the total sample is 20 people. The results showed that: (1) There was the effect of training the step-by-step pattern on crescent kick agility on UMKT PSHT UKM students who obtained the value of tcount = 9.531> t table = 2.262 with a probability value of 0.000 <α 0.05. (2) There is the effect of a straight-forward exercise on crescent kick agility on UMKT PSHT UKM students who obtained a tcount = 6.975> t table = 2.262 with a significance probability value of 0.000 <α 0.05. (3) There is a difference in the effect of step-to-side pattern training and straight-forward motion training on crescent kick agility in Mulawarman University PSHT UKM students by obtaining a tcount = 4.348> t table = 1.734 with a significance probability value of 0.000 <α 0.05.
L’altro non sono io
Authors: Montagna Nicola
Published: May 2020

Through the analysis of some texts recently published in English, this chapter aims to analyse the recent academic debate in the English-speaking world on the role of identity in the growth of consensus and diffusion of populist parties and movements. The first part of this study reconstructs the origins of the so-called identity politics, starting from the movements for the recognition of the 1980s and in particular from protests against the publication of the book The Satanic Verses of Salman Rushdie; the second part analyses the meaning of identity and the related concept of identity politics; the third part deals with some aspects of identity politics today and how the academic debate uses the category of white identity in relation to current populist politics; the chapter concludes with some critical reflections both on the use of the category of identity politics and on an interpretation of identity as a monolithic and homogeneous entity.
Representaciones de lo indígena en la literatura contemporánea argentina
Authors: García-Romeu José
Published: May 2020

In recent decades, the Argentine novel has reconfigured the representation of indigenous people, and in particular that of those who suffered, in the southern territories of America, the destruction of their culture between the 19th and 20th centuries. Our purpose is to observe how, in El entenado (1983) by Juan José Saer, La tierra del fuego (1998) by Sylvia Iparraguirre and La extinción de las especies (2017) by Diego Vecchio, the image of the indigenous ‘other’ becomes part, in universal terms, of the same, through a process that contradicts the national historical account.
Nós, o outro e os outros: a constituição multiétnica capixaba no caldeirão cultural do Espírito Santo, Brasil
Authors: Dadalto Maria Cristina , Beneduzi Luis Fernando
Published: May 2020

This paper aims to analyse the multiethnic constitution of Espírito Santo starting from the report book Encontro das Raças, published in 1997 by the journalist Rogério Medeiros. The book presents interviews with narratives of European immigrants and descendants – Pomeranians, Dutch, Italians, Polish, German, Tyrolean, and Swiss. During its historical, socio-cultural and demographic constitution, Espírito Santo also counted with the participation of Syrian and Lebanese immigrants – in the 19th and early 20th centuries – and Asians, as well as national migrants. Medeiros also discusses and presents narratives of the descendants of Africans, Indians and Portuguese who constitute the first matrix of miscegenation of the capixaba people. The purpose of the present study is to reflect on this relationship that Medeiros calls the “Meeting of the Races” from a perspective of the sense of belonging and power relations established between these various ethnic groups settled in the state from 1847, when the government of the province sought alternatives to transform Espírito Santo economically and initiated, through political actions, the process of installing European immigrants in its lands.
La literatura de los otros es mi propia literatura
Authors: Kalenić Ramšak Branka
Published: May 2020

This essay attempts to reveal the sophisticated relations of texts, continuations, imitations and quotations between the first modern novel of western literature, Don Quixote de Cervantes, and its first continuation, Don Quixote de Avellaneda. It seems that there has been an autobiographical text by Gerónimo de Passamonte (hypothetically its author is Alonso Fernández de Avellaneda) before the first part of Don Quixote that served as a palimpsest to Cervantes. Avellaneda, whose identity is unknown to the reading public and known to Cervantes, answered him literarily with his continuation in 1614; in turn, Cervantes wrote the second part of his Don Quixote in 1615 and responded with literature to all his imitators and adversaries. In this way, the network of hypertextuality and intertextuality was established, which, like other literary techniques proposed by Cervantes, served as a model for many authors in the future.
Verso dove? Migrazioni geografiche e identitarie nella letteratura ebraica moderna
Authors: Miccoli Dario
Published: May 2020

This chapter discusses modern Hebrew literature – from early 20th-century authors like Haim Nahman Bialik and Shmuel Yosef Agnon to more recent ones, such as Erez Biton and Ronit Matalon – as a ‘migrant literature’, whose history is rooted in a set of shifting physical and cultural geographies and in the circulation of people, ideas and styles from the Diaspora to the Land of Israel and viceversa. By conceiving modern Hebrew literature as a ‘migrant literature’, it is possible to better understand its inner heterogeneity and multilingualism, as well as its being part of a wide landscape of ‘Jewish literatures’ that cuts across Europe, the Middle East and other spaces.
Solubility EnhancementTechniques forPoorly Soluble Pharmaceuticals: A Review
Authors: Gupta Jyoti , Devi Anjana
Published: May 2020

Among newly discovered chemical entities about 40% drugs are hydrophobic which are failed to reach market due to their low aqueous solubility. For orally administered drugs solubility is one of the rate limiting parameter to achieve their desired concentration in systemic circulation for pharmacological response.Drug efficacy can be limited due to poor aqueous solubility and some drugs also show side effects like gastric irritation, peptic ulcers,due to their poor solubility. Because of solubility problem of many drugs the bioavailability of them gets affected and hence solubility enhancement becomes challenging. The present review is devoted to various traditional and novel techniques for enhancing drug solubility to reduce the percentage of poorly soluble drug candidates eliminated from the new formulation development.
Glossopharyngeal Neuralgia: An Approach to Diagnosis and Management
Authors: Goel Vasudha
Published: May 2020

Glossopharyngeal neuralgia is an uncommon facial syndrome with significant deleterious effect on the quality of life. The glossopharyngeal nerve is predominantly a sensory nerve with a limited number of motor and autonomic fibers. The central causes of glossopharyngeal neuralgia are commonly treated with neurosurgical interventions. Medical therapy and nerve blocks are predominantly used to treat peripheral causes of glossopharyngeal neuralgia. In this review article, we present clinical vignettes and describe practical aspects of intra-oral, extra-oral, and peripheral techniques to block the glossopharyngeal nerve. The glossopharyngeal nerve blocks should be performed in a monitored setting due to the potential for adverse complications.
Study of the radiographic parameters of normal ankles
Authors: Benevides Pedro Costa , Nery Caio Augusto de Souza , Godoy-Santos Alexandre Leme , Marion Alloza José Felipe , Prado Marcelo Pires
Published: May 2020

Objective: The authors carried out a bibliographic search for the radiographic parameters used to determine tibiotalar joint alignment, and suggest a set of parameters that constitute the minimum radiographic evaluation sufficient for the proper assessment of tibiotalar alignment. Methods: The search was conducted between May 2019 and January 2020 on the online platforms PudMed and Google Scholar with the following terms, used separately or jointly: “ankle arthritis, radiographic measurement, ankle alignment, alignment, anterior ankle instability, X-ray, and ankle injury”. Results: We selected twelve studies evaluating radiographic patterns of normal ankles, and identified a total of 15 radiographic measurements. Conclusion: The authors believe that a minimum radiographic assessment of tibiotalar alignment should include the following parameters on the anteroposterior radiograph: the distal tibial articular angle, the talar tilt and talus center migration. On the lateral radiograph, it should include: lateral distal tibial angle and lateral talar station. Level of Evidence V; Diagnostic Study; Expert Opinion.
A new path for the Journal of the Foot & Ankle - JFA
Authors: Godoy-Santos Alexandre Leme , Ortiz Cristian , Baumfeld Daniel , Khazen Gabriel , Hermida Luis , Prado Marcelo , Costa Marco Túlio , Herrera Mario , Sotelano Pablo , Felicissimo Paulo , Guerrero Santiago , Netto Cesar De Cesar
Published: May 2020

Hard work is the key to success. It may sound like a cliché, but the preparation and the release of this first edition of the new Journal of the Foot & Ankle (JFA) were based on this very concept, and we took it very seriously! For years many of us have dedicated time and efforts to bring this Journal to life. After countless meetings, discussions, phone calls, WhatsApp messages, and an infinite amount of writing, our collaborative hard work and friendship finally brought us here! Now we need to stay focused and ahead of the game, looking forward to the future and the innovations. We should aim to publish high-quality, unbiased research, with emphasis on strong clinical evidence.

Our vision is to support researchers and research that can enable the Orthopaedic Foot and Ankle Surgery Community to understand better the complexity of the pathologies, guide treatment, and, most importantly, improve the treatment results and quality of life of our patients. Our thoughts are that keeping all these goals in mind will allow us to achieve the expected acceptance and respect of the research community, as well as the desired indexation. It is not an easy task! But we are confident we can get there with your help!

We’re great believers in working as a team towards a common goal, and we are sure that with the help of our dedicated Foot and Ankle colleagues and researchers, we will soon make our vision become a reality! Let’s do it together!
Total ankle arthroplasty in Brazil. Current aspects and future prospects
Authors: Bitar Rogério Carneiro
Published: May 2020

Total ankle arthroplasty as a surgical treatment option for end-stage ankle osteoarthrosis has gained increasing prominence, especially in countries such as Brazil, where the technique is not yet widely disseminated due to various factors. Level of Evidence V; Therapeutic Study; Expert Opinion.
Radiographic study of Böhler and Gissane angles in the Brazilian population
Authors: Louro Eurico Carneiro da Silva , Faleiro Thiago Batista , Pereira Tiago Miranda , Ferreira Leonardo Donato de Souza , Rezende Roberto Guimarães , Andrade Tomás Amorim
Published: May 2020

Objective: Determine Böhler and Gissane angles in the Brazilian population and compare them with the data available in the literature. Methods: A total of 800 weightbearing lateral radiographs of the calcaneus were evaluated in adult patients of both sexes. The angles were measured using the digital Picture Archiving and Communication System. Results: The sample consisted of 800 patients; 554 (69.2%) were women and 246 (30.8%), men. In the sample evaluated, the Gissane angle is 110.6±11.9, while the Böhler angle is 32.6±6.1. No differences were observed in the angles in terms of the comparison between sex and age. Conclusion: In the Brazilian population, the Gissane angle is 110.6±11.9, while the Böhler angle is 32.6±6.1. There is no statistically significant difference in the comparison between sex and age. Level of Evidence IV; Therapeutic Study; Case Series.
Minimally invasive repair of acute Achilles tendon injury
Authors: Oliveira Rodolpho Lemes de , Martins Jefferson Soares , Silva Paulo Henrique Martins
Published: May 2020

Objective: Describe a minimally invasive surgical technique for acute repair of Achilles tendon injuries, and evaluate outcomes. Methods: Nine subjects with primary Achilles tendon injury who underwent the minimally invasive repair technique between July and October 2018 were assessed. All subjects were followed up, and the SF-36 quality of life questionnaire was applied after the first postoperative year to evaluate treatment outcomes. Results: The participants had average scores greater than 90 points in the SF-36 questionnaire, with widespread treatment adherence. Only one subject had an infectious complication in the postoperative period. Conclusion: The technique described for acute Achilles tendon repair is simple, uses basic materials, is a low-cost method and, in this series, produced good clinical outcomes measured by the SF-36 Questionnaire. Level of Evidence IV; Therapeutic Study; Case Series.
Abdominal syndrome in so-called «Outinflammatory diseases»; Two cases of family Mediterranean fever
Authors: Spivakovskay A. Yu. , Spivakovskiy Yu. M. , Chernenkov Yu. V.
Published: May 2020

The aim — on the example of the analysis of clinical observations, the authors draw attention to various variants of the course of the classic auto — inflammatory disease-familial Mediterranean fever (SSL) with severe abdominal syndrome.

Materials and methods: the article present clinical material on two observations of patients with SSL in clinical symptoms, which were dominated by abdominal syndrome, from the moment of their request for medical care to the verification of the diagnosis.

Results: The article presents brief information about the diseases of the group of auto-inflammatory (periodic fever syndrome with mevalonatkinase deficiency, TRAPS-syndrome, Crohn’s disease, familial Mediterranean fever), in the manifestation of which gastroenterological symptoms play a significant role. An example of «early» and «late» diagnosis of auto-inflammatory diseases is illustrated by the results of the analysis of two clinical cases of patients with SSL.

The analysis of the analyzed clinical cases confirms the multidisciplinary nature of the problem of auto-inflammatory diseases and the importance of readiness not only of rheumatologists, but also of other specialists to make such a diagnosis.
Liver fibrosis in a child with open ductus venosus Arantii
Authors: Nikitin A. V. , Skvortsova Т. A. , Khavkin A. I. , Volynets G. V. , Atameeva A. О.
Published: May 2020

The article presents a clinical case of liver fibrosis in a child on the background of open fetal vascular communication — ductus venosus Arantii. The clinical observation reflects the importance of early diagnosis, timely treatment of congenital pathology in children. It was shown that as a result of hepatoprotective therapy, the child showed a positive dynamics of clinical and laboratory parameters: a decrease in the severity of signs of portal hypertension, the size of the liver and spleen, a tendency to normalize biochemical parameters that reflect manifestations of the pathological process in the liver.
Condition digestive system of children with bronchial asthma
Authors: Tashmatova G. A. , Khalmatova B. T.
Published: May 2020

The purpose of the study is to study the characteristics of the digestive system in children suffering from bronchial asthma.

Materials and methods. A survey of 60 children with asthma in the acute stage conducted. The average age of the examined children was 8±1.1 years. All children, along with standard studies, conducted EFGDS, abdominal ultrasound, feces for dysbiosis.

Results. In case of bronchial asthma, a high frequency of the pathology of the gastrointestinal tract is detected, which is characterized by an erased, low symptom course. The most common pathology of the digestive tract, which was detected in children with asthma are gastritis 70%, superficial gastroduodenitis — 43.3%, biliary dyskinesia — 75%, intestinal dysbiosis — 58.3%.
Fatty acid metabolism in newborns with sepsis; Report 1 — New clinical outcome prediction scale
Authors: Gizatullin R. Kh. , Leiderman I. N. , Mukhametzyanov A. M. , Gizatullin R. R. , Sataev V. U.
Published: May 2020

The aim of our study was to develop a new scale for predicting clinical outcome in newborns with sepsis, taking into account the information about depth of metabolic disorders.

Methods. Design of study — retrospective observational single-center study. Medical cards data of 163 newborns with sepsis were included in analysis. To measure the predictive value of the analyzed clinical and laboratory signs we used the Kullback measure. The clinical outcome of the disease was determined as the response function: survived or died.

Results. An analysis of the predictive value of the clinical and laboratory parameters of in newborns with sepsis was made, the threshold values of the most informative indicators were developed, which were: the number of blood platelets, the level of total blood protein, body weight and the number of blood neutrophils. The Clinical and Laboratory Condition Index for Newborns scale has been developed, which takes into account the depth of metabolic disorders. ROC analysis (Area Under Curve — 0,723) and the information method (information coefficient 0.992) showed that the Clinical and Laboratory Condition Index score can be used in the intensive care unit to predict the risk negative clinical outcome and evaluate the effectiveness of treatment in infants with organ dysfunction caused by systemic infection.

Conclusion. New Clinical and Laboratory Condition Index score scale allows to predict the development of negative outcome of sepsis in newborns taking into account the depth of metabolic disorders in newborns with sepsis.
الاتجاه نحو الانتحار وعلاقته بضغوط الحياة الصادمة لدى طلبة الجامعة
Authors: رمضان غزوان , ابراهيم علي لميس
Published: May 2020

ان الاتجاه نحو الانتحار سلوك سلبي وهو احد اشكال السلوك العدواني الموجه نحو الذات  نتيجة لتفاقم ايذاء الذات المستمر في بعض التوترات الانفعالية. وضغوط الحياة الصادمة حالة من الاذى وعدم التوازن والاضطراب من المشاعر التي غالبا ما تؤدي الى تأثير عقلي وجسدي ناتج عن رد فعل طبيعي للحدث الصادم مثل الهزة الارضية، الزلازل ، سقوط طائرة ، انفجار، عنف، عنف اسري، اغتصاب، حروب ، كوارث طبيعية او من صنع الانسان. وهذه الاحداث قد تؤدي الى حدوث اضطرابات نفسية ناتجة عن التعرض لأحداث صادمة.

ويهدف البحث الحالي التعرف على

مستوى الاتجاه نحو الانتحار لدى طلبة جامعة

الفروق ذات الدلالة الاحصائية في  الاتجاه نحو الانتحار لدى طلبة  الجامعة تبعاً لمتغير الجنس .

الفروق ذات الدلالة الاحصائية في الاتجاه نحو الانتحار لدى طلبة  الجامعة تبعاً لمتغير المرحلة .

ضغوط الحياة الصادمة لدى طلبة الجامعة.

الفروق ذات الدلالة الاحصائية في  ضغوط الحياة الصادمة لدى طلبة الجامعة تبعاً لمتغير الجنس  .

الفروق ذات الدلالة الاحصائية في ضغوط الحياة الصادمة لدى طلبة الجامعة تبعاً لمتغير المرحلة .

معرفة طبيعة العلاقة الارتباطية بين الاتجاه نحو الانتحار وضغوط الحياة الصادمة لدى طلبة الجامعة .

واقتصر البحث على طلبة جامعة تكريت للعام الدراسي (2018-2019) وتضمنت عينة البحث (100) طالباً وطالبة موزعين حسب الجنس والمرحلة  ولتحقق اهداف البحث اعد الباحثان المقاييس التالية:

مقياس الاتجاه نحو الانتحار

مقياس ضغوط الحياة الصادمة

وتم التحقق من الصدق  والثبات للمقاييسن وعولجت البيانات احصائياً باستخدام الحقيبة الاحصائية للعلوم الاجتماعية (Spss) وأظهرت النتائج مايلي:

ان طلبة الجامعة ليس لديهم اتجاه نحو الانتحار

لا توجد فروق ذو دلالة احصائية في مستوى الاتجاه نحو الانتحار لدى افراد العينة تبعاً لمتغير الجنس المرحله.

ان طلبة الجامعة يتمتعون بمستوى مرتفع من ضغوط الحياة الصادمة

لا توجد فروق ذو دلالة احصائية في مستوى ضغوط الحياة الصادمة لدى افراد العينة تبعاً لمتغير الجنس والمرحلة.

توجد علاقة ارتباطية دالة احصائياً بين المتغيرين، الاتجاه نحو الانتحار وضغوط الحياة الصادمة.
الشعور بالوحدة النفسية لنازحي محافظة نينوى في المخيمات
Authors: نعمت عجاج عدي , حاتم فضيل ظفر
Published: May 2020

تعد اهمية هذا البحث بتركيزه على شريحة مهمة في المجتمع العراقي مرت بأزمات ونكبات وانعدام الشعور بالأمن والتوتر والقلق، وتهديداً لسلامة الانسان بسبب الصراعات الدموية والحروب الطاحنة وما ترتب عليها من دمار وفوضى، اذ استهدف البحث التعرف على مستوى الشعور بالوحدة النفسية للنازحين من محافظة نينوى الساكنين في مخيم (بحركة  وهرشم) وفقا للمتغيرات (الجنس ـ العمل) شملت العينة (120) نازح ونازحة بالطريقة القصدية من الذين يجيدون القراءة والكتابة ويكون عمرهم (18) سنة فما فوق، للعام (2019- 2020م)، اعد الباحثان أداة لقياس الشعور بالوحدة النفسية المكون من (20) فقرة، وتم التحقق من الصدق التكويني والظاهري، كما تم التحقق من ثبات الأداة بإعادة الاختبار فبلغ معامل الثبات (83 .0) واستخدم معامل ارتباط بيرسون والاختبار التائي لعينة واحدة وعينتين كوسائل إحصائية، وأظهرت النتائج ما يأتي:

ارتفاع مستوى الشعور بالوحدة النفسية لدى النازحين الساكنين في المخيمات.

وجود فرق دالة إحصائياً بمستوى الشعور بالوحدة النفسية تبعا لمتغير الجنس (ذكور- إناث) لصالح الذكور.

وجود فرق دال إحصائياً في المستوى للشعور الوحدة النفسية وفقاً لمتغير العمل (يعمل- عاطل عن العمل) ولصالح العاطلين عن العمل.
makalah penjas
Authors: Nicholas
Published: May 2020

makalah penjas permainan bola voli
Change management
Authors: Huan Dao Duy , Tung Dao Duy
Published: May 2020

An introduction to Change Management: An overview of the most important theories in the field of Change Management
Memfasilitasi Pendidik Dalam Mengembangkan Kompetensi Profesionalnya
Authors: Wangka Stevany Jimy
Published: May 2020

Keprofesionalan seorang pendidik dapat dilihat dari kompetensi pendidik, sertifikasi pendidik, dan tunjangan profesi pendidik. Ketiga hal yang telah dikaitkan tersebut mempunyai fungsi yang sangat menonjol dalam sekumpulan pendidik.. Setiap pendidik harus mempunyai kinerja yang baik, nilai kompetensi yang baik yang dimana hal tersebut dapat menunjang suatu pendidikan yang baik yang pada akhirnya memiliki kualitas pendidikan yang baik juga.
Upaya Peningkatan Minat Belajar Peserta Didik dengan Menggunakan Metode Cooperative Learning
Authors: Tarore Regina Septhiany
Published: May 2020

Model pembelajaran kooperatif adalah rangkaian kegiatan belajar siswa dalam kelompok tertentu untuk mencapai tujuan pembelajaran yang dirumuskan. Pembelajaran kooperatif ini merupakan salah satu bentuk pembelajaran yang berdasarkan paham konstruktivis. Dalam pembelajaran kooperatif diterapkan strategi belajar dengan sejumlah siswa sebagai anggota kelompok kecil yang tingkat kemampuannya berbeda. Namun di zaman yang sudah meningkat, peserta didik sudah mulai mengalami adanya penurunan dalam minat belajar dikarenakan pendidik yang masih sulit menerapkan metode-metode pembelajaran didalam kelas. Maka dari itu, sangat diperlukan adanya management dalam pembentukan kelompok belajar dengan menggunakan metode cooperative learning untuk meningkatkan minat belajar peserta didik dalam proses pembelajaran. Mengetahui peningkatan minat belajar peserta didik dengan menggunakan metode cooperative learning. Tujuan penulisan paper ini untuk mengetahui dan menjelaskan peranan cooperative learning dalam meningkatkan minat belajar peserta didik.
Response to Tocilizumab in Severe COVID-19
Authors: Baker Emma H , Patel Kamal , Ball Jonathan , Edwards Sarah , Harrison Thomas S , Kaul Arvind , Koh Mickey , Krishna Sanjeev , Kumar Vinodh , Leaver Susannah , Forton Daniel M
Published: May 2020

Background: Since the COVID-19 pandemic began in December 2019 no specific therapy for managing severe complications of infection has emerged, although this is under intensive investigation. Progressive pneumonia and multi-organ complications are managed with supportive care and COVID-19 has a mortality of >50% when ventilatory support is needed.Methods: We implemented a compassionate use protocol for tocilizumab, a humanised monoclonal anti-Il-6 receptor antibody. Patients with severe COVID-19 requiring oxygen or ventilation, and complicated by hyperinflammation and the cytokine release syndrome (CRS) received tocilizumab (8 mg/kg up to a maximum of 800 mg, with the option of a second dose given after 12-24 hours). CRS was defined as having at least three of: D-dimer above the upper limit of normal (ULN), rising C-reactive protein (CRP), ferritin >1000 ng/mL and lactate dehydrogenase (LDH) greater than the ULN.Oral consent for prescription of an off-label medicine was obtained from patients, their next of kin or representative, whenever possible. The treatment protocol adhered to the Monitored Emergency Use of Unregistered and Investigational Interventions of the WHO.Findings: Of seventeen patients with severe COVID-19 seen between 3-12th April 2020, eleven patients (seven ventilated and four receiving high flow oxygen) were treated with tocilizumab. Treatment normalised temperatures within 48 hours and was associated with a significant fall in CRP from 311 (138-332) (median, IQR mg/L) to 110 (58-184) (p = 0·001). For the group, oxygen requirements fell by 60±32% (95% CI 38-81) over 1 week (p<0·001). Two of seven patients on intensive care died, five have been extubated and two discharged. All four ward patients have also been discharged.Interpretation: Following tocilizumab treatment, we observed improvement in clinical and laboratory abnormalities in this small series. Compassionate use of tocilizumab can provide valuable information to support clinical trials in patients with severe COVID-19.
Moral Decision-Making during COVID-19: Moral judgments, moralisation, and everyday behaviour
Authors: Francis Kathryn , McNabb Carolyn Beth
Published: May 2020

The COVID-19 pandemic continues to pose significant health, economic, and social challenges. Given that many of these challenges have moral relevance, the present studies investigate whether the COVID-19 pandemic is influencing moral decision-making and whether moralisation of behaviours specific to the crisis predict adherence to government-recommended behaviours. Whilst we find no evidence that utilitarian endorsements have changed during the pandemic at two separate timepoints, individuals have moralised non-compliant behaviours associated with the pandemic such as failing to physically distance themselves from others. Importantly, our findings show that this moralisation predicts sustained individual compliance with government-recommended behaviours.
A comprehensive IVF laboratory COVID-19 pandemic response plan
Authors: SIG MEFS emrbyology , Choucair Fadi , Younis Nagham , Hourani Alia
Published: May 2020

The potential of a severe pandemic necessitates the development of an organized, rational plan for the operation of embryology/andrology laboratories without the compromise of the safety of personnel and gametes/embryos. A comprehensive pandemic response plan was proposed for embryology and andrology laboratories for prepandemic preparedness, reduction or hibernation of procedures and return to normal function. Preparation involves many plans and logistics before a pandemic risk rises. Many operational changes can be considered based on the severity and duration of the pandemic. This plan includes logistical arrangements, reducing labor needs, conserving supplies, protective measures for embryologists and biological materials.
A cross-sectional survey of psychological distress in a Mexican sample during the second phase of the COVID-19 pandemic
Authors: Toledo-Fernández Aldebarán , Betancourt-Ocampo Diana , Romo-Parra Héctor , Reyes-Zamorano Ernesto , González-González Alejandro
Published: May 2020

The objectives of this study were to describe severity of psychological distress (event-related stress, anxiety, and depression) during the second stage of COVID-19 pandemic in Mexico, and to explore associations between the indicators of psychological distress, sociodemographic characteristics and specific concerns about COVID-19. This report serves as a baseline measure of a longitudinal project to evaluate progression of psychological distress across stages of the COVID-19 pandemic in Mexico. An online survey was conducted in the State of Mexico from April 8th -18th, 2020, in a sample of men and women who are beneficiaries of a welfare institution in the region. Variables were measured with the Impact of Event Scale-6, Patient Health Questionnaire-9, General Anxiety Disoder-7, and a questionnaire of concerns about COVID-19. A total of 5974 participants were analyzed. Moderate levels of psychological distress (with 23.6% of participants meeting significant event-related stress, but mild levels of depression and anxiety) were found, as well as high values in all concerns about COVID-19, especially regarding financial disruption, worsening of local security and concern of a family member becoming infected. These concerns associated mild-to-moderately with the indicators of psychological distress. Higher values of event-related distress were found in women, individuals with higher educational attainment and those with any current high-risk medical diagnosis, though the effect sizes were mild. Though psychological distress and concerns about COVID-19 have reached significant levels during the pandemic in Mexico, overall, they have not yet reached dysfunctional levels.
Switching competitors reduces win-stay but not lose-shift behaviour: The role of outcome-action association strength on reinforcement learning
Authors: Srihaput Vincent , Craplewe Kaylee , Dyson Ben
Published: May 2020

Predictability is a hallmark of poor-quality decision-making during competition. One source of predictability is the strong association between current outcome and future action, as dictated by the reinforcement learning principles of win-stay and lose-shift. We tested the idea that predictability could be reduced during competition by weakening the associations between outcome and action. To do this, participants completed a competitive zero-sum game in which the opponent from the current trial was either replayed (opponent repeat) thereby strengthening the association, or, replaced (opponent change) by a different competitor thereby weakening the association. We observed that win-stay behaviour was reduced during opponent change trials but lose-shift behaviour remained reliably predictable. Consistent with the group data, the number of individuals who exhibited predictable behaviour following wins decreased for opponent change relative to opponent repeat trials. Our data show that future actions are more under internal control following positive relative to negative outcomes, and that externally breaking the bonds between outcome and action via opponent association also allow us to become less prone to exploitation.
Warning “Don’t spread” vs. “Don’t be a spreader” to prevent the COVID-19 pandemic
Authors: Yonemitsu Fumiya , Ikeda Ayumi , Yoshimura Naoto , Takashima Kaito , Mori Yuki , Sasaki Kyoshiro , Qian Kun , Yamada Yuki
Published: May 2020

The coronavirus disease 2019 (COVID-19) outbreak is threatening not only health but also life worldwide. It is important to encourage citizens to voluntarily practise infection prevention (IP) behaviours such as social distancing and self-restraint. Previous research on social cognition suggested that emphasising self-identity is key to changing a person’s behaviour. The present study investigated whether reminders that highlight self-identity would be effective in changing intention and behaviour related to the COVID-19 outbreak, and hypothesised that those who read reminders highlighting self-identity (‘Don’t be a spreader’) would change IP intention and behaviour better than those who read ‘Don’t spread’ or no reminder. We conducted a two-wave survey of the same participants with a one-week interval, during which we assigned one of three reminder conditions to the participants: ‘Don’t spread’ (spreading condition), ‘Don’t be a spreader’ (spreader condition), and no reminder (control condition). Participants marked their responses to IP intentions and actual behaviours each week based on the Japanese Ministry of Health, Labour, and Welfare guidelines. While the results did not show significant differences between the conditions, the post-hoc analyses showed significant equivalence in either IP intentions or behavioural scores. We discussed the results from the perspective of the effect size, ceiling effects, and ways of manipulation checks as future methods with more effective persuasive messaging. Following in-principle acceptance, the approved Stage 1 version of this manuscript was preregistered on the OSF at https://doi.org/10.17605/OSF.IO/KZ5Y4. This preregistration was performed prior to data collection and analysis.
Imported cases, community action, policy and institutional systems drive Hong Kong’s COVID-19 experience
Authors: Cruz Christian Joy P. , Ganly Rachel , Li Zilin , Gietel-Basten Stuart
Published: May 2020

This paper investigates the profile of COVID-19 cases in Hong Kong, highlighting the unique age structure of confirmed cases compared to other states. Whilst the majority of cases in most states around the world have fitted an older age profile, our analysis shows that positive cases in Hong Kong have been concentrated amongst younger age groups, with the largest incidence of cases reported in the 15-24 age group. This is despite the population’s rapidly ageing structure and extremely high levels of population density. Using detailed case data from Hong Kong’s Centre for Health Department and Immigration Department, we analyze the sex and age distribution of the confirmed cases along with their recent travel histories and immigration flows for the period January to April, 2020. Our analysis highlights Hong Kong’s high proportion of imported cases and large overseas student population in developing COVID-19 hotspot areas such as the United Kingdom. Combined with targeted and aggressive early policy measures taken to contain the virus, these factors may have contributed to the uniquely younger age structure of COVID-19 cases in the city. Consequently, this young profile of confirmed cases may have prevented fatalities in the city-state.
Quantum Complementarity: Both Duality and Opposition
Authors: Penchev Vasil Dinev
Published: May 2020

Quantum complementarity is interpreted in terms of duality and opposition. Any two conjugates are considered both as dual and opposite. Thus quantum mechanics introduces a mathematical model of them in an exact and experimental science. It is based on the complex Hilbert space, which coincides with the dual one. The two dual Hilbert spaces model both duality and opposition to resolve unifying the quantum and smooth motions. The model involves necessarily infinity even in any finitely dimensional subspace of the complex Hilbert space being due to the complex basis. Furthermore, infinity is what unifies duality and opposition, universality and openness, completeness and incompleteness in it. The deduced core of quantum complementarity in terms of infinity, duality and opposition allows of resolving a series of various problems in different branches of philosophy: the common structure of incompleteness in Gödel’s (1931) theorems and Enstein, Podolsky, and Rosen’s argument (1935); infinity as both complete and incomplete; grounding and self-grounding, metaphor and representation between language and reality, choice and information, the totality and an observer, the basic idea of philosophical phenomenology. The main conclusion is: Quantum complementarity unifies duality and opposition in a consistent way underlying the physical world.
Ethical Guidelines for Deliberately Infecting Volunteers with COVID-19
Authors: Richards Adair D
Published: May 2020

Global fatalities related to COVID-19 are expected to be high in 2020-21. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase 2 and Phase 3 trials could take less long to conduct if they used human challenge methods – that is, deliberately infecting participants with COVID-19 following inoculation.This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approvals processes so that they are in place when applications for trials are made.
Performance indicators contributing to success at the group and play-off stages of the 2019 Rugby World Cup
Authors: Bunker Rory , Spencer Kirsten
Published: May 2020

Performance indicators that contributed to success at the group and play-off stages of the 2019 Rugby World Cup were analysed using publicly available data obtained from the official tournament website using both a non-parametric statistical technique, Wilcoxon’s signed rank test, and a decision rules technique from machine learning called RIPPER. Our statistical results found that ball carry effectiveness (percentage of ball carries that penetrated the opposition gain-line) and total metres gained (kick metres plus carry metres) were found to contribute to success at both stages of the tournament and that indicators that contributed to success during group stages (dominating possession, making more ball carries, making more passes, winning more rucks, and making less tackles) did not contribute to success at the play-off stage. Our results using RIPPER found that low ball carries and a low lineout success percentage jointly contributed to losing at the group stage, while winning a low number of rucks and carrying over the gain-line a sufficient number of times contributed to winning at the play-off stage of the tournament. The results emphasise the need for teams to adapt their playing strategies from group stage to the play-off stage at the tournament in order to be successful.
مَقَالَةُ الْمَنْظُوْمَةِ لِمُعَلِّمِيْ فَضِيْلَةُ الرَّحْمِ
Authors: Setiawan Adib Rifqi
Published: May 2020

مَقَالَةُ الْمَنْظُوْمَةِ لِمُعَلِّمِيْ فَضِيْلَةُ الرَّحْمِ
Clinical Profile of Diabetic Ketoacidosis among Children in Eastern Nepal
Authors: Muktan Dipak , Tamang Ghising Lisa , Singh Rupa Rajbhandari
Published: May 2020

Background: Diabetic ketoacidosis (DKA) is a life threatening complication which is the most common reason for hospital admission in children with Type 1 Diabetes. This study was carried out to determine the clinical characteristics of children admitted with Diabetic Ketoacidosis.

Methods: Descriptive retrospective study was conducted at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. A total of 25 children of less than 20 years old diagnosed with Diabetic ketoacidosis who were admitted to the pediatric ward and pediatric intensive care unit from January 2013 to December 2017 were included in the study. Data were collected via hospital records of patients.

Results: The mean age at presentation was 10.5 ± 4.5 years. Sixteen (64%) children were newly diagnosed as diabetes while, nine (36%) children were known cases of diabetes. The most common precipitating factor for DKA was omission of insulin 6 (24%). Twelve (48%) children had presented with severe DKA.  Polyuria 23 (92%) was the commonest symptom followed by polydipsia 22 (88%), weight loss 17 (68%), abdominal pain 13 (52%), vomiting 13 (52%) and unconsciousness 8 (32%). The mean duration of symptoms before presentation was 11.3 ± 5.7 days. Mean HbA1c at presentation was 10.4 ± 2.2.

Conclusion: Majority of the patients was newly diagnosed as diabetes who presented with Diabetic ketoacidosis. Omission of insulin was the main precipitating factor. Polyuria was the most common presenting symptom. Proper follow up care of diabetes and community awareness programs should be emphasized to reduce the incidence of Diabetic ketoacidosis.
Prevalence of Osteoporosis and Osteopenia Status among Nepalese Population using Calcaneal Ultrasonography Method
Authors: Bagudai Satyajit , Upadhayay Hari Prasad
Published: May 2020

Background: A recent worldwide upsurge in the fracture incidence due to osteoporosis has underlined this underdiagnosed and undertreated condition. An awareness regarding the preventive, curative and rehabilitative care as well as a proper health policy is the need of hour. This requires a proper database of prevalence rate. This study aimed to find out the prevalence of osteoporosis and osteopenia by screening the bone health status in an apparently healthy population of Nepal.

Methods: A cross sectional study was conducted among 465 apparently healthy subjects of either gender in three tertiary care health centers of Nepal for bone mineral density measurement by calcaneal ultrasonography.

Results: The mean+SD of age among 465 patients was 45.47+14 years, including 43.2 % male and 56.8 % females. The prevalence of osteoporosis andosteopenia was 22.4% and 60.6% respectively. Our finding showed that prevalence of osteoporosis increases with age among either gender.

Conclusions: The prevalence of osteoporosis in Nepalese population was high in comparison to other countries. There is no significant association of osteoporosis with females in comparison to males. The prevalence was increasing with age in either gender. These findings will help in creating a proper database of this condition in Nepal, helping the population,physicians as well as policy makers to have a proper address to this global emerging health problem.
Prevalence and Epidemiological Variation of Oral Squamous Cell Carcinoma among Population of Central Nepal
Authors: Sharma Sandeep
Published: May 2020

Background: Squamous cell carcinoma (SCC) is the most common malignant neoplasm of the oral cavity and represents about 90% of all oral malignancies. Oral squamous cell carcinoma (OSCC) is an important cause of morbidity and mortality worldwide with an incidence rate that varies widely by geographic location. The purpose of this study was to identify any trends in prevalence at specific anatomic sites or within specific age or sex groups of OSCCs in Chitwan population of Nepal. 

Methods: The study covers the period between January 2016 and October 2018. OSCC cases were retrospectively analysed for site, age, gender and habits and the findings were formulated to chart the trends in Chitwan population.

Results: The study revealed a male to female ratio of 2.45:1 with the largest number of OSCCs developing in the fourth and fifth decades of life. Most commonly affected site was the buccal mucosa (66.06%), followed by retromolar area (19%), floor of the mouth (10.41%), lateral border of the tongue (1.81%), labial mucosa (2.26%), and palate (0.45%). Smokeless tobacco habit was more prevalent than smoking tobacco in both men as well as women. Chi Square test was done to show association between different variables i.e. between gender to site and gender to habit and gender to different grades of cancer, which were found to be non-significant.

Conclusions: Oral cancer is an important cause of morbidity and mortality worldwide with an incidence rate that varies widely by geographic location. Even within one geographical location, the variations are seen among groups categorized by age, sex, site or habit.
Outcome of Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinisinusitis Not Responding to Medical Therapy
Authors: Pyakurel Pradeep Kumar , Paudel Deepak , Chettri Shyam Thapa
Published: May 2020

Background: chronic rhinosinusitis (CRS) is common chronic condition and is treated with antibiotics, nasal irrigation and steroids. Patients who do not respond to medical therapy are subjected to functional endoscopic sinus surgery. The objective of the study is to assess the clinical improvement after functional endoscopic sinus surgery among the patients of chronic rhinosinusitis (CRS) who failed medical management. Methods: A Prospective longitudinal study conducted within a period of 1 year. Patient with CRS who failed with medical management were subjected functional endoscopic sinus surgery (FESS). Pre –operative symptoms score and endoscopic score were assessed and compared with that of post- operative scores at the end of 6 weeks and 12 weeks. Results: Fifty-two patients who completed three months of follow up were included in the study. The mean preoperative VAS symptoms score was 5.7 and was 2.23 after FESS and difference was significant (P <0.01). There was significant improvement of the endoscopic score (ES) after FESS, the mean ES preoperatively was 4.038 and it improved to1.31 at 6 weeks and 0.75 in the 12 postoperative weeks. Post-operative adhesion was the most common complication and occurred in 15% of patients. Conclusions: FESS is a safe procedure. Patients with CRS who don’t respond to medical therapy should undergo this safe surgical procedure FESS with good outcome.

Keywords: chronic rhinosinusitis; functional endoscopic sinus surgery; outcome.
Attitude, Motivation and Barriers for CSR Engagement among Travel and Tour Operators in Nepal
Authors: Baniya Rojan , Rajak Kripa
Published: May 2020

The surging interest of tourists in responsible business practices and their global popularity is making CSR imperative for tourism SMEs, including TTOs of Nepal. Consequently, there has been a rise in CSR engagements among tourism SMEs in developing countries. Nonetheless, due to limited attention by researchers, knowledge about their CSR engagement is scant. The same is also true for TTOs residing in Nepal. In such a scenario, it is prudent to generate an understanding of CSR engagement of Nepali TTOs. For this reason, this exploratory study investigated various dynamics of CSR engagement among TTOs (n=141) registered in the National Association of Tour and Travel Agents through a paper-based survey. The results showed that half of TTOs claimed that they had incorporated CSR in their mission and strategy; they exhibited positive attitudes about the benefits of CSR to businesses, customers’ favorability towards businesses simple menting CSR, and the need for a higher value to CSR within the tourism industry. Societal benefits and wellbeing, and the opportunity to market their image among customers motivated them to engage in CSR, whereas lack of resources and knowledge restrained them. Three fourth of them claimed to practice CSR of some sort, and most of them intended to continue their CSR engagement in the future. Collectively, TTOs had a positive outlook towards CSR. However, there are some deterrents for them to engage in CSR. This study provides valuable baseline insights to formulate the right plans and policies to influence CSR employment by TTOs, ultimately leading to sustainable tourism.