bluuebunny/crossref_metadata_2025 huggingface dataset:
Web-based Application for the Population Pharmacokinetic Service (WAPPS)'s impact on dosage selection: a single paediatric centre experience
Authors: Kwan Celia , Bhatt Mihir D. , Strike Karen , Decker Kay , Matino Davide , Chan Anthony K.C.
Published: November 2022

Background

Current treatment for severe haemophilia includes prophylactic factor replacement to prevent bleeding. Coagulation factor products have significant inter-patient variability in pharmacokinetic (PK) parameters. Optimal management requires tailoring prophylaxis to individual PK parameters. Web-based Application for the Population Pharmacokinetic Service (WAPPS) is a tool that estimates individual PK values using a population approach. Despite its growing use to help guide dosing selection, few studies have investigated its clinical impact.

Aim

To investigate any change in prophylaxis regimen and hours per week where factor level is under 1%, pre- and post-PK testing using WAPPS, for paediatric patients with severe haemophilia.

Methods

A retrospective chart review was conducted for all paediatric patients with severe haemophilia receiving care between April 2013 and July 2018 at McMaster Children's Hospital who have used WAPPS. Data extracted included: patient demographics, PK data generated by WAPPS, prophylaxis regimen pre- and post-PK testing, and reason for regimen change. The number of hours per week where factor level was under 1% pre- and post-PK testing was calculated using WAPPS.

Results

Thirty-one patients were included; 42% (n=13) changed their prophylaxis regimen after PK testing. After using PK data to personalise prophylaxis recommendations, there was a decrease in the number of hours per week where factor level is under 1% (from an average of 13.1 hours/week to 11.8 hours/week), though not statistically significant (p=0.16).

Conclusion

PK data generated by WAPPS has direct impact by informing changes to prophylaxis recommendations. This individualised approach promotes patient-centred care and patient engagement without increasing the time spent with factor levels below 1%. It also confirms and validates clinical practice.
The use of rIX-FP in patients with haemophilia B: a nurse's perspective
Authors: Garner Kara , Guelcher Christine , Pollard Debra
Published: November 2022

The management of patients with haemophilia is complex and requires lifelong care to be delivered by a specialist multidisciplinary team. Haemophilia B results from a deficiency or absence in coagulation factor IX (FIX), leading to easy bruising, and musculoskeletal and internal bleeding. For patients with severe or moderate haemophilia B, prophylaxis with standard half-life (SHL) coagulation FIX products requires frequent intravenous administration, which may negatively impact treatment adherence and increase burden of care. A recombinant fusion protein linking recombinant FIX (rFIX) with recombinant human albumin, rIX-FP, has an extended half-life compared with SHL rFIX, and has demonstrated a favourable safety and efficacy profile for the prevention and treatment of bleeding episodes in phase III and real-world studies of patients with severe haemophilia B. rIX-FP enables treatment to be tailored to the needs of individual patients, with dosing flexibility allowing selected patients to be treated with prophylaxis dosing intervals of 7, 10, 14 or 21 days. Patients switching to rIX-FP can reduce their annualised bleeding rate and some have successfully reduced their prophylactic dosing frequency while maintaining low bleeding rates and consistent factor consumption. This may ultimately minimise the occurrence of haemophilic arthropathy and improve patient quality of life. Educating patients and caregivers on the sustained use of rIX-FP prophylaxis is essential. The lifelong support and guidance provided by healthcare professionals at haemophilia treatment centres (HTCs) are critical for providing an optimal treatment approach that can increase adherence to treatment. This article reviews the pharmacokinetics, efficacy, and safety of rIX-FP demonstrated in clinical trials and clinical practice, and discusses haemophilia nurses’ clinical experiences with rIX-FP in patients in their HTCs.
Quantification-Protocol-miRNA-SCALONMC v1
Authors: Scalon Marcela
Published: November 2022

This protocol is intended as a guideline for the quantification of total miRNAs, from serum and plasma samples, using the Qubit® microRNA Assay Kit and the Qubit® 2.0 Fluorometer. This method have been able to reproducibly quantify small RNA in pure samples at levels as low as 0.5 ng in the assay tube following. The assay detects all types of small RNA, including microRNA and siRNA, both single stranded and double stranded. Samples for quantification are the final product of purification procedures, stored in 1,5ml microtubes at -80ºC. The aim of this protocol is to provide the exact amount of each sample to standardize the dilution for RT-rtPCR protocol.
Impacto de los Actos Comunicativos Dialógicos en la Argumentación Matemática del Alumnado con Trastorno del Espectro Autista. Un estudio de Caso sobre Educación Inclusiva
Authors: Díaz Rodríguez Luis , Díez Palomar Javier , Ward Bringas Silvia Evelyn , Natividad Sancho Laura
Published: November 2022

La Educación Inclusiva pretende mejorar la presencia, participación y aprendizaje de todo el alumnado. Desde esta perspectiva el presente artículo se centra en el aprendizaje de las matemáticas, para lo que se analizó cómo los actos comunicativos dialógicos impactan en la argumentación de las matemáticas del alumnado con Síndrome de Asperger durante el desarrollo de Grupos Interactivos (GI). La investigación se llevó a cabo mediante el enfoque cualitativo, con el método de estudio de caso y usando la observación como instrumento. Los resultados de la investigación muestran que, en el desarrollo del GI analizado, tanto el alumno sujeto de estudio como sus compañeros participan activa y colaborativamente en la resolución de la tarea matemática, para ello utilizan actos comunicativos dialógicos y construyen argumentos. Tras la discusión entre los datos obtenidos, antecedentes y teorías en las que se centra esta investigación, se puede afirmar que los actos comunicativos dialógicos que se llevaron a cabo dentro de los GI mejoran la argumentación matemática y por lo tanto el aprendizaje de las matemáticas del alumnado con Síndrome de Asperger, por lo que se llega a la conclusión de que lo GI son una Actuación Educativa de Éxito inclusiva.
Emotions, Personality Traits and Metacognitions as Predictors of Students’ Psychological Well-Being in Contemporary Situation
Authors: Denisova E.G. , Ermakov P.N. , Abakumova I. , Sylka N.V.
Published: November 2022

This study aims to comprehensively explore the emotional, personal, and metacognitive predictors of students’ psychological well-being. The article presents the results of identifiesying supporting and dysfunctional factors that affect the level of psychological well-being of the current generation of students. Study sample: 317 people subjects aged 18 to 45 years (average age 20.82) — undergraduate, graduate and postgraduate students. To measure these characteristics, the following methods were used: a short portrait questionnaire of the Big Five; methodology “Differential Scale of Emotions”; methodology for diagnosing the subjective well-being of the individual; Metacognitive Awareness Inventory; Metacognitive behavior self-assessment scale; test “Differential type of reflection”; Cognitive Emotion Regulation Questionnaire and the author’s self-assessment questionnaire of metacognitive behavior “Metacognitive skills in the structure of educational and professional activities”. It is shown that the level of subjective well-being differs significantly depending on the level of metacognitive involvement. A positive effect is also exerted by a high index of positive emotions, a greater level of extraversion and conscientiousness, and a low level of neuroticism. The data obtained can be helpful in developing programs for forming and reforming individual metacognitive strategies that contribute to successful adaptation and maintaining subjective well-being maintenance.
Selection and Validation of Potential Reference Genes for Quantitative Real-Time PCR Analysis in Blaptica Dubia (Serville, 1838) (Blattidae, Blaberidae)
Authors: KARAKAŞ Emin Ufuk , PEKTAŞ Ayşe Nur , BERK Şeyda
Published: November 2022

Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is an effective, reproducible, and dependable method for evaluating and targeting expression of genes. It is very important to normalize according to stably expressed housekeeping genes in order to facilitating gene expression studies and to acquire exact and meaningful results. The purpose of this study was to identify and validate six housekeeping genes (GADPH, RPS18, α-TUB, EF1α, ArgK and ACTB) in adults of cockroach species Blaptica dubia employing five different algorithms (geNorm, Bestkeeper, Normfinder, ΔCt method and RefFinder) to assess putative housekeeping gene expression stability. Our study also showed that the geNorm, Normfinder ΔCt method and RefFinder algorithms identified GADPH as the most stable housekeeping gene in B. dubia adults. Additioanlly, RPS18 was suggested as the most stable gene by GeNorm and BestKeeeper. ACTB has been shown to be by far the least stable of all algorithms. In addition, since there are few validation studies for reference genes in cockroaches in the literature, it is considered that it would be beneficial to increase the number of studies related with RT-qPCR on the reference genes validation under biotic and abiotic conditions in cockroaches.
Data-Driven Computational Modeling of Plasticity-Induced Damage Effects
Authors:   , Schlenker Sara Elizabeth , Kontsos Antonios
Published: November 2022

Computational modeling of damage is an important tool in understanding and predicting failure in engineering applications. Current modeling and simulation techniques often struggle to identify two aspects of failure which are of interest, including the location of damage onset and the prediction of damage evolution. There are multiple factors which cause this deficiency and include material, geometrical and loading aspects, among others. In this context, the use of Non-Destructive Evaluation (NDE) data has the potential to provide damage information into computational workflows. Specifically, recent advancements in sensing methods and data processing techniques have made possible the acquisition of high temporal and spatial resolution data related to damage. This dissertation seeks, therefore, to leverage these advancements and demonstrate numerical workflows which are based on using NDE data into Finite Element Models (FEMs) to improve aspects of damage modeling. To demonstrate this approach, Acoustic Emission (AE) data is first used to define a damage parameter within a plasticity FEM, which is shown to succeed in inducing deformation localizations that agree with related experimental observations. In addition, Digital Image Correlation (DIC) deformation data is used to further refine such data-defined damage parameter and assist also in the modeling of the characteristics of deformation localizations in specified regions of the model. Finally, full field, surface DIC data is incorporated directly into a custom-built, three-dimensional, non-local FEM model to assist in the prediction of onset, characteristics and evolution of plasticity-induced damage, originating in deformation localization sites observed experimentally. Details on the ways that such data-driven computational modeling techniques could increase the fidelity of and the confidence in failure prediction models are discussed.
Teenage pregnancies - A peril in covid pandemic
Authors: Limmala Rani Kumari , Vellanki Janaki
Published: November 2022

Teenage pregnancy is a global problem and is a high risk group. Adolescent pregnancy occurs when a teenager or underage girl, usually between the ages of 13 and 19, becomes pregnant. Adolescent pregnancies are more likely to occur in the marginalized communities commonly driven by poverty, lack of education and employment opportunities. Adolescent mothers aged 10-19years face higher risk of anemia, eclampsia, puerperal endometritis and systemic infections than women aged 20-24 years, as they have not completed their own development to give birth to another life.

A retrospective study was undertaken in department of obstetrics and gynecology of Gandhi Medical College during period of April 2019 to April 2022.

Out of the 38 cases, 18 cases were admitted during the year 2021 which was post COVID period these cases were the after effect of the consequences patients faced during the COVID season. The minimum age recorded during study period was 12 years, and maximum number of patients belonged to age group of 17 years (21%) and 19 years (21%). 17 Cases (45%) reported to the hospital during the second trimester. 22 cases were aborted.8 cases delivered at term. Complications like anemia were seen in few patients.

: Sex education for adolescent, support by talking about sex, with education about HIV, STI, contraception is cornerstone to prevent teenage pregnancies. Brining families and communities together to address topic on sexuality without any socio cultural resistance, talk about health risks of unprotected sex and teenage pregnancies is needed. An additional cause of unintended pregnancy is sexual violence, which is widespread with more than third of girls in some countries reporting that their first sexual intercourse was coerced which is still only the tip of the iceberg which is a serious issue to be addressed.
A study of foetomaternal outcome among pregnant hypothyroid women
Authors: Vangani Veena , Vangani Mahendra , Vangani Bhavya
Published: November 2022

During pregnancy one of the most common endocrinological disorder which are very often overlooked during pregnancy because of their nonspecific symptoms and the hypermetabloic state of pregnancy is Thyroid disorder. Optimal maternal thyroid function during pregnancy is important for both the mother and fetus.

The study was planned to determine the prevalence of hypothyroidism using the classical reference range of normal serum TSH as 0.4-6.2μIU/L. It also aimed to study the foetomaternal outcome among pregnant hypothyroid women, using the classical reference range and a lower cut off (<3μIU/L) of TSH for diagnosing hypothyroidism in pregnancy.

This was a longitudinal prospective study conducted in the Department of Obstetrics & Gynaecology, Suryanagari Hospital, in collaboration with the Departments of Endocrinology, Laboratory Medicine & Paediatrics. Before starting the study, clearance was taken from ethical committee of the hospital. A total of 522 pregnant women attending the antenatal OPD were recruited to determine the prevalence of hypothyroidism on the basis of TSH evaluation.

With our study we concluded that these very high prevalence of hypothyroidism in India and routine maternal thyroid function testing must be done as soon as pregnancy is confirmed thus saving lives of many infants who could lead rest of their lives happily and prosperously.
A study of frequency, indication and maternal outcome in emergency peripartum hysterectomy in a tertiary care hospital
Authors: Bharathi R  , Jayabharathi R
Published: November 2022

Antepartum and postpartum haemorrhage are life threatening condition. Obstetric haemorrhage often ends with Peripartum hysterectomy which is done to save the mother if medical and conservative surgical management fails. This study was done to analyse the frequency, indications and associated complications of peripartum hysterectomy.

This retrospective study is conducted in the Department of Obstetrics and Gynecology, Government Medical College Hospital, Kallakurichi, Tamil Nadu, over a period of one year from March 2021 to February 2022.

: Total mothers delivered during the study period was 8174. Emergency peripartum hysterectomy was performed in 28 women. Incidence of peripartum hysterectomy is 3.42/1000 deliveries (0.34%). Most were in the age group of 21-30 years. Majority of patients were multigravida. Most common cause for peripartum hysterectomy was atonic postpartum haemorrhage. Most common postoperative complication was post operative febrile illness.

Peripartum Hysterectomy for control of obstetric haemorrhage is a lifesaving procedure, However it is usually associated with significant morbidity and mortality. This can be reduced by effective antenatal care, tracking of high risk mothers and reduction of primary caesarean delivery as it has significant impact women’s child bearing and reproductive life.
Evaluation of the predictive value of uterine artery doppler in second trimester of pregnancy as a screening tool for preeclampsia
Authors: Kumar Kasiviswanathan Mohan , Krishnamurthy Aparna , Sharma Rajat Kumar , Maiti Gunadhar
Published: November 2022

This study was carried out to determine the validity and reliability of Uterine Artery (UtA) Doppler imaging as a screening tool for predicting preeclampsia among pregnant women attending a tertiary care hospital of the Armed Forces in second trimester.

Our study was a prospective diagnostic study carried out in 680 pregnant women (age group of 19 to 30 years) in second trimester. Maternal BP was recorded using automated BP apparatus on three occasions (15 minutes apart) in supine posture. This was followed by uterine artery Doppler with measurement of Resistivity index (RI) and Pulsatility index (PI). Patients were followed up every month till 12 weeks post-partum. Statistical analysis was done using SPSS version 21.

The mean uterine artery PI was 1.21±0.296 and the mean uterine artery RI value was observed to be 0.58±0.18. The incidence of preeclampsia among the study participants was observed to be 9.9%. The mean uterine artery PI and RI among patient with preeclampsia was found to be significantly higher than those without preeclampsia (p value <0.001). The uterine artery PI values of ≥1.3 when defined as a diagnostic cut off, the sensitivity and specificity was found to be 79.1% and 70.8% respectively. The accuracy was observed to be 71.62%. The uterine artery RI values of ≥0.7 when defined as a diagnostic cut off, the sensitivity and specificity was found to be 44.78% and 89.72% respectively. The accuracy was observed to be 85.29%.

Uterine artery PI parameter is found to have better sensitivity than RI in predicting preeclampsia. Consideration of both PI and RI parameters for prediction of preeclampsia significantly increased the specificity of Uterine Artery Doppler Imaging. Uterine Artery Doppler is a useful tool in predicting the risk of preeclampsia among women in second trimester of pregnancy.
Effectiveness of self instructional module on knowledge of menstrual disorders among adolescent girls
Authors: Mehazbeen
Published: November 2022

Menstruation is a normal monthly cycle in women. Women between puberty and menopause experiences menstruation. It can start between the age of 8-13 and last until between 45-55 years. Though menstruation is normal, some women experience dilemma during their monthly period like, menstrual cramps, or dysmenorrhoea or other menstrual disorders. The menstrual cramps may be severely painful and can interfere with regular activities, sometimes leading to absenteeism in school or in other functions A self instructional module will help the adolescent girls to gain knowledge about menstrual disorders and to seek medical advice promptly whenever needed. The present study was undertaken to evaluate the effectiveness of self instructional module on knowledge of menstrual disorders among adolescent girls.

This study made use of an evaluative approach with a one group pre-test post-test design. The sample for the study sample comprised of 60 adolescent girls. A disproportionate stratified random sampling technique was used to select 30 I PUC and 30 II PUC adolescent girls. Students were selected randomly by lottery method from each stratum of I PUC and II PUC. The tool and SIM were validated by 10 experts. Pre-testing and reliability of the tool was established prior to the pilot study. Pilot study was conducted among twelve adolescent girls. This gave a basis for the investigator to conduct the actual study. The actual study was conducted among 60 adolescent girls. Following the pre-test, SIM was administered and post-test conducted seven days after the administration of SIM. The obtained data was analyzed in terms of the objectives and hypotheses using descriptive and inferential statistics.

The findings of the study showed that SIM is an effective teaching strategy to increase the knowledge of adolescent girls on menstrual disorders.

The findings of the study proved that adolescent girls lacked knowledge on menstrual disorders. The SIM given by the investigator helped the adolescent girls to improve their knowledge. The effectiveness of SIM was tested in terms of gain in knowledge and the findings showed that it was statistically significant at 0.05 level of significance. The findings of the study proved that SIM is an effective strategy in improving the knowledge of the adolescent girls. All the subjects had a gain in knowledge compared to their pre-test knowledge scores. On the whole, carrying out the present study was really an enriching experience to the investigator. It also helped a great deal to explore and improve the knowledge of the researcher and the respondents. The constant encouragement and guidance by the guide, co-operation and interest of respondents in the study contributed to the fruitful completion of the study.
Study of polyps in female reproductive tract in a tertiary care centre
Authors: Deepthi G N  , Sunanda N
Published: November 2022

To study the clinical presentation, management of polyps of female reproductive tract. To know the correlation between ultrasonological finding and Histopathological findings.

This was a retrospective hospital based observational study. It was conducted in Cheluvamba hospital, attached to Mysore Medical college and Research Institute, Mysore. Data was collected from hospital registers who underwent surgery for diagnosis of polyp from the year 2018 to 2021 were included in the study. There were 50 cases in the study. They were managed according to their symptoms, age, desire for fertility and type of polyp.

Polyps are most common in the age group 31 to 40 years (42%) and in parous women. The most common presenting complaint was heavy menstrual bleeding (82%). Based on USG and HPE the most common type of polyp was leiomyomatous polyp. Heavy menstrual bleeding caused severe anaemia in 44% of women who required blood transfusion for correction anaemia. No cases of malignancy were diagnosed.

Polyps are an important cause of AUB. The resulting heavy menstrual bleeding can cause severe anaemia requiring blood transfusion, leading to morbidity. Clinical examination and ultrasound diagnosis correlates with histopathological diagnosis. Using clinical examination and ultrasound one can identify the site and type of polyp and decide on further management.
A self-study on identification of etiology of Anemia in pregnancy
Authors: Bajaj Archana Dhawan
Published: November 2022

Anemia in medical literature could be defined as when levels of hemoglobin are below two standard derivation of the mean for age and gender of patients. During pregnancy many women lacks the sufficient amount of iron which is needed for 2 & 3 trimesters due to significant changes in increase in volume of blood to support the growth of baby, person could suffer from anemia. Based on several researches conducted it have been stated that anemia is one of the most common complications which could occur in pregnancy.

A systemic self-study was planned to determine and review the possible cause of Anemia during pregnancy. With the application of electronic databases we searched PubMed, Google Scholar, Web of Science, Clinical Trial Gov, Medline Plus, health line, John Hopkins Medicine which were published in English language. This systemic self-study have reviewed the facts which were published earlier to determine the cause of anemia during pregnancy. Vast analysis was made to determine the cause of anemia during pregnancy.

We observed and concluded the fact that anemia during pregnancy occurs due to iron and folate deficiency. In more than 50 percent of studies conducted in pregnant women, we observed that one who have less adequate diet and did not received any prenatal iron and folate supplement have the chances to suffer from iron deficiency and folate deficiency anemia.

We conclude by delivery of very important message that adequate iron and folate intake is very crucial for both mother and child during pregnancy. Healthcare professionals must provide proper nutritional advice and essential supplementation which is required at their first consultation with mother’s which lowers and minimalizes the risk of anemia related complications in future.
A study on obstetric and perinatal outcome in a pregnancy complicated with oligohydramnios
Authors: Gowda Shashikala H
Published: November 2022

Oligohydramnios, defined as when the AFI is less than 5. Definition of increased or decreased amniotic fluid volume are based on sonographic criteria. Oligohydramnios complicates approximately 1 to 2% of pregnancies Amniotic fluid provides the cushion effect against the constricting confines of the gravid uterus. It creates space and helps in musculoskeletal development of foetus, helps in normal fetal lung development and prevents compression of umbilical cord, placenta and hence protects the foetus from vascular and nutritional compromises. Oligohydramnios is associated with high risk adverse perinatal outcome like fetal distress, meconium aspiration, low APGAR, joint contracture, pulmonary hypoplasia etc., and associated with maternal morbidity in the form of increased rates of induction and/or operative interference. This study is conducted to find out the effects of oligohydramnios in determining the obstetric and perinatal outcome.

To study, 1) Primary outcome- Obstetric outcome in terms of mode of delivery, indication for operative interference. 2) Secondary outcome- Neonatal outcome in terms of birth weight, Apgar score, colour of liquor, admissions to NICU.

This is a prospective observational study conducted on 80 patients presenting to Department of Obstetrics and Gynecology at KIMS hospital, Bengaluru from January 2019 to June 2020 who were diagnosed with oligohydramnios with intact membranes with AFI<5cms using sonographic criteria.

A total of 80 cases of Isolated Oligohydramnios were assessed. 38.7% cases delivered vaginally, 61.2% of cases underwent Cesarean section, 15% had meconium stained liquor, 15% had APGAR score of <7 at 1 minute, 42.5% had birth weight <2.5kgs and 37.5% of babies required NICU admissions.

The present study was conducted to know the fetomaternal outcome in pregnancies with oligohydramnios. The study showed oligohydramnios was associated with higher rates of induction and Cesarean section and associated with Low birth weight babies.
Squamous cell carcinoma of the oral alveolus during pregnancy: Perioperative management in a rural setting
Authors: Joseph Karuna Susan , Manoj G Mridul
Published: November 2022

A 30-year old pregnant woman presented to our hospital with stage 4 squamous cell carcinoma of the lower alveolus of the mouth. She underwent a transoral segmental resection of the tumour and left-modified radical neck dissection at 29 weeks of gestation. A multidisciplinary team was formed and careful consideration was given to preoperative evaluation, surgical and anaesthesia management, and postoperative care. The pregnancy was continued and the patient delivered a healthy baby at 35 weeks. This case highlights the perioperative interventions required to ensure the best possible outcomes for the mother and the baby.
Secondary hypokalemic non-periodic paralysis in a case of intractable hyperemesis gravidarum – A maternal near miss
Authors: Khan Shazia , Matta Madhuri , Maiti G D , Sharma Rajesh
Published: November 2022

Hyperemesis Gravidarum is a debilitating early pregnancy complication causing Hypokalemia and associated morbidity if timely recognition and intervention is not initiated. A rare sequelae of intractable hyperemesis is Non periodic Hypokalemic paralysis.

A 26 years old primigravida at 13 weeks 6 days of gestation was admitted with hyperemesis gravidarum preceded by nausea and vomiting of 10 days duration. Her sonography showed a single live fetus of corresponding maturity. She was treated with intravenous fluid therapy and parenteral antiemetics. As her hyperemesis continued despite all medications, she was started on steroid therapy, she however developed hypokalaemic paralysis with serum potassium of < 2.3mmEq/L and ECG changes of prolonged QT interval with u waves. Timely detection and potassium supplementation prevented adverse maternal outcome and patient recovered totally within 48 hrs of potassium infusion initiation.

Hypokalemia remains a morbid sequelae of hyperemesis gravidarum which can be missed in the early stages as patient may remain asymptomatic. It thus becomes essential to serially monitor such patients with daily serum electrolytes especially when on corticosteroid therapy for intractable Hyperemesis to prevent any maternal near miss condition.
A rare case of triplet heterotopic pregnancy - A case report
Authors: Ragam Akshitha Sai , Thonangi Aashritha , Sheela S R
Published: November 2022

Triplet heterotopic pregnancy refers to the presence of specifically 3 concurrent gestations with at least 1 being abnormally implanted. Heterotopic pregnancy is rare and estimated to occur in about 1 per 30,000 spontaneous pregnancies while a higher prevalence may occur in assisted reproduction techniques that may reach up to 1 case per 100 in some literatures. The triplet heterotopic pregnancies are often in association with risk factors, as tubal factor infertility, pelvic infections, in vitro fertilization, more embryos transfer, and use of pharmacologic ovulation induction. A 22-year-old primigravida with history of undergoing ovulation induction treatment with 2 & ½ months of amenorrhea was brought to the Emergency Department with complaints of pain abdomen, vomiting and generalized weakness since one day. Transvaginal ultrasound revealed a single live intrauterine gestation at 9 weeks 3 days with fetal cardiac activity alongwith a well defined round to oval anechoic lesion likely gestation sac within the left fallopian tube with moderate to gross hemoperitoneum leading to the diagnosis of a heterotopic pregnancy with left ruptured ectopic pregnancy. She underwent an Exploratory Laparotomy under general anesthesia and was found to have a left sided ruptured tubal ectopic at the isthmo-ampullary junction measuring about 4 x 5 cms for which salpingectomy was done along with an incidental finding of a right sided unruptured ectopic pregnancy in the ampullary region which was in the process of tubal abortion for which right salpingotomy was done. Hemoperitoneum of 900 ml was present. Serial USG monitoring and regular antenatal check ups were done for intrauterine pregnancy and patient was followed up till term. She was admitted at 38 weeks gestation and delivered a healthy, term male baby of birth weight 2.86 kgs through caesarean section.
Endometriosis externa: A rare presentation
Authors: Kavitha Thangarasu , Shanthi Nalli
Published: November 2022

Endometriosis externa is presence of endometrial glands and stroma outside uterus. Umbilical endometriosis (also called Villar’s nodules) and subcutaneous endometriosis are rare conditions that occur in elderly women without any menstrual complaints and pelvic endometriosis. The overall incidence of umbilical endometriosis is very low (0.1-0.5%). Here we report a rare case of endometriosis externa with umbilical menstruation in a woman with a previous history of cesarean section and myomectomy. After complete evaluation, the patient underwent excision of the endometriotic lesion with abdominoplasty with mesh repair. The possible cause of this type of endometriosis can be secondary type due to direct implantation of endometrial tissue in the subcutaneous tissue during the previous surgeries.
Orbital apex syndrome in rhino-orbito-cerebralmucormycosis (ROCM) – A prospective observational study
Authors: Kumar Niranjan Karthik Senthil , Alagappan Yogeswari , R P Mahalakshmi , Sundaram Gnanaoli Meenakshi
Published: November 2022

Orbital apex syndrome (OAS) is an uncommon clinical presentation consisting of complete ophthalmoplegia with vision loss, involving cranial nerves II, III, IV, V, and VI. OAS may result from trauma, malignancy, infection, inflammation, or vascular origins. Aims of the study were to analyse the incidence and presentation of orbital apex syndrome in rhino-orbital mucormycosis in a tertiary care hospital. A total of 29 cases (4.1%) out of 696 cases of invasive ROCM with OAS as a presenting feature were documented. Amphotericin B in both retrobulbar and intravenous routes played a crucial role in arresting the spread of the disease allowing only 8 (27%) cases to show disease progression. FESS if done appropriately with efficient debridement of necrotic infective tissue can be a powerful tool in redirecting the course of disease for the better (only 2 of 8 patients with CST at the time of presentation had a history of FESS done prior. ROCM is a severe, emergent and fatal infection requiring multidisciplinary management. It may often present with OAS initially. Mucormycosis must be considered in such patients and timely aggressive management must be initiated to avoid disastrous morbidity and mortality.
To study the significance of various risk factors in development of retinopathy of prematurity at a tertiary care center in Eastern Uttar Pradesh
Authors: Jhunjhunwala Aditi , Yadav Ram Yash Singh , Rai Chiranji , Srivastava Nupur
Published: November 2022

Retinopathy of prematurity is a multi factorial vaso-proliferative disease that is the most common cause of preventable childhood blindness worldwide.

This study aims to determine the frequency, clinical course and risk factors of ROP in premature infants treated in the Neonatal Intensive Care Unit (NNICU) of our hospital.

In this retrospective observational study the case records of 243 infants who visited our ROP clinic between January 2020 and august 2021 were reviewed.

The mean GA was 33.4 weeks and the mean birth weight was 1.3 kg. A total of 55 (22.82%) patients developed ROP. low birth weight (p value = <0.001), low gestational age (p value = <0.001), multiple pregnancy (p value 0.002), blood transfusion (p value = 0.033), sepsis (p value = 0.009, odds ratio = 2.29 at CI 95%), oxygen supplementation (p value = <0.001 odds ratio= 10.56 at CI 95%) and duration of oxygen (p value = <0.001, odds ratio =1.93 at CI 95%) were significant risk factor for development of ROP. 2 (3.63%) cases were zone I, 8 (14.54%) zone II, and 45 (81.81 %) in zone III. Out of which 8 had plus disease. Analysis of the risk factor for severity of disease was found to be statistically significant with multiple pregnancy (p value = 0.015).

Our study shows less gestational age, low birth weight and supplemental oxygen along with sepsis as biggest risk factor for development of ROP in our set –up and multiple pregnancy for severity.
Qualitative OCT biomarkers for visual improvement in treatment of diabetic macular edema
Authors: Radhakrishnan Natasha , Pillai Gopal S , Iyer Aishwarya
Published: November 2022

To identify baseline qualitatative OCT biomarkers that can predict good visual outcome in diabetic macular edema after treatment.

Prospective, observational study in the time period.

We included 37 eyes of 37 patients with treatment naïve diabetic macular edema who subsequently underwent treatment with injections of intravitreal Ranibizumab. Inclusion criteria was: Presenting vision < 0.3 logMaR (2) centre involving diabetic macular edema (CMT>250 microns). 3 injections were given monthly irrespective of treatment response followed by PRN dosing. Factors under evaluation were: 1) Submacular detachment (SMD) (2) cystoid changes in the inner and outer nuclear layer (4) Integrity of IS-OS junction. (5) Hyper Reflective Foci(HRF) and location (6) vitreomacular interface (7) Disruption of inner retinal layers(DRIL)

We included 37 eyes in our study. For analysis, based on final visual acuity patients were divided in two groups: (1) Group A: Good visual acuity (>10 ETDRS letter gain) and (2) Group B: Poor visual outcome (< 10 letter gain). Presence of SMD was more likely in Group B as compared to Group A. There was no significant difference between two groups for other mentioned parameters.

Presence of SMD was found to have most significance in predicting good visual acuity response to anti VEGF.DRIL was found to decrease during the treatment but a predictive role could not be demonstrated.
Factors Affecting Generation-Y Employee Engagement During a Pandemic: A Study from the Private Sector in Indonesia
Authors: Sudirman Acai , Lie Darwin , Wakhyuni Emi , Romy Elly , Basriani Agustin
Published: November 2022

It is important to assess the relationship between employees and the company they work for in order to build trust between both parties. This can lead to an increase in employee productivity. This study aimed to determine the effect of organizational trust, personal resources and work-life balance on employee engagement. The sample used in this study were workers belonging to Generation-Y with 190 respondents using a purposive sampling. Data collection was done through an online questionnaire. The SPSS application was used to analyze the data through research instrument testing with validity and reliability tests, multiple regression analysis, coefficient of determination and hypothesis testing. It is concluded that organizational trust, personal resources, and work-life balance have a significant effect on employee engagement.
Keywords: organizational trust, personal resource, work-life balance, employee engagement.
Foam-Forming Properties of Alternative Vegetable Proteins
Authors: Ramos Luana Cristina da Silva , Vidigal Márcia Cristina Teixeira Ribeiro
Published: November 2022

The substitution of animal protein for vegetable protein in foods has become increasingly demanded by consumers. In aerated food products such as ice cream, meringues, mayonnaise, and bakery products, proteins are one of the constituents responsible for sensory and technological attributes. In addition, proteins can act as surfactants in foaming systems. The protein source can influence the kinetic stability of these systems. Thus, knowing the foaming property of vegetable proteins is important to define the final application. Studies suggest that some alternative sources, such as vegetable proteins are promising in the development of foaming food formulations.
Study of the influence of the parameters of preparation of polymeric solutions obtaining nanofibers by electrospinning
Authors: Gonçalves Luiz Fernando Pimenta , Botezini Ariandy , Wittcinski Carlos Omizollo , Santos William Roberto da Silva , Gonçalves Erika Peterson
Published: November 2022

The technique of electrospinning polymeric nanofibers has been emerging in the academic environment due to its well-parias and low operational, but the production of these nanofibers finds challenges regarding homogeneity and reproduction of obtained results. As properties of polymeric solutions are important for the determination of electrospinning parameters, such as the applied electrical voltage and injection rate. Seeking rheological behavior of polymeric solutions; which may be affected by the concentration of the polymeric solution and the preparation temperature of these solutions. This way this work studied the effect of the production temperature of polyacrylonitrile and methyl acrylate copolymer solutions and related them to the nanofibers produced at the same injection rates and electrical stresses. It was observed the inversely proportional behavior between the temperature of preparation of the solutions and the viscosity of the solutions at room temperature, which reflects in the integrity and homogeneity of the fibers formed, with the formation of pearls in the nanofibers produced to more viscous solutions.
Aplicação tecnológica de prebióticos em produtos lácteos
Authors: Oliveira Bianca Cristina Rocha de , Soutelino Maria Eduarda Marques , Silva Gabriela Rodrigues Alves , Pagani Mônica Marques , Mársico Eliane Teixeira , Esmerino Erick Almeida , Silva Adriana Cristina de Oliveira
Published: November 2022

Seguindo a intuição do filósofo grego Hipócrates (460 a.C – 375 a.C) que considera o alimento como remédio. A ciência atravessa séculos no estudo de alimentos funcionais, impulsionando as indústrias na formulação de produtos inovadores, como por exemplo, a associação de ingredientes promotores de saúde em conjunto com propriedades tecnológicas desejáveis. Nesse sentido, o presente trabalho teve como objetivo realizar uma revisão de literatura sobre a aplicação tecnológica de diferentes fibras prebióticas em produtos lácteos. Os dados levantados demonstraram que as fibras alimentícias como frutooligossacarídeos (FOS), inulina e xilooligossacarídeos (XOS) podem proporcionar características tecnológicas desejáveis em produtos lácteos, podendo servir como agente substituto de gordura, texturizante, umectante, agente de corpo, agente edulcorante, além de possuírem o potencial funcional prebiótico. Por fim, evidencia-se assim as amplas possibilidades de aplicação de prebióticos em produtos lácteos, permitindo dessa forma que o setor laticinista diversifique seus produtos alinhadamente às demandas dos consumidores.
Análise de rótulos de ovos comercializados na cidade de Barreiras-BA
Authors: Dourado Michelle Souza , Lima Ítalo Abreu , Paranaguá Natyelle dos Santos , Costa Dhéssica Kellen Ferreira , Antunes Suzanne de Souza Tiano , Costa Tamires dos Santos
Published: November 2022

O presente trabalho objetiva realizar a análise dos rótulos das embalagens de ovos comercializados na cidade de Barreiras-BA e averiguar as condições de armazenamento do produto nos estabelecimentos, a fim de verificar se as mesmas estão atendendo as normas e legislações vigentes quanto à estocagem e informações obrigatórias que devem estar inseridas em seu rótulo. O trabalho foi realizado entre os meses de janeiro a março de 2022 em supermercados e mercadinhos da cidade de Barreiras-BA. No total foram analisadas 7 marcas, sendo posteriormente identificadas de A à G. Para a avaliação, foi elaborado um formulário do tipo check-list, por meio de um levantamento de informações úteis a serem utilizadas para a avaliação dos rótulos. Três marcas apresentaram os rótulos com o maior número de inconformidades quanto aos critérios determinados pelas legislações específicas de rotulagem de alimentos. A marca F apresentou o maior número de irregularidades, não constando a presença do Carimbo do SIF; expressão “não contém glúten”; classe; orientações de que o ovo cru ou mal cozido faz mal; tipo do ovo; grupo; orientações de armazenamento e informações nutricionais. Sendo assim, percebe-se que, mesmo havendo legislações específicas para a rotulagem de ovos no Brasil, ainda é recorrente encontrar marcas sendo comercializadas que não atendem a todos os requisitos estabelecidos pela legislação.
Teletrabalho e Qualidade de Vida: Estudo de Caso em uma Instituição Pública de Ensino no Brasil
Authors: Menezes Gisley Lima de , Socoloski André Luiz Mateus , Maia Marcos
Published: November 2022

Em meio às transformações no mundo do trabalho, as instituições são constantemente forçadas a se adaptar, revisando suas políticas, seus processos, práticas e rotinas de trabalho. O teletrabalho tem sido amplamente discutido como tema muitas vezes polêmico na administração pública e merecedor de estudos mais aprofundados. O objetivo deste artigo é descrever e caracterizar as percepções dos servidores públicos de uma instituição pública de educação, em relação ao teletrabalho enquanto fator de melhora da qualidade de vida, assim como suas possíveis vantagens e desvantagens. Desta forma, realizou-se um estudo de caso com servidores da carreira técnico administrativa. Os dados foram coletados por meio de questionário enviado aos trabalhadores e entrevistas com diretores. A amostra foi obtida por meio de procedimentos de amostragem probabilística. Dentre as vantagens identificas estão a melhor qualidade de vida, menos interrupção do trabalho, assim como maior produtividade em cumprir o estabelecimento de metas; por outro lado, o isolamento profissional, a extensão da jornada de trabalho e o isolamento social foram apontados como as principais dificuldades dessa modalidade de trabalho.
ON AND SETS
Authors:   University of Zakho, Ibrahim Hariwan Z.
Published: November 2022

In this article, we define an sets via defined on and investigate some of their properties. Moreover, we study the notion of closed set in topological spaces and present some of their respective features. Ultimately, we introduce and characterize and sets.
Analysis of the Effectiveness of the Use of Nitrogen Oxide Reducing Agent of Exhaust Gases of Diesel Engines
Authors:   Moscow Polytechnic University, Erokhov V.I. , Nadareishvili G.G. ,   Moscow Polytechnic University, Blinov A.S. ,   Bauman Moscow State Technical University (BMSTU)
Published: November 2022

The relevance of the article is due to the need to radically improve the environmental performance of automobile diesels. The most significant gaseous toxic component of spent diesel engines are nitrogen oxides. The mechanisms and models of nitrogen oxides formation in the diesel combustion chamber are considered. The analysis of methods for reducing the emission of nitrogen oxides with diesel exhaust gases has been carried out. The most effective method of their purification from nitrogen oxides is the use of SCR technology, in which an aqueous urea solution is supplied to the diesel exhaust system. At a temperature of about 130 °C, urea decomposes into ammonia and carbon dioxide. Ammonia released from urea reacts with nitrogen oxides of exhaust gases, reducing them to nitrogen. A method for calculating the urea supply to the diesel exhaust system has been developed. Tests of the YAMZ-6566 diesel engine equipped with the SCR system were carried out. With an excess urea ratio of 1.03, the efficiency of the SCR system ranged from 89 to 100 %, depending on the operating mode of the diesel engine.
Computational Study of the Working Process of a Dual-Fuel Hydrogen Engine
Authors:   Bauman Moscow State Technical University (BMSTU), Kuleshov A.S. , Gordin M.V. ,   Bauman Moscow State Technical University (BMSTU), Markov V.A. ,   Bauman Moscow State Technical University (BMSTU), Barchenko F.B. ,   Bauman Moscow State Technical University (BMSTU), Karpets F.S. ,   Bauman Moscow State Technical University (BMSTU)
Published: November 2022

from alternative raw materials. Hydrogen is considered as a promising alternative fuel. Using the Diesel-RK software package, computational studies of the effect of hydrogen supply on the workflow of a D-245 gas-diesel engine were carried out. The diesel cycle of the engine and its gas-diesel cycle with hydrogen supplies equal to 5, 10, 20, 40, 60 and 80 % are calculated (taking into account the difference in the heat of combustion of diesel fuel and hydrogen). The maximum equivalent efficiency of the diesel engine is achieved when 40 % hydrogen is supplied to the combustion chamber. In this case, compared to working only on petroleum diesel fuel, the effective efficiency of diesel increased by 6.7 %. The transition of diesel engines from petroleum diesel fuel to work with the addition of hydrogen in an amount of 40 % is accompanied by a decrease in the specific emission of carbon dioxide by 44 %, the smokiness of exhaust gases by 53 %. However, an increase in the content of nitrogen oxides in exhaust gases by 27 % was noted.