bluuebunny/crossref_metadata_2025 huggingface dataset:
A qualitative exploration of obesity bias and stigma in Irish healthcare; the patients’ voice
Authors: O’Donoghue Grainne , Cunningham Caitriona , King Melvina , O’Keefe Chantel , Rofaeil Andrew , McMahon Sinead
Published: November 2021

Background

Current data indicates 70% of adults with obesity report experiencing bias and stigmatisation when engaging with healthcare. Most studies to date, have focused on weight bias from a healthcare professional’s perspective. Few have explored weight bias from the perspective of the individual living with obesity and no study has conducted this research in the Irish context.

Aims

This study explored, the lived-in experience of individuals afflicted with obesity, when interacting with the Irish healthcare system. It examined whether participants encountered weight bias and stigma, if so, how it may have impacted them and gathered their suggestions on how it could be best addressed.

Methods

Employing a phenomenological approach, purposive sampling and semi-structured interviews were conducted with 15 individuals living with class II (BMI 35.0–39.9) or III obesity (BMI≥40kg/m2) who reported regular and consistent engagement with the Irish healthcare system. Predominant emergent themes were categorised using the interview domains; (1) experiences of obesity bias and stigma, (2) impact of this bias and stigma and (3) suggested avenues to reduce bias and stigma.

Findings

Participants reported experiencing high levels of weight bias and stigmatisation. Relating to experiences, three themes were identified; interpersonal communication, focus of care and physical environment. In terms of its impact, there were two emergent themes; negativity towards future healthcare and escalation of unhealthy behaviours. Suggested avenues to eliminate bias and stigma included the introduction of a timely and clear clinical pathway for obesity management and a focus on HCPs education in relation to obesity causes and complexity.

Conclusions

Outside of specialist obesity tertiary care, weight bias and stigmatisation is commonly reported in the Irish healthcare system. It is a significant issue for those living with obesity, detrimental to their physiological and psychological health. A concerted effort by HCPs across clinical, research and educational levels is required to alleviate its harmful effects.
Absolute quantification of E. coli virulence and housekeeping genes to determine pathogen loads in enumerated environmental samples
Authors: Hoorzook K. B. , Barnard T. G.
Published: November 2021

Quantifying pathogenic genes with q-PCR in complex samples to determine the pathogen loads is influenced by a wide range of factors, including choice of extraction method, standard curve, and the decision to use relative versus absolute quantification of the genes. The aim was to investigate the standardisation of q-PCR methods to determine enumerated E. coli gene ratios grown with the IDEXX Colilert® Quanti-Trays® using enteropathogenic E. coli as the model pathogen. q-PCR targeting the eaeA and gadAB genes was used to calculate the eaeA: gadAB ratios for clinical strains collected between [2005–2006 (n = 55)] and [2008–2009 (n = 19)] using the LinRegPCR software and Corbett Research Thermal cycler software. Both programs grouped the isolates into two distinct groups based on the gene ratios although the Corbett Research Thermal cycler software gave results one log higher than the LinRegPCR program. Although the eaeA: gadAB ratio range was determined using extracted E. coli DNA, the impact of free DNA and other bacteria present in the sample needed to be understood. Standard curve variations using serially diluted extracted E. coli DNA, serially diluted pure E. coli culture followed by DNA extraction from each dilution with or without other bacteria was tested using the eaeA q-PCR to quantify the genes. Comparison of the standard curves showed no significant difference between standard curves prepared with diluted DNA or with cells diluted before the DNA is extracted (P = 0.435). Significant differences were observed when background DNA was included in the diluent or Coliform cells added to the diluent to dilute cells before the DNA is extracted (P < 0.001). The “carrier” DNA and Coliform cells enhanced the DNA extraction results resulting in better PCR efficiency. This will have an influence on the quantification of gene ratios and pathogen load in samples containing lower numbers of E. coli.
Health system costs and days in hospital for colorectal cancer patients in New South Wales, Australia
Authors: Goldsbury David E. , Feletto Eleonora , Weber Marianne F. , Haywood Philip , Pearce Alison , Lew Jie-Bin , Worthington Joachim , He Emily , Steinberg Julia , O’Connell Dianne L. , Canfell Karen
Published: November 2021

Introduction

Colorectal cancer (CRC) care costs the Australian healthcare system more than any other cancer. We estimated costs and days in hospital for CRC cases, stratified by site (colon/rectal cancer) and disease stage, to inform detailed analyses of CRC-related healthcare.

Methods

Incident CRC patients were identified using the Australian 45 and Up Study cohort linked with cancer registry records. We analysed linked hospital admission records, emergency department records, and reimbursement records for government-subsidised medical services and prescription medicines. Cases’ health system costs (2020 Australian dollars) and hospital days were compared with those for cancer-free controls (matched by age, sex, geography, smoking) to estimate excess resources by phase of care, analysed by sociodemographic, health, and disease characteristics.

Results

1200 colon and 546 rectal cancer cases were diagnosed 2006–2013, and followed up to June 2016. Eighty-nine percent of cases had surgery, chemotherapy or radiotherapy, and excess costs were predominantly for hospitalisations. Initial phase (12 months post-diagnosis) mean excess health system costs were $50,434 for colon and $60,877 for rectal cancer cases, with means of 16 and 18.5 excess hospital days, respectively. The annual continuing mean excess costs were $6,779 (colon) and $8,336 (rectal), with a mean of 2 excess hospital days each. Resources utilised (costs and days) in these phases increased with more advanced disease, comorbidities, and younger age. Mean excess costs in the year before death were $74,952 (colon) and $67,733 (rectal), with means of 34 and 30 excess hospital days, respectively–resources utilised were similar across all characteristics, apart from lower costs for cases aged ≥75 at diagnosis.

Conclusions

Health system costs and hospital utilisation for CRC care are greater for people with more advanced disease. These findings provide a benchmark, and will help inform future cost-effectiveness analyses of potential approaches to CRC screening and treatment.
Assessment of hospitalization costs and its determinants in infants with clinical severe infection at a public tertiary hospital in Nepal
Authors: Shrestha Suchita , Chapagain Ram Hari , Purakayastha Debjani Ram , Basnet Srijana , Wadhwa Nitya , Strand Tor A. , Basnet Sudha
Published: November 2021

Sepsis, an important and preventable cause of death in the newborn, is associated with high out of pocket hospitalization costs for the parents/guardians. The government of Nepal’s Free Newborn Care (FNC) service that covers hospitalization costs has set a maximum limit of Nepalese rupees (NPR) 8000 i.e. USD 73.5, the basis of which is unclear. We aimed to estimate the costs of treatment in neonates and young infants fulfilling clinical criteria for sepsis, defined as clinical severe infection (CSI) to identify determinants of increased cost. This study assessed costs for treatment of 206 infants 3–59 days old, enrolled in a clinical trial, and admitted to the Kanti Children’s Hospital in Nepal through June 2017 to December 2018. Total costs were derived as the sum of direct costs for bed charges, investigations, and medicines and indirect costs calculated by using work time loss of parents. We estimated treatment costs for CSI, the proportion exceeding NPR 8000 and performed multivariable linear regression to identify determinants of high cost. Of the 206 infants, 138 (67%) were neonates (3–28 days). The median (IQR) direct costs for treatment of CSI in neonates and young infants (29–59 days) were USD 111.7 (69.8–155.5) and 65.17 (43.4–98.5) respectively. The direct costs exceeded NPR 8000 (USD 73.5) in 69% of neonates with CSI. Age <29 days, moderate malnutrition, presence of any sign of critical illness and documented treatment failure were found to be important determinants of high costs for treatment of CSI. According to this study, the average treatment cost for a newborn with CSI in a public tertiary level hospital is substantial. The maximum limit offered for free newborn care in public hospitals needs to be revised for better acceptance and successful implementation of the FNC service to avert catastrophic health expenditures in developing countries like Nepal. Trial Registration: CTRI/2017/02/007966 (Registered on: 27/02/2017).
Generational differences in international research collaboration: A bibliometric study of Norwegian University staff
Authors: Rørstad Kristoffer , Aksnes Dag W. , Piro Fredrik Niclas
Published: November 2021

This paper addresses the relationship between age and international research collaboration. The main research question is: do younger researchers collaborate more internationally than their senior colleagues? A common assumption is that younger generations are generally more internationally oriented than older generations. On the other hand, senior researchers may have larger international networks compared to younger colleagues. The study is based on data for 5,600 Norwegian researchers and their publication output during a three-year period (44,000 publications). Two indicators for international collaboration are used: The share of researchers involved in international collaboration measured by co-authorship and the average proportion of publications with international collaboration per researcher. These indicators reflect two different dimensions of international collaboration. Although the findings are not consistent across age cohorts and indicators of internationalization, the overall trend is that international collaboration tends to decline with increasing age. This holds both at aggregate levels and within groups of academic positions. However, the generational differences are not very large, and other variables such as the field of research explain more of the differences observed at an individual level.
Admission criteria in critically ill COVID-19 patients: A physiology-based approach
Authors: Ceruti Samuele , Glotta Andrea , Biggiogero Maira , Maida Pier Andrea , Marzano Martino , Urso Patrizia , Bona Giovanni , Garzoni Christian , Molnar Zsolt
Published: November 2021

Introduction

The COVID-19 pandemic required careful management of intensive care unit (ICU) admissions, to reduce ICU overload while facing limitations in resources. We implemented a standardized, physiology-based, ICU admission criteria and analyzed the mortality rate of patients refused from the ICU.

Materials and methods

In this retrospective observational study, COVID-19 patients proposed for ICU admission were consecutively analyzed; Do-Not-Resuscitate patients were excluded. Patients presenting an oxygen peripheral saturation (SpO2) lower than 85% and/or dyspnea and/or mental confusion resulted eligible for ICU admission; patients not presenting these criteria remained in the ward with an intensive monitoring protocol. Primary outcome was both groups’ survival rate. Secondary outcome was a sub analysis correlating SpO2 cutoff with ICU admission.

Results

From March 2020 to January 2021, 1623 patients were admitted to our Center; 208 DNR patients were excluded; 97 patients were evaluated. The ICU-admitted group (n = 63) mortality rate resulted 15.9% at 28 days and 27% at 40 days; the ICU-refused group (n = 34) mortality rate resulted 0% at both intervals (p < 0.001). With a SpO2 cut-off of 85%, a significant correlation was found (p = 0.009), but with a 92% a cut-off there was no correlation with ICU admission (p = 0.26). A similar correlation was also found with dyspnea (p = 0.0002).

Conclusion

In COVID-19 patients, standardized ICU admission criteria appeared to safely reduce ICU overload. In the absence of dyspnea and/or confusion, a SpO2 cutoff up to 85% for ICU admission was not burdened by negative outcomes. In a pandemic context, the SpO2 cutoff of 92%, as a threshold for ICU admission, needs critical re-evaluation.
The effectiveness of Non-pharmaceutical interventions in reducing the COVID-19 contagion in the UK, an observational and modelling study
Authors: Galanis Giorgos , Di Guilmi Corrado , Bennett David L. , Baskozos Georgios
Published: November 2021

Epidemiological models used to inform government policies aimed to reduce the contagion of COVID-19, assume that the reproduction number is reduced through Non-Pharmaceutical Interventions (NPIs) leading to physical distancing. Available data in the UK show an increase in physical distancing before the NPIs were implemented and a fall soon after implementation. We aimed to estimate the effect of people’s behaviour on the epidemic curve and the effect of NPIs taking into account this behavioural component. We have estimated the effects of confirmed daily cases on physical distancing and we used this insight to design a behavioural SEIR model (BeSEIR), simulated different scenaria regarding NPIs and compared the results to the standard SEIR. Taking into account behavioural insights improves the description of the contagion dynamics of the epidemic significantly. The BeSEIR predictions regarding the number of infections without NPIs were several orders of magnitude less than the SEIR. However, the BeSEIR prediction showed that early measures would still have an important influence in the reduction of infections. The BeSEIR model shows that even with no intervention the percentage of the cumulative infections within a year will not be enough for the epidemic to resolve due to a herd immunity effect. On the other hand, a standard SEIR model significantly overestimates the effectiveness of measures. Without taking into account the behavioural component, the epidemic is predicted to be resolved much sooner than when taking it into account and the effectiveness of measures are significantly overestimated.
Adopting Andersen’s behavior model to identify factors influencing maternal healthcare service utilization in Bangladesh
Authors: Kabir Md. Ruhul
Published: November 2021

Background

Equitable maternal healthcare service access and it’s optimum utilization remains a challenge for many developing countries like Bangladesh, and different predisposing, enabling, and need-based factors affect the level of maternal healthcare use. The evidently poor maternal healthcare service utilization and disparities among groups in Bangladesh are concerning considering its effect on maternal health outcomes. The study aimed to identify the factors that influence maternal healthcare service (MHS) utilization in Bangladesh by adopting Andersen’s behavior model of health service use as the theoretical framework.

Methods

The 2017–18 Bangladesh Demographic Health Survey (2017–18 BDHS) data were used which is nationally representative. The survey study used two-stage stratified sampling to select study households, and data were collected through face-to-face interviews. The desirable, moderate, and undesirable maternal health service (MHS) package was developed based on antenatal, and delivery care services use during pregnancy and childbirth. Multinomial logistic regression and discriminant analysis were performed to analyze the factors that affect MHS use.

Results

Out of 5,011 ever-married women, only 31.2% of women utilized the desirable level of MHS. The likelihood of using the desirable level of MHS package, relative to the undesirable category, was 9.38 times (OR: 9.38, 95% CI: 4.30–20.44) higher for women with a higher level of education compared to illiterate women, and the same trend was noticed for husband’s education. The wealth index had the highest standardized function coefficients (Beta coefficient: 0.49) in discriminatory function. Women with the richest wealth index were more than 23 times (OR: 23.27, 95% CI: 12.69–42.68) likely to have utilized desirable MHS than their poorest counterparts. The likelihood of service uses also varied according to the child’s birth order, administrative regions, and area of residence (rural vs. urban).

Conclusions

Policies and interventions directed towards poverty reduction, universal education, and diminishing geographical disparities of healthcare access might influence the desirable use of maternal healthcare services in Bangladesh.
Protocol: Benefits and harms of remdesivir for COVID-19 in adults: A systematic review with meta-analysis
Authors: Paludan-Müller Asger Sand , Lundh Andreas , Page Matthew J. , Munkholm Klaus
Published: November 2021

Background

Effective drug treatments for Covid-19 are needed to decrease morbidity and mortality for the individual and to alleviate pressure on health care systems. Remdesivir showed promising results in early randomised trials but subsequently a large publicly funded trial has shown less favourable results and the evidence is interpreted differently in clinical guidelines. Systematic reviews of remdesivir have been published, but none have systematically searched for unpublished data, including regulatory documents, and assessed the risk of bias due to missing evidence.

Methods

We will conduct a systematic review of randomised trials comparing remdesivir to placebo or standard of care in any setting. We will include trials regardless of the severity of disease and we will include trials examining remdesivir for indications other than Covid-19 for harms analyses. We will search websites of regulatory agencies, trial registries, bibliographic databases, preprint servers and contact trial sponsors to obtain all available data, including unpublished clinical data, for all eligible trials. Our primary outcomes will be all-cause mortality and serious adverse events. Our secondary outcomes will be length of hospital stay, time to death, severe disease, and adverse events. We will assess the risk of bias using the Cochranes Risk of Bias 2 tool and the risk of bias due to missing evidence (e.g. publication bias, selective reporting bias) using the ROB-ME tool. Where appropriate we will synthesise study results by conducting random-effects meta-analysis. We will present our findings in a Summary of Findings table and rate the certainty of the evidence using the GRADE approach.

Discussion

By conducting a comprehensive systematic review including unpublished data (where available), we expect to be able to provide valuable information for patients and clinicians about the benefits and harms of remdesivir for the treatment of Covid-19. This will help to ensure optimal treatment for individual patients and optimal utilisation of health care resources.

Systematic review registration

CRD42021255915.
Thrombotic events and rebleeding after hemorrhage in patients taking direct oral anticoagulants for non-valvular atrial fibrillation
Authors: Yanagisawa Daisuke , Abe Koichiro , Amano Hirohito , Komatsuda Shogo , Honda Taku , Manabe Daisuke , Yamamoto Hirosada , Kozuma Ken , Kodashima Shinya , Asaoka Yoshinari , Yamamoto Takatsugu , Tanaka Atsushi
Published: November 2021

Several direct oral anticoagulants have been developed to prevent cardiogenic thrombosis in patients with atrial fibrillation, on the other hand, have the complication of bleeding. Since clinical course after bleeding with direct oral anticoagulant remains unclear, the present retrospective cohort study was to clarify the course after hemorrhage among patients receiving direct oral anticoagulants. Among all 2005 patients prescribed dabigatran, rivaroxaban, apixaban, or edoxaban between April 2011 and June 2017, subjects comprised 96 patients with non-valvular atrial fibrillation who experienced relevant bleeding during direct oral anticoagulant therapy (Bleeding Academic Research Consortium type 2 or above). The clinical course after hemorrhage was reviewed to examine whether rebleeding or thrombotic events occurred up to the end of December 2019. Gastrointestinal bleeding was the most frequent cause of initial bleeding (57 patients, 59%). Rebleeding occurred in 11 patients (4.5%/year), with gastrointestinal bleeding in 10 and subarachnoid hemorrhage in 1. All rebleeding occurred in patients who resumed anticoagulation therapy. Another significant factor related with rebleeding included past history of gastrointestinal bleeding. On the other hand, major adverse cardiac and cerebrovascular events occurred in 6 patients older than 75 years old or more (2.5%/year), with systemic thrombosis in 4 and cardiac death in 2. All 4 patients with systemic thrombosis withheld anticoagulants after index bleeding, although only 10 patients withheld anticoagulation therapy. Rebleeding should be taken care of when anticoagulants are resumed after bleeding, particularly among patients who initially experienced gastrointestinal bleeding. Systemic thrombosis occurred at a high rate when anticoagulant therapy was withheld after bleeding.
A combined EM and proteomic analysis places HIV-1 Vpu at the crossroads of retromer and ESCRT complexes: PTPN23 is a Vpu-cofactor
Authors: Stoneham Charlotte A. , Langer Simon , De Jesus Paul D. , Wozniak Jacob M. , Lapek John , Deerinck Thomas , Thor Andrea , Pache Lars , Chanda Sumit K. , Gonzalez David J. , Ellisman Mark , Guatelli John
Published: November 2021

The HIV-1 accessory protein Vpu modulates membrane protein trafficking and degradation to provide evasion of immune surveillance. Targets of Vpu include CD4, HLAs, and BST-2. Several cellular pathways co-opted by Vpu have been identified, but the picture of Vpu’s itinerary and activities within membrane systems remains incomplete. Here, we used fusion proteins of Vpu and the enzyme ascorbate peroxidase (APEX2) to compare the ultrastructural locations and the proximal proteomes of wild type Vpu and Vpu-mutants. The proximity-omes of the proteins correlated with their ultrastructural locations and placed wild type Vpu near both retromer and ESCRT-0 complexes. Hierarchical clustering of protein abundances across the mutants was essential to interpreting the data and identified Vpu degradation-targets including CD4, HLA-C, and SEC12 as well as Vpu-cofactors including HGS, STAM, clathrin, and PTPN23, an ALIX-like protein. The Vpu-directed degradation of BST-2 was supported by STAM and PTPN23 and to a much lesser extent by the retromer subunits Vps35 and SNX3. PTPN23 also supported the Vpu-directed decrease in CD4 at the cell surface. These data suggest that Vpu directs targets from sorting endosomes to degradation at multi-vesicular bodies via ESCRT-0 and PTPN23.
Alphaherpesvirus-induced activation of plasmacytoid dendritic cells depends on the viral glycoprotein gD and is inhibited by non-infectious light particles
Authors: Delva Jonas L. , Van Waesberghe Cliff , Klupp Barbara G. , Mettenleiter Thomas C. , Favoreel Herman W.
Published: November 2021

Plasmacytoid dendritic cells (pDC) are important innate immune cells during the onset of viral infections as they are specialized in the production of massive amounts of antiviral type I interferon (IFN). Alphaherpesviruses such as herpes simplex virus (HSV) or pseudorabies virus (PRV) are double stranded DNA viruses and potent stimulators of pDC. Detailed information on how PRV activates porcine pDC is lacking. Using PRV and porcine primary pDC, we report here that PRV virions, so-called heavy (H-)particles, trigger IFNα production by pDC, whereas light (L-) particles that lack viral DNA and capsid do not. Activation of pDC requires endosomal acidification and, importantly, depends on the PRV gD envelope glycoprotein and O-glycosylations. Intriguingly, both for PRV and HSV-1, we found that L-particles suppress H-particle-mediated activation of pDC, a process which again depends on viral gD. This is the first report describing that gD plays a critical role in alphaherpesvirus-induced pDC activation and that L-particles directly interfere with alphaherpesvirus-induced IFNα production by pDC.
Flipped learning as a tool to enhance digital citizenship: How teachers’ experiences of online teaching during the COVID-19 pandemic can encourage participatory and justice-oriented citizenship
Authors: O’Brien Gearoid
Published: November 2021

In Ireland, civic, social and political education (CSPE) is a compulsory subject for all students in the first three years of post-primary education. CSPE is generally taught for one class period per week, which limits the ability to develop participatory or justice-oriented citizenship – it gives time for exposure to, but perhaps not practice of, these types of citizenship. Digital citizenship is a recently developed dimension of citizenship and is often focused only on safety and ethical elements. The changed teaching practices resulting from the COVID-19 pandemic have provided a unique opportunity to use flipped learning to develop participatory and justice-oriented digital citizenship. This article outlines examples of how two topics, promoting media literacy and conducting a survey of young people, can be taught moving from a personally responsible to a participatory and justice-oriented focus. Challenges are discussed and future research areas are suggested.
Bajo observación: inteligencia artificial, reconocimiento facial y sesgos
Authors: Balmaceda Tomás , Schleider Tobías , Pedace Karina
Published: November 2021

En este trabajo nos concentramos en la tecnología de reconocimiento facial y hacemos hincapié en que en las últimas décadas se instaló en el discurso público la idea de que este tipo de tecnología es “objetiva” y carente de los errores y sesgos humanos, adjudicándole cualquier responsabilidad al “buen o mal uso” que se haga de ella. Frente a esta retórica, argumentamos que a la hora de hablar de artefactos tecnológicos la neutralidad es imposible, aun en la instancia misma del diseño. A tal efecto, a partir de las ideas del pragmatismo norteamericano analizamos un caso real, para mostrar que no es posible sostener una dicotomía entre hechos y valores y que es necesario reconocer que no existe una distinción tajante entre el diseño de la tecnología y el uso que hacemos de ella.
Nuevas tecnologías, promesas y alienación tecnológica: una mirada crítica del fenómeno del voto electrónico como dispositivo técnico moderno
Authors: García Farjat Marcelo Josè
Published: November 2021

El presente artículo tiene como objetivo central caracterizar y discutir ciertas problemáticas que encierran los dispositivos electrónicos de votación desde una mirada sociológica y filosófica de la tecnología que sea capaz de tensionar algunos de los presupuestos y prenociones que subyacen a los intentos de modernizar los sistemas tradicionales de voto. En un contexto signado por la fascinación por las nuevas tecnologías, distintas voces se encargan de subrayar las presuntas ventajas de la votación electrónica como solución ante las dificultades que enfrenta la votación tradicional. Así, frente a las promesas y expectativas que envuelven a las narrativas tecnofílicas en torno a su implementación, también se busca poner en discusión ese cariz tecnooptimista que impregna a los discursos públicos a la luz de diferentes estudios que conciben al dispositivo del voto electrónico como una caja negra, al inhabilitar el control y auditoría del voto por parte de la ciudadanía. Por consiguiente, en tanto sistema opaco y cerrado, estos dispositivos aparecen como un fiel representante de la alienación tecnológica.
Parental consanguinity and congenital heart defects in Afghan children with Down’s syndrome
Authors: Sharifi Abdul Muhib , Jalal S. Najmuddin , Sediqi M. Sharif , Ibrahimi M. Akbar , Sharifi A. Wali
Published: November 2021

Abstract

Background: It seems that parents’ consanguinity status effects the pattern of congenital heart defects (CHDs). In this study the CHD pattern in children with Down’s syndrome (DS) was determined in Afghanistan’s children population with a high consanguineous marriage rate and compared with historical cohorts from populations with low prevalence of parental consanguinity.

Objective: This analytic cross sectional study aimed to determine the frequency and distribution of CHDs in Afghanistan children with Down’s Syndrome as a group in a community with a high consanguineous marriage rate and comparing these with different global studies and populations with low prevalence of consanguinity.

Methods: This analytic cross sectional study was conducted in a pediatric teaching hospital in Kabul city - Afghanistan, named Maiwand Hospital. The subjects were all children with DS proven by clinical and cytogenetic study and referred to the pediatric cardiology service from September 2018–September 2020. Parents’ consanguinity was documented and 2D echocardiography and Doppler studies were performed by two experienced pediatric cardiologists after physical examination, ECG, and chest X-ray for each patient.

Results: During the two-year study period, 120 DS patients were identified, 78 (65%) of whom had CHDs. The prevalence of isolated and multiple CHD in the 78 children with DS were 35% (42 patients) and 30% (36 patients), respectively. Ventricular septal defect (20.5%) and atrial septal defect (15.3%) were the most common isolated defects. The combination of VSD and PDA (20.5%) were the most frequent multiple CHDs. The most com­mon associations of CHD were VSD + PDA (20.5%) and VSD + ASD (10.2%). Consanguinity was found in 69.2 % of all parents.

Conclusions: A higher frequency of CHD was documented in DS children from this population with a high consanguineous marriage rate. The frequencies of specific lesions were almost similar to those reported locally and internationally; VSD was the most frequently detected in this study. Interesting was the predominance of left-right shunt lesions and the relative rarity of cyanotic and complex CHD in this DS population.

key words: congenital heart disease, atrioventricular septal defect, Down’s syndrome, trisomy 21, Afghanistan
Platelet-lymphocyte ratio and sepsis outcome in children
Authors: Kurniawan Ferry , Manoppo Jeanette I. Ch. , Runtunuwu Ari Lukas , Rampengan Novie Homenta , Lolombulan Julius
Published: November 2021

Background Sepsis is the most common cause of death in infants and children worldwide. Identification of patients with a high risk of death and accurately anticipating outcomes in the early phase is very important in order to provide adequate intervention to the patient. Predictors and scoring systems have been used to determine the prognosis of sepsis n children. The platelet-lymphocyte ratio (PLR), a newly-used marker for inflammation, has received recent attention, as it can act as an indicator in a variety of diseases, including sepsis.

Objective o investigate the relationship between PLR and clinical outcomes in pediatric patients with sepsis.

Methods This study was conducted using an analytic, observational method with a prospective cohort approach in children with sepsis in the Pediatric Intensive Care Unit (PICU) of Prof. Dr. R. D. Kandou Central General Hospital, Manado, North Sulawesi, from February to August 2020. We analyzed patients’ platelet-lymphocyteratio (PLR), mortality rate, and length of stay using SPSS software. The PLR were recorded once within the first 24 hours of PICU admission.

Results Of 96 PICU patients, 87 patients  were eligible for this study. In total, 50 patients (57.47%) died. Mean PLR was 77.53 among sepsis survivors and 157.2 among non-survivors (rpb=0.566, P<0.0001) indicating a strong relationship between PLR and mortality. We also found a strong positive linear relationship between PLR and PICU length of stay.

Conclusion Platelet-lymphocyte ratio is a predictor of sepsis outcomes that can be easily and inexpensively checked. Thus, it can be used in regions with limited health facilities.
EXPORT POSITIONS OF RUSSIA IN CENTRAL ASIA: REALITIES AND PROBLEMS
Authors: Butakova M. M. , Sokolova O. N.
Published: November 2021

The article is devoted to researching and assessing the state of affairs, identifying problems and prospects for Russia’s presence in the markets of Central Asian countries. The relevance of the problem is connected with the goals of maintaining the export positions of the Russian Federation in this market and with the goals of increasing the volume of non-resource non-energy exports.

The authors investigated the dynamics and structure of world and Russian exports to the countries of Central Asia, highlighted the dominant commodity groups of Russian exports for each importing country. As a result of the study of the territorial aspect and the related specifics of trade and economic relations, it was concluded that a deeper study of export opportunities and prospects of Russian regions bordering on countries-importers of Russian products in Central Asia was made.

The article outlines the problems of increasing competition in the markets of Central Asia and the negative impact on the prospects of Russian exports of falling incomes of the population and reducing market capacity due to the pandemic, the need to take a set of measures to maintain Russia’s competitive position in this market.

As a result the studies of the problems of the development of Russian exports the authors came to the conclusion that it is mutually beneficial and promising, to increase the supply Russian products to the countries of Central Asia the need to find ways to increase its efficiency, and strengthen state support for non-resource non-energy exports.
Pengembangan Media Pembelajaran Kimia Interaktif Berbasis Blended Learning Berorientasi Representasi Kimia
Authors: Luthfiyah Fifi
Published: November 2021

Penggunaan media pembelajaran berbasis ICT yang masih minim membuat guru sulit menjelaskan materi kimia yang sifatnya abstrak, sehingga diperlukan media pembelajaran yang dapat menggabungkan berbagai media menjadi satu agar dapat menggambarkan ketiga level representasi kimia yaitu dengan pembelajaran Blended Learning. Penelitian dilakukan dengan menggunakan model pengembangan 4-D ‎yang terdiri atas 4 tahap, yaitu define, design, development, dan disseminate. ‎Penelitian ini dibatasi sampai tahap ketiga atau development. Produk dinilai menggunakan instrumen penilaian kualitas skala Likert dan Gutmann. Produk yang ‎dikembangkan dinilai kepada dosen ahli media, dosen ahli materi, dan guru kimia SMA/MA dan direspon oleh peserta didik. Hasil penelitian menunjukan bahwa berdasarkan penilaian dosen ahli materi, dosen ahli media, dan guru kimia SMA/MA, produk yang dikembangkan memiliki kualitas yang sangat baik dengan presentase keidealan berturut-turut sebesar 75%; 93,8%; dan 88,33%. Sedangkan untuk respon peserta didiknya dikategorikan sangat baik dengan presentase keidealan sebesar 80%.
Pengembangan Modul Chemondroid Materi Tata Nama Senyawa
Authors: Nurmalitasari Adelina
Published: November 2021

Perkembangan teknologi informasi dan komunikasi yang semakin pesat mampu mengubah berbagai aspek dalam kehidupan manusia termasuk dalam bidang pendidikan. Salah satunya adalah pengembangan bahan ajar atau modul yang dapat memudahkan siswa untuk belajar. Tujuan penelitian yaitu untuk mengembangkan modul chemondroid materi tata nama senyawa, mengetahui kualitas modul berdasarkan penilaian guru, mengetahui respon siswa, dan mengetahui keterlaksanaan proses pembelajaran. Penelitian dilakukan dengan menggunakan model pengembangan 4-D ‎yang terdiri atas 4 tahap, yaitu define, design, development, dan disseminate. ‎Penelitian ini dibatasi sampai tahap ketiga atau development. Produk dinilai kualitasnya pada dua orang guru kimia dan sepuluh orang siswa menggunakan lembar penilaian kualitas serta lembar penilaan respon dengan skala Likert dan Gutmann. Uji coba terbatas dilakukan dua orang observer untuk mengetahui keterlaksanaan pembelajaran menggunakan modul chemondroid menggunakan lembar observasi keterlaksanaan. Modul chemondroid dikembangkan menggunakan software construc 2 dan Intel XDK yang dapat dioperasikan pada smartphone android dengan materi tata nama senyawa. Hasil penelitian menunjukan bahwa berdasarkan hasil penilaian kualitas guru mendapatkan kategori Sangat Baik (SB) dengan persentase 81.82%, sedangkan hasil respon siswa memperoleh persentase keidealan 86,67%. Hasil dari observasi keterlaksanaan menunjukkan bahwa modul chemondroid juga dikategorikan Sangat Baik (SB) dengan persentase keidealan kualitas sebesar 94,17%
Precisão de réguas endodônticas milimetradas e orifício calibrador, e avaliação da regularidade da superfície do orifício calibrador
Authors: Dadalti Manoela Teixeira de Sant’Anna , Dias Bruna Danielle Menezes , Bruno Adília Maria Vieira , Risso Patrícia de Andrade
Published: November 2021

Objetivo: O objetivo desse artigo foi avaliar a precisão das porções milimetrada e calibradora das réguas endodônticas, e avaliar a regularidade da superfície dos orifícios calibradores. Métodos: A porção milimetrada das réguas Angelus, Maillefer, Maquira, Microdont e Prisma foi avaliada com paquímetro eletrônico digital. Os orifícios calibradores da Maillefer, Prisma e Angelus foram medidos com um projetor de perfil. A regularidade da superfície dos orifícios calibradores foi classificada em S1 – sem irregularidades ou S2 – com regularidades. A análise de precisão das porções milimetrada e calibradora foi realizada com o teste t (p=0,05); e as frequências dos tipos de superfície, com o teste do qui-quadrado (p<0,05). Resultados: A Maillefer foi a única régua endodôntica com precisão em todos os comprimentos e orifícios. A Prisma apresentou estatisticamente mais orifícios do tipo S2, quando comparada com outras réguas endodônticas avaliadas (p<0,05). Não houve diferença estatisticamente significativa entre Angelus e Maillefer (p>0,05). Conclusão: A Maillefer apresentou precisão nas porções milimetrada e calibradora. As réguas endodônticas da Angelus não foram precisas em nenhum comprimento da parte milimetrada e não foram precisas na maioria dos orifícios calibradores. A régua endodôntica Prisma mostrou significativamente mais orifícios calibradores com irregularidades na superfície do que Angelus e Maillefer. Destaca-se a necessidade de controle de qualidade e padrões específicos para fabricação das réguas endodônticas.
Influência do pré-alargamento coronário na resistência à fadiga cíclica de instrumentos reciprocantes tratados termicamente
Authors: Coura Carla Andrade , Lima Carolina Oliveira de , Antunes Henrique dos Santos , Vieira Victor Talarico Leal , Silva Emmanuel João Nogueira Leal
Published: November 2021

Objetivo: O objetivo do presente estudo foi avaliar a influência do pré-alargamento coronário na resistência à fadiga cíclica de dois instrumentos reciprocantes tratados termicamente. Métodos: 20 instrumentos Reciproc Blue (R25 Blue) e 20 instrumentos X1 Blue (X1) foram utilizados para instrumentar blocos de resina simulando um molar superior com três canais radiculares. Os dentes foram divididos em quatro grupos (n=10), de acordo com o instrumento e com a técnica de instrumentação utilizada: grupos R25 e X1 - instrumentação com R25 Blue (25/0.08) ou X1 Blue (25/0.06), respectivamente, sem alargamento prévio; e grupos R25 ou X1 + pré-alargamento cervical - pré-alargamento com os instrumentos ProTaper Universal SX e S1 antes da instrumentação com R25 Blue ou X1. Os instrumentos foram testados com relação à fadiga cíclica utilizando-se um canal simulado de aço inoxidável com ângulo de curvatura de 86 graus e raio de curvatura de 6 mm. Os instrumentos foram acionados utilizando-se o movimento “RECIPROC ALL” do motor endodôntico (VDW) e o tempo de instrumentação até a fratura do instrumento foi contabilizado. Os resultados foram analisados pelo teste t de Student (p<0,05). Resultados: Os instrumentos X1 apresentaram maior resistência à fadiga cíclica do que R25 Blue em ambas as condições testadas (p<0,05). Não houve diferença entre os grupos com e sem pré-alargamento coronário para os instrumentos R25 Blue e X1 (p>0,05). Conclusão: O instrumento X1 Blue apresentou maior resistência à fadiga cíclica do que o Reciproc Blue. O pré-alargamento coronário não foi capaz de aumentar a resistência à fratura por fadiga cíclica dos instrumentos testados.
Futebol em sala de aula: a geometria dinâmica e a interpretação de um lance polêmico
Authors: Sibemberg Lucas , Notare Márcia
Published: November 2021

Durante o ano de 2019 um lance polêmico entre dois times do futebol brasileiro dividiu opiniões. Neste lance um jogador, aparentemente em posição de impedimento, marcou um gol, que foi validado com uma nova tecnologia digital presente nos jogos de futebol: o VAR (Video Assistant Referee). No presente artigo abordamos este lance de gol, utilizando matemática para explicar o porquê de a decisão final do VAR ter sido correta. Em seguida, apresentamos uma possível abordagem da jogada polêmica de futebol em sala de aula, a partir de uma atividade exploratória em ambiente de geometria dinâmica para o desenvolvimento de conceitos de projeção ortogonal e habilidades de visualização espacial. A atividade foi aplicada com estudantes do Ensino Médio e os resultados apontam que a exploração do modelo construído com geometria dinâmica auxiliou os alunos no entendimento do lance de futebol em questão e na compreensão do conceito de projeção ortogonal.
Bringing Japan back in
Authors: Árnason Jóhann Páll
Published: November 2021

Editorial
A Study of Social Imaginaries Journal, Zeta Books
Authors: Minářová Markéta
Published: November 2021

Review article
Jóhann Páll Árnason: The Labyrinth of Modernity. Horizons, Pathways and Mutations
Authors: Minářová Markéta
Published: November 2021

Book review: Jóhann Páll Árnason: The Labyrinth of Modernity. Horizons, Pathways and Mutations. Lanham – Boulder – New York – London: Rowman & Littlefield Publishers, 2020, 230 pp.
Nauka, technika i akcja: O Kulturach wizualnych science fiction Pawła Frelika
Authors: Bromboszcz Roman
Published: November 2021

Zostajemy rzuceni w świat, w którym wyciska się krople potu ze ścierek służących do wycierania siebie, w dość gorącym, nerwowym świecie urbanistyki lub, choć każdy to odradza, na wszechogarniającej nas pustyni. Chodzi tutaj o jak najbardziej zamknięty i wielokrotnie zapętlony sposób racjonowania wody. Nawet nasze odchody przechodzą ten proces. W nie nazbyt odległej przyszłości możemy zostać skonfrontowani z daleko idącymi przeobrażeniami przyrody, wynikającymi z zaburzenia globalnego ekosystemu działalnością człowieka, antropogeniką. Zarysowany powyżej kontekst odnosi nas jednocześnie do filmu krótkometrażowego Wanuri Kahiu „Pumzi” z 2009 roku oraz do publikacji, która o tym filmie wspomina, bierze go za swój element zainteresowania, analizy.
Międzygatunkowe strefy kontaktu. Relacje psów i ludzi (z „diabelską śliną w sercu”) w literackiej dystopii Josipa Mlakicia O zlatu, ljudima i psima
Authors: Szperlik Ewa
Published: November 2021

Przedmiotem analizy literaturoznawczej zaproponowanej w powyższym tytule jest tryptyk Josipa Mlakicia, utrzymany w konwencji futurystycznej antyutopii. Dzieło stanowi materiał badawczy podatny na zastosowanie różnorodnych, interdyscyplinarnych narzędzi metodologicznych (od ekokrytyki po animal studies). Poza symbolicznym ujęciem problematyki psów w historii kultury, punktem wyjścia dla rozważań nad postapokaliptyczną wizją świata totalitarnego, przez który przetoczyły się kolejne wojny, naruszające ekosystem, jest posthumanistyczna i postanatropocentryczna optyka obecnej i przyszłej kondycji ludzkiej, ze szczególnym uwzględnieniem szowinizmu gatunkowego. W antywojennej prozie bośniacko-hercegowińskiego pisarza gatunkowizm (speciesism), postrzegany przez pryzmat złożonych relacji ludzi i psów, przejawia się również w postaci zacierania granicy między pojęciem zwierzęcości i człowieczeństwa, w wizji świata, w której największym zagrożeniem okazuje się homo crudelis. W świecie przedstawionym Mlakicia relacje między człowiekiem a psem można zdefiniować jako przykład symbiotycznej kooperacji (companion species), „naturokultury”, realizowanej w rozmaitych „strefach kontaktu”. Pojawia się także kwestia zhierarchizowanych stosunków między ludźmi, bytów o słabej podmiotowości: ludzi wykluczonych, zmarginalizowanych i eksterminowanych wszelkich Innych, w tym niepełnosprawnych, stających się podporządkowanymi „psami”, o statusie ofiar. Oczekiwany efekt przeprowadzanego wywodu dotyczyć będzie ukazania funkcji literatury jako źródła refleksji i medium ekspresji (wynalazku, przypisanego człowiekowi), w odniesieniu do koncepcji zmierzchu antropocentryzmu.
“The First Swallow”: Avian Metaphors in Nikita Khrushchev’s Political Discourse
Authors: Carter Elena V.
Published: November 2021

Birds are a rich source for metaphors in paremias that are known to be a significant rhetorical force in various modes of communication. This article deals with the repertoire of ornithological proverbial texts utilized in the Soviet leader’s public speeches and memoirs, as well as in their English translations. The metaphor human is bird, in which there are various grounds of comparison, is explored. The peculiarities of using avian metaphors in the context of the original and the ways of their translation into English are scrutinized as well. The analysis of the material shows that the main features, shared by the Target (human) and the Source (bird species), are grounded on physiological characteristics and behavioral traits, having a negative slant. The equivalent and literal translations are applied as the main methods of rendition. Of particular interest are the metaphorical “animalistic metamorphoses” found in translation.
Ein neues zweisprachiges altbabylonisches Vokabular aus Ur
Authors: Ludwig Marie-Christine
Published: November 2021

This article presents the first edition of an Old-Babylonian acrographic vocabulary excavated in the city of Ur. Although fragmentary and poorly preserved, this text provides interesting new aspects for the understanding of the so-called „dialects“ of Sumerian and of bilingual language teaching in general, and identifieslurû(m) „(man with a) thin/croaky voice“ as a (person with a) speech defect described as „Emesal“. In addition, it contains entries of business terminology known from the north Babylonian „Sippar Phrasebook“, the Old Babylonian „Forerunner“ of canonical Ura 1 and 2.
Eine bedeutende Salzquelle in Karapınar Konya – Meke Gölü (Meke Maar) und ein Gleichsetzungsvorschlag fürliki„Salzlecke“ im Staatsvertrag des Kuruntija und Tutḫalija IV.
Authors: Maner Çiğdem
Published: November 2021

A systematic archaeological survey in the Southeast provinces of Konya has started to reveal the settlement pattern of the Bronze and Iron Ages in this region, which sheds light on the geo-environment, economy, road networks, interactions and cultures. This paper will specifically deal with the region of and around Meke Gölü and Karacadağ, located in Karapınar – Konya, and discuss the surveyed settlements and possible implications of the economy with salt trade as one of the main trade commodities. In this context the salt source of the saline lake Meke Gölü (Lake Meke), which is located south of Karacadağ, its significance and usage of salt will be explored. Finally, the equation of Meke Gölü with theliki(salt-lick) mentioned in the frontier description in the treaty between the Great Kings Kuruntija and Tutḫalija IV on the well-known Bronze Tablet discovered in Boğazköy – Ḫattuša, the capital of the Hittite Empire, will be suggested and debated.