bluuebunny/crossref_metadata_2025 huggingface dataset:
Studi jangkauan layanan Taman Kota Lumintang, Denpasar, Bali
Authors: Dwipayana I Gusti Ngurah Made , Kohdrata Naniek , Suyarto R.
Published: April 2021

Lumintang City Park is one of the green open spaces in Denpasar City. People frequently visit the city park to do some outdoor activities. The objectives of this study are to determine the service distance of Lumintang Park as a city park by its users in the context of the user’s home range, and to determine the frequency of user visits Lumintang City Park. The research method used in this study is a questionnaire method. Geographic Information System (GIS) is used to track down the domicile of the respondents. The study shows the area that serves most by Lumintang City Park is within the radius of 4 km. People who live in Denpasar are the dominant user of this city park. The highest frequency of visit to Lumintang City Park is one to two times a week.
Vegetation Effects on Soil Properties in the Monteagle Sandy Loam Series: Implications for Land‐use Change
Authors: Neil Allison
Published: April 2021

Soil properties are strongly influenced by the composition of the surrounding vegetation. We investigated soil properties of three ecosystems; a coniferous forest, a deciduous forest and an agricultural grassland, to determine the impact of land use change on soil properties. Disturbances such as deforestation followed by cultivation can severely alter soil properties, including losses of soil carbon. We collected nine 40 cm cores from three ecosystem types on the Roebuck Farm, north of Perth Village, Ontario, Canada. Dominant species in each ecosystem included hemlock and white pine in the coniferous forest; sugar maple, birch and beech in the deciduous forest; grasses, legumes and herbs in the grassland. Soil pH varied little between the three ecosystems and over depth. Soils under grassland vegetation had the highest bulk density, especially near the surface. The forest sites showed higher cation exchange capacity and soil moisture than the grassland; these differences largely resulted from higher organic matter levels in the surface forest soils. Vertical distribution of organic matter varied greatly amongst the three ecosystems. In the forest, more of the organic matter was located near the surface, while in the grassland organic matter concentrations varied little with depth. The results suggest that changes in land cover and land use alters litter inputs and nutrient cycling rates, modifying soil physical and chemical properties. Our results further suggest that conversion of forest into agricultural land in this area can lead to a decline in soil carbon storage.
Sin and Wikipedia: Mass Communication in the 21st Century
Authors: Song Celine
Published: April 2021

Using French philosopher Gabriel Marcel's influential work on technology as a jumping point, this paper takes a critical look at the nature and power of 21st century's major technique of mass communication. Marcel discusses the topic in his book Man and Mass Society using the time‐sensitive example about radios, used as a major means to propaganda and human degradation back in WWII. But what would he say about internet in the 21st century? Mass media is so powerful in Marcel's opinion that it "usurps a prerogative which looks like a distorted analogue, a caricature, of divine omnipresence". Although Marcel's worry about communication technique that "what starts off as a collection of means […] become the centre, the focus, of an obsessive cult" is a valid one, internet's problem of "too much information" and its innate interactivity are effective antidotes to many of such dangers. The impossibility of propaganda in the 21st century, the active membership and impotence of an individual internet user, and the non‐uniformity of internet are also discussed in depth.
Intellectual Property Rights, Biotechnology and Discourses of Development: Internal Contradictions and Forms of Resistance
Authors: Persaud Krishana
Published: April 2021

The International Covenant on Economic, Social and Cultural Rights identifies freedom from hunger and malnutrition as a fundamental human right of every individual. The current global food crisis undermines this right and has multi‐faceted repercussions for poverty reduction and sustainable development in the Global South. A plethora of explanations have been proposed regarding the causes of the current food crisis, while a biotechnological solution involving the expansion of Genetically Modified (GM) seeds in the Global South has gained renewed momentum and simultaneously increased resistance. This presentation will provide a nuanced understanding of the promotion of IPRs and biotechnological ‘inventions’ as contemporary facets of a hegemonic modernization discourse of development. By first critically examining the development of IPRs and their relation to biotechnology I provide a basis for understanding the internal contradictions of this technologically reductionist discourse. Using a detailed case study from India, I then illustrate the way in which the internal contradictions of this discourse result in particular forms of resistance which significantly challenge the structure of the global food system.
Can Right Ventricular Lead Position Influence Paced QRS Duration in Patients with Abnormal and Normal Left Ventricular Function?
Authors: Moey Melissa
Published: April 2021

Right ventricular apical pacing (RVAP) in pacemaker or implantable cardioverter‐defibrillator (ICD) therapy has been associated with the development and exacerbation of heart failure (HF). Studies have suggested that RVAP resulting in dyssynchronous left ventricular (LV) activation and prolonged QRS duration leads to progressive mechanical dysfunction, decreased systolic function and increased mortality. These data suggest that the effect may be most pronounced in patients with pre‐existing LV systolic dysfunction. Pacing at the RV septum however has demonstrated narrower paced QRS durations and is being considered as an alternative pacing site to the RVA. In this study, the effect of RV lead placement on the QRS duration in patients with LV systolic dysfunction who demonstrate a left ventricular ejection fraction (LVEF) < 35% and normal LVEF was compared.  Patients of a minimum age of 18 years with LVEF ≥ 50% (normal cohort) and LVEF ≤ 30% (HF cohort) were recruited. Four 3 minute high resolution recordings were obtained from an orthogonal lead position for subsequent offline signal averaging. Recordings of native rhythm and pacing at three RV sites: right ventricular outflow tract (RVOT), mid‐septum and RV apex (RVA) were obtained. A 12‐lead electrocardiogram (ECG) recording at each pacing site was stored for later confirmation of pacing location and comparison with paced averaged QRS duration. The QRS duration at different RV sites in the two populations was then compared.  As studies to date are limited, this study provided valuable insight on RV lead placement on QRS duration in device therapy for HF treatment.
7. An Examination of the Use of Salix Arctica for Dendrochronological Studies in the Arctic
Authors: Bassutti Anthony
Published: April 2021

Large scale land disturbances are occurring in sensitive Arctic regions as a result of climate change. These disturbances which are caused by permafrost melting and can damage fragile tundra ecosystems and have important impacts on downstream water quality. Determining the timeline of these disturbances will aid in the understanding of the effect of climate change in the Arctic. This can be performed through the analysis of environmental proxy records such as those found in the annual growth rings of trees, which express environmental stresses, such as those experienced during a land disturbance. Dendrochronology of the most northern occurring woody plant, Salix arctica (arctic willow) has been explored only a few times in the past, and its potential for paleoenvironmental studies in the Arctic have been largely over‐looked. We examined the thickness of annual growth rings from S. arctica from two areas of land disturbance on southern Melville Island, Nunavut. Common growth trends were found in both dead (snag) and living samples from the sites. Preliminary data show that a substantial disturbance in the growth of the samples is evident approximately 40 years ago and was likely due to land disturbance. These initial findings demonstrate the successful use of S. arctica as a paleoenvironmental indicator and provide useful tools to determine the timing of past permafrost disturbances and climate change in the Arctic. We are continuing to investigate additional samples from other sites to determine if the method can be used as a novel tool for understanding permafrost landscape dynamics.
Desperate Housewives and Soccer Moms: Examining the relationship between media representations and the lived reality of women in the suburbs
Authors: White Jessica
Published: April 2021

Has suburbia ever truly met the needs of the populations it claims to serve? Since its creation suburbia has been a centre of conflict between the image created by the media and lived realities. The post war images of femininity in the suburbs were ones of domesticity and a heteronormative family. In essence the “sitcom” family was created and reality was made to look like its television counterpart. Yet in real life, did any family look like that of Leave it to Beaver? Have our ideals of the perfect family living in the perfect house truly changed? If they have changed have they had an effect on policy makers and land developers? A brief historical examination of suburbia, its creation, and media images will be contrasted with the developments and policies we find in today’s suburbia. To partially answer my original question the demographic of women in suburbia, more specifically mothers will be discussed. Are today’s media images of suburbia a better depiction of lived realities or are urban political processes still at play to perpetuate an ideal image?
Pseudoaneurysm of the Dorsalis Pedis Artery Diagnosed on Point-of-Care Ultrasound
Authors: Friedman Nathan A. , Canders Caleb P. , Chiem Alan T.
Published: April 2021

A 46-year-old man presented with a painless mass on his dorsal right foot one week after striking it on a door. A traumatic hematoma was suspected, and needle aspiration of the mass is considered. However, point-of-care ultrasound performed by the emergency physician identified a pseudoaneurysm of the dorsalis pedis artery, a rare condition that can occur after minor trauma or iatrogenic intervention. This report demonstrates how point-of-care ultrasound can be used to identify a pseudoaneurysm of the lower extremity, thereby expediting emergency department workup and preventing potentially dangerous diagnostic procedures.
The PEGASUS Games: Physical Exam, Gross Anatomy, phySiology and UltraSound Games for Preclinical Medical Education
Authors: Hennekes Mary , Rahman Sarah , Schlosser Andrea , Drake Anne , Nelson Tessa , Hoffberg Emily , Jones Robert A.
Published: April 2021

Introduction: Gamification engages learners and has successfully taught point-of-care ultrasound (POCUS) to residents and fellows. Yet ultrasound (US) curricula in undergraduate medical education remains limited. This study assessed a gamification model integrating US, anatomy, physiology, physical examination, and radiology created for preclinical medical students as compared with traditional didactic education. Methods: Twenty first-year medical students participated in a session on neck and thyroid material. Students were randomly assigned to a game or non-game group. Game students participated in games incorporating thyroid US with exam maneuvers, other imaging modalities, physiology, and pathology. Non-game students were taught the same material with an instructor. Students were assessed with a pretest and immediate and delayed post-tests. Group differences and scores were assessed using t-tests. A Likert scale evaluated learners’ opinions of the educational experience. Results: The game group performed better than the non-game group on the immediate post-test (p = 0.007, CI = [0.0305, ∞]). There was no significant difference between the groups on the delayed post-test (p = 0.726, CI = [-0.120, ∞]). Students in both groups felt more confident in their knowledge of the material, and all students in the game group agreed that the games encouraged teamwork. Most (9/10) stated the games allowed them to learn the material more effectively and would like to see more gamification (8/10). Conclusion: This US education model incorporating gamification for preclinical medical students promotes teamwork and is as effective for learning material than a traditional learning model. Students additionally convey a positive attitude towards gamification.
CROP PRODUCTION AND LAND RESOURCES IN GALICIA DURING THE AUSTRO-HUNGARIAN PERIOD
Authors: Makaruk Ihor
Published: April 2021

Summary. The purpose of this study is to analyze the processes that took place in crop production within the context of Galicia agriculture development on the cusp of the 19th and 20th centuries. Conclusions. The article recognizes the impact of popular science education, which was one of the key criteria for the introduction of the up-to-date methods of economic management. This had a positive effect on the economic development of the region, which lagged far behind other regions of the Austro-Hungarian Empire. During the study period, there was a breakthrough in the methods and approaches to farming inasmuch as processes of mechanization, novel tillage techniques and land reclamation were introduced. The agricultural processing industry began to develop intensively coupled with a serious consideration given to selective breeding of animals. All these aspects have led to a significant improvement in the industry’s performance.
The subject has been partly studied in Poland and Austria whilst it was insufficiently considered in Ukraine. Therefore, the development of each sector of agriculture of Galicia at the turn of the century requires an extensive review. The research methodology. The article offers an attempt to analyze the development of crop production, the leading branch of agriculture. The study employed a comparative analysis, thereby allowing us to establish the dynamics of the crop production development in the region.
The scientific novelty. The archive materials of Ivano-Frankivsk, Lviv, Cracow, Warsaw, and Vienna were consulted for a comprehensive characterization of crop production in Galicia. The historiography of the research topic is divided into several periods: published papers of the late 19th – early 20th centuries, the interwar period, the Soviet era, the surveys of independent Ukraine as well as modern international studies.
Analysis of the sources proved the positive dynamics of the crop production development in the vast majority of its types. This was influenced by a number of objective factors, one of which was the scientific extension and the development of farming research in Galicia, the opening of specialized facilities, educational and scientific institutions that studied the issues faced by the economic managers of the industry.
THE PRESS AS A SOURCE FOR THE STUDY OF SOCIO-ECONOMIC PROCESSES IN THE GALICIAN PROVINCE AT THE END OF THE XIX CENTURY (BASED ON "GAZETA NADDNIESTRZAŃSKA" NEWSPAPER)
Authors: Telvak Vitalii , Yanyshyn Bohdan
Published: April 2021

Summary. The purpose of the study is to reconstruct the socio-economic life of Drohobych and Drohobych district in the late nineteenth century as represented by the newspaper "Gazeta Naddniestrzańska". The work’s methodological basis is an interdisciplinary approach with an emphasis placed on the structural and functional system analysis of historiographical facts and the method of critical analysis of documentary material. The article’s scientific novelty is an attempt to comprehensively analyse the materials of the journal "Gazeta Naddniestrzańska" as a source for studying socio-economic processes in Drohobych and Drohobych district in the late nineteenth century. Conclusions. The newspaper materials allow us to get acquainted with a range of cultural and socio-economic problems experienced by Drohobych district citizens in the late nineteenth century. The newspaper delivers an extremely dynamic image of the city’s daily life, and its articles are emotional and engaged in the interests of its ordinary residents. In addition, the broad public orientation of the newspaper’s editorial policy also allows getting acquainted with significant events in the socio-economic history of Galicia, the Austro-Hungarian Empire, Europe and the world. The "perspective from the province" attaches exceptional value to newspaper reports, as it sheds light on the specifics of their perception on the periphery of cultural and political life. The materials of "Gazeta Naddniestrzańska" allow reconstructing only certain aspects of the history of Drohobych and its district in 1884‒1889. However, taken together with official documents and periodicals published by the city’s Jewish community in the late 19th century, they provide a reliable source base for reconstructing Drohobych’s past in its socio-economic, political and cultural dimensions.
PEASANT PROBLEMS IN THE WORKS OF THE OUN IDEOLOGIST AND THEORETIST PETER FEDUN-"POLTAVA"
Authors: Ilnytskyi Vasyl , Hlibischuk Mykola , Kompaniiets Oleksii
Published: April 2021

Summary. The purpose of the article is to analyze the peasant issues in the ideological-theoretical and epistolary heritage of Peter Fedun-"Poltava". Research methodology – the principles of science, objectivity, historicism, methods of external and internal criticism of sources. The scientific novelty – P. Fedun’s vision concerning the solution of the peasant question in the future Ukrainian state is studied for the first time. Conclusions. Having analyzed the works of Petro Fedun-"Poltava", we claim that all of them are marked by the depth and breadth of the issues raised, some have not even lost their relevance to this day. The style of writing, the clear presentation of opinions, the processing of various literature (including foreign language) indicate to the author’s high intellectual level. Developments required an immediate response to them, therefore much attention was paid to refining the program principles and their popularization as well as refuting the myths created by the Soviet propaganda machine. In his works P. Fedun-"Poltava" wrote about the development of the future Ukrainian state, refinement of the program principles of the OUN, the problem of various social strata, justified its position on the confrontation among the Ukrainian political emigration and more. When considering the problems of different social strata, the question of the peasantry was among the central ones in the works of Peter Fedun. The researcher substantiated the OUN’s position on the peasantry, in particular: forms of land ownership and tools, collectivization (methods and forms of involvement in collective farms, the consequences for the peasantry and resistance to this policy), elections etc. "Poltava" considered the peasantry to be the foundation of the whole nation, emphasizing its contribution to the assimilation and denationalization policy of the occupiers, sacrifice, loyalty to national traditions, the presence of healthy morals and spirit.
According to P. Fedun, the economic basis of this society was to be public, national-state or social-cooperative ownership of tools and means of production in all major sectors of the economy, as well as planning and social control of all economic life. P. Fedun saw the solution of the land issue in the formation of national-state ownership of land in the future Ukrainian state, in parallel with individual or collective use of land. At the same time, in the future state, a parliamentary form of government should be established in the future state.
Artist's Statement: Continuum
Authors: Nancarrow Ree
Published: April 2021

Artist’s Statement for the cover art of IJPS volume 8, issue 1: Continuum, quilt
ÇOCUKLARDA ENDODONTİK ENFEKSİYONLARIN TEDAVİSİNDE ANTİBİYOTİK KULLANIMINA İLİŞKİN DİŞ HEKİMLİĞİ ÖĞRENCİLERİNİN BİLGİ DÜZEYLERİ
Authors: ERKMEN ALMAZ Merve , KOCAMAN Esma , BEZGİN Tuğba , YILDIZ Gözde
Published: April 2021

Amaç: Bu çalışmada; çocuk hastalarda endodontik enfeksiyonlarda sistemik antibiyotik kullanımına ilişkin, Ankara Üniversitesi ve Kırıkkale Üniversitesi Diş Hekimliği Fakültesi son sınıf öğrencilerine anket uygulanarak, öğrencilerin bilgi düzeyinin ölçülmesi amaçlanmıştır.Gereç ve Yöntemler: Ankara Üniversitesi’nden 155 öğrenci, Kırıkkale Üniversitesi’nden 69 öğrenci olmak üzere toplam 224 öğrenciye; çocuklarda kullanılan antibiyotikler ve endikasyonlarına yönelik sorular içeren anket uygulanmıştır. Anket verileri değerlendirildikten sonra veriler SPSS programı kullanılarak tanımlayıcı istatistikler ile analiz edilmiştir.Bulgular: İki yüz on yedi (%97.7) öğrenci anketi tamamlayarak çalışmaya dahil edilmiştir. Öğrencilerin %98.6’sı medikal alerjisi olmayan çocuk hastada antibiyotik olarak amoksisilini tercih etmiştir. Önerdikleri antibiyotik tedavi süresi ortalama 6.4±1.6 gündür. Penisilin alerjisi olan çocuk hastalar için ilk tercih edilen ilaç klindamisindir (%79.3). Reversible pulpitis ve vital pulpaya sahip irreversible pulpitisli dişlerde sırasıyla öğrencilerin %1.4 ve %11.9’u antibiyotik reçete edeceklerini bildirmiştir. İrreversibl pulpitis vakalarında devital pulpaya sahip dişlerde öğrencilerin %14.3’ü, lokalize dentoalveolar apse tanısı konulan olgularda öğrencilerin %48.8’i antibiyotik reçete etmiştir. Fasial selülit ve hastanın yüzünde etkilenen bölge tarafında diffüz şişlik tanısı konulan olgularda ise öğrencilerin %96.7’si antibiyotik reçete edeceğini belirtmiştir.Sonuç: Diş hekimliği son sınıf öğrencilerinin çocuk hastalarda endodontik enfeksiyonlarla ilgili antibiyotik kullanımında, bilgi düzeylerini geliştirmeleri gerekmektedir. Doğru vakaları teşhis ederek, öğrencilerin pulpa-periapikal patolojide antibiyotik reçeteleme konusunda daha iyi becerilere sahip olmaları eğitim döneminde sağlanmalıdır.
THE IMPORTANCE OF SACRUM MORPHOLOGY IN TRANSSACRAL AND ILIOSACRAL SCREW FIXATION
Authors: DURUSOY Serhat , PAKSOY Ahmet Emre
Published: April 2021

Objective: In this study, it was aimed to put forward the effects of the morphological characteristics of the sacrum on the choice of iliosacral or transsacral screwing.Material and Methods: The study was carried out on 224 patients who underwent computerized tomographic imaging of the pelvis between May 2016 and May 2019. By reviewing the images of the patients, parameters such as sacrum types, applicability for transsacral screwing, the narrowest diameter of the bone corridor in the coronal plane where the screw was placed properly, and the anteversion angle of the screw were evaluated. Moreover, the distribution of these data according to age and gender was compared between the groups.Results: Of the patients' sacrums; 72 (32.1%) were the ascending type, 28 (12.5%) were the descending type, 106 (47.3%) were the horizontal type, and 18 (8%) were the dysmorphic type. While transsacral screwing could be performed in 136 (60%) of the sacrums, it was not possible in 88 (40%). The width of the narrowest part where the iliosacral screw would pass was 19.52 (52 (min-max:11.8-47)) mm on average in all patient groups. There was no difference only between the horizontal and the descending types in terms of the narrowest diameter through which the iliosacral screw would pass. The anteversion angle of the iliosacral screw was 25.4 (min-max:5-52.5) degrees on average in all patients. The anteversion angle of the iliosacral screw varied between all sacrum types.Conclusion: Differences in the sacrum morphology in patients who will undergo iliosacral or transsacral screwing affect the choice of surgery to be applied. For this reason, preoperative surgical planning is essential according to the sacrum morphology.
Implementation and Analysis of Fractals Shapes using GPU-CUDA Model
Authors: Sallow Amira Bibo
Published: April 2021

The rapid evolution of floating-point computing capacity and memory in recent years has resulted graphics processing units (GPUs) an increasingly attractive platform to speed scientific applications and are popular rapidly due to the large amount of data that processes the data on time. Fractals have many implementations that involve faster computation and massive amounts of floating-point computation. In this paper, constructing the fractal image algorithm has been implemented both sequential and parallel versions using fractal Mandelbrot and Julia sets. CPU was used for the execution in sequential mode while GPUarray and CUDA kernel was used for the parallel mode. The evaluation of the performance of the constructed algorithms for sequential structure using CPUs (2.20 GHz and 2.60 GHz) and parallelism structure for various models of GPU (GeForce GTX 1060 and GeForce GTX 1660 Ti ) devices, calculated in terms of execution time and speedup to compare between CPU and GPU maximum ability. The results showed that the execution on GPU using GPUArray or GUDA kernel is faster than its sequential implementation using CPU. And the execution using the GUDA kernel is faster than the execution using GPUArray, and the execution time between GPU devices was different, GPU with (Ti) series execute faster than the other models.
Sexual Difference as a Question of Ethics: Alterities of the Flesh in Irigaray and Merleau-Ponty
Authors: Butler Judith
Published: April 2021

This article crosses the approach of the feminist philosopher Luce Irigaray, making reference mainly to her work An Ethics of Sexual Difference and the philosopher Merleau-Ponty, highlighting, especially, the chapter "The Intertwining- the Chiasm," of the book The Visible and the Invisible.  The first author quoted has a kind of relation of ambivalence and self-subordination in the way she puts herself in front of the texts of male philosophers, attributing power to them. Incorporating for her own text the philosophical tradition. Irigaray gets involved with Merleau-Ponty by an "interweaving", which will characterize the relations of flesh. It is worth noting that this article is unified by the purpose of the elaboration of what Irigaray calls an ethical relationship between the sexes. For her this relationship consists of the question "Who are you?” The vast debate involving ethics, sexual difference, and otherness of the flesh is being woven under the analysis of the two great philosophers mentioned.
Análisis de fracturas y caracterización de diaclasas de la formación Villeta, sector occidental de la subcuenca de Neiva
Authors: Monje Díaz Juan David , Latorre Bustos Nicole Daniela , Muñoz Quijano Ingrid Natalia
Published: April 2021

Para evaluar los yacimientos naturalmente fracturados se tienen diferentes fuentes de información y métodos que pueden ser de limitado acceso o de altos costos, especialmente para formaciones en las que se desconoce su nivel de productividad, o que aún no se ha estudiado para determinar su viabilidad como productora de hidrocarburos. Por lo que en este artículo se presenta la aplicación de un método de análisis de afloramiento, como fuente de información indirecta, para caracterizar y determinar las posibles vías de migración de las formaciones carbonatadas Hondita y Lomagorda pertenecientes al grupo Villeta. En el desarrollo de esta caracterización se implementó el uso de estrategias de muestreo de fracturas de tipo ventana rectangular, mediante el ejercicio de tomar medidas estructurales, como rumbo, buzamiento, separación y espaciamiento, sobre zonas delimitadas en los afloramientos de las formaciones de interés. Con ayuda de los resultados se identificaron 7 zonas de diaclasas, con una tendencia en rumbos de bajo ángulo con rangos en dirección noreste, estableciendo que esta sería la predominancia de migración de fluidos; dando una expectativa para que estos datos mejoren positivamente el desarrollo de los yacimientos.
Uso racional del Agua para un desarrollo económico y social sostenible
Authors: Bedoya Cardoso Marlio
Published: April 2021

El crecimiento acelerado de la población ha provocado presiones adicionales sobre los recursos naturales, impactando negativamente su calidad y comprometiendo seriamente la sustentabilidad de los mismos. Es indudable el aumento de la demanda de agua dulce para realizar las actividades antrópicas, generando sobreexplotación del recurso hídrico en las fuentes de abastecimiento. Por lo tanto, cada vez se hace más relevante el manejo integrado del recurso hídrico a nivel de cuenca, teniendo en cuenta, las características morfológicas de la misma, el cambio climático y la dinámica del crecimiento poblacional y económico de sus moradores.
Foreign bodies in the oesophagus on the example of patients of the Department of Paediatric Otolaryngology at the Medical University of Warsaw
Authors: Badełek-Izdebska Małgorzata , Zawadzka-Głos Lidia
Published: April 2021

Introduction. Foreign bodies in the oesophagus are one of the more frequent non-infectious reasons for a child’s visit to the hospital emergency room. Most often, children swallow items accidentally while having fun, learning about the world with the help of their senses, as well as when eating meals. It is coins, plastic or metal fragments of objects that are usually swallowed. Also, hard pieces of food may stick to the oesophagus. Aim. The aim of the study was to analyse clinical symptoms as well as diagnostic and therapeutic procedures in patients with suspicion of the presence of a foreign body in the oesophagus. Material and methods. The authors analysed clinical data of 49 patients hospitalized in the Department of Paediatric Otolaryngology at the Medical University of Warsaw due to the suspicion or presence of a foreign body in the oesophagus. What was also analysed, was the diagnostic and therapeutic process during which the initial diagnosis was confirmed or excluded. Results. The authors analysed the symptoms with which patients came to the hospital, the diagnostic and therapeutic procedures used and the results of treatment. Attention was paid to diagnostic difficulties that may be encountered by a physician in the Admission Room, and then an otolaryngologist qualifying the patient for interventional treatment or deciding on conservative procedures. Possible complications that may occur during ezophagoscopy are described. Conclusions. Foreign bodies in the oesophagus are a common problem in the paediatric population. The most common foreign objects are coins, metal or plastic items or food. The most dangerous foreign objects are disc batteries and sharp, large objects. Diagnostic imaging includes chest and neck X-ray, and in the case of non-contrasting bodies – X-ray with barium or a cotton ball soaked in contrast. The presence of clinical symptoms and/or imaging results suggesting the presence of a foreign body in the oesophagus is an indication for oesophageal endoscopy under general anaesthesia. Both rigid esophagoscopy and the use of a flexible fiberscope are burdened with a certain degree of risk, of which the parents should be informed before those are performer.
Profile of paediatric patient with nasal bone fracture
Authors: Palac-Siczek Małgorzata , Pilch Maciej , Zawadzka-Głos Lidia
Published: April 2021

Introduction. The nose is one of the most frequently injured areas on the face both in children and adults. The evaluation of paediatric patients with nasal injury is a challenge, and it often requires repeated physical examinations before referring the patient for surgical treatment. Nasal bone injury can either be isolated (prevalent type) or constitute an element of multiple-site facial injury. Essential aspects associated with the surgical treatment of nasal bone injuries include the timing of surgical intervention and adherence to meticulous surgical technique. Both factors are often implicated in treatment outcome and hence determine the final appearance of the nose and its function. Aim. The aim of study is to analyse the relation of patients age and sex compared to mechanism of trauma with paediatric patients. This study also analysed the length of period from injury to surgical intervention and time of hospitalization needed. Material and methods. The present paper contains an analysis of a total of 54 cases of children aged 2 to 17 years, who were operated on because of nasal bone injury in the Department of Paediatric Otolaryngology, University Clinical Centre in Warsaw, in the period from 1.01.2018 until 31.03.2018. The analysis is based on the medical records of the study patients. Results. The majority of cases were boys (65%). With respect to age, 4- and 5-year-olds, and 14-year-olds, were the predominant subgroups (13% of all cases, respectively). The dominant mechanisms of injury included falls (41%), beating (24%) and sports activities (26%). The patients typically underwent a surgical procedure on days 6-8 after the injury (65%), and the period of hospitalization was 2 days (69%). Conclusions. The most common nasal trauma of pediatric patient, majority boys, is the isolated fracture of nasal bone related to sports injury and beating. The fracture can be resettled mostly within one week after trauma and hospitalization takes one to two days.
Diagnostic evaluation of congenital respiratory stridor in children
Authors: Jabłońska-Jesionowska Monika , Zawadzka-Głos Lidia
Published: April 2021

Introduction. Congenital respiratory stridor in children is the result of respiratory tract pathology located at various anatomical levels. There is an ongoing debate on whether every case of stridor requires diagnostic evaluation and which method is the most effective for determining the final diagnosis. Aim. The aim of the present study is to answer the question which procedure should be performed to diagnose the casuse of congenital stridor in children and why, and what the most common cause of the stridor is. Material and methods. A group of 110 children examined due to congenital respiratory stridor was analysed. The children’s general condition was assessed and imaging studies and lower respiratory tract endoscopy were performed under general anaesthesia. In some children cardiac ultrasound and contrast-enhanced radiographic examination of the oesophagus or contrast-enhanced computed tomography scan of the chest were performed. Results. Children aged 3 days to 11 years were analysed. The most common cause of stridor was congenital laryngeal hypotonia found in 50% of children and the second most common was abnormalities of the great arteries in 28% of children. Biphasic stridor, which may be a sign of multiple respiratory abnormalities, was diagnosed most frequently. It was only lower respiratory tract endoscopy performed under general anaesthesia that made it possible to make the right diagnosis. Conclusions. The most useful diagnostic method for congenital respiratory stridor is lower respiratory tract endoscopy under general anaesthesia, which is used to evaluate both the larynx and the trachea since defects may coexist at various respiratory levels. It is also for this reason that the type of stridor is not tantamount to the level at which the pathology is located in the respiratory tract. One needs to bear in mind that abnormalities of the great arteries may also be the cause of congenital respiratory stridor.
Computed tomography-assisted morphological assessment of the components of the temporomandibular joint – a pilot study
Authors: Stańczyk Maja , Lukashevich Ronald , Gorzkowska Aleksandra , Urbańska Paulina , Laskowski Piotr , Woźniak Dominik , Stopa Zygmunt , Regulski Piotr , Franczyk Robert
Published: April 2021

Introduction. Temporomandibular joint (TMJ) disorders are a common diagnostic problem. No universal radiological parameter of the analysis was introduced. Aim. Comparison of values of selected radiological parameters between asymptomatic patients and those with the TMJ arthropathy. Material and methods. Retrospective analysis of CT scans of patients of the Department of Dental and Maxillofacial Radiology and the Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Medical University of Warsaw. Patients were divided into two groups: 1. without TMJ disorders, 2. with TMJ dysfunction symptoms. Following parameters of heads of mandible were analyzed bilaterally: shape, anteroposterior and lateromedial dimensions, the distance between lateral points of both heads (HL-HR), distance between a head and the mandibular fossa. The angle between the horizontal axis of the head of mandible and the line drawn by posterior points of heads of mandible was measured. Results. The most common type of the head of mandible in group 1 (40 patients; 13 women, 27 men) was convex (14 patients), in group 2 (16 patients; 14 women, 2 men) – plane (8 patients). Significant differences between groups were obtained for: GL-GP (group 1 – 120.35 mm, group 2 – 115.4 mm), dimensions of heads of mandible: lateromedial – 19.7 mm, 18.14 mm, anteroposterior – 8.03 mm, 7.04 mm for group 1 and 2, respectively. Conclusions. Computed tomography allowed for an accurate analysis of the TMJ components. Measurements of structures discussed in this work should be a part of the diagnosis of patients with TMJ dysfunction.
Autoimmunologiczna neutropenia u dzieci
Authors: Przybińska Aneta
Published: April 2021

Neutrophils play a significant role in immune response to bacteria. Mean normal neutrophil count lies in the range between 1.5-7.4 x 109/L and is age-dependent. Depending on the condition of the organism the neutrophil count can change. Neutropenia is a state defined as neutrophil count below 1.5 x 109/L. It can be classified as mild, moderate or severe. Neutropenia can be either congenital or acquired. The most common form of neutropenia is autoimmune neutropenia (AIN).
Zastosowanie alteplazy w nebulizacji u pacjenta z plastycznym zapaleniem oskrzeli po operacji sposobem Fontana – opis przypadku
Authors: Marczak Honorata , Strzelak Agnieszka , Bielecka Teresa , Szczukocka-Zych Agnieszka , Kulus Marek
Published: April 2021

Plastic bronchitis (PB) is a rare disorder in children but a known complication of Fontan palliation. It is characterised by the formation of muco-cellular casts inside the tracheobronchial tree, which can cause recurrent life-threatening airway obstruction. Common presentation of PB includes atelectasis and dyspnea with potentially fatal outcome. The pathogenesis of this condition is not thoroughly understood. However, the abnormalities of lymphatic vessels may play a role. Various treatment strategies have been anecdotally reported but only few treatment options have been shown to be effective. Authors present a case of a five-year-old girl with Fontan physiology who developed plastic bronchitis. Symptoms occurred 15 months after third stage of correction. Treatment with mucoactive agents and inhaled bronchodilatators had no beneficial effect. A trial of inhaled alteplase was administered and resulted in a full symptomatic recovery. This kind of treatment is unregistered in Poland. The pathophysiology, clinical manifestation and therapeutic opportunities for PB in patients after cardiac surgeries have been reviewed.
Innowacyjna metoda prowadzenia ITI za pomocą preparatu czynnika VIII z frakcją Fc u pacjentów z hemofilią A z obecnością inhibitora czynnika VIII – przegląd literaturowy
Authors: Trzaska Maciej , Karwacki Marek , Łaguna Paweł , Matysiak Michał
Published: April 2021

Eradication of factor VIII inhibitors using Immune tolerance induction (ITI) treatment is the standard of care for severe haemophilia A patients presenting with factor VIII inhibitors, but is not always effective. A description of the potential immunological tolerance effect of the IgG Fc domain of recombinant factor VIII Fc fusion protein (rFVIIIFc), as well as published experience with rFVIIIFc for ITI in patients with severe haemophilia A and high-titre inhibitors. Review of published literature describing cases of ITI with rFVIIIFc in patients with severe haemophilia A and high-titre inhibitors between November 2015 and June 2018. Four publications has been found. Of 56 patients with haemophilia A who presented with FVIII inhibitors, 28 achieved a negative Bethesda titre (< 0.6) after ITI treatment using rFVIIIFc. Additional patients continued on rFVIIIFc ITI at the time of publication, while a few were reported to have switched to bypass therapy alone or other factors . For those still undergoing ITI, longer follow-up is needed to determine final outcomes. No adverse events were reported. Based on literature review, preliminary evidence of FVIIIFc use in high risk, first-time ITI suggests rapid time to tolerization. For rescue ITI, rFVIIIFc showed therapeutic benefit in some patients who previously failed ITI. These findings give hope but highlight the need for further evaluation in ongoing clinical trials.
Twory w sercu – struktury anatomiczne i struktury patologiczne
Authors: Kucińska Beata , Werner Bożena
Published: April 2021

The increase in the availability of transthoracic echocardiography allows the diagnosis of not only congenital heart defects, which are the most common congenital defects in children, but also detection of cardiac masses such as thrombi, vegetations or heart tumors. Performing transthoracic echocardiography one should remember about normal anatomical structures in the atria and ventricles. The presence of central catheters and intracardiac leads favors the formation of thrombi in the heart. The vegetations which are characteristic for infective endocarditis mostly occur on the aortic and/or mitral valve. Primary cardiac tumors in children are very rare (approximately 0.2% of the population) and are usually oligosymptomatic. About 90% of them are benign tumors. The most common is the rhabdomyoma, which often coexists with tuberous sclerosis. The second most frequent tumor in children is a fibroma. Less common primary tumors in children are: teratomas, hemangiomas, lipomas, papillary fibroelastomas. In the differential diagnosis of cardiac masses comprehensive assessment and analysis of both imaging results, as well as medical history, physical examination, laboratory tests and other additional tests are extremely important.
Przejściowy zespół mieloproliferacyjny – praca poglądowa
Authors: Chyżyński Bartosz , Matysiak Michał
Published: April 2021

Children with Down syndrome (DS) are at increased risk of hematological disorders, in particular hematopoietic neoplastic diseases. A disorder characteristic for patients with DS is transient myeloproliferative disorder (TMD) occurring in about 30% of newborns with DS. The development of TMD occurs as a result of the cooperation of two genetic disorders – trisomy 21 (T21) and mutation of the GATA1 transcription factor gene. The clinical course of TMD varies from clinically silent to symptomatic with the occurrence of life-threatening complications. Most patients have spontaneous remission within 3 months without treatment. Patients who develop life-threatening complications may require cytostatic treatment. About 10-20% of patients who develop TMD during the neonatal period in the first 4 years of life will develop acute myeloid leukemia in Down syndrome (myeloid leukemia of Down syndrome – ML-DS). Due to the high risk of developing ML-DS, patients who have been diagnosed with TMD during the neonatal period should be under close hematological care up to 4 years of age.
Postępowanie w stanach nagłych u pacjentów z hemofilią
Authors: Sikora Ewa , Łaguna Paweł , Matysiak Michał
Published: April 2021

Haemophilia is congenital with haemorrhagic diathesis due to deficiency of VIII or IX o coagulation factor, which is manifested by an increased tendency to bleeds. The therapeutic procedure during bleeding is intravenous administration of missing IX or VIII coagulation factor. The article presents a diagram of emergency procedures during bleeding in different locations. When discussing these cases, we would like to emphasize that, regardless of the type of bleeding or injury, correct treatment is first and foremost substitution of the missing coagulation factor and then of imaging and laboratory diagnostics. Delayed administration of a factor concentrate may cause a risk to the patient's life.
Charakterystyka kliniczna grupy młodzieży z nadciśnieniem tętniczym z wykorzystaniem twarzy Chernoffa jako metody obrazowania wielu zmiennych
Authors: Wieniawski Piotr , Werner Bożena
Published: April 2021

Introduction. Chernoff faces, invented by Herman Chernoff in 1973, is a method of displaying multivariate data in the shape of a human face. Aim. The aim of the study was to characterize the group of adolescents with hypertension identified in the course of screening tests and to display it with the aid of Chernoff faces. Material and methods. The study group consisted of 690 middle and high school students aged 15-17, from randomly selected Warsaw and sub-Warsaw schools, 366 boys and 324 girls who underwent screening tests (I stage). Among them 40 students were diagnosed with arterial hypertension and qualified for diagnosis in the Department of Cardiology (II stage). Results. The results were presented graphically using Chernoff faces. Conclusions. Chernoff faces show the characteristics of small groups of patients differing from each other by a large number of analyzed parameters in much more efficient, effective and interesting way than standard charts and tables.
Najczęstsze powikłania transferu zarodków
Authors: Kozikowska Małgorzata , Grusza Mirosław , Mrugacz Grzegorz , Grygoruk Cezary
Published: April 2021

Embryo transfer (ET) has been recognized as a vital step which influences pregnancy rates in patients undergoing the in vitro fertilization process (IVF). The safe placement of embryos inside the uterine cavity is essential to obtain an optimal pregnancy rate. However, there is no guarantee that the embryos will remain in the uterine cavity after the procedure. Embryos have been found in catheters, on the cervix, and on the vaginal speculum. The performance of an atraumatic ET is essential to IVF success. The other factor influencing ET are contamination of the catheter with blood, mucus or endometrial tissue, as well as the occurrence of retained embryos. Embryo retention in the catheter is a common phenomenon, encountered by even the most experienced operators. Embryo retained in the transfer catheter or its sleeve require repeat transfer. Pregnancy rates after IVF-ET decrease in a stepwise fashion with the increasing frequency of uterine contractions. To achieve state of maximal uterus relaxation during embryo transfer it is advised to perform ET gently without excessive stimulation of the cervix. Despite revolutionary changes in the embryological laboratory, little has changed with process of ET over past 20 years. Even thought, ET seems to be relatively easy procedure it should be performed by the most experienced operators.
Recomendaciones para la realización de procedimientos quirúrgicos de urgencia, emergencia, trauma y cuidados críticos ante la situación de pandemia por COVID-19
Authors:   Asociación Argentina de Cirugía, Algieri Rubén D. , Donelly Ernesto
Published: April 2021

Conditions requiring emergency surgery and trauma care are still common in emergency systems and require immediate evaluation and timely resolution even during a pandemic as is currently happening with COVID-19, a scenario that threatens to affect their capacity to provide care5,8. In these cases, certain measures must be taken for the special care of health care workers and their patients, who are often admitted in critical condition and require an immediate surgical intervention that does not allow for any delay. For this purpose, an algorithm should be developed with recommendations which include a checklist to guide surgeons working in emergency and trauma systems about the issues to consider for the appropriate management and treatment of these conditions and for preparation of perioperative environments during the COVID-19 pandemic. The ultimate goal is to maintain adequate care with the necessary and required protection in each case5,8,11, raising awareness of the importance of preserving capacity to respond to these conditions that routinely occur in our community.