bluuebunny/crossref_metadata_2025 huggingface dataset:
Vernacular Accounting: Mengungkap Keunikan Komunikasi dalam Sistem Informasi Akuntansi
Authors: Wijiaya Riesanti E.
Published: December 2021

Buku dengan judul Vernacular Accounting: Mengungkap Keunikan Komunikasi berupaya menguak bagaimana orang-orang dalam perusahaan formal membentuk praktik keseharian mereka. Sebenarnya, perusahaan telah menerapkan SAP (System Application and Processing) dalam beberapa tahun terakhir ini. Namun, para pelaku SAP juga masih menggunakan sistem informal untuk memudahkan pekerjaan mereka. Sistem informal alternatif tersebut berjalan beriringan dengan sistem informasi formal. Adapun bagaimana dan mengapa mereka melakukan hal tersebut akan di-bahas tuntas dalam buku ini.
Acute toxicity, anti-inflammatory, analgesic and antipyretic effects of aqueous and hydroethanolic extracts of Brenania brieyi (Rubiaceae)
Authors: Nkundineza JC  , Nsonde Ntandou GF  , Boumba LS  , Kibamgou S  , Motondo E  , Abena AA
Published: December 2021

Brenania brieyi (Rubiaceae) is widely used in traditional Congolese medicine in the treatment of many pathologies that are manifested by inflammation, pain and fever. The objective of this study was to study the acute toxicity as well as to evaluate the antipyretic, analgesic and anti-inflammatory effects of the aqueous and hydro-ethanolic extracts of Brenania brieyibark on models of pyrexia, algesia and inflammation induced in rodents. The aqueous extract of Brenania brieyidoes not cause any mortality up to the dose of 4000 mg/kg, but promotes a slight increase in body weight. From 2000 mg/kg, the signs of toxicity observed were the significant decrease in mobility as well as the loss of alertness. At doses of 100 and 200 mg/kg, aqueous and hydro-ethanolic Brenania brieyiextracts showed a very significant anti-inflammatory effect (***p< 0.001) on edemas induced by carrageenin (1%), formaldehyde (2.5%) and histamine (1 mg/mL), greater than that of diclofenac at 10 mg/kg. At 200 mg/kg, both extracts showed a very significant analgesic effect (***p< 0.001), greater than that of paracetamol 100 mg/kg against pain induced by acetic acid 0.6% and formaldehyde 2.5%. Brenania brieyiwas slightly effective in the tail flick test. Brewer's yeast-induced hyperthermia was reduced by both extracts. However, the hydro-ethanolic extract proves to be more effective than the aqueous extract in all the tests carried out. These pharmacological effects would be related to the presence of alkaloids, tannins, flavonoids, anthraquinones, oses and saponosides.
Cultural Identity and Identity Crisis in the Selected Novels of Githa Hariharan
Authors: Dr. Leena V. Phate
Published: December 2021

Githa Hariharan is a successful feminist writer. Her first novel The Thousand Faces of Night (1992) won the prestigious Commonwealth Writers’ Prize for the best first novel in 1993. Her novels portray the struggle of female characters for their identities which are challenged by caste, religion, violence and nationality. The present paper is an attempt to examine and review the way Hariharan’s women characters encounter the orthodox roles and identity forced on them by the male-dominated social order as they try to rebuild a modern self-identity for them. For this purpose, her novels The Thousand Faces of Night, The Ghost of Vasu Master and Fugitive Histories are thoroughly studied in this paper.
An Inspiration to Womanhood through the poems of Kamala Das and Maya Angelou
Authors: Ms. Padma Ragam. S  , Dr. Jennifer G Joseph
Published: December 2021

History reveals that the girls and women had been kept in darkness from ages. They had no right to enjoy their fundamental rights. Women had been treated as inferior to men. They were tortured, suppressed, humiliated, and sexually harassed in all the fields. They were, not respected, and given importance and marginalized politically, economically, socially, culturally and emotionally. The condition of women had been very pathetic and, where rape, female foeticide, infanticide, dowry deaths and various kinds of exploitation were happening almost every day. The women were considered as a sexual object and to take care of the family over the years in the history. But gone are the days, where women were known by her husband’s name or by the name of the family. Now women are educated equal to men. Women can get empowered in their own choices by selecting their own jobs, own life partners, own places to study, and professions etc. They are working in all the fields and in every profession. They are in good positions in their work places. They are recognised by the society. They achieve many things and do wonders in their work places. They have become policy makers in their work places. They are recognised and respected in the family since they are working and earning money and taking care of their family. You can find women as president, chief minister, prime minister, director, principal, pilots, astronomers etc. Women have freedom to make their own choices. And now they have so many facilities announced by the governments where they can enjoy their freedom. Since there are special laws relating to women empowerment in favour of women, they feel free to enjoy their fundamental rights. This paper throws light on how women were leading their lives in the past and how they are leading their lives in the 21st century through the selected poems of Kamala Das and Maya Angelou. Both have been marginalized and subordinated, but difference lies between the way, they were victimized.
Indian Cinema: Making Departure from the Stereotypical Presentation of Women in Nuptial
Authors: Dr. Priyanka Kulhari
Published: December 2021

In the late 20th and 21st century various movements took place which challenged the stereotypical notions of gender in society. #MeToo movement gave a momentum to the society where people started talking about any kind of violence, sexual assault and harassment against women. Many government policies and laws were framed and implemented to provide equal opportunities to women in every field. Vishakha Guidelines and Internal Complains Committee are made mandatory at work place and education institutions to assure a safe and healthy environment for females. Now the issues brushed under the carpet for long have been brought into light. Issues which were considered taboo even to talk about are now discussed on public forums and academia, penned down in literature and projected in media and cinema. Women and their concerns and point of views found space in popular cinema and were acclaimed too by the critics as well as spectators. Bollywood has made deviations from the stereotypical portrayal of women and broke the silence on issues like sexual consent and female sexuality. It also showed the role of woman in marriage and how it’s changing with woman becoming economically independent and realizing her real worth. The present paper will deliberate on the institution of marriage and the role of woman in it in the Indian society especially in the context of Indian cinema. It will discuss recent Indian cinema which came with stories in which decision-making power has been exercised by women in a nuptial and consent of a girl in a marriage has been considered. Gender roles in a marriage will also be analysed which has been shown deviating from the stereotypical notion especially in the movies Ki & Ka and Tumahari Sulu. It will include the movies which have at the centre the idea that the courage of a woman can put a full stop to the deep-rooted patriarchy of centuries in our society. The paper will include only popular cinema made in Hindi language film industry known as Bollywood in the last decade like Dil Dhadkane Do, Badrinath Ki Dulhania, Secret Superstar, Parched and Tumhari Sulu.
The Theme of Protest and Freedom in Cry, the Peacock
Authors: Prof. Dr S. U. Chavan
Published: December 2021

The conflict between social institutions and individuals is a complex and perplexing issue for many scholars. While reflecting on this issue, some scholars propagate the privilege to individuality, the others to the social institutions. Many scholars consider it as a matter of mutual coordination and interest. The need for a relative space for an individual and the requirement of the social institutions for regulating control over an individual’s uncensored wills are equally important. However, safeguarding or maintaining the margins of both entities is complex work. Regulating uncensored wills or reducing excessive encroachment of institutional authorities is a difficult task; it needs to be addressed with a scientific approach. The Indian social system is conservative and has been maintaining its dominance over the women’s class from the time unknown. The society, after allotting all the privileges to male members, refuses to consider women as individuals, having space and freedom. It expects women to be timid, docile, submissive and obedient. As a result, they feel tyrannized and experience untold sufferings. When the patriarchal system becomes over oppressive, it leads women to absolute confinement; the life of complete closure is highly disappointing and frustrating. The forces that obliterate their rights include gender discrimination, marriage-system, orthodox traditions, customs, rituals and class status. A woman is born with a destitute to experience a collision with the subjugating elements in her life and while wrestling against it she has little success. She goes through a perpetual war against the controlling institution while creating a space for her individuality and freedom. The factors like these rob women characters of happiness and advantages and lead women to live an insignificant life, full of suffering.
The Inconspicuous Relationships between Language Acquisition and Learning
Authors: Mr. V. Heymonth Kumar
Published: December 2021

This research paper throws light on the inconspicuous relationships between language acquisition and learning. It introduces the meanings of language acquisition and learning based on the researches of Pritz Hutabarat and Imran Hussain. Tools for language acquisition, such as movies, games and social networks, are explained clearly in this research paper followed by the definitions of language acquisition and its characteristics. Tools of language learning, such as classroom education and activities, are explained in detail along with the definitions of language learning and its characteristics. These mentioned parts have the testimonials of Fernandes Arung, Aladdin Assaiqeli, Yolanda A.Rankin, Rachel Gold, Bruce Gooch, Hosni M.El-Dali, Parlingdungan Pardede, Eva Alcon, and Jenny X. Montano-Gonzalez. Behaviourist Theory, The Innateness Theory, Cognitive Theory, The Motherese Theory, and Socio-Cultural Theory are the theories of language development that present in this research paper. To prove these language developmental theories, Entisar Khalifa Aljoundi and Dr. Md. Enamel Hoque’s research findings based on the experimental findings of Edward Thorndike, B.F Skinner, Noam Chomsky, Jean Piaget and Lev Vygotsky are provided with suitable examples. This research paper is aimed to spotlight the two most inconspicuous relationships between language acquisition and learning.
A Critique of Twentieth Century Feminist Criticism
Authors: Dr Vijay Nagnath Mhamane
Published: December 2021

Feminist criticism arose in response to developments in the field of the feminist movement. Many thinkers such as John Stuart Mill, Mary Wollstonecraft raised their voice against the injustice done to women in every sphere of life. As this gained momentum throughout the world, feminist also awakened to the depiction and representation of women in literature which is one of the influential medium of socialization and culture. They argued that woman and womanhood are not biological facts but are given social constructs. One is not born a woman, but becomes one through culture and socialization. At first, feminist criticism was reactionary in the nature in the sense that they exposed stereotypical images of women in the literature. These images of women were promulgated by the male writers. These images of women were what men think of women. Gradually, feminist criticism moved from this phase to more constructive work. They unearthed many women writers that were either suppressed or neglected by the male literary tradition. In this way, they created a separate literary tradition of women writers. Feminist critics divided this tradition in such phases as feminine phase, feminist phase and female phase. They also studied the problems faced by female creative writers.  They used theories from post-structuralism, Marxism, psychoanalysis to study the nature of female creativity. They also realized that there is an innate difference between male and female modes of writing. Feminist critics also exposed the sexiest nature of man-made language. They also exposed phallic centrism of much of the western literary theory and criticism. They also started to study the language used by the women writers. Simon De Beauvoir, Virginia Woolf, Elaine Showalter and Juliet Mitchell are some of the feminist critics discussed in this paper.
Cultural Ecological Attitudes in Gita Mehta’s A River Sutra
Authors: Dr O. T. Poongodi
Published: December 2021

One of the sparkling stars in the galaxy of Indian writers, Gita Mehta is the brightest. Her novels are written with Indian perspectives and they are explorations of the tension generated by the east-west encounters. Her novel A River Sutra is a colourful fictional account of India that mirrors Indian history and culture. It connects Indian mythology with various depictions of love in its many aspects. It told through a pen-pusher and his encounter with six pilgrims on the banks of the Narmada. In Western Feminist studies, the woman is always portrayed with a quest for freedom from the urban exploitative society to nature. It is appealing to determine that this concept receives a new dimension in a different cultural context. In this novel, Mehta has shifted her focus from the interactions between India and the west to exploring the diversity of cultures within India. Gita Mehta uses the Narmada as the thread, which holds together the main story and the six sub-stories. The present paper discusses in detail the theory of eco-criticism and it aims at highlighting an understanding of various terms like green studies and nature studies, as well as describes in fair detail, the different subfields of eco-criticism, namely, Cultural ecology, Eco-feminism and Gyno-Ecology.
Magic Realism in African Literature: A Study on Selected Works of Ben Okri and Nadine Gordimer
Authors: Mahesh Chandra Tiwari
Published: December 2021

This article examines the evolution of magical realism as a narrative style used by African writers throughout the transition period, and how it became increasingly suited to African literary sensibilities at the time. At the same time, magical realism relies heavily on African oral traditions, serving as a site of convergence for black and white writing under apartheid, as well as exemplifying the synthesis of Eurocentric Western logic and African tradition. This article discusses the possible origins of the proliferation of African texts embracing this narrative mode in the immediate aftermath of apartheid's demise, as well as the possible reasons for the gradual abandonment of magical realist narrative strategy in the post-millennial era, while discussing magic realism in relation to Ben Okri's and Nadine Gordimer's post-apartheid novels. As a consequence of the short cohabitation of the two literary forms in African literary history, African magical realism works will be located at the intersection of celebration and disillusionment literature.
Reading Skill: A Key to the Development of Language Acquisition
Authors: Ramesh Chandra Pradhani
Published: December 2021

Every human being more or less wants to express something to somebody for which one needs a language. Some expressions of poets, singers, artists, writers, social workers, leaders, politicians and philosophers are placed in printed materials - newspaper, periodicals, journal, magazines and above all books by means of language for future generations to come. Moreover, the same thing in same language can be expressed by different people in different ways in various places. Thus the scope of language gets enlarged day by day coming contact with other languages as the river gets widened running continually over years accompanied by other small drains, rivulets etc. Needless to say, unfathomable is the depth of language that cannot be measured in a single day or effort. The vast arena of language may be cultivated by the habit of constant reading which involves both speaking & listening skills. By reading one move in the world of language. One cannot acquire the use of language unless and until one is exposed to it. It is the style of language that helps the speaker to attract and win everybody’s heart. This paper examines how language skills are cultured by reading activity. It also explores possible ways of how reading skill, firstly; enriches the readers with profound vocabulary, secondly; enables them to use language with clarity, accuracy and fluency, and last but not the least; makes the speakers well communicative, interactive, and economic in effective use of language. Lack of language creates a communication gap and this small gap invites a massive misunderstanding which very often spoils unity, integrity, brotherhood among the users, and after all makes human beings dumb and dull.
Study of Marginalization of Women in Rama Mehta's Inside the Haveli
Authors: Krishna Murari Shukla  , Dr. Ram Prakash Pradhan
Published: December 2021

In the social structure of this world, there are various forms of people like class, community, caste, religion or gender, suffering from the dominated sensibility of social, political, economical or ethical values but their exploitation has been general in the tendency of common perception. The close observation of these people is categorized under the head of marginalization. Marginalized people are often defined socially, politically, culturally and legally deprived of their ‘rights’ as human beings in every sphere of life and cultural society. The various groups of people, living or surviving on the verge, can be assessed with their caste, class, religion or gender differentiations. In this regard, women’s position in the society and family has been one of the most considerable issues. The condition of women whether as masters or servants has equally been dominated and deprived of rights in the men dominated society. The present paper explores the marginalization, suppression, deprivation, gender inequality and feminine sensibility of women within the patriarchal system of the society in the novel Inside the Haveli.
AUTOMATED INSTALLATION FOR MILK COOLING USING A NATURAL COOLING AGENT
Authors:   Altai State Agricultural University, Sadov V.V. , Kapustin N.I. ,   Altai  State  Agricultural  University
Published: December 2021

In the chain from milk production to the sale of dairy products, the process of ensuring the required temperature is the main one. Moreover, to cool the milk, the tempera-ture of the cooling agent should be above milk freezing. Taking into account the fact that the process of cooling and storing milk in a chilled form imposes strict requirements for reliability and quality of management on farms, compressor refrigeration units have been used in recent years despite high energy consumption. Theanalysis of technical solu-tions in this direction by the example of farms of the Altai and Novosibirsk Regions showed that during the greatest boom of the livestock industry, film-tray, spray-cooling tow-er, and pipe and tank installations using natural cooling agents were widely used. Taking into account the climatic features of the area when choosing water cooling units as an intermediate coolant made it possible to significantly reduce energy consumption for milk cooling especially in winter. However, the complexity of controlling the process of preparing the intermediate coolant with unpredictable environmental parameters did not allow for high reliability and quality of manual control. A device for cooling the in-termediate coolant with the main -natural cold in winter with an automatic direct-acting regulator that provides the required operating mode of the cooling unit is proposed. The variants of automatic device operation both when the outdoor air temperature decreases and increases are con-sidered. An automated installation for cooling the interme-diate coolant with natural cold may be recommended both for cattle farms and processing enterprises
INFLUENCE OF FERTILIZERFORMS AND RATES ON TOMATO FRUIT QUALITY INDICES
Authors:   Novosibirsk State Agricultural University, Pastukhova A.V. , Petrov A.F. ,   Novosibirsk State Agricultural University, Gavrilets N.V. ,   Novosibirsk State Agricultural University
Published: December 2021

This paper discussesthe results findings on the effect of nitrogen fertilizers as urea-ammonia liquor (KAS-32) and ammonium nitrate of various application rates (40,80 and 120 kg of primary nutrient per ha) on the quality of tomato fruits grown on the field and under cover.Various research methods were tested. They made it possible to identify biologically active substances of tomato fruits which helped to examine fruit chemical composition of experimental vari-eties with the determination of dry solids, total sugar, vita-minC, total acidity, lycopene and nitrates. It was found that under cover, the application of nitrogen-containing fertiliz-ers increased dry solids by an average of 23-25%, total sugar -by 55-61%, vitamin C -by 33-41% as compared to the control. On the field, the dry solids content increased by 35-45%, total sugar -by 74-83% and vitamin C -by 37-42%. However, the application of the maximum rates of N120fertilizer decreased dry solids content by 5-6% as compared to N80. At the same time, there was an increase of fruit total acidity as compared to the control: up to 32% under cover, and up to 16% on the field. Although as sugar content increased, the acidity had almost no effect on the eating qualities. In all variants, the nitrate content did not exceed themaximum permissible concentration. The ob-tained data confirmed the positive effect of certain rates of nitrogen-containing fertilizers on the structure, quality and safety of the obtained tomatoes. This result will make it possible to recommend the testedmethods and rates of fertilization during the growing season.
DYNAMIC EFFECTS OCCURRING IN THE MECHANICAL SYSTEM OF VIBRATORY FODDER GRAIN CRUSHER
Authors:   Altai State Agricultural University, Fedorenko I.Ya. , Levin A.M. ,   OOO “Sibirskaya tekhnologicheskaya kompaniya”, Tabaev A.V. ,   Altai State Agricultural University
Published: December 2021

In the mechanical system of the proposed fodder grain grinder, two dynamic effects are manifested: anti-resonance of a two-mass system and self-synchronization of unbalanced rotors. These effects occurring simultane-ously in one machine are constantly opposed to each oth-er. Indeed, anti-resonance leads to small vibrations of the first mass to which the vibration exciters are rigidly at-tached. Self-synchronization of vibration exciters requires large oscillations of this mass as a common carrier body through the oscillations of which self-synchronization is carried out. On the other hand, in the theory of synchroni-zation, the paradox of inoperative connections is known which states that during synchronization of vibration excit-ers the carrier body may be motionless and begins to oscil-late only if the synchronous phasing of the rotors is violated for some reason. Therefore, the research goal is to exper-imentally confirm the joint manifestation and “coexistence” of these effects in the proposed crusher, as well as to study the possibility of their use for technological purposes. A mathematical model of vibrations of the working bodies of a vibratory fodder grain crusher was obtained taking into account its design features and the interaction of the work-ing bodies with the technological environment. It is theoret-ically determined and experimentally confirmed that in the mechanical system of a vibratory fodder grain crusher, two dynamic effects are manifested: anti-resonance of a two-mass system and self-synchronization of unbalanced roranges of the working bodies. The rotations of the vibration exciter rotors are synchronous-cophased that has a posi-tive effect on the functioning of the crusher.
Clinical and genetic profile of Brazilian patients with dysferlinopathies – A retrospective study
Authors: Farias Igor Braga , Badia Bruno de Mattos Lombardi , Costa Gustavo Carvalho , Machado Roberta Ismael Lacerda , Marin Carolina Maria , Pinto Wladimir Bocca Vieira de Rezende , Souza Paulo Victor Sgobbi de , Oliveira Acary Souza Bulle
Published: December 2021

Introduction: Dysferlinopathies are a group of conditions that are caused by mutations in the dysferlin gene. Objectives: To characterize the clinical phenotypes and genotypic spectrum of dysferlinopathies patients and to estimate the progression of functional and motor decline. Design and setting: Retrospective analysis of the medical records of patients followed up at our institution between 1995 and 2020. Methods: Patients were selected based on the following inclusion criteria:(i) Identification of a mutation defined as pathogenic in homozygosis or compound heterozygosis in the Dysf gene;or (ii)compatible clinical manifestations and decreased expression of dysferlin in immunohistochemistry on muscle biopsy. Classification of the phenotype was based on the first symptoms. Functionality was defined by the Gardner–Medwin & Walton(GMW) scale modified for dysferlinopathy. Results: 23 patients were included in the study. 16 were classified as limb-girdle muscular dystrophy autosomal recessive 2 (LGMDR2), 4 as Miyoshi muscular dystrophy, 2 as proximo-distal onset and 1 as asymptomatic hyperCKemia. Thighs adduction was the most affected movement in the first evaluation (mean strength=3). Plantar flexion was the movement with the greatest decline in strength(mean=-0.10 points on MRC/year;pT, Arg2042Cys and c.2643+1G>A, p.?(splicing), found 3 times each. There was no statistical difference in muscle strength in the first evaluation, motor and functional decline between the phenotypes. Conclusion: While LGMDR2 was the most common phenotype at onset, with the exception of asymptomatic hyperCKemia, there were not a clear difference in the pattern of progression between them.
Relationship between sleep disorders and headache in adolescents
Authors: Oliveira Gabriel Santana Pereira de , Bierhals Isabel de Oliveira , Santos Iná da Silva dos
Published: December 2021

Introduction: Headache is a frequent neurological complaint among adolescents, reducing quality of life in this age group. This study aims to evaluate the prevalence of headache, its characteristics and association with sleep disorders in adolescents from the 2004 Pelotas Birth Cohort. Methods: Data from the perinatal and 15-year-old follow-up of the 2004 Birth Cohort were used to define the occurrence of headache and its characteristics (intensity, location and type). Sleep disorders were used as exposure and referred to frequency in the month prior to the interview, including: long sleep latency, insomnia and nightmares. Statistical analysis was performed calculating crude and adjusted prevalence ratios to assess the relationship between sleep disorders and headache. Results: The occurrence of headache was reported by 51.7% of the adolescents. More than a third of them reported severe or disabling pain. More than two thirds of adolescents with long sleep latency or insomnia classified their sleep as bad or very bad, and 64.6% of these reported headache. Adolescents with long sleep latency or insomnia ≥3 times/ week were 42% more likely to have headache than those who didn’t report difficulty falling asleep. Among adolescents who rated their sleep as bad and very bad, the probability of headache was 33% higher compared to those who rated sleep as very good. Conclusion: The prevalence of headache is high in adolescents and it’s associated with sleep disorders. Thus, sleep hygiene measures and clinical evaluation are essential to identify and treat these comorbidities, ensuring improvement of headache.
Type 1 neurofibromatosis and its relation to the occurrence of cerebral vascular accident
Authors: Silva Bruno Custódio , Santos Fernanda Silva dos , Simioni Victória Porcher , Konopka Ana Luíza Kolling , Zen Paulo Ricardo Gazzola , Rosa Rafael Fabiano Machado
Published: December 2021

Context: Neurofibromatosis type 1 (NF1) is characterized by “café-au-lait” (CAL) spots, ephelids, cutaneous neurofibromas and iris Lisch nodules. Case report: A 63 year-old female patient came to evaluation due to NF1. She had a history of CAL spots, nodules on the skin, cognitive deficit and seizures. Chest X-ray showed several small nodules scattered in soft tissues of the thoracic wall. Magnetic resonance imaging of the skull demonstrated a possible increase in intracranial pressure. Computed tomography scan of the skull showed a hypodense area in the left hemisphere, consistent with a recent ischemic stroke. At the consultation, the patient reported episodes of headache, dizziness, nausea, vomiting, walking difficulty and pain in the thighs. On physical exam, she presented macrocephaly and diffuse nodular lesions. She also had masses in the abdominal and pelvic regions. On neurological exam, there was a pyramidal syndrome with right release pathway; ataxic gait; grade IV strength and Babinski sign. The patient was referred for surgical removal of the neurofibromas and died due to perioperative complications. Conclusions: Among patients with NF1, stroke is more common and occurs at a younger age than in the general population. The vasculopathy seen in NF1 involves the anterior and middle cerebral arteries, which can have serious or even fatal consequences. Anatomical vascular variants and intracranial aneurysms also occur more frequently in individuals with NF1.
Epidemiological profile of bacterial meningitis in the state of São Paulo
Authors: Teles Daniel Rocha Diniz , Soares Sabrina de Freitas Barros , Oliveira Paloma Fernandes de , Silva Matheus Gomes Diniz e , Segundo Antonio Fernando Soares Menezes
Published: December 2021

Introduction: Meningitis is an inflammatory process of the meninges, which can be of infectious cause or not. Among the infectious, the bacterial is the most alarming for society, since it has a much higher rate of morbidity and mortality. Objectives: Analyze and describe the epidemiological profile of bacterial meningitis in the State of São Paulo. Methods: Descriptive epidemiological study of cases of bacterial meningitis in the State of São Paulo, carried out through the DATASUS platform, in the period from 2016 to 2020. Results: The State of São Paulo registered 4013 cases of bacterial meningitis, 67.1% of the cases in the Southeast (5977), being responsible for 53% of the cases of this disease in Brazil. The most affected age group in the State was 0 to 4 years, 33.7% of the total, while elderly people aged 80 and over were the least affected (2.3%). As for deaths, São Paulo recorded 862 and a mortality rate of 21.4%, higher than the country average (20.5%), representing 64% of deaths in the Southeast region. In addition, males were the most affected, registering 58.1% of the total, while females registered 41.8%. Conclusions: São Paulo has the majority of cases and deaths from bacterial meningitis in its region, with a mortality rate that exceeds Brazilian averages and which contributes to the Southeast having more than half of the cases of meningitis in Brazil. More active epidemiological surveillance and greater dissemination of information on meningitis and its signs and symptoms is necessary.
Changes in deglutition in patients with neoplasms of the central nervous system interned in the general hospital and maternity of Cuiabá – MT
Authors: Mendes Larissa Carvalho de Toledo , Santos Daniela Tonellotto dos , Caldas Cláudia de Souza Ozores
Published: December 2021

Introduction: Tumors of the central nervous system are considered rare, belonging to the types of tumors that cause functional deficits and whose symptoms are often overlooked. Dysphagia is the most frequent manifestation in these patients, resulting in malnutrition, dehydration, pulmonary complications and even a cause of death, causing great impact on public health. Objective: to identify early the risk of dysphagia in patients in the postoperative period of neurosurgery. Design and setting: prospective and descriptive study carried out in the neurosurgery service with individuals in the postoperative period of neoplasms of the Central Nervous System of the General Hospital and Maternity of Cuiabá. Method: Twenty patients participated in the research, aged 18 years or over and of both sexes. The Phonoaudiological Protocol for Risk Assessment for Dysphagia was used for data collection, by means of the swallowing test of water, soft foods, classification, degree of dysphagia and conduct. This study was submitted to and approved by the Research Ethics Committee under number 4,196,826. Results: The participants in this study are on average 56 years old, 60% male, 55% from the interior of Mato Grosso and in relation to the proposed treatment, 100% of the participants were referred for neurosurgery. Conclusion: The study contributed to the characterization of patients, of which 70% had the International Classification of Diseases D430 and 80% maintained normal swallowing in the postoperative period, with important findings regarding the functionality of swallowing and food safety of the sample.
Congenital anomalies of the central nervous system: prevalence in a fetal medicine service in the Brazilian Midwest
Authors: Moraes Carolina Leão de , Tacon Fernanda Sardinha de Abreu , Matos Andréa de Faria Rezende , Melo Natália Cruz e , Castro Michelle Hermínia Mesquita de , Amaral Waldemar Naves do
Published: December 2021

Introduction: Approximately 21% of congenital anomalies (CA) involve the Central Nervous System (CNS), constituting one of the most common birth defects, affecting 1 to 10: 1,000 of live births. Objective: To analyze the prevalence of CNS anomalies diagnosed by obstetric ultrasound. Methods: Prospective longitudinal cohort study carried out in a public fetal medicine service in Goiânia with pregnant women who were attended in high-risk prenatal care. The patients were followed up during the ultrasound exams from March 2018 to March 2019. Results: 225 cases of pregnant women with ultrasound diagnoses of CA were surveyed during the investigated period. CNS anomalies were the most prevalent, being present in 34.22% (77/225) of the cases. The mean maternal age of pregnant women was 25.55 years and mean gestational age was 28.84 weeks. Hydrocephalus was identified in 23 pregnant women (29.87%), being the most prevalent CNS anomalie. Anencephaly was present in 24.68% (19/77) and holoprosencephaly in 18.18% (14/77). Other CA were also diagnosed (21/77), such as meningocele, spina bifida, acrania, among others. However, they showed a lower prevalence in relation to hydrocephalus, anencephaly and holoprosencephaly. Conclusion: The findings are essential for the planning and allocation of hospital resources and investment in health. Besides that, to adequate and specific prenatal care, is indispensable in the search for reducing the incidence of these malformations, morbidity and improving survival rates of the affected population.
New pharmacological strategies for the treatment of alzheimer’s disease
Authors: Silva Letícia Freitas de Castro , Weber Elisa Pinheiro , Toledo Gleice Silva , Almeida Josiane Fonseca
Published: December 2021

Introduction: Alzheimer’s disease (AD) is seen as the most important dementia, prevalent in the elderly over 60 years old. There is still no cure, and the pharmacological strategies are to delay the symptoms and development of the pathology. The pathophysiological mechanisms are: hyperphosphorylation of the tau protein and aggregation of amyloid-β. Update studies of the tested therapies target the main pathological mechanisms: accumulation of β amyloid (inhibitors and modulators of β-secretase and γ-secretase and active and passive anti-Aβ immunotherapies), tau protein (inhibition of abnormal hyperphosphorylation with GSK-3 inhibitors, passive and active immunotherapies and the use of intrathecal antisense oligonucleotides (ASOs) and correction of the ApoE protein (increase lipidation, correct structure, clearance of non-lipid ApoE and reduction of ApoE expression). Objectives and methodology: To develop a bibliographic review in order to address new drugs in the treatment of Alzheimer’s. Qualitative and descriptive study carried out by literary review with research on PubMed. Results: Several drugs have been tested in clinical trials, however, due to lack of effectiveness, none have been approved. Therefore, it’s important to understand the limitations of the tests developed as flaws in the methodology, insufficient understanding of the mechanisms involved and inclusion of patients in different stages of AD, so that future investigations can overcome these gaps. Conclusion: It’s important to investigate new pathophysiological mechanisms, as well as the factors that trigger AD. Diagnosis is essential, with further studies to identify new biomarkers of the disease that will also have an impact on the conduct of clinical trials.
The risks of sleep fragmentation on cognitive skills: a systematic review
Authors: Rangel Elen de Souza , Costa Julio Cezar Albuquerque da , Marinho Ana Carolina Soares , Santos Laís Rosa e Silva Oliveira , Lima Letícia Emanuelle de Almeida , Freires Leogildo Alves
Published: December 2021

Background: The sleep fragmentation may conduct to breakdown in neutral networks, which tends to affect cognitive abilities or cognitive skills (CS) and bring notable deficits to the subject’s typical neuronal functioning. Objectives: Analyze the academic discussion of this theme and how this sleep deprivation can incapacitate the CS elemental to properly functioning circadian rhythm, as well as its multifactorial causes may be related to the subject’s complaint. Methods: To this article, it has been accomplished a systematic review on PubMed and Virtual Health Library database, using the descriptors “Sleep” and “ Cognitive abilities”, using articles from the last two years. Nine articles were used to guide this study. Results: It was possible to analyze that there are multifactorial complements related to sleep disturbance - neurodegenerative disorders, lack of sleep, prescription stimulants. The studies show that it is essential to elaborate a therapeutic plan, to define which CS is affected and what is going to be done about it, since the existing especifities may be present in neural correlates or in different CS, which makes indispensable the therapeutic plan. Conclusion: After all, it is indispensable the continuity of studies that research affected neural correlates in front of sleep deprivation, in order to understand sleep dysregulation for cognitive skills and provide an effective therapy for society, which permeates, consequently, a better quality of life.
The cost-effectiveness of the treatment of acute ischemic stroke with the use of thrombolytics in Brazil
Authors: Martins Marcos Vinicius Teixeira , Brito Veronica Perius de , Oliveira Stefan Vilges de
Published: December 2021

Introduction: Ischemic stroke causes major impacts on morbidity and mortality and intravenous thrombolysis is one of the main treatments. However, it has important temporal limitations, which justifies the study of other techniques. Objectives: Analyze the cost-effectiveness of treatments for acute stroke with the use of thrombolytics. Methodology: Epidemiological study with data from the Sistema de Informações Hospitalares do Ministério da Saúde, between 2015 and 2020 in Brazil. Results: There were 16488 hospitalizations, with an average cost of R$ 2687.70 (±379.40) and an average stay of 8.80 (±0.99) days. From 2015 to 2017, these values were, on average, 1829.67 (±917.46) hospitalizations, R$ 2715.50 (±190.86) and 9.80 (±1.62) days. Between 2018 and 2020, there are 3666.33 (±437.58), R$ 2773.22 (±108.86) and 8.13 (±0.29) days. The Northeast, Southeast and South of the country predominated with 36.09% (±0.73), 27.15% (±0.68) and 32.02% (±0.71) of occurrences, respectively. Average investments per hospitalization, for these regions, were R$ 2397.89 (±82.45), R$ 3178.29 (±38.89) and R$ 2806.16 (±56.33). As for the average stay, it was 7.30 (±1.11), 9.11 (±0.89) and 9.40 (±0.78) days. In public systems, 65.09% (±2.97) of registered treatments, the average cost was R$ 2815.09 (±122.34) and the average stay was 12.00 (±1.33) days. In private institutions these values were R$ 2747.14 (±98.13), and 8.90 (±0.92) days. Conclusions: There were increases in hospitalizations and costs with a reduction in length of stay. In addition, there were pronounced disparities between the regions of the country and public and private systems, which undermine equity in the health system.
Pompe disease: case report in siblings
Authors: Barros Eduarda Pereira de , Baggio Fábio Lima , Ventorin Bruna Giaretta , Morceli Amanda Raminelli , Almeida Diogo Fraxino de
Published: December 2021

Introduction: Pompe disease (PD) affects lysosomal digestion due to absence or low action of the enzyme acid α-glucosidase (GAA), with accumulation of glycogen, causing overflow of enzymes and autophagy, which affects striated muscle. PD is divided into infantile, juvenile, and adult clinical forms, with severity determined by amount of residual GAA activity. Case: P1) 45-year-old man admitted with acute respiratory failure (RF), starts mechanical ventilation. History of weakness, dyspnea, dysphagia. He had decreased proximal muscle strength at lower limbs (LL). Sequencing of GAA gene: autosomal recessive deficiency of two variants. Apnea-hypopnea-index (AHI):10.5. GAA enzyme replacement therapy (ERT) was requested. Judicially denied by disease progression. P2) 40-year-old man presented with loss of muscle strength at LL for 15 years, associated with snoring, daytime somnolence. Brother with similar complaints. He had proximal muscle weakness at LL. Positive genetic panel for PD. AHI:23.5. Judicially released ERT treatment and reported improvement. Discussion: Adult form of PD manifests itself with mild phenotype, with presence of residual GAA activity, which causes different clinical expressions. Main manifestations are symmetric proximal muscle weakness in LL and Gowers’ sign. Frequent death cause in late form is RF, which occurs early, unlike other neuromuscular diseases. In Brazil, PD is underdiagnosed, with approximately 2500 cases. Treatment is performed with Myozyme®, an ERT, not available in SUS, which makes treatment difficult. Conclusion: PD is a serious condition, with high underdiagnosis because of its similarity to other myopathies, which allows disease progression. Furthermore, the variability of GAA mutations allows for distinct phenotypes
Transcranial Magnetic Stimulation (TMS) and its cortical targets in the treatment of fibromyalgia: a systematic review
Authors: Corrêa Mônia Rieth , Lellis Caio de Almeida , Siqueira Maria Antônia da Costa , Barros Filho Marcondes Bosso de , Vieira Ricelly Pires , Silva Ledismar José da
Published: December 2021

Background: Fibromyalgia (FM) is a non-inflammatory disease with unknown etiology expressed by diffuse musculoskeletal pain, whose definition and management are subjects of controversies. Thus we aimed to review the literature on efficacy and main cortical targets of TMS for FM. Methods: A systematic review was carried out in PubMed databases, along with the terms DeCS/MeSH: “Fibromyalgia AND (Transcranial Magnetic Stimu-lation OR TMS)”. Randomized studies and clinical trials published in the last 10 years were selected. After exclusion, 11 articles remained. Results: The references found for TMS in the treatment of FM indicate average reduction in pain symptoms (29%). TMS showed significant improvement in pain measured by visual analog scale and was more advantageous in clinical and functional improvement, but less efficient in psychiatric conditions. In female patients, active use of repetitive high-frequency TMS was significantly better on pain, quality of life (QoL) and depression. Another study showed that 20 sessions produced significantly lasting pain inhibition and improved QoL when operated at 10 Hz. Moreover, the right dorsolateral prefrontal cortex or the left motor cortex can have antidepressant and pain-modulating effects. Evidence also points to an important improvement in physical and general fatigue, as well as greater chance of clinical improvement in pain intensity. Conclusions: Evidence on TMS for FM available so far is promising, with potential to represent a valuable and safe therapeutic option. However, more and larger studies are needed to elucidate mechanisms and effectiveness better
Evaluation of adult and elderly performance in MoCA and verbal fluency test in Recife-PE
Authors: Plácido Talita Gabriele de Queiroz , Rocha Filho Pedro Augusto Sampaio , Silva Júnior Mário Luciano de Mélo
Published: December 2021

Background: Considering the increase in life expectancy, the use of screening tests contributes to the detection of cognitive decline. However, different socioeconomic conditions can influence the performance of individuals. Objectives: To compare the performance of participants in the Montreal Cognitive Assessment (MoCA) and the Verbal Fluency Test (VFT), assessing the influence of schooling on the score. Design and setting: Cross-sectional, descriptive study, with 21 participants without cognitive complaints, between January and April 2021, in Recife, Pernambuco. Methods: Data were analyzed through SPSS software, Shapiro-Wilk test and Pearson’s correlation coefficient (PCC). Results: In all, 21 MoCA tests were applied (Average score: 19.8 points; SD = ± 4.3). The population has a mean age of 56.2 years (SD = ± 10.2), education of 11.8 years (SD = ± 3.5), and a predominance of females (93.5%). In the VFT, the total average performance resulted in 11.5 words (SD = ± 5.1), the first interval, 6.1 (SD = ± 2.5), the second, 2.8 (SD = ± 1, 9) and the third, 2.1 (SD = ± 2.1). There was a correlation between the performance in MoCA and VFT (PCC = 0.717; P = 0.01), and between performance and years of schooling (MoCA: PCC = 0.688; P = 0.01 vs VFT: PCC = 0.489; P = 0.02). Conclusions: Both tools were correlated with the participant’s level of education. However, VFT obtained a lower correlation