bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction between Atlantic cyclones and Eurasian atmospheric blocking drives warm extremes in the high Arctic
Authors: Murto Sonja , Caballero Rodrigo , Svensson Gunilla , Papritz Lukas
Published: May 2021

Abstract. Atmospheric blocking can influence Arctic weather by diverting the mean westerly flow polewards, bringing warm, moist air to high latitudes. Recent studies have shown that diabatic heating processes in the ascending warm conveyor belt branch of extratropical cyclones are relevant to blocking dynamics. This leads to the question of the extent to which diabatic heating associated with midlatitude cyclones may influence high-latitude blocking and drive Arctic warm events. In this study we investigate the dynamics behind 50 extreme warm events of wintertime high Arctic temperature anomalies. Classifying the warm events based on blocking occurrence within three selected sectors, we find that 30 of these events are associated with a block over the Urals, featuring negative upper-level PV anomalies over central Siberia north of the Ural Mountains. Lagrangian back-trajectory calculations show that almost 60 % of the air parcels making up these negative PV anomalies experience lifting and diabatic heating (median 11 K) in the six days prior to the block. Further, almost 70 % of the heated trajectories undergo maximum heating in a compact region of the midlatitude North Atlantic, temporally taking place between six and one days before arriving in the blocking region. We also find anomalously high cyclone activity (on average five cyclones within this five-day heating window) within a sector northwest of the main heating domain. In addition, 10 of the 50 warm events are associated with blocking over Scandinavia; the contribution of diabatic heating to these blocks is again around 60 % for six-day back-trajectories, of which 60 % undergo maximum heating over the North Atlantic but generally closer to the time of arrival in the block and further upstream relative to heated trajectories associated with Ural blocking. This study highlights the role of diabatic heating in high-latitude blocking dynamics and the importance of the interaction between midlatitude cyclones and Eurasian blocking as driver for Arctic warm extremes.
Familial Hyperinsulinism due to HNF4A Deficiency and Benign Premature Adrenarche: A Case Report
Authors: Compton Edward , Geller David , Vidmar Alaina
Published: May 2021

Background: Familial Hyperinsulinism due to HNF4A deficiency (FHI-HNF4A) is a form of diazoxide-sensitive, diffuse hyperinsulinism, characterized by transient or persistent hyperinsulinemic hypoglycemia, and a propensity to develop Maturity-Onset Diabetes of the Young type 1 (MODY1). The association between FHI-HNF4A deficiency and benign premature adrenarche (BPA) is unknown.

The Case: We report the case of a 5-year-old girl with FHI-HNF4A, controlled on diazoxide, who presented with BPA and Tanner stage III pubic hair associated with body odor and acne. Work-up revealed elevated dehydroepiandrosterone sulfate (DHEAS), elevated free testosterone, and advanced bone age. Insulin levels were elevated in the setting of normal fasting blood glucose. We discuss the possible hormonal underpinnings of hyperandrogenism.

Conclusion: Though the underlying pathophysiology of this phenotype is unclear, a possible synergistic mechanism exists between insulin-induced hyperandrogenism and HNF4A deficiency leading to a transient decrease of SHBG and thus increased free testosterone levels. Further investigation is required to determine the association between HNF4A dysfunction and BPA.
DEVELOPMENT OF A METHOD FOR MECHANICAL PROCESSING OF RUBBER SHAFT FROM SOFT RUBBER FOR POLYGRAPHY EQUIPMENT
Authors: Anastasia Igorevna Khokhryakova , Rais Salikhovich Muzafarov , Sergey Alexandrovich Shilyaev
Published: May 2021

The article discusses the current problem of machining a rubberized shaft from soft rubber, in particular turning, for printing equipment. During the processing of rubberized shafts with soft rubber, galling, burning, tearing of pieces of rubber and cutting ability of the cutter occur, sharpened cutters are not enough for a full passage along the entire length of the shaft.
LEGAL STATUS OF EMPLOYEES OF BODIES AND INSTITUTIONS OF THE CRIMINAL ENFORCEMENT SYSTEM IN RESOLVING ISSUES AT THE STAGE OF EXECUTION OF THE JUDGMENT
Authors: Kuznetsova Natalia Evgenievna
Published: May 2021

The purpose of the study is devoted to topical problems of the status of employees of the penal system at the stage of execution of a court sentence. The paper identifies the problems of determining the status of employees of the penal system at the stage of execution of a court sentence, and also suggests some methods and mechanisms for solving these problems.
Ethical considerations of age-based allocation of intensive care treatments amid the COVID-19 outbreak
Authors: Zheng David
Published: May 2021

With the COVID-19 outbreak severely overwhelming healthcare systems worldwide, countries must decide on allocation criteria for scarce intensive care resources such as ventilators, leaving some without life-saving treatment. Groups such as the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) have suggested using age as allocation criteria, prioritizing the young over the elderly. In judging the morality of such criteria, different ethical frameworks must be applied. From a utilitarian perspective, age-based allocation ensures “the greatest good” – that those with greater “therapeutic success” or “quality-of-life” get access to intensive treatment. However, age poorly predicts prognostic outcomes, and quality-of-life measures are inherently value-laden. From a contractarian view, a morally justifiable action is one made in ignorance of one’s own stake in the outcome. In this lens, age-based allocation is justified since it maximizes the most life-years for the most people. However, it relies on the same flawed assumptions as utilitarianism. From a prioritarian view, age-based allocation ensures that the rights of the young to live out a “normal life span” are respected. However, such judgements ignore the positive experiences of later life and cannot be made on a patient’s behalf. Through a deontological lens, age-based allocation is discriminatory as it views elderly people as means to an end rather than individual agents. Ultimately, the rationing criteria a society uses reflects its values, with age limitations implicitly devaluating the elderly. Therefore, allocation guidelines should deemphasize age in favor of more predictive and less discriminatory measures like multimorbidity or frailty.
What Predicts the Mood of Athletes Involved in Preparations for Tokyo 2020/2021 Olympic Games During the Covid – 19 Pandemic? The Role of Sense of Coherence, Hope for Success and Coping Strategies
Authors: Szczypińska Marta , Samełko Aleksandra , Guszkowska Monika
Published: May 2021

The aim of the study was to identify coherence, hope for success and coping strategies as predictors of mood among this year’s Olympians in the context of coronavirus events. The relationships between the above variables and the mood of athletes were analysed. The study group consisted of 57 athletes – women (29) and men (28) between 18 and 39 years of age – representing various sports disciplines who were preparing for the Tokyo Olympics. The research was conducted in the period of April 7-28, 2020 during the first threat of COVID-19 pandemic, following the decision to move the Summer Olympics to the year 2021. It was time of the greatest national restrictions and information about the postponement of the games had been received. As a result of the step regression analysis, three predictors of vigour were established: sense of meaningfulness, coping with stress through positive reframing, and not using the self-blaming strategy. A positive predictor of anger was the use of substances. Confusion was predicted based on the frequency of behavioral disengagement. Behavioral disengagement predicted the severity of depression. Predictors of fatigue were the sense of meaningfulness, and the strategies of positive reframing and self-blaming. The results obtained emphasize the importance of positive reframing as a factor contributing to maintaining a positive mood state. In contrast, behavioral disengagement and self-blaming were strategies that lowered the mood of elite athletes. The results confirm the importance of factors included in the salutogenic model (sense of coherence, coping strategies) as predictors of athletes’ mood during a pandemic.
Perfil epidemiológico de pacientes HIV positivos coinfectados com o Toxoplasma gondii, Citomegalovírus e Trypanosoma cruzi
Authors: Cordeiro e Castro Mariane , Gomes Ferreira Liandra , Silva Paraguassu Maria Júlia , Gomes Rodrigues Sarah , Paulo dos Santos Odeony , José Borges Cristiane , Ramos de souza Marise
Published: May 2021

Este trabalho teve como objetivo determinar o perfil epidemiológico e características associadas de pacientes HIV positivos coinfectados com o Toxoplasma gondii, Citomegalovírus e Trypanosoma Cruzi, cadastrados e/ou acompanhados no Serviço de Assistência Especializada (SAE). Um estudo descritivo transversal, por meio de análise documental das anotações de consultas realizadas e documentadas em prontuário pela equipe multiprofissional de 323 prontuários cadastrados e/ou em acompanhamento, provenientes de dez municípios pertencentes a Regional de Saúde, com cadastro no SAE de um município do Sudoeste Goiano, com coleta de dados entre os meses de junho e novembro de 2016 no Serviço de Assistência Especializada. Do total de sorologias analisadas, observou-se prevalência de coinfecção de 70% (226) para Toxoplasma gondii, 87% (281) citomegalovírus e 1,9% (06) Trypanosoma Cruzi. As coinfecções estiveram relacionadas ao gênero, faixa etária e estado civil. Os resultados desta investigação poderão contribuir no planejamento e implementação de ações de saúde, orientando medidas preventivas para grupos vulneráveis à coinfecção.
Parceria ensino-serviço na formação em odontologia
Authors: Nunes Maria de Fatima , Oliveira Barbosa Sandra de Cássia
Published: May 2021

Resumo: A parceria ensino-serviço é fundamental na formação de futuros profissionais, assim como na educação permanente dos profissionais que já atuam nos serviços de saúde. O objetivo deste estudo foi sistematizar e compreender problemas diagnosticados nas unidades básicas de saúde da família (ESF), por estudantes da graduação em Odontologia da Universidade Federal de Goiás (FO/UFG). Foi utilizada a pesquisa documental para levantamento dos dados em projetos acadêmicos elaborados no período de 2006 a 2013, por alunos de graduação do sétimo período no Estágio em Odontologia Coletiva I. Os problemas relatados nos projetos acadêmicos aconteceram em 16 unidades de ESF do Município de Goiânia-Go e foram diagnosticados pelo método da estimativa rápida. Os 80 projetos elaborados pelos acadêmicos foram examinados e apresentou um total de 950 problemas diagnosticados. Os problemas elencados variaram de acordo com o território onde o estágio aconteceu. Após a coleta realizada pelos acadêmicos os problemas foram hierarquizados em função da viabilidade de intervenção. Os problemas priorizados foram aqueles que tiveram soluções a nível local. Após a coleta dos dados, foi realizada a categorização e emergiram sete categorias e 15 subcategorias. Dentre as categorias, as mais citadas foram ‘gestão’ e ‘problema social’ e, das subcategorias foram ‘gestão pública’, ‘gestão dos serviços de saúde’ e ‘organização dos processos de trabalho’. As categorias menos citadas foram ‘trabalho em equipe’ e ‘controle social’. Concluiu-se que as categorias se interligam umas às outras, demonstrando que os problemas de saúde muitas vezes têm diversas causas e necessitam de soluções compartilhadas. Vários destes problemas não têm solução a nível local, relacionam-se aos determinantes sociais de saúde e merecem atenção especial da gestão dos serviços. A categorização dos problemas demonstrou a amplitude das dificuldades vivenciadas pelas equipes de saúde da família, e a necessidade de inserção dos acadêmicos de odontologia precocemente nos serviços de saúde, para vivenciarem a realidade prática, na busca de uma formação que aproxime o futuro profissional de odontologia das reais necessidades da população.
 
Palavras chaves: Ensino na saúde. Ensino-serviço. Odontologia.
Percepção dos idosos sobre as ações de educação em saúde desenvolvidas na atenção básica
Authors: De Lima Pollyana , Sugai Mortoza Andrea , Silva Pereira Edna Regina
Published: May 2021

O Ministério da Saúde define como porta de entrada a Atenção Básica e como prioridade a realização de ações de educação em saúde para otimizar a saúde da pessoa idosa. Trata-se de uma pesquisa qualitativa exploratória realizada com idosos na Atenção Básica que objetivou verificar o conhecimento dos idosos sobre educação em saúde com ênfase nas facilidades e dificuldades na realização de ações educativas. A técnica de coleta de dados foi o grupo focal. Utilizou-se a Análise de Conteúdo Temática, como proposta por Bardin, para análise de dados. Participaram dos grupos focais 15 idosos. Dos grupos focais emergiram 4 categorias: Educação como comportamento versus educação como ferramenta; O aprendizado e as trocas de experiências dos idosos nas atividades educativas; Características pessoais que interferem na participação de ações de educação em saúde; descobrindo a educação em saúde como mecanismo para alcançar a qualidade de vida. A maioria dos idosos remetem conceito de educação em saúde ao ato do profissional de saúde ser cortês e educado e pouco como ferramenta para aquisição de conhecimento. Atribuem grande importância ao sentimento de acolhimento e pertencimento aos grupos de educação.  Apontam como facilitadores no processo de educação em saúde a proximidade das unidades de saúde com suas residências a disponibilidade e tempo. As dificuldades na realização e adesão às atividades educativas relatadas pelos idosos estão vinculadas às barreiras para locomoção, a falta de incentivo por parte de familiares e cuidadores e a não adaptação às atividades propostas
Neoliberalismo e Ciência Política: contribuições teóricas sobre a crise da democracia
Authors: Guimarães Juarez , Cruz Carlos Estevão Caligiorne
Published: May 2021

Este artigo propõe uma reflexão, sistematização e orientação de uma ampla literatura internacional sobre o neoliberalismo, com o objetivo de trabalhar seu conceito político e tornar seu uso mais rigoroso, delimitado e regulado na Ciência Política. Com esse objetivo, o artigo inscreve o conceito na tradição histórica do liberalismo, por meio de um tratamento de filosofia política. Adota uma abordagem histórica e contextual para estruturar uma narrativa do processo de expansão política do neoliberalismo, identifica a ascensão do neoliberalismo como princípio de legitimação dos Estados e, por fim, aponta sinteticamente a relação entre o predomínio do neoliberalismo e as mudanças legais e constitucionais no Estado liberal. Como conclusão, são apresentadas algumas contribuições teóricas que esse conceito político de neoliberalismo pode oferecer para a reflexão contemporânea sobre os impasses da democracia.
SPOR HİZMETLERİNİN ÇEŞİTLİLİĞİNİN BELİRLENMESİ VE SINIFLANDIRILMASI AMACIYLA ÇOK AMAÇLI REKREASYONEL SPOR MERKEZİ WEB SİTELERİNİN ANALİZİ
Authors: YİĞİT Oktay , DİNÇ Fatih
Published: May 2021

Amaç: Bu araştırmanın amacı ilk olarak, çok amaçlı rekreasyonel spor merkezlerinin sportif hizmet çeşitliliğini web sayfaları aracılığıyla belirlenmesi ve sınıflandırmasıdır. İkinci olarak rekreasyonel spor merkezlerinde en çok tercih edilen spor hizmetlerinin belirlenmesidir. Yöntem: Araştırma örneklemini evreni temsil ettiği varsayılan İstanbul ilinde bulunan 69 çok amaçlı rekreasyonel spor merkezlerinin web siteleri oluşturmuştur. Araştırma betimsel bir araştırma olup, yöntem olarak içerik analizi yöntemi kullanılmıştır. Çok amaçlı rekreasyonel spor merkezlerinin web sitelerinin içerik analizinden elde edilen veriler SPSS 24 programı kullanılarak istatistiki olarak anlamlandırılmıştır. Verilerin değerlendirilmesinde tanımlayıcı analiz yöntemleri kullanılmıştır. Bulgular: Araştırmada 212 adet sportif hizmet ve 28 adet destekleyici hizmetin rekreasyonel spor merkezlerinin web sitelerinde yer aldığı tespit edilmiştir. Bu hizmetler temelde ana hizmetler (sportif hizmetler) ve destekleyici hizmetler olarak sınıflandırılmıştır. Sportif hizmetler kendi içinde, fitness, yoga, pilates, cycling, WOD, Aerobic, savunma/ dövüş sporları, dans, ABS, bosu, sınıflama yapılmayan stüdyo dersleri, havuz alanı dersleri, tenis alanı dersleri, spor okulları, sportif tesis kullanım hizmetleri şeklinde sınıflandırılmıştır. Rekreasyonel spor merkezlerinin web sitelerinde en çok yer alan sportif hizmetlerin (% 15 ve daha fazla), fitness, body building, personal trainnig, cross fit, cardio, functional trainning, yoga, pilates, pilates reformer, spinning, kick box, box, zumba, curnch, yüzme, tenis, destekleyici hizmetlerin de sauna, buhar, hamam, masaj, SPA ve cafe olduğu tespit edilmiştir. Sonuç: Araştırma sonucunda çok amaçlı rekreasyonel spor merkezlerinde sportif hizmetlerin (n=212) ve destekleyici hizmetlerin (n=28) çeşitliliğinin oldukça artığı gözlemlenmiştir. Bu nedenle temelde sportif hizmetler ve destekleyici hizmetler şeklinde bir sınıflandırılma yapılmıştır. Sportif hizmetlerin kendi içerisinde 15 farklı sınıflamaya sahip olduğu gözlemlenmiştir. 20 tane spor hizmetinin ve 5 tane destekleyici hizmetin diğerlerine göre daha fazla çok amaçlı rekreasyonel spor merkezi web sitelerinde yer aldığı gözlemlenmiştir.
茶企营销渠道策略发展之研究—以八马茶业为例
Authors: 王 静 , 李 凯悦
Published: May 2021

在中华文化里，茶文化也有着举足轻重的地位。伴随着现代经济的快速发展。人们的生活方式有了很大的转变，人们开始注重产品的内涵与背后的文化。在饮食方面，人们也开始追求健康、高质量与文化性。人们消费行为的改变使得品茶行为更加频繁，茶叶需求量迅速增加。八马茶业股份有限公司的前身是百年前的“信记”茶行，其掌门人王文礼先生是中国非物质文化遗产代表性传承人，也是铁观音发现者王士让的第十三代传人，公司以连锁经营的模式在国内茶业市场占有一定地位。本文以八马茶业公司为例，探讨茶企的渠道策略，通过整理分析八马茶业公司的渠道结构和渠道策略存在的问题，给予一定的建议。
Armuoto betono bažnyčios:
Authors: Deveikienė Vaiva , Deveikis Steponas
Published: May 2021

Sakralinių pastatų statybai ir architektūrinei raiškai skiriamas didžiulis visuomenės ir architektų dėmesys, naudojamos kokybiškos medžiagos, taikomos naujos statybos technologijos. Architekto Antano Vivulskio (1877–1919) ryžtas statyti Lietuvoje, Vilniuje, bažnyčios pastatą iš armuoto betono (gelžbetonio) sietinas  su jo studijų metu Vakarų Europoje, ypač Prancūzijoje, prasidėjusia armuoto betono bažnyčių statyba. Straipsnyje analizuojama A. Vivulskio bažnyčios statybos projekto Vilniuje kontekstas, pateikiama XX a. pradžios armuoto betono bažnyčių statybos Prancūzijoje pavyzdžių.
Features of the Formation of Biological and Cellulosolytic Activity in Soils of Anthropogenous Transformed Ecosystems
Authors: Сыщиков Дмитрий Валерьевич , Агурова Ирина Владимировна , Сыщикова Оксана
Published: May 2021

It was found that among the studied monitoring sites in terms of biological activity, the microbial communities of primitive undeveloped soils on sandstone and ordinary chernozem were the least susceptible to the negative influence of environmental factors. The most significant increase in cellulosolytic activity is characteristic of primitive sedimentary undeveloped soils and chernozem usual medium-thick loamy, which indicates a more active activity of microorganisms, and hence a greater availability of elements of mineral nutrition for plants.
Žinių valdymo modelis sveikatos technologijų ir biotechnologijų atvirųjų inovacijų ekosistemoje
Authors: Urbanavičius Dainius , Kučinskienė Jurga , Galdikienė Nijolė , Brezgytė Eglė
Published: May 2021

Straipsnyje pristatomas žinių valdymo modelis sveikatos technologijų ir biotechnologijų atvirųjų inovacijų ekosistemoje. Apžvelgiamos teorinės žinių valdymo galimybės, pristatoma sveikatos technologijų ir biotechnologijų atvirųjų inovacijų ekosistema bei šios ekosistemos žinių valdymo modelis.
Da formalidade da docência acadêmica à docência experienciada na escola
Authors: Esteves Rosa Maria Maia Gouvêa , Lemgruber Márcio Silveira
Published: May 2021

Este artigo objetiva,  a partir das  pesquisas desenvolvidas por Nóvoa (1992) e Tardiff (2012),  e por outros pesquisadores que discutem a formação de professores, compreender que não é somente os saberes formais da academia que determinam o fazer do professor, mas que são essenciais outros saberes, como aqueles construídos ao longo de sua carreira, oriundos de suas práticas, à luz do que ocorre no cotidiano escolar,  assim como aspectos de vida pessoal, que trarão novas discussões e avanços nos aspectos teóricos e práticos inerentes à carreira docente. Para tanto é importante  que as pesquisas realizadas sobre o fazer dos professores considerem estes como sujeitos e não como meros objetos de investigação. Também propõe-se entender,  por meio da metodologia desenvolvida por Nóvoa, por que  alguns professores fazem uso da tecnologia da comunicação e da informação e outros não;  o que se dá nesse processo que leva alguns professores a   diferenciarem seus percursos pegagógicos de seus pares?
Análise microbiológica da água de coco comercializada por ambulantes na cidade de Volta Redonda - RJ
Authors: Duarte Rosângela , Mallet Aline Cristina Teixeira
Published: May 2021

A comercialização da água de coco por ambulantes cresce significativamente como forma de uma renda extra. Com a finalidade de impedir a contaminação do alimento a ser comercializado, estudos evidenciam que, para o manuseio do coco, o manipulador precisa estar capacitado em condutas de boas práticas sanitárias. Diante disso, o estudo teve como objetivo avaliar a qualidade microbiológica de água de coco comercializada por ambulantes do município de Volta Redonda, RJ. As análises foram realizadas durante os meses de julho e agosto de 2016. Realizaram-se em laboratório análises para coliformes totais e coliformes a 45 ºC, Salmonella spp. e pH. Para contagem de coliforme, utilizou-se a técnica do número mais provável (NMP). Amostras analisadas confirmaram presença de coliformes termotolerantes, estando em desacordo com as normas sanitárias determinadas pela legislação vigente, necessitando-se a adoção de medidas que previnam a contaminação do fruto.
A gestão ambiental de campi universitários sustentáveis
Authors: Trigo José Aires , Trigo Aline Guimarães Monteiro
Published: May 2021

A crise ambiental agravada pelo padrão de consumo desenfreado e por um modelo de produção intensivo em uso de recursos naturais suscita profundas transformações na forma de pensar e agir, trazendo enlevo ao conceito de Desenvolvimento Sustentável. De forma contundente, o tema passa a fazer parte das agendas de discussões em eventos de magnitude global. Omesmo ocorre no cenário acadêmico, no entanto, este fato não se aplica apenas à inclusão de disciplinas sobre a temática nos currículos, ou em linhas de pesquisa, mas, para além disso, o repensar das operações diárias dos campi, traduzindo-se na sua adaptação a parâmetros de sustentabilidade. Nesse sentido, o presente artigo visa discutir a relevância da inclusão da dimensão ambiental nas ações de gestão em campi universitários, buscando uma convergência com as principais recomendações governamentais e não-governamentais. Para tanto se optou pelo uso da pesquisa bibliográfica, de cunho qualitativo e de caráter exploratório.
The Importance of Interreligious Dialogues on Ethics and Law: A Global Percpective
Authors: Gabriel Ingeborg
Published: May 2021

The present article pleads for the revival of an interreligious dialogue on ethics and law as an instrument of peace and reconciliation. Whereas the first phase of IRD was marked by a considerable prominence of these topics, the have become of less importance in the second phase. This needs correction for two reasons. Theoretically the rationality of dogmatic or systematic insights (as found in all faith traditions) is largely exclusive, whereas the rationality of ethics, also religiously founded ethics, is basically inclusive. It is therefore open to dialogue. There exists considerable common ground on norms, rules and values between religious traditions, which are to serve humans, the society and the political community. This is of particular importance in today’s multi-religious societies as well as in a world more than ever interconnected by globalization. The article concludes with an analysis of the document on Human Fraternity of Pope Francis and Grand Imam Ahmad al-Tayyeb and its ethical approach to dialogue.
Advanced Breast Cancer in Nigeria: A Single Centre Experience
Authors: P.N. Wichendu , A. Dodiyi-Manuel
Published: May 2021

Background: Breast cancer is the most common cancer globally and in Nigeria, it constitutes about 12% of all new cancers and 25% of all cancers in women. In Nigeria, the majority of patients present with late disease and globally, advanced breast cancer is associated with a low survival rate among patients. This study seeks to review the presentation of advanced breast cancer as seen in the University of Port Harcourt Teaching Hospital, Southern Nigeria. Patients and Methods: This is a 5-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Records of patients that presented to the hospital within the study period with histologically proven breast cancer (stages 3 and 4) were retrieved, and relevant data extracted and analysed using SPSS version 22. Results: There were 47 patients with advanced breast cancer and they were all females. Their ages ranged from 25 to 72 years with a mean of 43.9 ± 4.7 and peak age of 31–50 years. Majority of the patients (72.3%) had stage 3 disease while 13 (27.7%) of them had stage 4. The lung was the commonest metastatic site and this was seen in 7 (14.9%) patients, followed by the liver in 1 (2.1%). Conclusion: Advanced breast cancer remains a dreaded disease that reduces patients’ quality of life significantly and may also be rapidly fatal. Community-based efforts in collaboration with Non-Governmental Organizations (NGOs) targeted at information dissemination to the public, and offering breast cancer screening and subsidized cancer treatment are essential to reduce the mortality associated with this deadly disease.
Numerical Investigations on Rotatry Micropolar Fluid in Hydromagnetics Permeated with Suspended Particles Saturating Porous Medium
Authors: Sharma Pushap Lata , Gupta Sumit
Published: May 2021

This paper deals with the convection of micropolar fluids heated and soluted from below in the presence of suspended particles (fine dust) and uniform vertical rotation and uniform vertical magnetic field in a porous medium. Using the Boussinesq approximation, the linearized stability theory and normal mode analysis, the exact solutions are obtained for the case of two free boundaries. It is found that the presence of the suspended particles number density, the rotation parameter, stable solute, magnetic field intensity and medium permeability bring oscillatory modes which were non–existent in their absence. It is found that the presence of coupling between thermal and micropolar effects, rotation parameter, solute parameter and suspended particles may introduce overstability in the system. Graphs have been plotted by giving numerical values to the parameters accounting for rotation parameter , magnetic field solute parameter, the dynamic microrotation viscosity and coefficient of angular viscosity to depict the stability characteristics, for both the cases of stationary convection and overstability. It is found that Rayleigh number for the case of overstability and stationary convection increases with increase in rotation parameter, as well as with magnetic field intensity, solute parameter and decreases with increase in micropolar coefficients and medium permeability, for a fixed wave number, implying thereby the stabilizing effect of rotation parameter, magnetic field intensity ,solute parameter and destabilizing effect of micropolar coefficients and medium permeability on the thermosolutal convection of micropolar fluids.
Analytical Method Development and Validation for the Simultaneous Estimation of Metformin Hydrochloride and Alogliptin by RP-HPLC in Bulk and Tablet Dosage Forms
Authors: Rana Kapil , Sharma Pushpendra
Published: May 2021

Objective: The day by day new combinations drugs are being introduced in market. Then the multiple therapeutic agents which acts at different sites are used in the management of various diseases and disorders are done. Thus it is necessary to develop methods for analysis with the help of number of analytical techniques which are available for the estimation of the drugs in combinations. An accurate, precise and reproducible RP-HPLC method was developed for the simultaneous quantitative determination of Metformin Hydrochloride (MET) and Alogliptin (ALO) in tablet dosage forms. Methods: Younglin (S. K.) gradient system UV detector and C18 column with 250 mm x 4.6 mm i. d. and 5μm particle size Acetonitrile: OPA water (80: 20v/v) pH 2.5 was used as the mobile phase for the method. The detection wavelength was 283 nm and flow rate was 0.9ml/min. Results: In the developed method, the retention time of MET and ALO were found to be 6.366 min and 8.616 min. The developed method was validated according to the ICH guidelines. Conclusion: In this methods linearity, precision, range, robustness were observed. The method was found to be simple, accurate, precise, economic and reproducible. So the proposed methods can be used for the routine quality control analysis of MET and ALO in bulk drug as well as in formulations.
APAKAH PELAPORAN BERKELANJUTAN MEMODERASI RELEVANSI NILAI INFORMASI AKUNTANSI?
Authors: Kuswanto Randy
Published: May 2021

This study aims to obtain empirical evidence about the effect of sustainability reporting as a moderating variable on value relevance concept. Prior studies suggest that sustainability report can enhance the company’s financial performance which has similar context with value relevance. This study modifies Ohlson Model (1995) with additional moderating variable to capture the effect of sustainability reporting in Indonesia. The population in this study is all public listed company in Indonesia Stock Exchange in 2016. Pair matching and purposive sampling is used as a sampling method to collect 76 samples. The results of this study show sustainability reporting failed to indicate its moderating effect both on the interaction with earning and book value. Nevertheless, value relevance of group who published the sustainability report is higher than the opposite group. As a final result, this study provides empirical evidence that sustainability report cannot increase the firm value in value relevance model but could increase the level of value relevance itself.
Study of Inter-arm Variation of Blood Pressure in Normal and Diabetic In-dividual in Out Patient Department of Nepal Medical College
Authors: Poudyel Pragati , Adhikari Seerina
Published: May 2021

Introduction: Growing incidence of hypertension and its significant association with diabetes mellitus are being observed in both developing and developed countries around globe. Scanty literature is available about the comparative study of inter-arm variation of blood pressure in normal individuals and diabetic among Nepalese population. This research was performed to determine extent of inter-arm variation in normal individuals and diabetics.

Methods: A descriptive observational study was carried out from 2013 January to 2014 January in a tertiary level teaching hospital of Nepal. After taking the consent and giving necessary instructions, blood pressures were measured in both the arms one after another in sitting posture using mercurial sphygmomanometer and Littman cardiosonic stethoscope. Arterial blood pressure was measured by palpatory method followed by auscultatory method The cuff pressure at which the tap sound were first perceived was noted as systolic blood pressure (SBP). Similarly, diastolic blood pressure (DBP) was noted at the point where the sound disappeared.

Results: A total of 120 volunteers between ages of 40-80 years were studied. Highly significant inter-arm variation of both SBP and DBP was found in diabetics as compared to normal (p<0.01). Highly significant inter-arm variation was found in diabetic male and female as compared to their normal counter parts (p<0.01).

Conclusion: This study showed that there was significant inter-arm variation of SBP and DBP in diabetic and normal individual. So, this study encourages to measure blood pressure (BP) in both arms for proper treatment planning of an individuals.
A Notorious Mimicker Nasal Melanoma: A Case Report
Authors: Bastakoti Shankar , Kumar Gautam Dej , Raj Upreti Suraj , Jha Nandita , Dhungana Ishan
Published: May 2021

Melanomas arising in the nasal cavity or paranasal sinus are rare and have a poor prognosis and is more aggressive than cutaneous counter part. The incidence rate reaches its peak when the patients are in the 5th to 8th decades of life, and the disease is slightly more common in males than females; age and sex do not affect the prognosis. We present a case with histologically deceiving features which was proven Malignant Melanoma by application of Immunohistochemistry. On sinoscopic examination, a mass noted of which incisional biopsy was obtained. Histologically, poorly differentiated Sinonasal carcinoma and Malignant Vascular Neoplasm was differential diagnosis.

On immunohistochemistry, strong expression of SOX-10, Melan-A, HMB-45 was observed and p63, CK-7, CK20, Synaptophysin, CD56, CD138, CD45, S100, Desmin, Myogenin were all non-immunoreactive. Thus Malignant Melanoma was final diagnosis.Awareness of melanoma mimickers is very important for clinicians in general, and
A Case Report of Angioplasty and Stenting Experience for Peripheral Arte-rial Disease of the Lower Limbs at Annapurna Neurological Institute
Authors: Raj Pandey Sandeep , Jha Anik , Acharya Sudikchya , Dhakal Sudan
Published: May 2021

Atherosclerosis leading to stenosis or blockage in the major vessels of lower extremities causes peripheral arterial disease(PAD). PAD may be asymptomatic in early stage. But in late stage PAD present in the form of intermittent claudication (IC) or critical limb ischaemia (CLI) . The Fontaine classification is commonly used to measure the severity of disease which is staged from l-asymtomatic to lV-gangrene. PAD can be treated by medical , endovascular and surgical management

The purpose of this case report is to consider the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities.
Kathmandu Declaration on Cysticercosis : Towards Eradication
Authors: Pant Basant , Onta Sharad , Nath Pyakurel Sushil , Man Karmacharya Biraj , Kumar Nirmal Bimal , Flisser Ana , Lightowlers Marshall
Published: May 2021

In December 2018, an international conference on cysticercosis was held in Kathmandu,Nepal with the theme, “Towards Eradication”. With the collaboration and participation of human-health and animal-health related organizations, the culmination of this event was the Kathmandu Declaration on cysticercosisrealizing an urgency to take action for its prevention and management.Of the 10 points mentioned in the declaration, all of the keynote speakers and participants on the conference endorsed the activities on commitment for eliminating cysticercosis, urgedthe government to internalize its primary responsibility and role in controlling cysticercosis, and called for the stakeholders for multisectoral collaboration. The authors believe that this declaration and further action definitely strive towards meeting the theme of the conference to eradicate cysticercosis with
An Autopsy Study of Atherosclerotic Changes in Coronary Arteries at B.P. Koirala Institute of Health Sciences
Authors: Raman Parajuli Sudhir , Yadav Bishwonath , Karki Prahlad , Upadhyaya Paricha , Jha Shivendra
Published: May 2021

Introduction: Atherosclerosis is a giant killer and the incidence of atherosclerosis in coronary arteries is rapidly increasing. The study was designed to assess the atherosclerotic lesions in coronary artery and to correlate the risk factors related to prevalence of atherosclerosis.

Methods: Heart from 100 medico legal autopsy cases ranging between ages 15 to 35 years which came to BPKIHS Dharan were taken for this study and processed for coronary arteries using conventional technique. They were then studied,and grading was done based on Modified American Heart Association (AHA) classification of atherosclerosis.

Results: Intimal thickening was noted in more than 90% in all three coronary arteries followed by intimal xanthoma whereas intermediate lesion for atherosclerosis was not found. Age, gender, smoking and alcohol in relation to atherosclerosis were found to be of no significance.

Conclusion: The study highlights the impact of atherosclerotic lesions in the Eastern region of Nepal. Meticulous postmortem examination along with histopathological study is the best possible way to study atherosclerotic disease in humans and risk factors associated with it.
A Imagem Construída. O culto do monumento histórico e da ruína nas fotografias de Carlos Relvas
Authors:   Universidade Nova de Lisboa, Vilaça Margot
Published: May 2021

O principal intuito deste ensaio obriga a que nos coloquemos na posição da objetiva de Carlos Relvas - extensão natural do seu braço e, acima de tudo, do seu olhar -, de modo a que consigamos interpretar os critérios que informam a realização das suas fotografias. Estaremos perante um conjunto fotográfico puramente documental, mera experimentação de uma arte acabada de surgir? Não será possível afirmar que existe uma manipulação deliberada da imagem final, que revela um posicionamento específico face aos monumentos fotografados?
O Pierrot-Artista na Viragem do Século: Autorretrato com o Laço Negro de Aurélia de Sousa (1866-1922)
Authors:   Universidade Nova de Lisboa, Komissarova Elena
Published: May 2021

O presente artigo destaca a importância de uma obra da pintora portuguesa Aurélia de Sousa (1866-1922) - o Autorretrato com o Laço Negro (c.1895) - para todo o percurso autorretratístico da sua autora. Um dos oito autorretratos conhecidos até agora da artista, nele Aurelia escolheu para a sua autorrepresentação um personagem arquetípico, o do Pierrot-Artista. A obra representa um momento crucial para a mulher-artista na viragem de século XIX para o século XX: a afirmação da sua vocação.
A Exposição Internacional do Centenário da Independência do Brasil de 1922 no processo de modernização da cidade do Rio de Janeiro
Authors:   Universidade Federal Fluminense, de Azevedo Ribeiro Fernanda
Published: May 2021

Tratamos da inserção da Exposição do Centenário da Independência de 1922 no processo de modernização da cidade do Rio de Janeiro, entre 1822 e 1930. Buscamos esclarecer os antecedentes e razões que concorreram para a sua realização e o seu papel no processo de modernização, que ocorria através de transformações do espaço urbano, com modificações significativas na estrutura e no ambiente construído. Analisamos, ainda, a produção do espaço, destacando a atuação de Carlos Sampaio na preparação da cidade.
As origens da nação na pintura de história: de Victor Meirelles a Belmiro de Almeida e além
Authors:   Universidade Federal do Rio de Janeiro, Frazão Conduru Guilherme
Published: May 2021

Neste texto, pretende-se explorar possíveis conexões - e desconexões - entre a Primeira Missa no Brasil de Victor Meirelles e Os Descobridores de Belmiro de Almeida. Embora produzidas em contextos históricos e políticos muito distintos, ambas as pinturas enunciam narrativas sobre as origens da nacionalidade, bem como propõem pontos de vistas para se pensar a nação brasileira e o significado da identidade nacional.
Iconografia política: o céu e as calças de Nicolas-Antoine Taunay
Authors:   Universidade Federal do Espírito Santo, Dantas Bárbara
Published: May 2021

Segundo um método de análise que envolve a ideia de iconografia política, a partir de Carlo Ginzburg, e o conceito de "representação," a partir de Georges Didi-Huberman, este trabalho busca inserir Nicolas-Antoine Taunay em seu contexto histórico por meio da análise de seu retrato feito por um colega de profissão e de uma paisagem brasileira, pintada pelo próprio Taunay, na qual ele se representou. A intenção é encontrar, nestas obras, como o artista encarou a si e o meio que o rodeava, no trânsito que fez entre Paris e o Rio de Janeiro.
Using ClassDojo to motivate kids participation in the efl online classes during the Covid-19 pandemic: a case study
Authors: Santos Jardel Coutinho dos , Vélez Ruiz Mayra Carolina
Published: May 2021

Introdução: A pandemia da COVID-19 mudou a forma como as aulas eram ministradas em todo o mundo. Os professores equatorianos foram obrigados a implementar aulas de forma síncrona e assíncrona. Consequentemente, todo o conteúdo foi adaptado para este novo tipo de aula. Por outro lado, os alunos, apresentam cansaço durante as aulas, desmotivação para aprender e infelicidade com a nova modalidade. Estudos têm demonstrado as vantagens do Computer Assisted Language Learning (CALL) para motivar os alunos. Método: Este estudo de caso teve como objetivo investigar a eficiência do ClassDojo para motivar a participação de alunos equatorianos durante as aulas online de inglês. Uma amostra de 29 alunos do sexto ano de uma escola particular, com idades entre 9 e 11 anos, participou desta pesquisa. Os dados foram coletados durante quatro meses de aulas (agosto a novembro de 2020) por meio de provas (pré e pós), entrevista e diário do professor. Resultados: Após a implementação do aplicativo, os participantes apresentaram diferença significativa entre o pré-teste (M = 2,03, DP = 1,26) e o pós-teste (M = 7,28, DP = 1,69) com p = 0,00 e d de Cohen = 3,52. Os resultados recolhidos do pré e pós-teste revelaram que o ClassDojo motivou a participação dos alunos nas aulas. Os resultados da entrevista mostraram as opiniões positivas dos alunos sobre o uso do ClassDojo. Conclusões: Este aplicativo permitiu aos participantes aprender, interagir e se divertir ao mesmo tempo. Esta pesquisa é dirigida a professores que têm aulas online e desejam aumentar a participação dos alunos.
Concatenations: On the Works of Olga Tokarczuk
Authors: Czapliński Przemysław , Woźniak Bartosz
Published: May 2021

This paper is a micro-synthesis of Olga Tokarczuk’s prose works. The initial assumption is that the main driving force in the author’s prose narratives is desire which determines the actions of her protagonists and influences the genre of said works. This assumption allows for discovery of discrete stages in Tokarczuk’s prose fiction. In the first stage from Podróż ludzi Księgi [The journey of the people of the book, 1993] to Prawiek i inne czasy [Primeval and other times, 1996], the strongest driving force is the desire for knowledge. In the second period from Dom dzienny, dom nocny [House of day, house of night,1998] to Bieguni [Flights, 2007] the desire is to focus on the Other, taking the form of solidarity. Finally, in the third period from the novel Prowadź twój pług przez kości umarłych [Drive your plow over the bones of the dead, 2009] to Księgi Jakubowe [The books of Jacob, 2014], the desire is directed against unjust laws, presupposing a recognition of the world order, and defining obligations towards other lives.
Time of Microhistory and Time of Micro-theater in Olga Tokarczuk’s Novels
Authors: Świerkosz Monika , Kowalcze-Pawlik Anna
Published: May 2021

This article details two ways of conceptualizing the experience of the past by the characters in Olga Tokarczuk’s prose fiction, which assume the form of a personal micronarration and the form of a microtheater. Utilizing Frank Ankersmit’s categorization of symbolic (metaphorical) signs and indexical (metonymic) signs, the article draws attention to the coexistence of different orders of speaking and staging (theatricalizing) history in the works under discussion. What is emphasized is the fundamental but ambivalent role of the body that as the vehicle of memory and an object of various processes of appropriation and reification. Such an ambiguous status of the body is underlined by the usage of the motifs often present in Olga Tokarczuk’s writing: those of the doll/puppet and of miniaturization. These speak to the desire to go beyond the anthropocentric vision of the human and the world, life and death, agency, and passivity.
Madwoman at Large: Prophetic Anger and Just Revenge in Olga Tokarczuk’s Drive Your Plow over the Bones of the Dead
Authors: Kowalcze-Pawlik Anna
Published: May 2021

This article explores the use of anger as a modus operandi of the protagonist in Olga Tokarczuk’s Prowadź twój pług przez kości umarłych [Drive your plow over the bones of the dead, 2009] and discusses the significance of intertextual indebtedness of the novel to William Blake’s poetry and the Romantic approach to anger for the construction of the plot and the main character. In order to achieve these ends, it elaborates on the generic provenance of Tokaruczk’s novel and provides a brief overview of Western approaches to anger. Attention to gendered aspects of noir fiction and the construction of anger in the Western tradition brings to light cultural presuppositions which affect the assessment of the vengeful impulse of the protagonist and which have possibly influenced the reception of the novel in Poland and abroad.
Vascular Plants of Maryland, USA: A Comprehensive Account of the State's Botanical Diversity
Authors: Knapp Wesley , F. C. Naczi Robert
Published: May 2021

This checklist provides the first complete,
vouchered account of Maryland’s vascular flora. In total, we discuss 3,525 taxa
and document 2,918 established taxa for the state of Maryland, 71.8% of which
are native and 28.2% of which are introduced. Of the native species, 737 (25.3%)
are tracked by the Maryland Natural Heritage Program
as of conservation concern. We exclude 324 taxa reported from Maryland by
previous authors and provide justifications for these exclusions. Knapp, Wesley M., and Robert F. C. Naczi. Vascular
Plants of Maryland, USA: A Comprehensive Account of the State’s Botanical
Diversity. Smithsonian Contributions to
Botany, number 113, viii + 151 pages, 1 figure, 17 May 2021.
Vascular Plants of Maryland, USA:
Authors: Knapp Wesley M. , Naczi Robert F. C.
Published: May 2021

This checklist provides the first complete, vouchered account of Maryland’s vascular flora. In total, we discuss 3,525 taxa and document 2,918 established taxa for the state of Maryland, 71.8% of which are native and 28.2% of which are introduced. Of the native species, 737 (25.3%) are tracked by the Maryland Natural Heritage Program as of conservation concern. We exclude 324 taxa reported from Maryland by previous authors and provide justifications for these exclusions.