bluuebunny/crossref_metadata_2025 huggingface dataset:
OUTPATIENT PULMONOLOGY: LUNG ULTRASOUND EXAMINATION
Authors: Boiko D. M.
Published: July 2021

Epidemiological situation associated with coronavirus disease (COVID-19) widespread in the world, changes the approaches to healthcare provision. The field of respiratory medicine, especially in an outpatient setting, also adapts in terms of organization and technology. The optimization of diagnostics during the initial or follow-up examination of patients by means of focused lung ultrasound (FLUS), will help to expand the pulmonologist�s diagnostic and therapeutic capabilities at current conditions. The aim of the study was to evaluate diagnostic features of FLUS in combination with classical methods such as chest percussion and auscultation in an outpatient setting in patients with COVID-19 at the convalescence stage, based on the results of retrospective data analysis. Materials and methods. The analysis included data from 14 patients (8 men and 6 women, mean age (49,6 � 12,8) years) with typical set of clinical, laboratory and instrumental manifestations of COVID-19, who were examined by a pulmonologist at the convalescence stage after cessation of the self-isolation period. FLUS was performed routinely in suspected or clinically evident signs of pulmonary opacity. Results. In 10 (71.4 %) patients characteristic auscultatory signs associated with pulmonary consolidation were found. In majority of cases (12 � 85.7%) focal and/or diffuse inerstitial syndrome (IS) was revealed by FLUS, accompanied by typical auscultatory pattern (bronchial or weakened vesicular breathing sound, bronchophonia, crepitations) and/or percussion abnormalities (dullness over the lung). The results of retrospective analysis of FLUS data in COVID-19 patients suggested a persistent focal and/or diffuse IS up to 63 days of illness in avarage. The obtained data analysis revealed statistically significant (p = 0.03), weak, negative (Tau = - 0.41) relationship between the disease duration and auscultatory and percussion data, in the presence of ultrasound signs of lung opacity. Conclusions. Auscultation and percussion are valuable diagnostic markers, but their value for detection of pulmonary consolidation decreases after 30 days of COVID-19. FLUS qualitatively complements the diagnostic effectiveness at outpatient pulmonologist� examination when it is necessary to evaluate IS presence in lung parenchyma. The number of subjects and the heterogeneity of the group impose certain limitations on interpreting of the results. Further extensive research is needed to implement this method into routine clinical practice. Key words: COVID-19, focused lung ultrasound.
IFLAMMATION, HYPOXIA, AND ANEMIA IN PATHOGENESIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: LITERATURE REVIEW AND OWN RESEARCH
Authors: Radchenko O. M. , Fedyk O. V.
Published: July 2021

The aim was to highlight the leading links of pathogenesis of chronic obstructive pulmonary disease (COPD) using published data and the results of own research. Material and methods. The publications of the last 5 years have been picked up for review from Pubmed library. Own research has been based on retrospective analysis of medical records from 470 patients with COPD (246 men and 224 women, median age 62 years). Results. According to literature data chronic persistent inflammation, manifesting by activation of multiple cells with excessive production of number of biologically active substances, is a leading link of COPD pathogenesis. Second important link of COPD pathogenesis is energydependent hypoxia with signalling pathway change and super expression of hypoxia-inducible factor. An important role plays chronic disease anaemia, occurring due to effect of pro-inflammatory cytokines and hypoxia-inducible factor which, in turn, preserves inflammation and hypoxia. According to own data a decrease of blood oxygenation and decline in lung function also testify to existing relationship between inflammation and hypoxia. Active inflammation correlated with decreased bronchial patency. Anaemic syndrome in COPD patients was associated with higher levels of neutrophils, ESR, C-reactive protein, total fibrinogen, seromucoids and integral haematological indices, as well as low blood oxygenation and decrease of velocity parameters of lung function. Conclusion. Inflammation, hypoxia and anaemia are three connected links of pathogenesis of COPD, which create vicious circle and possibly determine disease progression. Key words: chronic obstructive pulmonary disease, pathogenesis, inflammation, hypoxia, hypoxia-inducible factor, anaemia.
Comparison of Stochastic Forecasting Models
Authors: Shah Shalin
Published: July 2021

In this work, we compare several stochastic forecasting techniques like Stochastic Differential Equations (SDE), ARIMA, the Bayesian filter, Geometric Brownian motion (GBM), and the Kalman filter. We use historical daily stock prices of Microsoft (MSFT), Target (TGT) and Tesla (TSLA) and apply all algorithms to try to predict 54 days ahead. We find that there are instances in which all algorithms do well, or do poorly. We find that all three stocks have a strong auto-correlation and a high Hurst factor which shows that it is possible to predict future prices based on a short history of past prices. In the geometric Brownian motion model, there are two parameters for drift and diffusion which are not time dependent. In our more general SDE model (TDNGBM), we have time-dependent drift and time-dependent diffusion terms which makes it more effective than GBM. We measure all algorithms on the correlation between the predicted and actual values, and the mean absolute error (MAE) and we also report confidence intervals generated by the methods.Confidence intervals are more important than point forecasts, and we seethat TDNGBM and ARIMA produce good bounds.
Dolezal, L., Rose, A., and Cooper, F. COVID-19, Online Shaming and Healthcare Professionals.
Authors: Dolezal Luna , Rose Arthur , Cooper Fred
Published: July 2021

As previous pandemics have taught us, coming into contact with, or being associated with, a highly infectious and potentially deadly disease has social consequences. Hence, it is no surprise that stigma and shame have developed around COVID-19. Although there have been outpourings of support and admiration for health-care workers for their work in this pandemic, health professionals have been among those directly affected. This article considers how shame has been part of healthcare workers’ experience during the COVID-19 pandemic because of social media use and instances of online shaming.
HUKUM PERDAGANGAN
Authors: kardilla
Published: July 2021

Tujuan yang ingin dicapai dalam jurnal ini untuk menganalisis perdagangan berdasarkan Nilai moral Islam, dimana di pasar terdapat dua pelaku penjual sertayang membeli. Sumber yang paling utama dari jurnal ini yaitu studi literatur.Penulis Mengambil kesimpulan Ada banyak perihal dalam perdagangan yang tidak pas dengan syariat Islam. Oleh karena itu, perlu ada perbaikan sistem sertakerjasama antara seluruh elemen bisnis, masyarakat serta pemerintah. Dalam menentukan nilai dalam Islam (menentukan) harga tidak di bolehkan, sebabpenetapan harga dilakukan kepada kekuatan pasar, ialah permintaan daya sertapasokan daya. ini di sesuai dengan krateristik perdagangan Islam dimana pelaku pasar harus mempromosikan kesalehan, keadilan serta kebaikan, menjaga tanda?tanda Islam, menerapkan manajemen yang baik.
Protective Immunity against COVID-19
Authors: Priyadarshini Anjali , Gupta Archana , Yadav Manoj Kumar , Vibhuti Arpana , Pandey Ramendra Pati , Raj V. Samuel
Published: July 2021

Tuberculosis and Covid-19 infection measure two quite different diseases- TB is caused by a sort of bacterium whereas Covid-19 is caused by a virus. However, the BCG immunizing agent would possibly facilitate individuals build immune responses to things aside from TB, inflicting "off-target effects," In different words, in run format, individuals started learning positive in obtaining the immunizing agent that had nothing to try and do with TB, several studies showed however the BCG immunizing agent affects individuals with kind one although the precise mechanism for these off-target effects of the BCG immunizing agent is not clear, it's believed that the immunizing agent will cause a nonspecific boost of the reaction. There is presently no immunizing agent or treatments approved by the United States of America Food and Drug Administration for the novel coronavirus. BCG is usually innocuous with the most facet impact the event of inflammation at the positioning of injection. Supported by these observations BCG so emerges as a possible candidate for the development of innate and adjustive reactions which can be non-specifically taking care of mycobacterium and different infectious agents against that vaccine remains not on the market.
Investigating how neonicotinoids effect Abundance, Behaviour, Condition, Reproductive success and Survival for non-target terrestrial arthropods.
Authors: Robson William , stewart gavin
Published: July 2021

This meta-analysis aims to update and improve upon a previous attempt at understanding the effects neonicotinoids have on non-target terrestrial arthropods. While the original authors carried out sufficient analysis on the data they collected, there are new methodologies that can improve the accuracy of the final effect sizes produced. This new meta-analysis will use a multi-level approach, meaning that it will not consider data to be independent from the studies they were collected from. Instead the data and subsequent effect sizes will be nested within the studies, allowing for a truer effect size to be synthesised.
Konsep kepemilikan dalam islam
Authors: solihin Della citra
Published: July 2021

AbstractAbstract: This article discusses the concept of ownership that exists in Islam. In the concept of Islamic ownership, humans are expected to be able to manage large and extensive natural resources in a more organized manner. Islam teaches the concept of restrictions on property ownership, but does not eliminate individual ownership rights over an object. The concept of Islam in public and state ownership provides comfort and welfare for all levels of society because with good state management natural resources can be distributed to every individual in a guaranteed and appropriate manner. The implications of the concept of ownership in Islam will be able to realize justice, a principle in Islam that is not only justice for individuals but also for all people as a whole.Keywords: Concept, Ownership, Justice in IslamAbstrak: Artikel ini membahas tentang konsep kepemilikan yang ada dalam Islam. Dalam konsep kepemilikan Islam, manusia diharapkan dapat mengelolaan sumber daya alam yang besar dan luas menjadi lebih teratur. Islam mengajarkan konsep pembatasan dalam kepemilikan harta benda, tetapi tidak menghilangkan hak kepemilikan individu atas suatu benda. Konsep Islam dalam kepemilikan publik dan negara memberikan kenyamanan dan kesejahteraan bagi seluruh lapisan masyarakat karena dengan pengelolaan negara yang baik sumber daya alam dapat didistribusikan kepada setiap individu secara terjamin dan tepat. Implikasi dari konsep kepemilikan dalam Islam akan mampu mewujudkan keadilan, suatu prinsip dalam Islam tidak hanya keadilan bagi individu tetapi juga secara keseluruhan bagi semua orang.
Perancangan dan Pembuatan WEB dengan Blogspot
Authors: Hidayat Alfie
Published: July 2021

Seiring dengan berjalannya perkembangan zaman, ilmu pengetahuan dan teknologi informasi serta komunikasi semakin canggih. Kita tidak akan mengalami kesulitan lagi untuk mendapatkan pengetahuan dan informasi, karena sekarang segala sesuatu sudah dapat dicari melalui media internet, yang sebelumnya media berita diberitakan dalam media koran, radio, dan lainnya,sekarang berita dapat lebih mudah kita dapatkan melalui handphone atau telpon genggam yang bias kita gunakan dalam sehari-hari sekarang karena zaman makin berkembang dan teknologi makin canggih kita bisa lebih mudah mendapatkan berita terbaru dengan mencarinya di google.Melihat salah satu website terkenal dari google yaitu Blog atau Weblog.
ANALISIS KINERJA KEUANGAN PT. BANK NEGARA INDONESIA (Persero) Tbk. Tahun 2019-2020
Authors: Suryawan Hilman
Published: July 2021

Dalam dunia perbankan, keuangan sangat berpengaruh terhadap kelangsungan kegiatan suatu perbankan serta setiap individu dalam perbankan itu. Dalam suatu perusahaan juga diperlukan suatu analisis laporan keuangan untuk mengetahui kemampuan perusahaan dalam mengatasi masalah keuangan perusahaan serta pengambilan keputusan yang cepat dan tepat. Rumusan masalah dalam penelitian ini adalah bagaimana kinerja keuangan pada PT. Bank Negara Indonesia (Persero) Tbk. tahun 2019-2020. Tujuan penelitian adalah untuk mengetahui kinerja keuangan pada PT. Bank Negara Indonesia (Persero) Tbk. tahun 2019-2020. Teknik analisis data yang digunakan dalam penelitian ini dengan menggunakan rasio keuangan bank. Berdasarkan hasil penelitian rasio keuangan korporasi bank masih mengalami fluktuasi. Penilaian Likuiditas PT. Bank Negara Indonesia (Persero) Tbk. Masih mampu membayar kewajiban keuangannya. Penilaian Solvabilitas Bank memiliki permodalan yang memadai. Penilaian terhadap profitabilitas perusahaan masih mengalami peningkatan laba.Kata Kunci : Laporan Kinerja Keuangan, Rasio Keuangan
Mindsponge mechanism
Authors: Nguyen Minh-Hoang , Vuong Quan-Hoang , Ho Manh-Toan , Le Tam-Tri
Published: July 2021

The mindsponge mechanism (mindsponge framework, mindsponge concept, or mindsponge process) provides a way to explain how and why an individual observes and ejects cultural values conditional on the external setting. The term “mindsponge” derives from the metaphor that the mind is analogized to a sponge that squeezes out unsuitable values and absorbs new ones compatible with its core value. Thanks to the complexity and well-structuring, the mechanism has been used to develop various concepts in multiple disciplines. One such concept is "cultural additivity"
An open-source package with interactive Jupyter Notebooks to enhance the accessibility of reservoir operations simulation and optimisation
Authors: Peñuela Andres , Hutton Christopher , Pianosi Francesca
Published: July 2021

In this paper we present the interactive Reservoir Operations Notebooks and Software (iRONS) toolbox for reservoir modelling and optimisation. The toolbox is meant to serve the research and professional community in hydrology and water resource management and contribute to bridge the gaps between them. iRONS is composed of a package of Python core functions and a set of interactive Jupyter Notebooks. Core functions implement typical reservoir modelling tasks and the interactive Jupyter Notebooks illustrate, with practical examples, the key functionalities of iRONS. We describe our development philosophy, the key features of iRONS, and report some results of evaluating the effectiveness of interactive Jupyter Notebooks for training and knowledge transfer. The paper may be of interest also beyond the water resources management field, as an example of how Jupyter Notebooks and interactive visualisation help improving the documentation and sharing of open-source code and the communication of underpinning methodologies.
MmWave V2X Cooperative Diversity Relay Channel with Feedback Delay and Link Blockage
Authors: Balti Elyes
Published: July 2021

In this work, we present a framework analysis of a millimeter wave (mmWave) vehicular communications systems. Communications between vehicles take place through a cooperative relay which acts as an intermediary base station (BS). The relay is equipped with multiple transmit and receive antennas and it employs decode-and-forward (DF) to process the signal. Also, the relay applies maximal ratio combining (MRC), and maximal ratio transmission (MRT), respectively, to receive and forward the signal.As the vehicles' speeds are relative high, the channel experiences a fast fading and this time variation is modeled following the Jake's autocorrelation model. We also assume narrowband fading channel. Closed-form expressions of the reliability metrics such as the outage probability and the mean rate are derived. Capitalizing on these performances, we derive the high signal-to-noise-ratio (SNR) asymptotes to get full insights into the system gains such as the diversity and coding gains.
Seismic behavior of pile group in soil slope
Authors: Zadehmohamad Mehdi , Moradi Majid , Ghalandarzadeh Abbas
Published: July 2021

Seismic behavior of pile group in slope is interested for many years by researchers .Inthis research Shaking table tests were conducted by means of a rigid-box with 1.8m in length,0.8 in width and 1.2 in height in order to investigate the effects of the location of pile group insand slope on its seismic behavior .A cap supported by a pile group was set in a dry sandslope, and subjected to sinusoidal base motion with constant frequency. Soil used in this studywas firoozkuh sand 161 with 60% relative density. The tests were scaled at 1/10th and the pileswere made from aluminum with 95cm in length and they have fixed head condition.Discussions are focused on the behavior of pile groups in different situations. Main interestsare recognition the effect of slope movement and location of pile group on bending behaviorof piles.
The Development of Vocational Interests in Early Adolescence: Stability, Change, and State-Trait Components
Authors: Gfrörer Thomas , Stoll Gundula , Rieger Sven , Trautwein Ulrich , Nagengast Benjamin
Published: July 2021

Vocational interests predict major life outcomes such as job performance, college major choice, and life goals. It is therefore important to gain a better understanding of their development during the crucial years of late childhood and early adolescence, when trait-like interests are starting to develop. The present study investigated the development of vocational interests in a longitudinal sample, comprising N = 3,876 participants—assessed at four time points from ages 11 to 14. Stability, state-trait variance components, mean-level development, and gender differences in mean-levels of Holland’s (1997) RIASEC dimensions were examined. Stabilities were moderate for all dimensions, but Realistic, Investigative, Social, and Conventional interests became more stable over time. For Realistic, Artistic, Social, and Conventional interests, the trait variance increased over time. At age 14, all dimensions had substantial trait variance components. The mean-levels of Realistic, Investigative, Artistic, and Conventional interests decreased over the 3 years (-0.44 < d < -0.24). Initial gender differences—with girls having higher Artistic and Social interests and boys having higher Realistic and Investigative interests—increased over time. By investigating the development of vocational interests in late childhood and early adolescence, we complement previous findings and provide first insights about state-trait proportions in early adolescence.
Combating Effort Avoidance in Computer Adaptive Practicing: Does a Problem Skipping Restriction Promote Learning?
Authors: Savi Alexander Olof , van Klaveren Chris , Cornelisz Ilja
Published: July 2021

Effort is key in learning, as evidenced by its omnipresence in both empirical findings and educational theory. At the same time, students are consistently found to avoid effort. In this study, we investigate whether limiting effort avoidance improves learning outcomes. We also examine differences in learning outcomes for a substantive typology of students: toilers (practice many problems), skippers (skip many problems), and rushers (provide fast responses). In a large-scale computer adaptive practice system for primary education, over 150000 participants were distributed across four conditions in which a problem-skipping option was delayed by 0, 3, 6, or 9 seconds. The results show that after a 14-week period, there are no average treatment effects on learning outcomes across conditions. Also, no consistent conditional average treatment effects are found across the typology. However, different types of students have different learning outcomes, showing that the typology used is meaningful. We conclude that the scale of the experiment suggests a precise null finding, but caution that this should not be interpreted as evidence of no effect. Problem-skipping restrictions may require a longer-lasting implementation to accumulate the desired effect.
Schooling substantially improves intelligence, but neither lessens nor widens the impacts of socioeconomics and genetics.
Authors: Judd Nicholas , Sauce Bruno , Klingberg Torkel
Published: July 2021

Schooling, socioeconomic status (SES), and genetics all impact intelligence. However, it is unclear to what extent their contributions are unique and if they interact. Here we used a multi-trait polygenic score for cognition (cogPGS) with a quasi-experimental regression discontinuity design to isolate how months of schooling relate to intelligence in 6,567 children (aged 9-11). We found large, independent effects of schooling (β ~ .15), cogPGS (β ~ .10), and SES (β ~ .20) on working memory, crystallized (cIQ), and fluid intelligence (fIQ). Notably, two years of schooling had a larger effect on intelligence than the lifetime consequences, since birth, of SES or cogPGS based inequalities. However, schooling showed no interaction with cogPGS or SES for the three intelligence domains tested. While schooling had strong main effects on intelligence, it did not lessen, nor widen the impact of these preexisting SES or genetic factors.
How Protective Buffering Harms Post-Divorce Adjustment in Parent-Adolescent Relationships
Authors: van der Wal Reine C , Grosfeld Eva , der Vlist Merel Nap-Van , Nijhof Sanne , Finkenauer Catrin
Published: July 2021

After a divorce, parents and children try to minimize each other’s distress by hiding their feelings and pretending they are doing fine, a coping strategy called protective buffering (PB). Although there is substantial evidence that PB among romantic partners harms both partners’ well-being, the consequences of PB in parent-child relationships remain unclear. To examine PB among parents and children, we conducted a survey study among 100 dyads of Dutch divorced parents and their adolescent children. We examined actor and partner effects of PB on post-divorce adjustment. We additionally investigated whether decreases in authenticity and intimacy explained the association between PB and post-divorce adjustment. Data were analyzed by employing an Actor-Partner Interdependence Model (APIM) and an APIM extended to Mediation. Results revealed that PB was negatively associated with parents’ life satisfaction, and to children’s life satisfaction and divorce-specific well-being. These negative actor effects were mediated by decreased authenticity for both parents and children. Consistent with research on PB in romantic relationships, PB not only impeded own post-divorce adjustment, but also the adjustment of the person participants tried to protect. Specifically, children’s PB was negatively associated with their parents’ divorce-specific well-being. Although further research is needed, the present study was the first to provide insights into the paradoxical effects of PB in parent-adolescent relationships.
Research in Hard-To-Reach Populations: Challenges and Strategies for Conducting Sexual Violence Studies in Applicants for International Protection beyond the European General Data Protection Regulation
Authors: De Schrijver Lotte , Inescu Adina C. , Hahaut Bastien , Vandeviver Christophe , Nisen Laurent , Keygnaert Ines
Published: July 2021

Background: Conducting research in hard-to-reach populations such as applicants for international protection (AIPs) brings along a number of research challenges. This is especially true for sexual violence (SV) research.Methods: We developed a study design with the intent to reach AIPs in a randomized and anonymous manner including potential illiterate respondents as well, while avoiding as much bias as possible. However, this method was developed just before the entry into force of the new European General Data Protection Regulation (GDPR), upon which important new research challenges emerged. Results: This paper describes the original study design developed to estimate SV prevalence in AIPs in Belgium. We discuss the impact of the GDPR on the recruitment strategy applied to conduct a survey on SV in a randomly selected sample of AIPs, the adapted approach to conduct the study beyond GDPR and lessons learned for future research on sensitive topics in hard-to-reach populations such as AIPs. Conclusions: To achieve reliable prevalence numbers and provide high-quality data on SV in AIPs while respecting the GDPR regulations, studies will require an approach that has become significantly more time consuming and resource-intensive to implement.
Does democratization process lead to positive environmental public policies in the Colombian case?
Authors: Velandia Hernandez Carolina
Published: July 2021

Does democratization process lead to positive environmental public policies in the Colombian case? By focusing on variations in authoritarianism and democratic rule during the 1990s, this paper tests the hypothesis that an increase in democratic rule produces changes to environmental protection along two levels, legal framework and institutional accountability. The dependent variables are democratization and authoritarianism. The independent variable is the level of environmental protection in the public policy outcome. The qualitative analysis is focused on the factors and causal mechanism that allows to evaluate the hypothesis. The findings are that the periods of authoritarian rule and democratic rule are highly influenced by two factors. The first is domestic (postcolonial institutions, regime’s organizational strength, elites’ cleavages, revolutionary and counterrevolutionary movements, and the strength of environmental movement) and second international (western linkage and international organizations’ influence). The Colombian case in the 1990s allows for an identification of these different characteristics of authoritarian and democratic regimes and the causal mechanisms that promote or avoid environmental protection.
MANTRA The Power of Words
Authors: Arifin Antoni Ludfi
Published: July 2021

Apa yang kita ucapkan sebenarnya akan menjadi/ bermakna “doa”. Bung Antoni menyebutnya “mantra”. Buku ini mengangkat kata-kata bijak, kata-kata positif yang diungkap banyak pihak/ pakar ataupun yang berasal dari kutipan-kutipan ayat-ayat suci (dalam hal ini Alquran). Doa ataupun mantra tersebut yang dibahas dalam buku ini akan “memenuhi” kosmos, alam raya ini, di mana manusia hidup di salah satu bagiannya. Mungkin kita tidak dapat membayangkan bagaimana “reaksi” alam raya jika dipenuhi dengan “kabut” doa ataupun mantramantra negatif.
UP Super Vision, Super Action! [8 Jalan Rahasia Percepatan Hidup Sukses]
Authors: Arifin Antoni Ludfi
Published: July 2021

Pandangan jauh ke depan, visi, yang telah ditetapkan oleh manusia untuk diraih umumnya bertujuan mementingkan diri sendiri dan bersifat keduniawian. Kita puas jika apa yang diharapkan—visi, tujuan hidup, mimpi—telah sesuai dengan kenyataan. Namun, sebenarnya visi yang mementingkan diri sendiri itu bukanlah tujuan utama kehidupan di dunia ini. Karena manusia yang melandaskan pada pencapaian pribadi-duniawi biasanya tidak pernah merasa cukup, puas, bahkan jauh dari kata “bahagia”. Ia “gila” diri karena terlena dengan kepentingan pribadi semata dan mengejar kepentingan dunia. Lupa akan tujuan akhir kehidupan, berpulang ke kampung akhirat. Bahkan, tak jarang banyak yang melangkah di jalan gelap, pengap, tanpa pelita penerang jalan.
Economic Analysis for Replacement of 11kV overhead Koteshwor Feeder by Underground Distribution System
Authors: Sah Ganesh Kumar , Poudel Laxman
Published: July 2021

Cost effective, Aesthetic and Reliable energy supply is the need of any mankind. In this study, economic analysis for replacement of 11 kV overhead distribution feeder by 11kV underground cable is done with reference to Koteshwor Feeder under Baneshwor Distribution and Consumers Service. The reliability indices like SAIDI, SAIFI, ENS etc. is performed by using DigSilentPowerFactory software. The reliability of overhead distribution system is evaluated by using real system data system and similarly, historical IEEE standard data is used for underground distribution system. The reliability indices are compared for both distribution systems. Result shows that interruption in the overhead system is more than underground distribution system, the energy not supplied to the customer by overhead distribution system is also more than underground distribution system. The replacement cost estimation is performed by using Nepal Electricity Authority (NEA) unit rate and KEI industries quoted price for NEA underground project. The B/C ratio and Present Worth value for the 25-year period of useful life shows that the replacement of the existing overhead distribution system by underground distribution system is financial suitable and can be payback by revenue save from the Energy Not Supply (ENS) lower value of underground distribution system than overhead distribution system. In order to get the continuous of supply, esthetic and public safety in electricity distribution field one may have to bear initially extra cost to use underground distribution systems which finally get payback. Thus, in case of densely populated city like Kathmandu, underground distribution system is reasonable requirement for continuous supply, esthetic and public safety in electricity distribution filed.
Impact of Road Cuts in Slope Stability in Hilly Regions of Nepal
Authors: Shrestha Jagat Kumar
Published: July 2021

This paper reviews the geological and engineering aspects of rural road construction in the hilly areas of Nepal. The general background in geological, climatic and geographical setting is briefly presented in reference to the five-zone Himalayan model for the Nepal Himalayas. Then, alignment selection of rural roads is discussed in the context of the five zone mountain model. The impact of road cross section design and construction on mountain slopes has been studied. The cut width is a key geometric design parameter that has a significant impact on slope stability and volume of excavation. The choice of cut width in cross-section is reviewed and appropriate cut width in cross-section is recommended in terrain slopes to minimize slope failures and volume of excavation.
Revealed Preference Analysis for Mode Choice in Graduate Level Engineering Students of Kathmandu Valley
Authors: Chataut Piyush , Shrestha Pradeep Kumar
Published: July 2021

Proper planning which is the key element in ensuring infrastructure efficiency, relies on demand analysis. Among the various trips under the domain of demand analysis educational trips occupy a significant part and hence the knowledge about patterns and attitudes of these trips is important to policymakers and infrastructure planners. The current study analyzes the mode choice of graduate-level engineering students in Kathmandu valley where the current transportation system is facing multiple problems thus requiring a proper planning intervention. This study reveals the educational mode preference among the students of engineering colleges. The reveal preference survey was conducted at the various engineering colleges in Kathmandu valley. The study concludes that the travel distance, number of siblings, and vehicle ownership effects the selection of personal modes of transport and distance effects the selection of public transportation, walking option being base criteria for both the cases. It is recommended that existing walking conditions should be improved within the educational zones while public transport which are preferred options for long journeys be designed considering movement between zones.
Analysis of Greenhouse Gas Emission From Aircrafts and Ground Service Equipment at Tribhuvan International Airport of Nepal
Authors: Acharya Ramesh , Bhattarai Nawaraj
Published: July 2021

This paper highlights the trend of carbon dioxide emission and its reduction measure at Tribhuvan International Airport, which is the only international airport of Nepal. The landing and take-off (LTO) cycle of three-year (2016 to 2018) data were gathered from Civil Aviation Authority of Nepal (CAAN) for all types of aircrafts and fuel consumption data of each ground service equipment (GSE) were collected from Nepal Airlines Corporation (NAC).  With the help of LTO emission factors published by different institutions and collected data, the emission was calculated and overall (international, domestic, helicopters and GSE) CO₂ emission in the year 2016, 2017 and 2018 was found to be 56.55, 65.66 and 71.89 Kilotonnes respectively. Upon validation of calculated emission the discrepancy of 2.59% was found. The CO₂ emission was forecasted up-to 2030 considering two scenarios namely, time series analysis and regression analysis. Lastly, for the CO₂ reduction from GSE the scenario; Electrical GSE and Construction of Aerobridge was studied and from which it was found that the CO₂ will be reduced by 80% if implemented.
Riesz Potential and Fractional Maximal Function
Authors: Ghimire Santosh
Published: July 2021

In this article, we begin with Riesz potential. We then discuss some properties of the Riesz potential. Finally we discuss a relation of  Riesz Potential with fractional maximal function in the sense that fractional maximal function can be controlled by Riesz potential and the fractional  maximal function maps  the space Lp to Lq whenever the Riesz potential does.
Social Responsibility for Health during COVID-19 Pandemic
Authors: Shakya Dhana Ratna , Shrestha Ravi Ram , Koirala Sarun , Kafle Santosh Upadhyaya , Subedi Prasanna , Anand Ayush , Ghimire Aparna , Gurung Kishor , Pokharel Krishna
Published: July 2021

Health is a fundamental right for which concerned sides should bear the responsibility at the individual, societal, state, and international level. Not only curative but preventive, promotive, and rehabilitative services should also be availed in accessible, affordable, and acceptable form. The quest for health becomes more intense during adverse periods like a pandemic. The whole world has witnessed the COVID-19 pandemic, the unprecedented pandemic of this century. This quest is more dismal in developing nations like Nepal when even resource-rich countries are laid down by it. The quest of health demands, hence more during this pandemic, for the bearing of the responsibility by all. Here, we have made an attempt to draw together the general and some specific responsibilities of various direct stakeholders in this pandemic with multifaceted mayhem. We have incorporated here, the responsibilities of the public, COVID and non-COVID patients, media personnel, health science students, professionals, institutions, state, and media to ensure or safeguard the health of self and others in this pandemic.
Outcome of Neonatal Hyperbilirubinemia from a Tertiary Care Hospital in Eastern Nepal: A Cross-sectional Study
Authors: Kafle Shyam Prasad , Bhatta Mukesh , Shrestha Ramesh , Sitaula Sarita , Koirala Namu , Koirala Anupam
Published: July 2021

Background: Timely detection and treatment of pathological hyperbilirubinemia in newbornscan prevent acute bilirubin encephalopathy and its consequences. We aimed to identifyitsoccurrence, presentationtime, phototherapyduration, need for exchange transfusion,and outcome.

Methods: In this cross-sectional study, we enrolled all the babies admitted for pathological neonatal hyperbilirubinemia in the university hospital ofBPKIHSin a one-yearduration. Babies with life-threatening congenital malformations or conjugated bilirubin >20% of total serum bilirubin or >2 mg/dl were excluded. Obstetric profile of mothers, clinical and laboratory parameters of babies, onset time of pathological jaundice, duration of phototherapy, need for exchange transfusion or intravenous immunoglobulin were recorded. Neonatal outcome was classified as good and poor and its association with potential predictors analyzed. 

Results: One-hundred and fifty babiesdeveloped neonatal jaundice requiring treatment. The most common causes includedABO and Rh setting. No cause was found in 26 (18%) babies. One-hundred and eight babies (72%) were only managed withphototherapy whereas 42 (28%) required both phototherapy and double volume exchange therapy. The majority (84.5%) had good outcome without any residual neurological deficit at discharge.Babies with total serum bilirubin >20 mg/dl at presentation, duration of phototherapy >44.8 h, ABO setting, hemolysis, and out born statussignificantly developed poor outcome (p < 0.05).

Conclusion: About 15% of the babies with hyperbilirubinemia had acute bilirubin encephalopathy at discharge suggestive of poor outcome. Babies with high bilirubin at presentation, longer duration of phototherapy, ABO settings, hemolysis, and out born statusdeveloped poor outcome.
Delayed Presentation of a Penile Fracture: A Case Report
Authors: Yadav Ashok Kumar , Singh Sudhir Kumar , Chapagain Raju , Das Prem , Osti Jag Mohan , Neupane Durga
Published: July 2021

Penile fracture is a urological emergency caused by blunt trauma to an erect penis. We report a case of a 40-year-old male who presented with a complaint of a painful swelling of the penis for 4 days. On examination, a flaccid swollen tender penis with bluish discoloration over the shaft and scrotum was noted. A clinical diagnosis of delayed penile fracture was made which was managed immediately surgically under spinal anesthesia. Ourreport emphasizes that penile fracture is diagnosed solely on a reliable history and clinical examination. It has outstanding outcome despite delayed presentation if treated promptly.
Detection of Carbamazepine Level among Patients Visiting Psychiatric and Pediatric Services of a Tertiary Hospital in Eastern Nepal
Authors: Panday Dipesh Raj , Rauniar Gajendra Prasad , Rai Dilli Sher , Panday Karishma Rajbhandari , Basnet Madhur , Kafle Shyam Prasad
Published: July 2021

Background: Carbamazepine plasma level is directly related to dose, therapeutic effect, and toxicity. We aimed to observe its plasma level and relationship with dose among psychiatric and pediatric patients.

Methods: This observational study was performed in the Therapeutic Drug Monitoring Laboratory of a university hospital for a period of 1.5 years. Twenty-six consenting patients visiting either psychiatric or pediatric service and taking carbamazepine same dose for > 8 days (i.e. > 6 half-lives) were enrolled. The primary outcome was plasma carbamazepine level as determined by a High-Performance Liquid Chromatography machine. The secondary outcome included its correlation with dose assessed by the Spearman rho’s correlation coefficient.

Results: The mean dose received by the patients was 13.31 ± 5.39 mg/kg/day in pediatrics and 8.33 ± 2.29 mg/kg/day in psychiatry.  The plasma levels [median (IQR)] were 10.01 (6.27, 13.35) mg/L and 10.53 (5.17, 15.19) mg/L respectively in pediatric and psychiatric patients. Thirteen patients (50%) had therapeutic, 10 (36.46%) had above therapeutic, and 3 (11.54%) had subtherapeutic plasma level. Neurocysticercosis (23.1%) in pediatrics and partial seizure (69%) in psychiatry were the most common diagnosis. Symptom-control was achieved in 19 (73.1%) patients. The plasma carbamazepine level did not correlate with dose either in pediatric patients (p = 0.42) or in psychiatry patients (p = 0.63). 

Conclusion: The plasma carbamazepine levels [median (IQR)] in pediatric and psychiatric patients were 10.01 (6.27, 13.35) mg/L and 10.53 (5.17, 15.19) mg/L respectively. The plasma level was normal in half of the recruited patients and did not correlate with dose.
Acanthamoeba Keratitis- Camouflage Entity in Eastern Nepal: A Case Series
Authors: Singh Sanjay Kumar , Ambur Karthik , Poudyal Prija , Malla Sagun , Rajbanshi Amit
Published: July 2021

Acanthamoeba keratitis is a sight-threatening corneal infection and is a growing clinical problem in the world. Though Acanthamoeba keratitis is considered uncommon and rarely reported in Nepal, we encountered six cases in 2019. All patients had redness, photophobia, decreased vision, and pain with ring infiltrate. Ten percent potassium hydroxide mount revealed Acanthamoeba cyst in all cases. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks and Polymerase Chain Reaction revealed T4 genotype Acanthamoeba in four cases. Amoebicidal treatment was started with chlorhexidine 0.02% eye drop half-hourly and supplementary treatment included moxifloxacin eye drop, a combination of polymyxin B sulfate, neomycin sulfate, and bacitracin eye ointment. After treatment, one patient had the best-corrected visual acuity of 6/9 while others had a visual outcome of hand movement. A high level of clinical suspicion and wet mount examination of specimen from infected corneal tissue are essential to aid in rapid diagnosis.
Serum Vitamin D Level in Patients Undergoing Coronary Artery Catheterization
Authors: Nepal Bikash , Sah Ajit , Karki Biplave , Ghimire Jeet Prasad , Mahaseth Aditya , Pandit Swapnil , Sah Ajit , Uranw Surendra , Pandey Naveen Kumar , Shah Prashant , Karki Prahlad
Published: July 2021

Background: Vitamin D deficiency may be a risk factor for coronary artery disease (CAD). We aimed to measure the prevalence of vitamin D deficiency in CAD and its association with severity of angiographic proven CAD.

Methods: This prospective, cross-sectional study included 106 consecutive patients who were admitted for typical angina and had signs of myocardial injury (ECG findings and/ or elevated troponin I or CK-MB) and who underwent coronary angiography at the university hospital of BPKIHS from August 2020 to April 2021. Patients were categorized into angiographic proven CAD group and angiographic normal coronary artery group. Serum vitamin D level was classified as normal (≥ 30 ng/ml) and deficiency (< 30 ng/ml).

Results: Out of 106 patients, 78 patients (73.6%) had vitamin D deficiency and 28 (26.4%) had normal vitamin D level (p = 0.39). Vitamin D level (mean ± SD) in patients with angiographic normal coronary artery and angiographic proven CAD were 25.94 ± 11.63 ng/ml and 26.07 ± 12.90 ng/ml respectively (p = 0.97). Prevalence of vitamin D deficiency was 75.0% and 64.3% in significant CAD group and normal coronary artery group respectively (p = 0.39). Similarly, frequency of vitamin D deficiency were 68.6%, 78.3% and 88.90% in single, double, and triple vessel disease respectively (p = 0.21). The vitamin D level (mean ± SD) in single, double and triple vessel disease were 27.31 ± 14.02 ng/ml, 25.69 ± 12.72 ng/ml, 23.08 ± 9.45 ng/ml respectively.

Conclusion: The prevalence of vitamin D deficiency in both angiographic normal coronary artery and angiographic proven CAD were high but comparable. There was no association of vitamin D deficiency with severity of angiographic proven CAD.
Comparison of Upper Lip Bite Test with Modified Mallampati Test and Thyromental Distance for Prediction of Difficult Intubation
Authors: Koirala Sabin , Shakya Bigen Man , Marhatta Moda Nath
Published: July 2021

Introduction: The prediction of difficult intubation using simple bedside test is of great importance to prevent mismanagement of airway. This study was conducted to compare Upper Lip Bite Test (ULBT) with Modified Mallampati Test (MMT) and Thyromental Distance (TMD) for the prediction of difficult intubation.

Method: This was descriptive cross-sectional study conducted in 121 patients of  American Society of Anaesthesiologists Physical Status (ASA PS) I and II patients scheduled for elective surgery requiring general anaesthesia with endotracheal tube. The airway assessment of the patients was done one day prior to the surgery using Upper Lip Bite Test (ULBT), Modified Mallampati Test (MMT) and measurement of Thyromental Distance (TMD) . On the day of surgery during laryngoscopy, Cormack-Lehane (CL) grading was recorded. The CL grading of III and IV was labeled as difficult intubation. The Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Likelihood Ratio (LR) of ULBT, MMT and TMD were calculated and compared.

Results: The total percentage of difficult intubation, defined by Cormack-Lehane (CL) III and IV was 16.52 %. The sensitivity, specificity, PPV, NPV and accuracy of Upper Lip Bite Test (ULBT) was 50%, 100%, 100%, 91% and 91.74% respectively. ULBT had a significantly higher sensitivity, specificity and PPV when compared to MMT or  TMD or MMT and TMD when combined together.

Conclusions:  Upper Lip Bite Test (ULBT) is better   predictor of difficult intubation  and it should be used along with other test during airway assessment.
Comparison of Inhalational Vital Capacity Induction with Sevoflurane to Intravenous Induction with Propofol
Authors: Adhikari Krishna Murari , Lakhe Gajal
Published: July 2021

Introduction: Intravenous propofol is commonly used for induction of general anesthesia because it is  smooth and rapid. Inhalational induction method is used in limited situations like absence of venous access and difficult intubation.  Sevoflurane also produces rapid induction comparable to propofol. We conducted this study to compare induction time and quality of sevoflurane with that of propofol.

Methods:Total 102 patient undergoing elective laparoscopic surgery were divided into Group S and Group P with 51 patient in each group. In group S patient were induced with Sevoflurane 8% via vital capacity induction method. In group P, patients were induced with injection propofol 1% with titrating dose. Induction time, hemodynamic changes and complications during induction, patient satisfaction and cost of induction were compared.

Results: Induction was rapid in Group S (53.33±17.29s) compared to Group P (72.27±25.15s) (p=0.01). The heart rate and mean arterial pressure were stable in both groups upto one minute after induction. Hypotension occurred more in Group P than in Group S (47.05%vs.37.25%).Cough (9.80 %vs.5.88%) and excessive secretions (5.88%vs.0%) were common in Group S while apnea (3.92%vs5.88%) and involuntary movements(17.64% vs. 27.45%) were common in  Group P. Patient satisfaction score was high in both the groups. Cost of induction was cheaper in Group S compared with Group P (1.6±0.54 $vs.1.9±0.43$).

Conclusions: Vital capacity induction with 8% sevoflurane has rapid induction and cheaper as compared to intravenous induction with propofol in a titrating dose. Hemodynamic changes and complications were comparable in both the groups.
Noninvasive diagnosis of Helicobacter pylori among patients with dyspepsia
Authors: Thapa Suresh , Thapa Jiwan , Karki Binod , Khadka Dibas , Bhandari Thapa Anju
Published: July 2021

Introduction: Helicobacter pylori (H. pylori) infection is a common disease with disparity in geography, age, race and socioeconomic status. Present study aims to assess the accuracy of noninvasive diagnostic tests.

Methods: This is a hospital based cross sectional, observational study of 100 dyspeptic patients during November 2017- June 2018. Profile of dyspeptic patients were recorded in a proforma and accuracy of serology and stool antigen test for H. pylori was compared with histology detection in gastric biopsies.

Results: Mean age of patients was 39.5±13.7 years with almost equal gender distribution. Prevalence of H. pylori was 56% with dyspeptic symptoms in gastric biopsies. Significant association of the infection was seen in patients with a longer duration of dyspepsia, pangastritis on endoscopy and chronic gastritis on histologic examination. Stool antigen test had good sensitivity (71%) and specificity (82%) for H. pylori detection compared with standard histological diagnosis.

Conclusion: Overall prevalence of H. pylori was 56% and was more common in patients of age > 44 years with dyspepsia. Stool antigen has a good diagnostic accuracy and can be used in resource limited settings. However, we recommend a community based study in larger population.