bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical audit of inguinal hernia surgery under local anaesthesia at a district hospital set up in central India
Authors: Jain Anurag , Jain Rajiv , Gupta Hariom
Published: May 2019

Background: This article outlines the results of audit for feasibility and reliability of use of local anaesthesia as a routine practice in inguinal hernia surgery in an Indian district hospital setup. Through this prospective study an effort have been made to analyse practicability of local anaesthesia for inguinal hernia surgery in terms of cost effectiveness, minimizing recovery period, and reducing routine case load on hospitals with a goal to provide health for all, in a set up where patient load outnumber resources both in expertise and facilities.Methods: A prospective analysis and auditing of 120 patients with unilateral inguinal hernia who underwent inguinal hernia surgery by Lichtenstein tension free mesh repair under local anaesthesia at Sehore district hospital during the study period was done. The primary outcomes of the study were analysed on grounds of cost benefit, patient satisfaction levels, complications such as infection, haematoma, chronic pain, and recurrence.Results: The mean age of patients in present study was 44.23 years (20-76 years). The mean operating time was 70 minutes (40-90). The mean post operative room stay was 3.3 hours (2-6 hours). Intraoperatively 30 patients (25%) had problems such as pain, bradycardia/tachycardia, hypotension, perspiration. Recurrance was observed in 1 patient (0.83%) during the mean follow-up of 3.6 months (1-6 months).Conclusions: In hernia repairs local anaesthetic is reliable, easy, safe and cost effective technique and its use can dramatically reduce waiting period for operation in planned surgeries.
Role of HbA1c with mortality and severity among the patients of Acute coronary syndrome: a prospective study
Authors: Chandel Satish , Parihar Shishirendu , Gramani Bharat , Dubey T. N.
Published: May 2019

Background: Blockage of coronary artery lead to a reduction of blood flow towards heart resulting in Coronary Artery Disease (CAD). CAD leads to myocardial complications. CAD is one of the important causes of death all over the world including India. Diabetes mellitus is a risk factor for CAD. Reports have also shown to increase in cardiovascular morbidity among patients with glucose intolerance. In present study we tried to find the relationship of HbA1c levels with mortality, morbidity, and severity in Acute Coronary Syndrome (ACS).Methods: Two hundred patients with ACS were studied from 2018 to 2019 at Gandhi Medical College and Hamidia Hospital, Bhopal. Following a thorough medical history routine medical examination including laboratory investigations was performed in all the patients. Electrocardiography (ECG), creatine phosphokinase-muscle/brain (CPK-MB), echocardiography and coronary angiography (CAG) was also done as part of this study.Results: Mean age of the study cohort was 59.17±8.75 years. Out of 200 subjects, 110 (55%) were non-diabetic, 52 (26%) were diabetic, 38 (19%) had weakened glucose tolerance and 82 (41%) had hypertension. Left ventricular dysfunction (LVD) and heart failure (HF) were the common complications and were more prevalent among diabetic patients than the nondiabetics (p=0.009). HbA1c level (7.01±2.23) was high among subjects with complications than the subjects without complications (6.01±1.36).Conclusions: The patients with DM have higher morbidity and mortality than the non-diabetic patients of ACS and therefore such patients should be screened for diabetes and glucose intolerance for better management of CAD.
A study of the influence of lipid profile in diabetic patients on the incidence of cerebrovascular events
Authors: Khalid Taha Mahboob Ali , G. Rahul Gandhi
Published: May 2019

Background: The relationship between elevated serum lipids and atherosclerosis is well established. Recent studies have demonstrated not only that the serum lipid concentration but also the distribution of TG and cholesterol within major lipoprotein classes are of importance for the development of atherosclerosis. Elevated plasma concentrations of LDL and decreased HDL are associated with increased risk of atherosclerosis. To study the influence of lipid profile in diabetic patients on the incidence of cerebrovascular events.Methods: The study was based on 60 patients meeting the inclusion criteria from those who were admitted at Shadan Institute of Medical Sciences, Hyderabad, India from Feb 2013-May 2014. Detailed history was taken and thorough physical examination done pertaining to the involved condition. Patients who were conscious, slow progression of neurological deficit, rapid onset of lateralizing signs with variable blood pressure were considered to be suffering from infarction.Results: The mean values of lipid profile were significantly different among the gender. There were more females with medium and high TC values as compared to females and this difference was found to be significant. Though the number of females with high HDL values was more than males, the difference was not found to be significant. The number of females with high LDL values was far more than males and this difference was found to be significant. Though the number of females was more with high TG values, the difference was not found to be significant.Conclusions: In conclusion, our study gives evidence that poor glycemic control is a strong risk factor for stroke in patients with NIDDM.
Significance of serum electrolyte imbalance and comparison between different testing methods in patients with altered sensorium presenting to tertiary care hospital
Authors: Dumra Harjit S. , Patel Kautuk A. , Raval Gopal , Dandnaik Mansi , Patel Amrish
Published: May 2019

Background: Electrolyte disorders are common in patients in the emergency department and intensive care unit, and have been associated with increased morbidity and mortality. In this respect sodium and potassium are the most important cations, whose improper adjustment may cause severe neuromuscular disorders. This study was designed to compare values obtained by laboratory and point-of-care testing and also to find most frequent electrolyte abnormalities.Methods: Observational Study was done on 51 patients presenting to Tertiary care Hospital emergency department with altered sensorium between 1st January 2016 to 31st May 2017 fulfilling the inclusion criteria and willing for participation by giving written informed consent. Electrolytes were tested in patients with GCS 14 or less by both point of care system and in the laboratory.Results: The distribution of mean sodium and potassium levels did not differ significantly between two techniques (P-value>0.05). The sodium and potassium levels by POC and laboratory techniques are significantly and positively correlated (P-value<0.001). The distribution of mean along with 95% CI of mean of amount of bias in the estimation of Sodium and Potassium levels by POC against Laboratory method is 3.50 [2.79-4.20] mEq/L and 0.83 [0.55-1.11] mEq/L respectively. The most common electrolyte abnormality was hyponatremia.Conclusions: We concluded that it is advisable to do a point-of-care electrolyte in Emergency department and Intensive care unit. By use of point-of-care testing, we can identify electrolytes imbalance early in emergency department. Point-of-care electrolyte levels had a near comparable value with laboratory electrolyte levels.
Role of educational intervention with practical demonstration in improving inhaler technique
Authors: Bhushan Bharat , Singh Kulbir , Abraham Jebin , Goyal Deepak , Bhatnager Arjun , Chungath Jain Thomas , Bharti Heena , Sharma Karan
Published: May 2019

Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.
Spectrum of opportunistic infections in relation to CD4 counts in HIV/AIDS patients admitted in the department of general medicine of a tertiary care hospital
Authors: Pandharpurkar Deepak , Devulapally Nagender , Gouthami B. , Krishna Gudikandula
Published: May 2019

Background: HIV/AIDS was first recognized in USA in 1981 when centre for disease control (CDC) reported unexplained occurrence of Pneumocystis carinii pneumonia in 5 healthy homosexuals. Soon it was recognized in drug abusers and blood transfusion recipients. The present study has been taken up with an aim to know the incidence of various opportunistic infections in HIV positive patients and to correlate different opportunistic infections (OIs) with the CD4+cellcount.Methods: Sample of 132 cases admitted in Gandhi hospital during the study period were taken. CD4+ counting of blood samples was done by Flow cytometry as per manufacturer’s instructions (FACS Calibur, Becton- Dickinson, Immunocytometry system). Correlation of CD4 cell counts was done with the respective opportunistic infections.Results: TB (50%) is the most frequent OI followed by candidiasis (49%), pneumocystis (16%) and others. The mean CD4 cell count in TB was 110.80/mL and in candidiasis 97.84/mL. Low values were observed in CMV (27/mL) and in toxoplasmosis (61.66/mL).Conclusions: In most of the patient’s respiratory system was the most common system involved by OIs and had CD4 T cell count below 200/mL. Early diagnosis and prompt treatment of opportunistic infections is important. This study helps the clinicians in proper guidance to come up before development of severe immunodeficiency to prevent serious and fatal outcome.
Height is a risk factor for development of peripheral insensate neuropathy
Authors: J. Sujjay , Green Siva Ranganathan , A. Mohamed Kasim
Published: May 2019

Background: Peripheral insensate neuropathy is one of the most common and forms of peripheral neuropathy. It is a preeminent cause for disability, foot ulcers, deformity and amputations in individuals who are at risk.Methods: A study was conducted in Mahatma Gandhi Medical College & Research Institute, Pondicherry, India in the year 2017-18, which included examination of 760 people of more than 30 years of age by random sampling method who was attending the outpatient clinic. The Semmes Weinstein monofilament was adopted to ascertain the presence of peripheral insensate neuropathy.Results: In present study, the prevalence of peripheral insensate neuropathy was 3.2%. As the height increased, the prevalence of peripheral insensate neuropathy increased, regardless of other independent risk factors like diabetes, hypertension, etc. The risk of the peripheral insensate neuropathy increases at a height of >171.5cm in males and at a height of >164.5cm in females.Conclusions: The authors confirm that body height is a significant and independent risk factor for peripheral insensate neuropathy, regardless of co-morbidities. Height as a guide, helps the health care professionals in identifying the people who are at risk for peripheral insensate neuropathy.
Using modified tutorless problem-based learning approach with ‘SET triggers’ to teach diabetes mellitus to undergraduate medical students
Authors: Patil Karan Shrikant , Gupta Dinesh Chandra , Ganeshpure Swapnil
Published: May 2019

Background: The purpose of this study was to introduce modified form of conventional problem-based learning (PBL) i.e. “Tutor less PBL” in educating medical students about type 2 diabetes mellitus (T2DM). Medical students are future physicians and can be effective healthcare professionals to screen and manage diabetes at community level. Poor levels of awareness as well as lacunae in teaching diabetes have been reported among medical students. The study aimed to assess the knowledge of undergraduate medical students about T2DM by using “Tutorless PBL” method.Methods: Sixty-two 8th semester medical students from one of the private medical colleges in Mumbai city attained knowledge about T2DM through “Tutorless PBL” and “conventional PBL”. “A structured set of engagements triggers” (SET) was used in Tutorless PBL. Students responded through pre and post-test questionnaires and ‘student’s unpaired t test’ compared their test scores. Fourteen item questionnaires with Likert scale evaluated students’ feedback about both methods.Results: The post test scores were more for students in “Tutor less group” than in “tutored group” (15.37 vs. 14.01). The difference was statistically significant (t=5.87, p<0.001). All (100%) students appreciated both methods for enhancing their knowledge about T2DM. “Tutor less PBL” was found to be more effective than “conventional PBL” in promoting self-learning and critical thinking abilities.Conclusions: Both methods were beneficial to students in terms of clarifying the topic, improving group interaction and yielding self-directed learning. Tutorless problem-based learning can be an effective option especially in resource (faculty) limited setting.
Auto Immune Mixed Haemolytic anaemia: A rare presentation of SLE
Authors: Srikanth Mote , Lokesh S. , Dutta Anirban , Dhanashekaran Vaishnavi
Published: May 2019

Auto Immune Mixed Haemolytic Anaemia (AIHA) is defined as presence of both warm and cold antibodies against patient’s own red blood cells which is diagnosed by monospecific Direct anti-globulin test. Hereby we report a middle-aged women old women who was a known case of hypothyroidism on regular medication, presented with history of fatigability, exercise intolerance and exertional breathlessness of 1 month duration. The patient was subjected for preliminary investigations, which revealed severe anaemia with hemoglobin of 3.6 g% and an increased reticulocyte count of 12% with normal total leukocyte and platelet counts. Peripheral smear revealed anisopoikilocytosis, nucleated RBCs and schistocytes. Biochemical tests for haemolysis was evaluated which showed and elevated LDH levels (780U/L), and a reduced serum haptoglobulin levels. Liver Function test revealed a total bilirubin of 6.8mg/dl with indirect bilirubin of 5.4 mg/dl with normal liver enzymes. Baseline evaluation of Auto immune haemolytic anaemia with coombs test turned out to be positive. Patient was subjected for Mono specific DAT, Indirect Anti-globulin test (IAT) and antibody screening. Mono specific DAT showed both Anti IgG and anti C3 antibodies. IAT test was positive at 4⁰C and negative at 22⁰C and 39⁰C which confirmed that the AIHA was of mixed warm and cold type. On evaluation for connective tissue diseases, patient serum was reactive for ANA and ds-DNA and found to have Systemic Lupus Erythematosus which is a rarity and was responded to corticosteroids.
Acute liver failure secondary to chronic lymphocytic leukemia
Authors: Saini Rohin , Mishra Arvind , Gupta Kamlesh , Anand Rohit , Tripathi Umesh , . Hashim
Published: May 2019

Chronic lymphocytic leukemia is an indolent malignancy of lymphocytes commonly seen in elderly. Dissemination of malignancy is a rare cause of acute liver failure and has rarely been reported. Here we describe the case of a sixty five year old male presenting with acute liver failure. He is a diabetic with no known history of seropositive hepatits or addiction. Bone marrow and liver biopsy suggestive of chronic lymphocytic leukemia. He eventually succumbed to his illness.
Multiple myeloma with primary systemic amyloidosis affecting cutaneous, gastro intestinal and cardio-vascular system
Authors: A. S. Mohammed Feros , Shanmugam Lokesh
Published: May 2019

Amyloidosis refers to a group of disorders characterized by extracellular deposition of protein fibrils. Primary systemic amyloidosis is commonly due to an underlying plasma cell dyscrasia. Infiltrative amyloid cardiomyopathy is a rare cause of predominantly diastolic myocardial disease. Restrictive cardiomyopathy is the main finding in cardiac amyloidosis and results from the replacement of normal myocardial contractile elements by infiltration and interstitial deposits of amyloid, leading to alterations in cellular metabolism, calcium transport, receptor regulation, and cellular edema. Injury can also occur from circulating light chains in the absence of amyloid fibril formation. Cardiac amyloidosis should be considered in any patient presenting with congestive heart failure, preserved systolic function, and a discrepancy between a low QRS voltage on electrocardiography and an apparent left ventricular hypertrophy on sonogram. The pattern of left ventricular diastolic dysfunction changes during the course of amyloidosis and the classically described restrictive physiology occurs only in advanced stages of the disease. This is a case report where an unusual extensive cutaneous and cardiac involvement provided the sign of widespread systemic deposition of amyloid protein which eventually led to the diagnosis of multiple myeloma.
Saber sheath trachea in chronic obstructive pulmonary disease patients
Authors: Verma Lokesh , Borana Hemant , Desai Govind , Tak Sanidhaya
Published: May 2019

Saber sheath trachea is defined as an anteroposterior (sagittal) diameter of intrathoracic trachea exceeding to lateral (coronal) by a ratio of 2:1 as measured at the site 1 cm above the aortic arch and the extra thoracic trachea being normal. It is most commonly seen in males and is considered to be a diagnostic sign of Chronic obstructive pulmonary disease.
Evaluation of relationship between bone mineral density and fragility fracture in perimenopausal women between 40-58 years of age: a hospital based prospective observational study
Authors: Kumar Arvind , Pheroz Mozammil , Chopra Rajesh K. , Tungoe Benthungo , Kumar Narendra , Aggarwal Yatish , Sarwar Samrin , Soni Manoj
Published: May 2019

Background: At present the risk assessment for osteoporosis using low bone mineral density (BMD) is based on data obtained from elderly females, largely ≥ 65 years of age. The risk factors for low peak bone mass or accelerated bone loss that occurs during perimenopausal phase is ignored in this risk assessment. Osteoporosis is found to occur at a relatively younger age in the Indian population. Although lower BMD values have an established identity as a major risk factor for fractures in postmenopausal women, we endeavour to evaluate relationship between bone mineral density and fragility fracture in perimenopausal women.

Methods: 65 Patients were recruited for the study. After X-ray of involved part, patients were divided into cases (with fracture, n=33) and control (no bony injury, n=32). All patients underwent dual energy X-ray absorptiometry (DEXA) scan. Results of DEXA scans were evaluated in both the groups. BMD was expressed in g/cm2.

Results: 33 patients (50.77%) were diagnosed as fracture, 32(49.23%) had no bony injury. Threshold bone mineral density (BMD) for fragility fracture found out asfor L1, cut off ≤0.767. For L2, cut off ≤0.829. For L3, cut off ≤0.811. L4, cut off ≤0.798. For L1-L4, cut off ≤0.845. For left femur total hip, cut off ≤0.918. For left forearm-total, cut off ≤0.411. For right femur total hip-cut off ≤0.795. For right forearm-total, cut-off≤0.382.

Conclusions: Perimenopausal women having BMD below threshold for involved site are at risk of fragility fracture and should be given prophylactic treatment to improve bone mineral density.
Los costos de la modernización: cambios en los factores tierra y trabajo en Entre Ríos, Argentina, entre 1830 y 1880
Authors: Djenderedjian Julio
Published: May 2019

Este trabajo intenta mostrar cómo afectó el encadenamiento de los costos de la tierra y del trabajo en el largo plazo a una economía rural dominada por la ganadería extensiva de exportación. Las rigideces desarrolladas durante años de bonanza, y las distorsiones generadas a partir del uso relativo de factores, introdujeron fragilidades particularmente evidentes en coyunturas críticas, y volvieron difícil el paso a pautas intensivas de explotación. Más aún, la misma crisis política y social pudo en parte al menos haber sido generada por esas rigideces. En todo caso, el análisis intenta mostrar que no puede atribuirse a explicaciones simplistas la conducta de los actores de entonces respecto de la inversión de capital y la innovación.
Re-formulation zakat system as tax reduction in Indonesia
Authors: Djatmiko Harry
Published: May 2019

Zakat is one of the Islamic financial instruments which is obligatory for every Muslim whose earnings reach the prescribed amount (nishab). On the other hand taxes must still be paid as an obligation of every citizen. Under the law, it is stated that zakat can be a deduction from taxable income. The aim of this research is to offer a more advanced concept, namely zakat can be a deduction from income tax. The technique used in this research is content analysis on the literatures discussing about zakat and tax in Islam. The results of this study suggest that zakat as a deduction from income tax has a greater impact than zakat as merely a deduction from taxable income. Zakat as a deduction from income tax will increase the impact of zakat in a larger economy. Zakat merupakan salah satu instrument keuangan Islam yang wajib ditunaikan oleh setiap umat muslim yang pendapatannya telah memenuhi jumlah yang ditentukan (nisab). Sedangkan, di sisi lain pajak harus tetap dibayarkan sebagai suatu kewajiban dari setiap warga Negara. Berdasarkan undang-undang, disebutkan bahwa zakat dapat menjadi pengurang penghasilan kena pajak. Tujuan penelitian ini ialah untuk menawarkan suatu suatu konsep yang lebih maju yaitu zakat dapat sebagai pengurang pajak penghasilan. Teknik analisis yang digunakan ialah analisis isi terhadap literatur-literatur terkait zakat dan pajak dalam Islam. Hasil penelitian menunjukkan bahwa zakat sebagai pengurang pajak penghasilan memiliki dampak lebih besar daripada jika zakat hanya sebagai pengurang penghasilan kena pajak. Zakat sebagai pengurang pajak penghasilan akan meningkatkan dampak zakat di dalam perekonomian yang lebih besar
Are the civilization diseases the result of organohalogen environmental pollution?
Authors: Góralczyk Katarzyna , Majcher Anna
Published: May 2019

The notion of ‘civilization diseases’ is used to describe certain ailments whose aetiology is difficult to explain based on the knowledge about the functioning of the body and its metabolism. Only studies at the cellular level, on biochemical changes shed light on the causes of some diseases described as civilization diseases (cancers, cardiovascular and respiratory diseases, obesity, psychomotor disorders in children and an increase in the frequency of malformations). The factors whose incontestable influence on the increase in the frequency of occurrence of various ‘civilization diseases’ has been proved are persistent organic pollutants, among others belonging to the group of organohalogen compounds. Among organohalogen pollutants one needs to distinguish organochlorine compounds, which have been used as pesticides, and pollution emitted by various industries such as dioxins and furans, polychlorinated biphenyls, and polybrominated organic compounds used as flame retardants and perfluoroalkylated substances, which are characterized by high chemical and thermal stability as well as high surface activity due to which they may be widely used as oleophobic and hydrophobic factors.
Removal of Malachite Green from Waste Waters by Bentonite Based Photocatalyst Technology
Authors: POLAT Kinyas , YURDAKOÇ Mürüvvet
Published: May 2019

MgFe2O4-B/Ag3VO4 visible light active photocatalyst was successfully synthesized for the photocatalytic decolorization of organic pollutants. Malachite green (MG) was selected as a model dye representing those pollutant chemicals. The catalyst was characterized by X-ray diffraction (XRD), scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy (EDS). Malachite green (MG) decolorization was carried out by visible light irradiation of a 105 W tungsten light source. Decolorization yield and kinetic studies were traced by the help of a UV-Vis spectrophotometer. Kinetic model of decolorization was derived from Langmuir–Hinshelwood (L–H) model and found coherent to first order kinetics. Catalysis reaction showed high dependency on pH especially out of 5-7 range which gave high decolorization. Photocatalytic activity also depended on concentration with dual character in which high concentration hindered the light coming to catalyst surface but on the other hand it supported the activity by boosting the dark adsorption resulting in a decolorization time changing from 40 to 100 min. After the reaction was completed, powders of catalyst were effortlessly removed from the medium by a magnet bar. It was shown that MgFe2O4-B/Ag3VO4 photocatalyst has a potential to be simple and efficient alternative material for the removal pollution resources from wastewaters.
A FUNÇÃO SIMBÓLICA DO DIREITO AMBIENTAL: CONSIDERAÇÕES SOBRE O TEMA 30 ANOS DEPOIS DA CONSTITUIÇÃO DE 1988
Authors: Freitas Ana Carla Pinheiro , Pompeu Gina Vidal
Published: May 2019

A função simbólica do Direito Ambiental é assunto atual e grave. Por esse motivo insiste-se em uma revisita ao tema, 30 anos depois da Constituição de 1988. O presente texto abre discussão acerca das várias definições do conceito de simbólico, no contexto da obra “a constitucionalizacão simbólica”, de Marcelo Neves. O capítulo seguinte é dedicado à apresentação e leitura atualizada do caso concreto citado pelo Prof. Wolf Paul no seu texto, que deu origem à presente discussão acerca da função simbólica do Direito Ambiental. O terceiro capítulo é dedicado ao questionamento sobre a argumentação jurídica como ideologização da verdade que expõe uma verdadeira "aliança entre opostos”. No derradeiro capítulo é abordada a função do Direito, a positivação de novos valores e seus reflexos, na seara do Direito Ambiental. Estes valores encontram-se inseridos no âmbito técnico-racional e no  técnico-instrumental. A metodologia seguida baseia-se em pesquisa bibliográfica e em estudo analítico-descritivo e exploratório.
THE RESURGENCE OF OLD FORMS IN THE EXPLOITATION OF NATURAL RESOURCES: THE COLONIAL ONTOLOGY OF THE PRIOR CONSULTATION PRINCIPLE
Authors: Castro Douglas de
Published: May 2019

The need to deal with anthropogenic effects over the environment surfaced in the 1960´s mainly due to accidents all over the world with severe impacts on the environment. Therefore, International Environmental Law gained traction and international institutions legitimacy based on the universality of the formation of International Law and the objectivity and neutrality of the science, generating essential exclusions and implication for Global South countries. As colonial domination as part of the imperial projects ceased with the recognition of the sovereignty and self-determination of nations, a new form of granting access to natural resources was necessary. In this study, we argue that International Law and Institutions are proxies of the old ways of imperialism and colonial venture by imposing legal obligations and standard practices to countries disregarding their own experiences, cultures, and values, which has in the principle of prior consultation and its derivatives the most representative stance. As such, the study relies on TWAIL and Elite Theory to unveils the role of International Law and local elites to legitimize the domination and exclusion.
CRISPR-CAS9, BIOSSEGURANÇA E BIOÉTICA Uma Análise Jusfilosófica-Ambiental da Engenharia Genética
Authors: Reis Émilien Vilas Boas , Oliveira Bruno Torquato de
Published: May 2019

A nova técnica de engenharia genética CRISPR-Cas9 projeta benefícios e riscos de se manipular e alterar geneticamente organismos vivos, de forma a trazer características favoráveis a eles mesmos e aos seres humanos. Com abordagem interdisciplinar, envolvendo a Filosofia, o Direito, a Biossegurança e a Bioética, o artigo objetiva verificar quais as consequências que o uso da referida técnica pode trazer à natureza genética dos organismos, sobretudo dos pontos de vista ético e jurídico. Como referência jurídica e de Biossegurança, optou-se pela Lei brasileira n. 11.105/2005 e, como referência filosófica e bioética, abordou-se a controvérsia entre os pensadores alemães Jürgen Habermas e Peter Sloterdijk, que analisaram o tema da engenharia genética e do risco da eugenia. Trata-se de pesquisa teórico-bibliográfica, que emprega o raciocínio dedutivo sobre os impactos jurídicos-filosóficos do uso da técnica do CRISPR-Cas9. A prática da engenharia genética, apesar dos riscos, pode ser um procedimento inevitável diante do atual estágio de desenvolvimento humano e enfrentá-la com a compreensão das responsabilidades jurídica e bioética torna-se essencial.
Overview X Swimming Pool Sanitation In Banyuwangi
Authors: Fitria Dwi Lailatul , Azizah Nur Risca , Khawari Rizka , Hadi Faris Mohammad , Puspikawati Septa Indra
Published: May 2019

Pool sanitation needs to be monitored and monitored against the physical environment that affects human health in order to prevent the occurrence of transmission and source of disease in the pool. The swimming pool business standard is set in the Minister of Tourism of Republic of Indonesia Regulation No. 16 of 2015. Based on SWOT analysis conducted by the researchers, the position of swimming pool X in Banyuwangi is in quadrant IV. The purpose of this research is to know the description of sanitation of swimming pool X in Banyuwangi. This research uses observational method which analyzed with descriptive. The time of the research on June 3, 2016 took place in the swimming pool X Banyuwangi. Observations were performed using a research instrument. The research instrument contains 5 variables ie place, building, swimming pool, supporting facilities and infrastructure facilities. Intrumen is prepared based on the Minister of Health Regulation No. 61 of 1991 that has been processed. The results showed the total value of place variables (3.45), building variables (3.6), pool variables (6.6), supporting facilities (6.0), and infrastructure (2.2) swimming pool X in Banyuwangi is in good condition with value 82,7% (21,85). Suggestions for pool manager X in Banyuwangi to separate chemical warehouse with First Aid Equipment (P3K) equipment and hygiene kits such as broom, waste shovel, sprinkler of swimming pool filtration, vacuum equipment and others.
Analysis The Level Of PM2,5 And Lung Function Of Organic Fertilizer Industry Workers In Nganjuk
Authors: Azizah Imfatul Tria Nur
Published: May 2019

Organic fertilizer industry in Nganjuk uses manure as basic materials of production. Its process produced particulate matter 2,5 (PM2,5) in the form of dust and smoke. PM2,5 can be inhaled and be retained until alveoli, so it is potentially caused lung function impairment to the workers. The objective of this research was to analyzed the level of PM2,5 and lung function of organic fertilizer industry workers in Nganjuk. The type of this research was observasional descriptive quantitative with cross sectional design. The research sample was using total population of 10 production workers. The result of this research showed that the level of PM2,5 inhaled which exceeded Threshold Limit Value (TLV) or > 3 mg/m3 were on 2 workers who worked on drying and packing process. The average of PM2,5  environment level which exceeded TLV were on manufacturing of granuls, heating and packing process area. Workers who had lung function impairment were 4 workers (40%). Lung function impairment more likely found in workers with exposure of PM2,5 inhaled≤ 3 mg/m3, has age 41 – 60 years, worked period < 5 years, always using cloth as respiratory protective equipment, and had worked in the other places either direct or indirect exposure of dust. The conclusion of this research is production workers of organic fertilizer industry in Nganjuk has risk of lung function impairment. Suggestions for the owner of organic fertilizer industry in Nganjuk are to install natural and unnatural ventilations and to provide air purifying respirators.
Trumpova doktrina i realistička tradicija
Authors: Popović Petar
Published: May 2019

Polazište ovog rada nedavni je prijepor suvremenih realista oko aktualne dvojbe je li vanjskopolitička doktrina američkog predsjednika Donalda Trumpa realistička. Autor ukazuje da je navedena polemika posljedicom zastarjelog, tautološkog, ali još uvijek i neprevladanog dualističkog diskursa u teorijama međunarodnih odnosa, koji dijeli teoriju i vanjskopolitičku praksu na dva dominantna pravca: realizam i liberalizam. Na temelju dosadašnje teorijske kritike novog realizma, ili neorealizma, članak potvrđuje da ovaj suvremeni realistički pravac epistemološki ne pripada tradiciji realizma na koju se poziva, nego se svojim predodžbama o moći, državi i međunarodnom sustavu utemeljuje u političkom idealizmu: pravcu mišljenja koji se redovno pripisuje liberalima I kojemu je tradicionalni, ili „klasični“ realizam bitno suprotstavljen. Analizirajući glavne podudarnosti između pretpostavki neorealizma i načela Trumpove doktrine, ovaj rad navodi na zaključak da Trump nije realist nego protuliberalni idealist. Pojam „protuliberalni idealizam“ prikladniji je za razmatranje aktualne američke vanjske politike u kontekstu njene hegemonijske pozicije u liberalnom međunarodnom poretku.
Modern-Day Crusaders in Europe. Tradition, Family and Property
Authors: Datta Neil
Published: May 2019

Three recent events affecting human rights in sexuality and reproduction (a proposed ban on abortion in Poland, blocking support for She Decides in Croatia and halting a civil union law in Estonia) were spearheaded by organizations which appear to be the national antennae of the transnational, socially conservative network called Tradition, Family and Property (TFP). TFP refers to a set of interrelated conservative, Catholic-inspired organizations which share a common world view inspired by the TFP founder, Plinio Corrêa de Oliveira. Originating in Brazil in 1960 and eventually spreading throughout the world, TFP has long been an insurrection movement within Catholicism, with a distinct way of working by fusing social conservatism with economic hyper-liberalism and a legacy of complicity with far-right movements. Having withered away from Latin America, TFP is now an active European network with positions against sexual and reproductive rights (SRR ) among its priorities. TFP’s influence on SRR takes three main routes: social mobilization; norm entrepreneur and entering decision-making spaces. TFP has found new horizons in Eastern Europe and ambitions to influence the European Union and the United Nations. The reactionary narrative of TFP espousing religious orthodoxy and sanctifying economic inequality could become attractive to some by offering religious legitimization for illiberalism and authoritarianism.
Dopaminergic Cellular and Circuit Contributions to Kappa Opioid Receptor Mediated Aversion
Authors: Margolis Elyssa , Karkhanis Anushree
Published: May 2019

Neural circuits that enable an organism to protect itself by promoting escape from immediate threat and avoidance of future injury are conceptualized to carry an “aversive” signal. One of the key molecular elements of these circuits is the kappa opioid receptor (KOR) and its endogenous peptide agonist, dynorphin. In many cases, the aversive response to an experimental manipulation can be eliminated by selective blockade of KOR function, indicating its necessity in transmitting this signal. The dopamine system, through its contributions to reinforcement learning, is also involved in processing of aversive stimuli, and KOR control of dopamine in the context of aversive behavioral states has been intensely studied. In this review, we have discussed the multiple ways in which the KORs regulate dopamine dynamics with a central focus on dopamine neurons and projections from the ventral tegmental area. At the neuronal level, KOR agonists inhibit dopamine neurons both in the somatodendritic region as well as at terminal release sites, through various signaling pathways and ion channels, and these effects are specific to different synaptic sites. While the dominant hypotheses are that aversive states are driven by decreases in dopamine and increases in dynorphin, reported exceptions to these patterns indicate these ideas require refinement. This is critical given that KOR is being considered as a target for development of new therapeutics for anxiety, depression, pain, and other psychiatric disorders.
Synthesis and Cytostatic Effect of 3’-deoxy-3’-C-sulfanylmethyl Nucleoside Derivatives with D-xylo Configuration
Authors: Bege Miklós , Kiss Alexandra , Kicsák Máté , Bereczki Ilona , Baksa Viktória , Király Gábor , Szemán-Nagy Gábor , Szigeti Zsuzsa , Herczegh Pál , Borbás Anikó
Published: May 2019

A small library of 3’-deoxy-C3’-substituted xylofuranosyl-pyrimidine nucleoside analogues were prepared by photoinduced thiol-ene addition of various thiols, including normal and branched alkyl-, 2-hydroxyethyl, benzyl-, and sugar thiols, to 3’-exomethylene derivatives of 2’,5’-di-O-tert-butyldimethylsilyl-protected ribothymidine and uridine. The bioactivity of these derivatives were studied on tumorous SCC and immortalized control HaCaT cell lines. Several alkyl-substituted analogues elicited promising cytostatic activity in low micromolar concentrations with a slight selectivity toward tumor cells. Near-infrared live-cell imaging revealed SCC tumor-cell specific mitotic blockade via genotoxicity of analogue 10, bearing an n-butyl side chain. This analogue essentially affects chromatin structure of SCC tumor cells, inducing a condensed nuclear material and micronuclei as also supported by fluorescent microscopy. The results highlight that the thiol-ene chemistry represents an efficient strategy to discover novel nucleoside analogues with non-natural sugar structures as anticancer agents
Fully-Autonomous Operation of an AC Micro-grid with Inherent Seamless Switching
Authors: Liu Baoquan , Liu Yan , Zhu Yixin , Shi Yong
Published: May 2019

This paper proposes a novel micro-grid structure, which can operate fully-autonomously with inherent seamless switching. It can operate independently in both grid-connected and islanded mode as a self-governed entity without relying on the utility grid. An AC/DC/AC converter is employed as the interface between the micro-grid and the utility grid, which enables the two entities to have different voltages in grid-connected mode. Seamless switching between operation modes can be achieved naturally. The micro-grid is regulated to exchange predefined amount of power with the utility grid in grid-connected mode. This will benefit the power dispatching algorithm of the power system. The predefined power is estimated based on power forecasting of local renewable generations and loads with consideration of the Sate of Charge (SOC) of the battery, and is updated and broadcasted every certain period. A small scale AC micro-grid with a rotating generator, battery storage and solar arrays etc. is built for investigation. Matlab/Simulink results are provided to validate the robustness and flexibility of proposed micro-grid and its operation strategy.
Study on the Spatial Pattern of Innovation Output and Influencing Factors in Guangdong-Hong Kong-Macao Greater Bay Area
Authors: Yang Dongliang , Li Chunfeng
Published: May 2019

The advantageous location, port clusters, strong economic strength, developed financial system, rational and orderly urban division of labor and modern industrial system of Guangdong-Hong Kong-Macao greater bay area provide sustainable driving force for innovation activities in this region. This paper selected the Gini-coefficient, first degree index and concentration index to measure the spatial pattern characteristics of innovation output in Guangdong-Hong Kong-Macao greater bay area. The results show that the innovation output presented a spatial pattern of center-periphery in the study region with Shenzhen and Guangzhou as the dual centers and engines of innovation and Dongguan and Foshan as the main innovative areas. Further empirical analysis of the impact of various factors on innovation output in the study region found that R&D expenditure, the number of R&D personnel, the level of economic development and industrial structure all have significant promoting effects on innovation output. Accordingly, this paper put forward countermeasures and suggestions to promote the innovative development of Guangdong-Hong Kong-Macao greater bay area and build a world-class scientific and technological innovation bay area.
Analysis of Fatigue Strain, Fatigue Modulus and Fatigue Damage for the Model formulation of Concrete based on Strain Life Approach
Authors: Yadav Indra , Thapa Kamal Bahadur
Published: May 2019

Analysis of Fatigue Strain, Fatigue Modulus and Fatigue Damage for the modeling of concrete plays a vital role in the evolution material behaviour which is heterogeneous and anisotropic in nature. In this paper, the Level-S nonlinear fatigue strain curve, fatigue modulus curve, residual strain curve of concrete in compression, tension, flexure and torsional fatigue loading were proposed using strain life approach. The parameters such as physical meaning, the ranges, and the impact on the shape of the curve were discussed. Then, the evolution model of fatigue modulus was established based on the fatigue strain evolution model, fatigue modulus evaluation model, residual strain evaluation model, secondary strain evaluation model. The hypothesis of fatigue modulus is inversely related with the fatigue strain amplitude. The fatigue evolution of concrete damages the bond between material grains, changed the orientation of structure of molecules and affects the elastic properties resulting in the reduction of material stiffness and modulus by utilizing strain life analysis, regarding stiffness degradation and inelastic deformation by formation of microcracking, macro cracking, cracking which is heterogeneous and anisotropic in nature . This paper presents the Fatigue Strain Life Model and analyses of fatigue strain, fatigue modulus and damage parameters of concrete which is capable of predicting stiffness degradation, inelastic deformation, strength reduction under fatigue loading. Hence, the obtainable results were compared with experimental results for the validation of the proposed model.
IMPLEMENTATION OF NUMBERED HEADS TOGETHER (NHT) MODEL BASED ON AUDIO VISUAL MEDIA TO IMPROVE CONCEPTS COMPREHENSION OF COOPERATIVE
Authors: Arsitarasmi Rokhmah Dwi , Sadiman Sadiman , Hadiyah Hadiyah
Published: May 2019

The purpose of the research is to improve comprehension of the concept of cooperatives by applying Numbered Heads Together (NHT) model based on audio visual media in fourth grade students. The type of this research is classroom action research, it consists of two cycles. The subject of this research are the teacher and students in fourth grade of State Primary School Totosari No. 102 Surakarta at 2017/2018 academic year consist of 33 students. The data collecting technique using test, interview, observation, and documentation. The data validity techniques using content validity and triangulation of technique. The data analysis technique using Miles & Huberman interactive analysis model. The conclusions of the research are applying Numbered Heads Together (NHT) model based on audio visual media could improve comprehension of the concept of cooperatives.
IMPLEMENTATION OF COOPERATIVE LEARNING MODEL TYPE MAKE A MATCH TO IMPROVE CONCEPTS COMPREHENSION OF TWO DIMENTIONAL FIGURE CHARACTER
Authors: Utomo Santri Prabowo , Sukarno Sukarno , Sriyanto Muhammad Ismail
Published: May 2019

The purpose of this research is to improve concepts comprehension two dimentional figure character through the implementation of cooperative learning model type Make a Match. The source of the data comes from teachers, students, and researches. The data collection technique is by test, interview, observation, and documentation. The validity of the data used content validity and data triangulation. The data analysis used interactive data analysis by Miles and Huberman (2014) which consist of data reduction, data presentation, and conclusion. The results of this research is the average scores that students classical mastery cycle I and cycle II increased. The average scores is 87,5 in cycle II with students classical mastery 88,89% or 16 students of 18 students is completed. The conclusion of this research is through the implementation of cooperative learning model type Make a Match can improve concepts comprehension mathematics leaning about two dimentional figure character.
IMPROVEMENT OF LISTENING SKILL THROUGH DIRECTED LISTENING THINKING ACTIVITY (DLTA) LEARNING STRATEGY
Authors: Rahayu Susanti Fuji , Sukarno Sukarno , Sularmi Sularmi
Published: May 2019

The students listening skill are still low. The purpose of this research are: 1) to improve listening skill through DLTA for second grade students of State Primary School Tegalsari Number 60 Surakarta at 2017/2018 academic year, 2) to describe the improvement result listening skill for second grade students of State Primary School Tegalsari Number 60 Surakarta through DLTA learning strategy. The data collecting techniques used are observation, interview, documentation, and test. The data validity test use triangulation of sources and technique and content of validity. The data analysis techniques is interactive analysis model. The clasical mastery criteria for pre-cycle is up to 26,09% from 23 students achieved the minimal competences criteria (70). At the first cycle, the clasical mastery up 56,52% and at the second cycle up to 91,30%. Based on this research we can conclude that application Directed Listening Thinking Activity (DLTA) learning strategy can improve listening skill.
APPLICATION OF SOMATIC AUDITORY VISUALIZATION INTELLECTUALLY LEARNING STYLE TO IMPROVE THE UNDERSTANDING OF THE CONCEPT OF STRUGGLE TO MAINTAIN INDEPENDENCE
Authors: Pramuharti Marlita , Hartono Hartono , Kuswadi Kuswadi
Published: May 2019

The purpose of this research is to improve the understanding of the concept of struggle to maintain independence with the implementation of Somatic Auditory Visualization Intellectually (SAVI) learning model in grade V SD Negeri Setono No.95 Surakarta academic year 2017/2018. This research is a classroom action research  and conducted in three cycles and each cycle of two meetings. Each cycle consists of four stages of planning, implementation, observation, and reflection. Data collection techniques using observation, interviews, documentation, and tests. Technique of data validity test using technique triangulation and content validity. Data analysis technique using interactive analysis model and comparative descriptive. The average grade of the class before the action was 43.3 with a percentage of mastery of 2.7% or 1 of 36 students that reaching the minimal mastery criteria that is 72. Finally in cycle III the grade point average increased to 83.87 or 31 of 36 students reached the minimal mastery criteria. Thus it can be concluded that the application of Somatic Auditory Visualization Intellectually (SAVI) learning model can improve understanding of the concept of struggle to maintain independence.

 