bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Motor Symptom Laterality on Clinical Manifestations and Quality of Life in Parkinson’s Disease
Authors: Cubo Esther ,   Coppadis Study Group: AdarmesAD AlmeriaM Alonso LosadaMG Alonso CánovasA Alonso FrechF ÁlvarezI Álvarez SaucoM Aneiros DíazA ArnáizS ArribasS Ascunce VidondoA AguilarM ÁvilaMA Bernardo LambrichN Bejr-KasemH Blázquez EstradaM BotíM BorrueC BuongiornoMT Cabello GonzálezC Cabo LópezI CaballolN Cámara LorenzoA CarrilloF Carrillo PadillaFJ CasasE CatalánMJ ClaveroP Cortina FernándezA CosgayaM Cots ForasterA Crespo CuevasA CuboE de Deus FonticobaT de Fábregues-BoixarO Díez-FairenM ErroE EscalanteS Estelrich Peyr, Martínez-Martín Pablo , González-Bernal Jerónimo , Casas Elena , Arnaiz Sandra , Miranda Javier , Gámez Pedro , Santos-García Diego
Published: July 2020

Background: The asymmetry of motor manifestations present in Parkinson’s disease (PD) suggests the existence of differences between both hemispheres. As a consequence, this asymmetry might contribute to different PD clinical phenotypes. Objective: To study the relationship between motor symptom laterality with motor, non-motor symptoms (NMS), freezing of gait (FOG), and quality of life (QoL) impairment in PD. Methods: In this cross-sectional study, we measured motor symptoms severity and complications with the Unified Parkinsons’ disease Rating Scale (UPDRS), FOG with the FOG questionnaire, QoL with the 39-item PD Quality of Life Questionnaire Summary Index, and NMS with the NMS, Visual Analogue Scales for Pain and Fatigue, Beck Depression Inventory-II, Impulsive-Compulsive Disorders, and PD Sleep and Cognitive Rating scales. We defined left and right motor laterality using the UPDRS part III. We used comparative, regression, and effect size analyses to evaluate the impact of asymmetry on motor and NMS, FOG, and QoL. Results: 342 left (LPD) and 310 right (RPD) patients, with a mean age of 62.0±8.8 years, were included. In multivariate regression analysis, LPD was associated with a greater motor (OR = 1,50, 95% CI 1.02–2.21), FOG (OR = 1.56, 95% CI 1.01–2.41), and overall NMS impairment (OR = 1.43, 95% CI 1.001–2.06), and better QoL (OR = 0.52 95% CI 0.32–0.85). Overall, only a mild effect size was found for all comparisons in which significant differences were present. Conclusion: In this large multicenter study, motor symptom laterality seems to carry a mild but significant impact on PD clinical manifestations, and QoL.
Management of Visual Dysfunction in Patients with Parkinson’s Disease
Authors: Savitt Joseph , Aouchiche Rachid
Published: July 2020

Parkinson’s disease (PD) is a movement disorder with many symptoms responsive to treatment with dopamine agonists, anti-cholinergics and the dopamine precursor, levodopa. The cardinal features of PD include tremor, rigidity, bradykinesia, and postural instability. There also are non-motor features that include sleep disorders, cognitive and affective dysfunction, hyposmia, pain and dysautonomia (constipation, bloating, orthostasis, urinary symptoms, sexual dysfunction, dysphagia). Among these non-motor features are signs and symptoms of visual system impairment that range from subtle examination findings to those causing severe disability. In this review we describe common PD-related abnormalities in the visual system, how they present, and potential treatments.
Multimorbidity and Frailty: Tackling Complexity in Parkinson’s Disease
Authors: Tenison Emma , Henderson Emily J.
Published: July 2020

Parkinson’s disease (PD) is a condition that predominantly affects older people. It is imperative that clinical management considers the other significant illnesses that people with PD accumulate as they age in conjunction with their resilience to cope with physiological change. Multimorbidity and frailty act synergistically to heighten the risk of adverse outcomes for older people with PD. These states are associated with increased likelihood of hospitalization, polypharmacy, adverse drug effects including the anticholinergic burden of medications, drug-disease and drug-drug interactions. Management should be integrated, holistic and individualised to meticulously balance the risks of interventions considering the vulnerability of the individual to recover from disturbance to their environmental, physical and cognitive equilibrium.
EVALUASI LAPORAN KINERJA INSTITUSI PADA BADAN PERENCANAAN PEMBANGUNAN DAERAH (BAPPEDA) PROVINSI SULAWESI UTARA
Authors: Simanjuntak Lucyana Aprillya , Manossoh Hendrik , Rondonuwu Sintje
Published: July 2020

The performance report of government agencies performance is a form of accountability in presenting, reporting and disclosing the mission of the agency in the form of activities and activities that are the responsibility of the stakeholders who have the right and authority to request such accountability. Performance Reports presented in accordance with applicable regulations can be utilized to make a decision and steps to be taken in the future in improving agency performance. This study aims to determine the performance report of BAPPEDA has been presented in accordance with the regulations and assess the work achievements of BAPPEDA. The analytical method used is descriptive qualitative. The results of this study indicate that the BAPPEDA performance report is in accordance with the guidelines of the State administration agency (LAN) and the BAPPEDA performance achievements are in good class so that the BAPPEDA performance report can be used for decision making.
The quality of fiber and the effectiveness of use in rations of Holstein-Kholmogor cows
Authors: Kuz'mina Lyudmila , Kartashova Anastasiya
Published: July 2020

Abstract. The purpose of the research is to determine the optimal level of fibre and its fractions, neutral detergent fibre (NDF) and acid detergent fibre (ADF), in the ration of cows with milk yield 6–7 thousand kg according to the period of the physiological cycle. The scientific and economic experiment was carried out with two groups of cows, control and test, 10 animals in each other, during the whole period of lactation. The ration of control group cows corresponded to the economic one. The analysis of the crude fibre in feeds doesn't identify a reasonably accurate content of the fibre and its fractions. Therefore, the research includes the elaborated method of fractionation of structural carbohydrates (Van Soest et al.). As a result of the research, the optimal level of the crude fibre and its fractions (NDF and ADF) was determined in the cow rations according to the periods of the physiological cycle. It was established that the level of the crude fibre should be 20.5 %; NDF – 40.0 %; ADF – 25.0 % during the first phase of lactation (14–100 days). For the period of the second phase of lactation (101–200 days) the content of the crude fiber – 22,5 %, NDF – 41,3 %, and ADF – 26,3 %. For the period of the third phase of lactation (201–305 days) the level of the crude fibre should be 25,0 %; NDF – 45,5 %; ADF – 25,4 %. The novelty of the research is that we determined the requirements of the milk cows for the crude fibre, NDF and ADF according to the physiological periods in the conditions of the Arctic region. Separation of the fibre into fractions makes it possible to reveal more fully its composition, and consequently to show more precisely digesting of each fraction in the gastrointestinal tract of ruminants and to determine the role of fibre in providing of animals by energy.
School Based 4-H Programming: Middle and High School Age Youth Programs
Authors: Spero Vanessa
Published: July 2020

All youth, regardless of age, are at risk for engaging in negative behaviors that can get them into trouble during the afterschool hours when parents and other family members are at work. Middle and high school-age youth are at an age where they can most benefit from increasing opportunities to participate in programs with a positive adult role model, gain necessary life skills, and increase their knowledge of accessible opportunities. Middle and high school programs have the potential to support graduation rates and increase post-secondary school success. This 4-page publication of the UF/IFAS Florida 4-H Youth Development Program provides strategies for success in developing these programs in your community. Written by Vanessa Spero-Swingle. https://edis.ifas.ufl.edu/4h400
Valuing Florida Water Resources: Water Use in Irrigated Agriculture
Authors: Borisova Tatiana , Shah Syed Irfan Ali , Wade Tara , Grogan Kelly , Bi Xiang
Published: July 2020

Water resources provide us with a variety of goods and services (altogether often referred to as ecosystem services or environmental services.) Part of a series entitled Economic Value of Florida Water Resources, this 5-page fact sheet written by Tatiana Borisova, Syed Irfan Ali Shah, Tara Wade, Kelly Grogan, and Xiang Bi and published by the UF/IFAS Food and Resource Economics Department assesses the economic value of the ecosystem services provided by irrigation water and shows the importance to agriculture of water resource protection and restoration.  http:edis.ifas.ufl.edu/fe1057
El Mandato del Dispositivo de Registro Electrónico, reglas de las horas de servicio e Implicaciones para los Transportistas de Productos del Sudoeste de Florida
Authors: Roka Fritz , Wade Tara , Peña-Lévano Luis , Sprouse Craig
Published: July 2020

El Mandato del Dispositivo de Registro Electrónico (ELD por sus siglas en ingles), se convirtió en mandato para vehículos motorizados comerciales (CMV) el 18 de diciembre del 2017. El 18 de junio del 2018, después de 90 días de extensión, el mandato también se aplicó a transportistas de productos. El propósito principal detrás del ELD fue asegurar el cumplimiento con los requerimientos de Horas de Servicio (HOS) por autotransporte y sus conductores. Este artículo se enfoca en el movimiento interestatal de propiedades (productos), and sus objetivos son: 1) revisar las reglas HOS; 2) clarificar las excepciones agrícolas a las reglas HOS; y 3) ofrecer una discusión preliminar a cómo los ELD podrían afectar a los productores del sur de Florida. Fritz Roka, Tara Wade, Luis Peña-Lévano, y Craig Sprouse. UF/IFAS Food and Resource Economics Department. http://edis.ifas.ufl.edu/fe1058
Plant Biostimulants: Definition and Overview of Categories and Effects
Authors: Albrecht Ute
Published: July 2020

This new 4-page article provides an overview of a group of crop production materials termed “plant biostimulants,” which are frequently promoted as environment-friendly alternatives to chemical-based products. It explains their regulatory status and presents an overview of the most popular materials (e.g., beneficial fungi, seaweeds, and silicon) and their effects on plants. Written by Ute Albrecht and published by the UF/IFAS Horticultural Sciences Department. http://edis.ifas.ufl.edu/hs1330
Biology and Management of Pusley (Richardia L.) in Tomato, Pepper, Cucurbit, and Strawberry Production
Authors: Sharpe Shaun M. , Boyd N. S. , Marble Chris , Steed Shawn
Published: July 2020

Four species of pusley (Richardia L.) are widespread and common weeds in Florida vegetable and strawberry production. We refer to the native plant Richardia scabra L. as Florida pusley. This discrimination is necessary because these species are often referred to collectively as Florida pusley due to overlapping distributions, similar growth habits and leaf morphologies, and difficulty identifying without the presence of fruit. This new 6-page publication of the UF/IFAS Horticultural Sciences Department describes the different pusley species and provides management options for strawberry, pepper, cucurbits, and tomato. Written by Shaun M. Sharpe, Nathan S. Boyd, Chris Marble, and Shawn Steed. https://edis.ifas.ufl.edu/hs1331
Diaprepes Root Weevil on Southern Highbush Blueberry in Florida
Authors: Phillips Douglas A. , Liburd Oscar E. , Duncan Larry W.
Published: July 2020

Citrus root weevil, Diaprepes abbreviatus (Linnaeus) is a destructive pest on citrus trees. It is now becoming a significant pest on blueberry in central Florida, at times causing major damage to blueberry bushes that are more than two years old. This 3-page fact sheet written by Douglas A. Phillips, Oscar E. Liburd, and Larry W. Duncan and published by the UF/IFAS Entomology and Nematology Department will educate blueberry growers on how to monitor, identify, and control citrus root weevil. http://edis.ifas.ufl.edu/in1241
Poinsettia Thrips, Impatiens Thrips (suggested common names) Echinothrips americanus Morgan (Insecta: Thysanoptera: Thripidae)
Authors: Panthi Babu , Liburd Oscar E. , Renkema Justin
Published: July 2020

Echinothrips americanus Morgan is an important greenhouse foliage pest of vegetable and ornamental plants (Figure 1). This pest is polyphagous, reported from 48 plant families worldwide. The preferred hosts of Echinothrips americanus belong to the Araceae and Balsaminaceae plant families (CABI/EPPO 2014). This pest is native to eastern North America (Stannard 1968) and was first reported in 1984 on poinsettia, Euphorbia pulcherrima (Euphorbiaceae), in Georgia (Oetting 1987). Other important greenhouse crops damaged by this pest include Impatiens spp. (Balsaminaceae), gerbera, rose, sweet pepper, cucumber and eggplant (Vierbergen et al. 2006).

On EDIS: https://edis.ifas.ufl.edu/in1246

On Featured Creatures: http://entnemdept.ufl.edu/creatures/ORN/THRIPS/Echinothrips_americanus.html
Research on the Significance of Electronic Integrated Graphic Teaching Method for High School English Writing
Authors: Tang Xuqiu
Published: July 2020

English writing, as a must-learn content for English learning and one of the five major language skills, is an important reflection of students’ ability in language output, and has become the focus of English teaching in high schools. However, there are still problems in the teaching of English writing. It has become an important issue that need to be studied about how to further improve students’ writing efficiency and writing quality, and further improve their English writing ability. The electronic integrated graphic teaching method is based on graphic theory under the development of modern information technology. This article briefly explains the electronic integrated graphic teaching method, and specifically analyzes the application of this teaching method for the teaching of English writing.
Analysis of Market Orientation and Innovation on SMEs Business Performance: Evidence in Kebumen
Authors: Susilowati Ika , Kaharti Eni
Published: July 2020

This study aims to analyze empirically the influence of customer orientation, competitor orientation, coordination between functions, innovation on business performance in SMEs in Kebumen. The research data was obtained from SME businesses to scientifically test whether customer orientation, competitor orientation, coordination between functions, innovation affects business performance. The sample used in this study were 100 SMEs in Kebumen Regency who had met the established criteria. The analytical method used is multiple linear regression analysis, using the SPSS 21.0 for windows statistical computer program. The results of hypothesis testing in this study indicate that customer orientation and coordination between functions have a positive effect on business performance. Whereas competitor orientation and innovation have no influence on business performance.
Neophilia dan Dampaknya Bagi Kualitas Pengalaman Penikmat Makanan Lokal Kota Kebumen
Authors: Wibawanto Sigit
Published: July 2020

This study is limited to the discussion of food consumption which is explored from the dimensions of local food preferences in destinations. This study has three objectives: to establish the neophilic tendency of foods to determine the consumption of new foods; how is the quality of food experiences with neophilia personalities; and how tourist food experiences are moderated by travel motives for new experiences about food in the places visited. This study illustrates a descriptive research scheme, tested on travelers who happen to pass through the city of Kebumen who enjoy "Ambal" satay food by 100 respondents. The study used a partial statistical test (t-test) and Moderated Regretion Analysis (MRA) to look for the effect of variable X on the Y variable. The results showed neophilia personality had a positive effect on the quality of experience. Travel motives that moderate the neophilia personality are not able to moderate the relationship of the neophilia personality to the quality of experience. The conclusions of the study show the higher the neophilia personality and travel motives, the more it can affect the quality of the experience but not with moderation.
Pengaruh Corporate Social Responsibility Terhadap Tax Avoidance pada Perusahaan Manfaktur yang Terdaftar pada Bursa Efek Indonesia Tahun 2014-2017
Authors: Setiawati Farida , Adi Priyo Hari
Published: July 2020

This study aims to examine and provide empirical evidence of the influence of corporate social responsibility (CSR) against tax avoidance. The independent variables of this study are CSR, size control variables and financial performance which are proxy through leverage, the dependent variable is tax avoidance. The independent variable is measured using a corporate social responsibility index (CSRI), the size control variable is measured by total company assets, the financial performance control variable is measured by a debt to equity ratio (DER), the dependent variable tax avoidance is measured using the effective tax rate. The population used is manufacturing companies that have been listed on Bursa Efek Indonesia in 2014-2017 . The research sample was determined using 89 random sampling techniques with company data. Data processing in this study uses multiple regression analysis models (MRA). Regression analysis results show that the varibales corporate social responsibility has a positive impact on tax avoidance.
The Valuasi Saham yang Masih Layak untuk Dikoleksi di Bursa Efek Indonesia (BEI) pada Saat Pandemik Covid -19
Authors: Alhazami Lutfi
Published: July 2020

Penilaian harga saham sangat dibutuhkan pada saat pandemik Covid-19 untuk mengurangi resiko kerugian. Penelitian ini bertujuan untuk memilih saham yang layak untuk dibeli dan dijual pada saat pandemik Covid-19. Hampir semua perusahaan mengalami penurunan harga saham pada saat pandemik Covid-19, oleh sebab itu dalam mengurangi resiko kerugian bagi investor, perlu dilakukan valuasi. Penelitian ini menghasilkan harga wajar suatu saham dan menentukan saham yang layak untuk dijadikan pilihan dalam berinvestasi pada saat pandemik Covid-19.  Metode yang digunakan adalah analisis deskriptif dengan pendekatan kuantitatif. Penelitian ini menggunakan perusahaan yang termasuk dalam LQ 45 sampai Januari 2020. Sampel diperoleh sebanyak 15 perusahaan dengan teknik pengambilan sampel purposive sampling. Pengukuran valuasi harga saham dilakukan menggunakan pendekatan Price Earning Ratio (PER). Hasil penelitian menunjukan bahwa  3 dari 15 dalam kondisi undervalued murah dan layak dibeli, kemudian 7 perusahaan merupakan saham dengan kondisi overvalued dan 5 perusahaan sisanya dalam kondisi correctly valued.
Determinants of Cocoa (Cacao Theobroma) Farmers Uptake of Crop Insurance: Evidence from Ekiti State
Authors: Olowa Olatomide Waheed , Olowa Omowumi Ayodele
Published: July 2020

Cocoa farmer faces increasing challenging environment through exposure to risks factors which have impacted negatively on their production or output. Since farmers are primary producers and often times lack capacity to control risks factor, it is important to manage this factors. This study examines the cocoa farmers’ risk preferences and crop insurance perception and isolates the drivers of decision to uptake crop insurance among cocoa farmers in Ekiti state. The sample for the study consist of 200 cocoa farmers who were household heads selected through multi-stage sampling across four Local government areas of Ekiti State who are predominantly cocoa producers. Data collected on socio-demographic characteristics, perception of crop insurance and risk preferences, were analyzed using descriptive statistics and binary logistic model. Results showed that majority of the cocoa farmers were without crop insurance, with higher enrolment in Membership of cooperative society, owned their land, larger household size and lower educational level but higher level of farm experience when compared to cocoa farmers who are holding crop insurance. Farmers risk preferences showed no significant difference between farmers with or without insurance. Education (β=0.59), Household size (β=0.0029) and Debt use (β=0.02), Membership of cooperative (β=-4.53), Farming Experience (β=-2.51), Owned Land (β=-2.19) and Non-Farm Income (β=-0.65) were among the significant determinants of insurance uptake. Risk mitigating measures such as provision of necessary incentives such as improved varieties of cocoa seedling, as well as provision of fertiliser and approved pesticides, financial assistance, and simple processing technologies that produce standard cocoa bean plus a re-jigged Nigeria Agricultural Insurance Corporation (NAIC) for an improved discharge of its function are recommended.
Motivated behavior in intimate relationships: Comparing the predictive value of motivational variables
Authors: Zygar-Hoffmann Caroline , Pusch Sebastian , Hagemeyer Birk , Schönbrodt Felix D.
Published: July 2020

Motivational variables are considered fundamental factors influencing the occurrence of behavior. The current study compared different types of motivational variables (implicit and explicit motive dispositions, motivation as states and as aggregated person-level variables) in their ability to predict communal and agentic behavior reports in intimate relationships. 510 individuals completed measures of dispositional communion and agency motives and participated in a dyadic experience sampling study with five assessments per day across four weeks. They reported on their momentary communal and agentic motivation, as well as on their own and their partner’s behaviors. All examined types of motivational variables predicted certain behavior reports on the between-person or within-person level and had incremental effects beyond the other motivational variables in at least one motive domain. Directly replicating and conceptually extending prior research, the effects of motivational states and their aggregates were consistently found across behavioral outcomes, across self- and partner-reports and across the motive domains of communion and agency. Using the example of motivational states, the general value of assessing within-person variables for psychological phenomena in ESM-designs is discussed.
Temporal dependency of emotional states at work and its relationship with dynamic performance
Authors: De Longis Evelina , Alessandri Guido
Published: July 2020

Emotion dynamics, how people’s emotions fluctuate across time, represent a key source of information about people’s psychological functioning and well-being. Investigating emotion dynamics in the workplace is particularly relevant, as affective experiences are intimately connected to organizational behavior and effectiveness. In this study, we examined the moderating role of emotional inertia in the dynamic association between both positive and negative emotions and self-rated job performance among a sample of 120 Italian workers (average age 41.4, SD = 14), which were prompted six times per day, for five working days. Emotional inertia refers to the extent that emotional states are self-predictive or carry on over time and is measured in terms of the autocorrelation of emotional states across time. Although inertia has been linked to several indicators of maladjustment, little is known about its correlates in terms of organizational behavior. Findings revealed that workers reporting high levels of positive emotions and high inertia rated their performance lower than workers high in positive emotions, but low in inertia. In contrast, the relation between negative emotions and performance was not significant for either high levels of inertia or low levels of inertia. Taken together, these results suggest the relevance of investigating the temporal dependency of emotional states at work.
A Política Nacional de Educação Ambiental e seus Desdobramentos no Município de Toledo, PR
Authors: Aparecida Ribeiro Nepomoceno Taiane , Carina Gazolla Volpiano Luana , Trajano Rowedder Vania , Renate Von Borstel Roesler Marli
Published: July 2020

A Educação Ambiental é um componente de extrema importância para a formação de uma sociedade mais crítica e sustentável. Nesse sentido, as iniciativas, criadas para dar suporte a este fim, são medidas que podem colaborar com a melhoriado meio ambiente e da qualidade de vida da população local e global, contudo, mais importante do que a sua promulgação é a sua implementação enquanto política pública. A principal finalidade deste trabalho é discutir a Política Nacional de Educação Ambiental e seus aspectos práticos, especialmente no que se refere aos espaços e ações ambientais no município de Toledo-PR. Para tanto, foi realizada uma pesquisadocumental de normativas, documentos e sites oficiais do município, sobre a Educação Ambiental no contexto das ações práticas, complementada pela literatura nacional acerca da questão. Nesse sentido, identificou-se que o município de Toledo-PR possuimuitas ações, programas, projetos e espaços destinados à Educação Ambiental, os quais são essenciais para a promoção de uma nova forma de cuidar, conviver e transformar as relações que mantemos com o meio ambiente e com os seus diversos componentes.Assim, a construção da Educação Ambiental como política pública implementada no município implica em processos diretos e indiretos que propõem recuperar a noção de sustentabilidade e o fortalecimento da emancipação como fomento de ação sociopolítica.
Educação Amorosa
Authors: Jorge da Silva Amarildo , Jorge Corrêa João , Carlos Rolim de Moura José
Published: July 2020

O artigo expõe uma reflexão sobre o ato de educar no processo de conversão do conhecimento implicado em conhecimento explicado. Entende-se o processo educativo como um ato amoroso. O pressuposto é que a Educação Amorosa em suagênese tem o potencial e a imanência de corroborar no processo de conversão de saberes tácitos individuais em expertises coletivas na educação de um novo homo em processo permanente de transformação e aprendizado. A construção filosófica, teórica e metodológica do texto se deu na perspectiva sistêmica, na biologia do amor e em alguns excertos da teoria da complexidade. A questão inquietadora é: quais as implicações da educação amorosa no processo de conversão do conhecimento tácito individual em conhecimento coletivo explícito? O objetivo é compreender e refletir sobre as implicações do ato de educar no processo de conversão de conhecimento implicado em conhecimento explicado. Um olhar mais atento mostra um sistema educativo no ocidente, principalmente no Brasil, fragmentado, performático e alienante do sujeito em sua essência. Observa-se que qualquer que seja o ambiente (empresarial, organizacional e ou institucional) pode ser convertido em um ambiente educativo e de aprendizado permanente (comunidade de prática). O aparato educativo é um espaço de construção do sujeito com o outro, da reelaboração de conteúdos e da sua responsabilidade no meio ecológico em que se insere.
Ensino Ativo ou Aprendizagem Ativa?
Authors: Viapiana Norma
Published: July 2020

Editorial
Electricity efficiency of auxiliary power systems in coal thermal power plant
Authors: Mujanović Azrina , Konjić Tatjana , Dedić Adisa
Published: July 2020

Renewable energy sources such as hydro, wind and solar energy are taking an increasing share in the electricity mix. However, electricity production from thermal power plants is independent of the weather conditions and is still important as a back-up power source to renewable energy sources. Given the fact that the electricity market is open, it is clear that each MWh is important. Therefore, auxiliary power systems as a part of thermal power plants should be also energy efficient. The main aim of the presented research was to investigate the efficient operation of different consumers in the auxiliary power system in the old-dated thermal power plant ‘’Tuzla’’ depending on different power at generator output. The performed analysis identified consumers suitable for electricity efficiency improvement giving results of power savings obtained on modestly available measurements and old-date technical documentation. Following obtained results, some recommendations for improving electricity efficiency were proposed with a rough calculation of possible savings. Measurements of auxiliary power system consumption depending on power at generator output in new thermal power plant ‘’Stanari’’ was presented. Future trends and directions in thermal power plant automation were also discussed.
Differential diagnosis of pancreatic diseases: new approaches in laboratory and radiologic diagnosis
Authors: Vinokurova L. V. , Lesko K. A. , Bordin D. S. , Dubtsova E. A. , Tyulyaeva E. Yu. , Varvanina G. G.
Published: July 2020

Aim. To assess significance of serum fibronectin (FN) and new approaches of processing computed tomography (CT) results for pancreatic cancer (PC) and chronic pancreatitis (CP) differential diagnosis.

Materials and methods. Data of 49 patients with pancreatic lesions who underwent multislice computed tomography (MSCT) with intravenous contrast enhancement and FN evaluation in 2018 were analyzed. There were 29 (59.2%) males and 20 (40.8%) females, mean age 51.9±13.9 (30–82). All patients were divided in 3 groups: 1 — PC (17 patients, 34.6%) — morphologically verified, 2 — chronic pancreatitis with previous pancreonecrosis (CPPN) — 16 patients, 32.7%, 3 — chronic calcifying pancreatitis (CCP) — 16 patients, 32.7%. We calculated median of enhancement gradient between region of interest and intact parenchyma (Мgrad) based on MSCT results. Pearson’s correlation coefficient (rp) was calculated for correlation assessment.

Results. We assessed mean Мgrad and mean serum FN rate in all three groups: PC — 28.1±2.6, р=0.0001, CPPN — 14.9±2.4, р=0.07, CCP — 13.3±0.7, р=0.08 for Мgrad, and 239.8±30.1, p=0.8, 243.5±33.8, p=0.7, 227.2±34.3, p=0.8 for serum FN rate, respectively. There was statistically significant strong correlation of Мgrad in patients with PC (rp=0.63, p=0.0001). We revealed cut-off point of Мgrad value for PC that was 20 (p=0.001). There were no statistically significant correlations of serum FN rate in all groups (PC rp=0.04, p=0.8; CPPN rp=0.06, p=0.7; CCP rp=-0.03, p=0.8).

Conclusions. Mgrad evaluation based on MSCT is an informative marker for differential diagnosis between PC and chronic pancreatitis, high rates of Мgrad positively correlate with PC existence. There was no correlation between serum FN rate and existence of PC, CPPN or CCP.
Risk assessment of pathological conditions caused by circulating H. pylori strains
Authors: Karimova D. K. , Sobirova G. N. , Karimov M. M.
Published: July 2020

In recent years, there has been an increase in the prevalence of inflammatory and destructive diseases of the gastroduodenal zone, which is primarily explained by Helicobacter pylori (H. pylori) infection. One of the main factors of H. pylori pathogenicity is presence of cytotoxin-associated gene — CagA. It is known that CagA-positive H. pylori strains are associated with the development of atrophy, tumor invasion and rapid metastasis. A number of recently published studies have revealed that CagA is a polymorphic gene which contains a different number of repetitive sequences located in the 3’ region. Each repetitive region of CagA contains Glu-Pro-Ile-Tyr-Ala (EPIYA) profiles including tyrosine phosphorylation. Depending on the sequence of the EPIYA profile, there are 4 segments: EPIYA-A, EPIYA-B, EPIYA-C, EPIYA-D, each containing a repetitive region. Geographical features of the prevalence of H. pylori strains depending on the sequence of EPIYA have been revealed: EPIYA-A region of the western isolates of this bacterium is associated with EPIYA-A, EPIYA-B, EPIYA-C segments, while the eastern CagA-positive H. pylori isolates are characterized by the A-B-D type of the CagA gene. Data illustrating the strong correlation between the western CagA-positive H. pylori strains, which have a repeating EPIYA-C segment, and the development of precancerous states, as well as gastric cancer, are presented. H. pylori strains containing simultaneously A-B motives of EPIYA or one C-type of the CagA gene are associated with a 7-fold increase of risk of gastric cancer compared to CagA-negative strains; presence of two or more EPIYA-C motives is associated with a 30-fold increase of this risk.
Role of endoscopy in diagnosis and treatment of gallstone disease complicated by the pathology of the extrahepatic bilary tract (literature review)
Authors: Samoilenko G. E. , Klimanskyi R. P. , Zharikov S. O. , Makhnik V. V.
Published: July 2020

The article presents current literature data of domestic and foreign authors on the main problems of endoscopic diagnostics and complex approach to treatment of gallstone disease complicated by pathology of the extrahepatic biliary tract. Efficiency of one-stage and two-stage methods of surgical treatment of cholelithiasis and the possibility of their practical application are considered. Complex approach for minimally invasive bile duct interventions with cholecystoccholedocholitiase, which can be conditionally divided into laparoscopic, mini-access, endoscopic by duodenoscope, cholangioscopy, ultrasound-controlled biliary intervention, is analyzed. Methods of diagnostic testing that can be divided into preoperative and intraoperative, non-invasive and invasive used in patients with cholecystoccholedocholitiase, namely fibrogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, percutaneous-transhepatic cholangiography, diagnostic laparoscopy, intraoperative cholangiography, intraoperative ultrasound, angiography. New concepts of providing surgical care to patients with this pathology are presented, which include one-stage performance of cholecystectomy with priority use of intraoperative antegrade endoscopic papillosphincterotomy, and retrograde litho-extraction under duodenoscope control, in comparison with the two-stage tactics of correction of cholelithiasis with pathology of extrahepatic biliary tract, when the first stage includes its decompression, rehabilitation, and the second — cholecystectomy. Statistical data of complications arising during diagnostic and therapeutic manipulations in patients with cholelithiasis complicated by pathology of the extrahepatic biliary tract are presented. Number of cases of postoperative mortality depending on the severity of complications of cholelithiasis is also considered.
Management of autoimmune pancreatitis
Authors: Akshintala V. S. , Singh V. K.
Published: July 2020

The article contains modern data on such a chronic pancreatic disease as autoimmune pancreatitis (AIP). Statistical data on the prevalence and incidence of AIP are presented, the current international classification of this pathology is considered, the main features of type 1 AIP (lymphoplasmacytic sclerosing pancreatitis, LPSP) and type 2 AIP (idiopathic duct centric pancreatitis, IDCP) are put forward. The clinical manifestation of these types is different: obstructive jaundice develops more often in patients with LPSP, while patients with IDCP mostly have acute pancreatitis. The presence and variety of extrapancreatic manifestations of the disease with extremely frequent concomitant development of ulcerative colitis is emphasized. The features of serological diagnosis of AIP and the role of IgG4 level in determining the type of disease are considered. The proper techniques of AIP instrumental diagnostics are listed, the typical changes detected during computed tomography and the distinctive histological characteristics of LPSP and IDCP are considered. The feasibility of a differential diagnosis between AIP and pancreatic cancer is indicated by analyzing the results of serological, imaging, and histological studies. The algorithm of management of AIP patients depending on the type of disease is described, as well as the tactics of prescribing corticosteroids, immunomodulators upon LPSP and IDCP. Immunomodulators of choice (mycophenolate mofetil, azathioprine) are indicated, and rituximab administration features are considered. Possible signs of AI recurrence are listed (IgG4-sclerosing cholangitis, high IgE level).
Comparative analysis of resection and draining interventions in patients with cystic pancreatic lesions
Authors: Koshel A. P. , Klokov S. S. , Dibina T. V. , Drozdov E. S. , Rakina Yu. Yu.
Published: July 2020

Aim of study: to evaluate the results of draining and resection interventions in patients with pancreatic cystic lesions.

Materials and methods. A retrospective analysis of the treatment of 50 patients with pancreatic cystic lesions of various etiologies was conducted. All patients included in the study underwent surgical treatment, namely 20 (40.0%) resection interventions (RI) and 30 (60.0%) draining interventions (DI). Comparison of short- and long-term outcomes of treatment between the two groups was carried out.

Results. There were no statistically significant differences in body mass index in the compared groups. The average duration of surgery in DI group was significantly lower than in RI group (142.5±4.9 and 278.5±6.9, p<0.001). The mean intraoperative blood loss, as well as the length of hospitalization, was significantly lower in DI group as compared with RI (390±28.4 ml, 500±27.4 ml, p=0.008; 8.5±0.9 days, 13.8±3.9 days, p<0.001). The severity of postoperative complications was proved to be significantly higher in RI group (p<0.05). However, when analyzing long-term results, the attacks-free course of the disease was observed only in RI group.

Conclusion. If technically possible, DI is more preferable than RI in patients with pancreatic pseudocysts. RI should be performed in patients with cystic neoplasia.
Renal and Bleeding Complications in Critically Ill Covid-19 Patient-A Case Report
Authors: Pia Masuma Islam , Islam Tasbirul
Published: July 2020

The ongoing outbreak of Covid-19 presented with a wide variety of clinical manifestations. Apart from the common respiratory complications, acute renal impairment and bleeding complications on full anticoagulation has been also observed in some patients. Here we report a 67 year old male with COPD and CKD presented with symptoms of covid-19 and found ground glass opacity on CT scan and bibasilar opacity on chest X-ray, admitted to the hospital and he was initially stable after supportive management, discharged home on antibiotics but readmitted after 4 days with worsening shortness of breath, hypoxia, tachycardia (A-fib with Rapid Ventricular Response) and high ESR. He was started on High flow nasal cannula (HFNC), diltiazem, adenosine and antibiotics ultimately needed intubation. While he was on antibiotics, hydroxychloroquine, DVT prophylaxis and statin he developed septic shock two days after intubation. Next day he had to receive Continuous Renal Replacement Therapy (CRRT). He was placed on heparin infusion. With clinical improvement the patient was extubated to HFNC, but after one day of extubation he developed bradycardia, hypotension and gradually became unresponsive. He was given vasopressors and intubated again. CT scan showed retroperitoneal hematoma 10 x7 x 12 cm. His heparin was discontinued and was managed conservatively. With supportive treatment his clinical condition improved gradually and was extubated again. CRRT was switched from CVVH (Continuous Veno -Venous Hemofiltration) to HD and eventually he was discharged home. Clinicians should remain watchful at all stages of critical care management of COVID 19 because timely intervention and drug adjustment is lifesaving.

J Bangladesh Coll Phys Surg 2020; 38(0): 136-140
Haematologic Profile Abnormalities and Coagulopathy Associated with Covid-19: A Prospective Study of 100 Patients
Authors: Bhuiyan Mohammed Nuruzzaman , Giti Susane , Hossen Mohammad Shameem Muntasir , Rahman Md Moshiur , Zannat Major Nur E , Chokroborty Sonia
Published: July 2020

Background: The number of COVID-19 patients is exponentially increasing worldwide since December, 2019. Management in intensive care units (ICU) has become a major challenge; therefore, time demanding laboratory markers for early recognition of morbid forms is utmost important for timely triaging of patients.

Objective: The present study aimed to evaluate the role of haemotological and Coagulation profile in the assessment of disease severity of COVID-19. Methods: The current study is an observational study done prospectively in Armed Forces Institute of Pathology (AFIP) during the period of 28 March 2020 to 15 May 2020. The study subjects were haematological and coagulation profile data of 100 COVID-19 patients grouped in non-ICU and ICU at the baseline and at 4th day of admission in Combined Military Hospital (CMH), Dhaka. All the data were recorded and analyzed by SPSS 20.0 programme.

Results: Here subjects with featured of lymphopenia were detected prominently in our COVID-19 ICU patients with a median nadir ALC of 0.9 x109/L. The most common pattern of coagulopathy observed in patients hospitalized with COVID-19 is characterized by elevation in fibrinogen and Ddimer levels, particularly significantly higher in ICU group.

Conclusion: The present study is a reflection of significant anomalies in haematological and coagulation parameters during the disease process with COVID-19.

J Bangladesh Coll Phys Surg 2020; 38(0): 61-66
Convalescent Plasma: A Potential Treatment for COVID-19
Authors: Khan Mohiuddin Ahmed , Akter Mafruha
Published: July 2020

As no specific standard therapies have been approved for Coronavirus disease 2019 (COVID-19), so prevention and supportive care dominate the approach to COVID-19. Exposure to this severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in an adaptive immune response that commonly include antibodies with neutralization activity. Treatments directly targeting the virus and the inflammatory response to it remain investigational. Convalescent plasma (CP) is such a therapy that had been reported hundred years back in studies from the Spanish influenza era. So the idea of convalescent plasma from subjects who have recovered from viral infections has been used to both prevent or treat disease. Over the past two decades’ notable examples of the successful use of convalescent plasma (CP) include influenza, measles, Middle East respiratory syndrome (MERS), Ebola and severe acute respiratory syndrome (SARS). Two case series were recently published by China examining the therapeutic use of CP in patients with COVID-19. In the context of pandemic situation, the Food and Drug Administration (FDA) allowed to use COVID-19 convalescent plasma as Investigational New Drug (IND) since April 2020 to help patients with serious or immediately life-threatening illness associated with COVID- 19. Case series studying convalescent plasma use in the treatment of COVID-19 have been promising, but additional, high-quality studies are needed to determine the efficacy of the treatment when applied for prophylaxis, for early phases of illness and for severe illness. Bangladesh also started program to use convalescent plasma for severe and critical COVID-19 patients under limited clinical trial.

J Bangladesh Coll Phys Surg 2020; 38(0): 109-115
Coronavirus Disease 2019 (COVID-19) – An Overview
Authors: Bashera Ariful , Das Debashish , Faiz M Abul
Published: July 2020

The coronavirus disease 2019 (COVID-19) is now a pandemic with a massive death toll across the world. The knowledge and understanding of this novel coronavirus transmission and pathogenesis are evolving. Although the landscape of vaccine and drug development is changing at an unprecedented pace, currently, there is no specific effective treatment. Proper and timely management of severe and critically ill COVID-19 patients is crucial to reduce deaths in the ongoing pandemic. Ramping up testing capacity alongside a test strategy in place, ensuring adequate resources, i.e., protective gear, O2 supply, ICU facilities are essential requirements in the fight against COVID-19. Infection prevention and control measures at a personal level (e.g., handwashing, wearing masks, proper donning and doffing of personal protective equipment), and at hospital settings (e.g., hospital cleanliness, safe handling, and disposal of waste) are extremely important to reduce the risk of infection. COVID-19 pandemic has caused a global crisis that requires a multidisciplinary response and concerted effort to ensure resilience in health systems.

J Bangladesh Coll Phys Surg 2020; 38(0): 84-90
Key Informant Methods: An Innovative Social Mobilization Strategy to enable Communitybased Diagnosis, Treatment and Rehabilitation for People with Disability
Authors: Pandey Ashok , Gautam Pratima
Published: July 2020

Key informant method is an innovative technique for identifying people who are disabled in the community, by training local volunteers to act as key informants. Key informants are the local native people include teachers, village doctors, local health workers, religious leaders, community leaders, students, traditional healers, police, NGO staffs, health professionals, local journalists, village councils etc. For them, host organization organized a training to train the key informants to identify and refer the suspected disable people. The study proved key informant method as a valid method for identification of disabling children. Key informant method had a high sensitivity (average 98%) for case detection in all groups but specificity was lower (average 44%), particularly for hearing impairment. Key Informant Method can be used to collect data on types of disabilities, cause, the magnitude of impairments, severity, quantify a need for disabled people, and making access to services (including adoption, health check-up, vocational training, rehabilitation, and other facilitation training).Keywords: Bangladesh; disability; key Informant; key informant methods
Nepal’s Response to Contain COVID-19 Infection
Authors: Piryani Rano Mal , Piryani Suneel , Shah Jay Narayan
Published: July 2020

Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a ‘global pandemic’ by WHO on 11 March, 2020. Government of Nepal’s steps from 18 March, 2020 led to partial lock down and countrywide lockdown imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal’s response to contain COVID-19 infection discussed under three headings: Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled.Keywords: COVID-19; lockdown; Nepal; pandemic; response