bluuebunny/crossref_metadata_2025 huggingface dataset:
Heat and Moisture Exchanging Filter pada Pasien COVID-19 yang Menjalani Sectio Caesarea
Authors: Dewi Fitri Hapsari , Purwoko  , Gita Nur Siwi
Published: March 2022

Coronavirus Disease 2019 (COVID-19) menjadi topik hangat di dunia termasuk Indonesia sejak muncul kasus di Wuhan, Hubei, Cina pada Desember 2019. Dalam lingkup anestesi obstetri, Sectio Caesaria (SC) pasien COVID-19 merupakan problem yang membutuhkan perhatian. Royal College of Obstetricians and Gynaecologists (RCOG) merekomendasikan anestesi intraspinal pada operasi SC pada pasien terkonfirmasi atau dengan suspek COVID-19. General anestesi (GA diketahui dapat meningkatkan resiko aerosolisasi yang dapat membahayakan petugas medis. Anesthesia Patient Safety Foundation (APSF) merekomendasikan penggunaan Heat and Moisture Exchanging Filter (HMEF) pada breathing circuit anestesi tindakan GA pasien COVID-19 dimana HMEF bekerja sebagai filter yang dapat memfiltrasi bakteri dan virus. Penggunaan HMEF dipercaya dapat menurunkan resiko kontaminasi silang.
Hubungan Neutrophil – Lymphocyte Ratio (NLR) Terhadap Mortalitas Pasien Sepsis di Unit Perawatan Intensif RSUP Haji Adam Malik Pada Tahun 2018
Authors: Lubis Bastian , Hasby Ahmad Yapiz , Putra Alvin Oktomy , Yanni Gema Nazri , Amelia Putri
Published: March 2022

Sepsis adalah keadaan disfungsi organ yang mengancam jiwa yang disebabkan karena disregulasi respon tubuh terhadap infeksi. Sepsis juga merupakan penyebab kematian utama di antara pasien kritis unit perawatan intensif non-koroner di Amerika Serikat. Tahun 2010 tercatat prevalensi pasien rawat intensif yang menderita sepsis di Rumah Sakit Dr.Cipto Mangunkusumo adalah 25% dengan derajat mortalitas sebesar 77,3%. Untuk menilai seberapa berat respons inflamasi digunakan biomarker. Salah satu biomarker yang digunakan adalah neutrophil-lymphocyte ratio (NLR). Sampai saat ini masih belum digelar konsensus untuk melihat hubungan antara NLR dengan prognosis pasien sepsis. Melihat hubungan neutrophil-lymphocyte ratio terhadap mortalitas pasien sepsis di ICU RSUP Haji Adam Malik.Penelitian ini merupakan penelitian analitik dengan desain penelitian berupa cross-sectional. Data penelitian ini menggunakan data sekunder berupa rekam medis dan metode pengumpulan data berupa total sampling. Dari hasil penelitian, didapatkan insidensi sepsis di Intensive Care Unit (ICU) Rumah Sakit Umum Pusat (RSUP) Haji Adam Malik sebanyak 97 pasien dan didominasi oleh pasien lansia dan laki-laki dengan jumlah pasien masing-masing sebesar 58 orang. Analisis bivariat menggunakan uji Fisher’s Exact Test didapatkan tidak adanya hubungan yang signifikan secara statistik dengan nilai p value 0,371 antara NLR terhadap mortalitas pasien sepsis. Tidak didapatkan hubungan neutrophil-lymphocyte ratio terhadap mortalitas pasien sepsis.
Kanabis dan Penggunaannya dalam Terapi Nyeri Kronis
Authors: Datu Madonna Damayanthie , Prasetyadhi Jokevin
Published: March 2022

Nyeri kronis adalah "nyeri tanpa nilai biologis nyata” yang bertahan hingga lebih dari 3 bulan. Pasien yang menderita nyeri kronis sering kali memiliki penyakit biologis yang tidak dapat dipisahkan dari faktor kognitif, afektif, perilaku, dan sosial sehingga memiliki dampak negatif terhadap kualitas hidup. Banyak penelitian telah dilakukan untuk menemukan cara penanganan nyeri yang adekuat dengan efek samping seminimal mungkin. Bunga dari tanaman kanabis (Cannabis sativa) telah mulai digunakan sebagai analgesia nyeri kronis, namun efikasinya masih kontroversial. Konstituen utama kanabis seperti delta 9-tetrahydrocannabinol (THC), cannabidiol (CBD), dan cannabinol (CBN) telah diketahui memiliki kontribusi terhadap mekanisme mengurangi nyeri. Sediaan kanabis bervariasi dengan rasio THC/CBD yang berbeda-beda, disertai dengan potensi efek samping pada berbagai sistem organ. Rute pemberian yang paling umum adalah inhalasi dan oral. Walaupun kanabis dapat digunakan sebagai salah satu penanganan nyeri kronis, namun dalam penggunaannya dapat berpotensi disalahgunakan hingga menyebabkan efek psikotik. Oleh karena itu, diperlukan pemahaman yang baik mengenai farmakologi kanabis agar dapat digunakan sebagai alternatif pengobatan nyeri kronis.
Perbedaan Efektivitas Iodine Povidone 1% dan Listerine® sebagai Preparat Perawatan Mulut terhadap Pencegahan Ventilator Associated Pneumonia
Authors: Chuandy Indra , Ardana  , Putro Bambang Novianto
Published: March 2022

Pendahuluan: Ventilator associated pneumonia (VAP) merupakan pneumonia yang muncul dalam waktu 48 – 72 jam setelah intubasi. Insidennya mencapai 9 – 27% dengan tingkat mortalitas lebih dari 50%. Perawatan mulut merupakan salah satu cara mencegah VAP pada pasien yang menggunakan ventilasi mekanik. Penelitian ini bertujuan untuk mengetahui prevalensi VAP dan efektivitas preparat antiseptik pada perawatan mulut pasien terintubasi terhadap pencegahan VAP.

Metode: Penelitian uji klinis acak tersamar tunggal dilakukan terhadap 36 pasien dengan ventilasi mekanik. Sampel dibagi menjadi 2 kelompok, yaitu kelompok iodine povidone 1% dan Listerine®. Awalnya dilakukan penilaian kebersihan mulut dengan Simplified Oral Hygiene Index. Setelahnya, dilakukan perawatan mulut menggunakan salah satu preparat. Setelah 48 jam, dilakukan penilaian ulang kebersihan mulut dan skor CPIS. Timbul VAP bila skor CPIS ≥ 6.

Hasil: Kelompok iodine povidone 1% memiliki perubahan skor kebersihan mulut dengan selisih yang lebih kecil (0,195) dibandingkan Listerine® (0,3605). Hal ini menunjukkan bahwa Listerine® lebih efektif dalam menjaga kebersihan mulut (p = 0,024). Listerine® secara signifikan lebih efektif dalam mencegah VAP bila dibandingkan dengan iodine povidone 1% (p = 0,001). Tidak ada perbedaan signifikan pada subjek yang meninggal akibat VAP positif maupun negatif (p = 0,280).

Kesimpulan: Listerine® memiliki efektivitas lebih tinggi dalam mencegah VAP dibandingkan dengan iodine povidone 1%.
Comparisons of Center of Mass during Golf Swings of 7 Iron or Driver
Authors: Kim Sukwon
Published: March 2022

Golf game is competitive and it has attracted many participants due to its unique features. In the many features, kinetics of golf swing was analyzed to improve one’s performance level. The present study examined the center of mass (COM) of a recreational golfer during a phase from address to backswing top for two different golf clubs. Kinematic data were evaluated. The results indicated that there were some differences in COM between two different golf clubs.
Separating FECG from MECG and Analyzing Fetal Heart Rate
Authors: Mir Farhad Ahmad , Mehra Monika
Published: March 2022

Figuring out fetal coronary heart can be essential for monitoring the situation of a fetus. While an ECG signal is recorded by way of putting electrodes on the maternal stomach, the fetal ECG is regularly masked by using the maternal ECG sign and noise. Via using an LMS adaptive filter to extract the fetal ECG signal, after which the use of the Pan & Tompkins algorithm to hit upon the QRS complexes, the fetal heart may be determined with very low errors.
HSV Values and OpenCV for Object Tracking
Authors: Gulzar Mir Mahpara , Singh Ravinder Pal , Mehra Dr Monika
Published: March 2022

This research shows how colour and motion may be utilised to speed up the surveillance of things. Video tracing is a technique for detecting a huge vehicle over a long distance using a camera. The main goal of video tracking is to link objects in subsequent video frames. When objects move faster than the frames per second, maintaining connection might be difficult. Using Hue saturation space values and OpenCV in separate video frames, this article shows how to follow moving objects in real-time. We begin by finding the HSV value of the object to be tested, and then we understand the steps along. The tracking of the items was shown to be 90 percent accurate.
The Effect of Capital Adequacy Ratio (CAR) And Loan To Deposit Ratio (LDR) To Return On Asset (ROA) on PT BJB Tbk
Authors: Juniarti Weny
Published: March 2022

This study determines how the effect of Capital Adequacy Ratio (CAR) and Loan to Deposit Ratio (LDR) on Return On Assets (ROA) at PT. Bank BJB Tbk. This study uses data from the company's financial statements at PT. Bank BJB Tbk from 2011 to 2020. The data were processed and analyzed using the Eviews 9 application program. The results of the study showed that the Capital Adequacy Ratio (CAR) variable had no positive and insignificant effect on profitability which was calculated using return on assets (ROA). The Loan to Deposit Ratio (LDR) variable has no positive and insignificant effect on profitability which is calculated using return on assets (ROA). Capital Adequacy Ratio (CAR) and Loan To Deposit Ratio (LDR) have no significant effect on profitability which is calculated using Return On Assets (ROA) the results of R2 = 0.329 or 32.9% and the remaining 67.1% is influenced by other factors.
PENERAPAN DATA MINING DALAM PROSES PREDIKSI PERCERAIAN MENGGUNAKAN ALGORITMA NAIVE BAYES DI KABUPATEN ACEH TENGAH
Authors: Laila Sari Desi , Saputra Mahmuda , Gemasih Husna
Published: March 2022

Marriage in the view of Islam is something sacred, meaning worship to Allah SWT, following the sunnah of the Prophet Muhammad and carried out on the basis of sincerity, responsibility, and following legal provisions that must be heeded. In Aceh province, the divorce rate from Aceh Syari'ah Court data throughout 2017, the number of divorces occurred reaching 5,399. The data and facts about the divorce case are a reality that must be accepted even though it is bitter, and while looking for the best way and strategy to prevent divorce from an early age. Based on the divorce rate which continues to increase every year, it is necessary to have data to determine the factors that influence divorce. Thus, these data can be used as a decision-making tool that can later be a good solution for the government, society and for married couples in the future. Naïve Bayes classification is a simple probability classification based on the application of the Bayes Theorem with the assumption that the explanatory variables are independent or (independent). In this case, it is assumed that the presence or absence of a particular event from a group is not related to the presence or absence and other events. With a system to predict divorce, it can help users who want to know divorce predictions.
Towards a New Perspective in Ethics in Islam
Authors: Bouhafa Feriel
Published: March 2022

Introduction to the themed section.
Psychology and Ethical Epistemology
Authors: Shihadeh Ayman
Published: March 2022

We examine a hitherto unstudied debate, turning on the epistemology of value judgements, between Ashʿarīs and Baṣran Muʿtazilīs of the late eleventh and twelfth centuries. Al-Ghazālī and al-Rāzī countered Muʿtazilī ethical realism, here defended by al-Malāḥimī, by developing an emotive subjectivism underpinned by increasingly sophisticated psychological accounts of ethical motivation. Value judgements, they maintained, arise not from knowledge of some ethical attributes of acts themselves, but from subjective inclinations, which are often elusive because they can be unconscious or indirect. We also argue against the widespread notion that Ashʿarīs espoused an anti-rationalist ethics, and we show that they were not only ethical rationalists, but also the more innovative side in this debate.

Keywords: al-Ghazālī, Fakhr al-Dīn al-Rāzī, al-Malāḥimī, Avicenna, Ashʿarism, Muʿtazilism, Value Theory, Moral Realism and Anti-Realism, Emotivism, Moral Psychology, Rationalism, Intellect (ʿaql), Estimation (wahm), Disposition (ṭabʿ), Widely-Accepted Premises (mashhūra), Reputable Premises (maḥmūda)
Interpretari psihanalitice in operele pictorului Alex Ivanov
Authors: Trifu Simona
Published: March 2022

Cartea de fata reprezinta o premiera in psihanaliza romaneasca, fiind o colectie de interpretari psihodinamice ale operelor de arta ale pictorului, graficianului si sculptorului Alex Ivanov, cu referire stricta la dinamica intrapsihica a personajelor, asa cum ele se rasfrang in functia analitica a mintii specialistilor care au realizat interpretarile. Se doreste o „vivisectie” a unei lumi artistice prezentate ca vie si in dinamica, un organism in sine, in care pictorul este exclusiv inima acestuia, creierul si gandirea critica fiind a specialistilor in arealul psihanalitic.
CARACTERIZAÇÃO GEOMORFOLÓGICA DA REGIÃO CÁRSTICA ARCOS-PAINS E DE SEUS SISTEMAS CÁRSTICOS
Authors: Timo Mariana Barbosa
Published: March 2022

A região do Grupo Bambuí, conhecida como Província Espeleológica do Bambuí (PEB), ocupa uma área de aproximadamente 150.000 km2 e abrange as porções centro oeste, norte e noroeste de Minas Gerais; leste do Distrito Federal; nordeste de Goiás; sudeste do Tocantins; e oeste da Bahia. Devido à grande área ocupada pela Província Espeleológica do Bambuí, esta pode ser dividida em distritos. O objetivo deste artigo é a caracterização da Região Cárstica de Arcos-Pains, e de seus sistemas cársticos correlatos, a partir da utilização de dados geológicos, geomorfológicos, espeleológicos e hidrográficos. O carste regional é bem evoluído, com extensos maciços calcários marcados por diferentes tipos de lapiás (karren). Além disso, apresenta drenagem predominantemente subterrânea com a presença de sumidouros, ressurgências, cânions, dolinas e feições residuais, comuns na paisagem cárstica. Estruturas geológicas marcantes, como dobras e falhas, também se fazem presentes. Por outro lado, as atividades humanas podem impor profundas modificações na paisagem desta importante região cárstica, especialmente por causa da mineração, visto que ali encontram-se instaladas diversas empresas de extração de calcário, além de indústrias cimenteiras e de produção de cal. Tal uso do solo, aliado à precária gestão do Patrimônio Espeleológico, vem ocasionado impactos ambientais significativos no carste regional. Dessa forma, ter como base os estudos do carste faz-se extremamente necessário, pois a sensibilidade dos aquíferos cársticos à poluição é muito alta.
A DISSOCIAÇÃO ENTRE QUANTIDADE E QUALIDADE NA PRODUÇÃO GEOMORFOLÓGICA BRASILEIRA NO SÉCULO XXI
Authors: Salgado André Augusto Rodrigues , Marent Breno Ribeiro
Published: March 2022

Algumas características da Ciência de um país podem ser identificadas pela sua produção científica. O presente trabalho investiga a evolução da relação entre quantidade e qualidade da produção brasileira em Geomorfologia em periódicos. Isto foi feito através de dados apresentados pelo International Science Ranking, que acompanha as métricas de publicação e citação por país e por área do saber. Os resultados obtidos indicaram que entre 2010 e 2019, a produção científica brasileira em Geomorfologia mais do que triplicou. Entretanto, mesmo com mais artigos publicados para serem citados, a evolução no ranking de citações foi pequena. Este fato indica haver uma dissociação entre quantidade e qualidade da produção geomorfológica brasileira no período considerado. Não foi possível determinar com exatidão por qual razão ocorreu essa dissociação. Entretanto, três hipóteses foram consideradas como podendo ter agido em conjunto: o rápido crescimento do número de pesquisadores em Geografia no Brasil, o crescente custo financeiro para realização de pesquisas com maior impacto e o grande número de periódicos geográficos nacionais bem avaliados no sistema Qualis CAPES Geografia.
CONFLITOS DO USO DA TERRA EM ÁREAS PROTEGIDAS POR LEI NO PARQUE ESTADUAL DO RIO PRETO E ZONA DE AMORTECIMENTO, MINAS GERAIS
Authors: Ferreira Marcelo Angelo , França Luciano Cavalcante de Jesus , Morais Marcelino Santos de , Gontijo Bernardo Machado , Gorgens Eric Bastos , Mucida Danielle Piuzana
Published: March 2022

O presente estudo objetivou identificar áreas de conflitos em Áreas de Proteção Permanente (APP) e Áreas de Uso Restrito (AUR) no Parque Estadual do Rio Preto (PERP) e sua Zona de Amortecimento (ZA). O trabalho parte das evidências de entender o estado de conservação no PERP e sua ZA aplicando as diretrizes de APP e AUR apresentados no Código Florestal Brasileiro vigente. Empregando recursos disponíveis em ambiente SIG (sistema de informações geográficas), delimitou-se e mapeou-se classes de uso da terra e as APP de nascentes e cursos d’água; bordas de tabuleiros ou chapadas; áreas com declividade superior a 45º; áreas com altitude superior a 1800 m; e AUR com base nos parâmetros, definições e limites estabelecidos pela Lei nº 12.651. A partir da sobreposição destes mapas analisou-se a ocorrência de conflito de uso na área. As classes de uso da terra foram: Afloramento Rochoso (49,70%), Formação Campestre (28,34%), Agropecuária (2,70%), Solo Exposto (4,62%) e Água (0,29%) Dentre as categorias de APP observamos maior ocorrência das APP nascentes (8,41%) e cursos d’água (54,24%). As APP declividade > 45° (0,58%) e altitude superior a 1800 m (0,03%) apresentaram menor ocorrência. Os usos da terra em APP do tipo nascente e cursos d’água e AUR foram mais expressivos nas classes de Afloramento Rochoso, Formação Florestal e Formação Campestre. As classes de Agropecuária e Solo Exposto apresentaram baixa incidência no conflito de uso em todas as APP e AUR analisadas. Porém, ao analisar sua ocorrência entre as categorias de APP verificou-se maior ocorrência de uso indevido nas APP nascentes e cursos d’água. Com base nos resultados observamos a eficiência do uso das ferramentas nos SIG, confirmando a potencialidade deste como subsídio nas políticas públicas e gestão eficiente do uso da terra.
DIAGNÓSTICO DA PRODUÇÃO AGRÍCOLA DO ESTADO DO PARANÁ E ALTERNATIVAS DE DESTINAÇÃO DOS RESÍDUOS AGROINDUSTRIAIS
Authors: Silva Jean Victor Nery da , Espadrizano Bruna Stefany dos Santos , Porto Carlos Eduardo , Sakai Otávio Akira , Batistela Vagner Roberto
Published: March 2022

O estado do Paraná situa-se como um importante polo do agronegócio e do setor agroindustrial nacional, com produção tanto no eixo alimentar quanto não-alimentar. No presente estudo, realizou-se o diagnóstico da produção agrícola do estado do Paraná com base nos dados consolidados do ano de 2018, investigou-se a contribuição de cada região intermediária do estado e realizou-se uma apresentação das principais possibilidades de valorização de resíduos agroindustriais. Por meio de dados do IBGE e IPARDES, as três principais culturas do estado do Paraná são a de cana-de-açúcar, soja e milho, seguindo a mesma tendência nacional, sendo o terceiro estado brasileiro com maior produção agrícola entre cultura temporárias e permanentes. Avaliou-se que a região de Curitiba é a que apresenta maior capacidade financeira do setor agroindustrial embora a região Noroeste do estado do Paraná seja a aquela que produz mais toneladas de grãos. Fato interpretado como a inclusão da região portuária do litoral do estado na região de Curitiba e a necessidade da instalação de mais agroindústrias no Noroeste do Estado. A compostagem, alimentação animal, biossorventes, compensados, compósitos, biocombustíveis e biotecnologia foram apontadas como possibilidades de valorização de resíduos agroindustriais, contribuindo para a sustentabilidade das cadeias produtivas. Dessa forma, espera-se com este trabalho favorecer o desenvolvimento do setor agroindustrial do estado do Paraná e divulgar as potencialidades de destinação de resíduos agroindustriais, completando o ciclo de beneficiamento agrícola.
Das Deutsche Reich und der Weltpostverein
Authors: Wendt Gunnar
Published: March 2022

Embedded in the context of foreign and foreign economic policy, this thesis examines Germany's role in the founding of the Universal Postal Union and its shaping until 1914. Founded in 1874 in Bern as a result of a German initiative, the Universal Postal Union established a European-transatlantic communications order that achieved global validity by the turn of the century. Based on German, French, and Swiss archival material as well as a wealth of printed sources, this study examines how the German Empire systematically promoted the founding of the Universal Postal Union and its global expansion as part of a foreign policy specific to the political field. In doing so, the study directs attention to a structural contribution of the empire to the development of an increasingly integrated world economy around 1900.
Architektur als zweiter Körper
Authors: Koppen Gemma , Vollmer Tanja C.
Published: March 2022

What spaces and architectures do people need to get healthy? How do healthcare buildings of the future take into account and meet the needs of people who are ill? The structural change in the German health care system requires new, sustainable architectural concepts that are derived from a deeper understanding of human nature on the one hand and a new understanding of architecture on the other.

The book combines empirical findings of Modern Architectural Psychology with a novel understanding of architectural aesthetics and quality to create a design methodology that focuses on the patient's experience. "Architecture as a second body" becomes the most important shell of a fearing soul in the sick body.

The synthesis of exploratory and evidence-based design sets out to break through outdated structures and requirements in hospital design while initiating change in university teaching. The book is a basis for argumentation for committed medical professionals, a reference book for architects interested in science, and a textbook for students of architecture and psychology.
Evolutionary Patterns of the Internal Structures of Generative Organs in Angiosperm Plants
Authors: L. Kordyum Elizabeth , A. Kravets Helen
Published: March 2022

Evolutionary patterns of the internal structures of generative organs in angiosperms are considered in light of the idea on their close dependence on the appearance of angiospermy – formation of the ovary closed cavity by carpels– macrosporophylls. A characteristic feature of the sexual process in gymno- and angiosperms is the independency of water for fertilization, unlike all lower plants and pteridophytes. The main direction of the further evolution of the sexual process consisted in the modification for adaptations that ensure the successful fertilization in new conditions. The guidelines and levels of evolution include aromorphosis, allomorphosis, specialization and reduction which are considered to be concrete examples of microstructure of generative organs.
Advanced Breeding Approaches for Developing Cowpea Varieties in Dryland Areas of Limpopo Province, South Africa
Authors: Nwafor Akanwe Asiwe Joseph
Published: March 2022

Cowpea is an important grain legume because it is a major source of cheap dietary protein. In the last four decades, the production of cowpea in South Africa is limited by lack of improved varieties that exhibit good agronomic traits and pest resistance. The purpose of the study was to develop cowpea varieties with important economic traits to meet the needs of the farmers. Germplasm lines were evaluated in field trials to select the promising lines that were used in hybridization to develop well-adapted elite genotypes. Pair-wise crosses were made to develop broad-based segregating populations. Pedigree, recurrent selection methods were used to advance the promising genotypes. Ten genotypes expressed high grain yield with combined pest resistance (aphids, bruchid, virus, leafhopper and bacterial blight). The implication of this achievement is that farmers can attain more grain yield per land area with reduced cost of pest control and increase the profit margin of the farmers. Furthermore, four elite varieties (JanaFod, ARC-GCI-CP76, UL-58 and UL-1010) have been registered and awaiting commercialization. The future activity is to commercialize the varieties to enhance uptake and availability of seeds to seed growers, farmers and consumers.
Perspective Chapter: Total Vaginal Hysterectomy for Unprolapsed Uterus
Authors: Bratila Petre
Published: March 2022

Vaginal hysterectomy was the first method to extract the uterus. Vaginal hysterectomy goes back a long way into the history of medicine. Although the first hysterectomy was carried out by Themison of Athens in the year 20 B.C., the idea of extracting the uterus through the vagina was first mentioned in 120 B.C. by Soranus of Ephesos, a distinguished obstetrician. The first elective vaginal hysterectomy was performed by J. Conrad Langenbeck in 1813. The patient was a 50-year-old multipara, who suffered from chronic pelvic pain attributed to a prolapsed uterus with a hard, bleeding tumor. The operation was carried out in challenging conditions, without anesthesia, proper instruments, or surgical assistants. Until the early 1950s, vaginal hysterectomy was the method of choice for removing the uterus. With the widespread introduction of general anesthesia and antibiotic therapy, the site of vaginal hysterectomy was taken over by abdominal hysterectomy. With the introduction of minimally invasive surgery in gynecology, vaginal hysterectomy has regained its place. Harry Reich performed the first total laparoscopic hysterectomy in 1989, being one of the most renowned vaginal surgeons, and he still claims at the beginning of the 21st century that … when the first choice of approach for hysterectomy is possible, is the vaginal route. This chapter presents the relevant anatomy from the point of view of the vaginal surgeon and the standard technique used by the author in over 5,000 vaginal hysterectomies. All intraoperative drawings and photographs are original.
Complexity of Regeneration Dynamic at the Ecocline between Mixedwood and Coniferous Domains of the Southernmost Boreal Zone in Eastern North America
Authors: Messaoud Yassine
Published: March 2022

To explain the ecocline between the southern mixedwood and the northern coniferous bioclimatic domains dominated, respectively, by balsam fir (Abies balsamea (L.) Mill.) and black spruce (Picea mariana (Mill.) B.S.P.), 59 field sites and 7010 sample plots (from the Quebec Ministry of Forests, Wildlife, and Parks), with no major disturbances, were selected throughout the two bioclimatic domains. Regeneration (seedlings and saplings), mortality (difference between seedlings and saplings) of balsam fir, and black spruce (saplings) were examined, accounting for parental trees, main soil type (clay and till), summer growing degree-days above 5°C (GDD_5), and total summer precipitation (May–August; PP_MA). Balsam fir regeneration was more depended on parental trees and soil type than black spruce. Balsam fir mortality was related to seedling competition, species composition of the canopy, and the soil type. GDD_5 and marginally PP_MA were beneficial and detrimental for respectively balsam fir and black spruce regeneration. The ecocline mixedwood/coniferous bioclimatic domains was attributed to a northward gradual decrease of balsam fir regeneration and increase of its mortality, due to cooler temperatures, shorter growing seasons, and decrease of the parental trees. However, balsam fir persists above this ecocline, where parental trees populations and good establishment substrates occur.
Perspective Chapter: Exercise-Eating Pattern and Social Inclusion (EES) is an Effective Modulator of Pathophysiological Hallmarks of Alzheimer’s Disease
Authors: Sultana Afroza , Alauddin Md
Published: March 2022

Alzheimer’s Disease (AD), a common type of dementia, characterized by the presence of aggregated extracellular amyloid-beta (Aβ), intracellular hyper phosphorylation of tau protein and neurodegenerative with cognitive decline. It is projected that 141 million people will be suffering with AD by 2050 but no effective drug treatment is discovered without side effects. There is an urgent need for the application of alternative and non-pharmacological interventions for AD. Sporadically found that exercise or diet therapy or social activity may positively influence the AD. In this review we discussed the process of how Exercise-Eating pattern and Social inclusion (EES) has been shown to have fewer side effects and better adherence with AD. In this mechanism the EES can modulate the brain metabolic factors, brain-derived neurotrophic, ketone bodies, lactate, cathepsin-B, irisin, hormonal balance in AD. This review also described the potential biological mechanisms underlying exercise (modulation of biomolecule turnover, antioxidant and anti inflammation), eating pattern (bioactive compounds) and social inclusion that is very important to ameliorate the pathophysiological hallmarks of Alzheimer’s disease. Thus, this EES can be an effective approach to manage the neurodegenerative disorder as well as Alzheimer’s disease.
Artificial Intelligence and IoT: Past, Present and Future
Authors: Suriyan Kannadhasan , Ramalingam Nagarajan
Published: March 2022

Artificial intelligence (AI) approaches have recently made major impacts in the healthcare field, igniting a heated discussion over whether AI physicians would eventually replace human doctors. Human doctors are unlikely to be replaced by machines anytime soon, but AI may assist physicians make better clinical decisions or even replace human judgment in certain areas of healthcare (e.g., radiology). The increased availability of healthcare data and the rapid development of big data analysis tools have made recent productive applications of AI in healthcare possible. When driven by appropriate clinical queries, powerful AI systems may find clinically valuable information hidden in enormous volumes of data, which can help clinical decision making. The internet of things (IoT) is a network of many interconnected things that may communicate with one another across a computer network. We may get information from this global network by connecting sensors to it. Thanks to the computer network, we can obtain this information from anywhere on the planet. The internet of things (IoT) enables physical objects to connect to the internet and create systems using various technologies such as near-field communication (NFC) and wireless sensor networks (WSN).
The “Lateral Transshipment” is a Cooperative Tool for Optimizing the Profitability of a Distribution System
Authors: Fadoi Elleuch
Published: March 2022

In this chapter, we discuss a network consisting of a distribution center (or central depot) and two retailers who serve customers. D1 andD2 represent, respectively, the demands of retailer 1 and 2. We assume that the demandDi (i = 1, 2) at retailer i follows a normal distribution with mean μi and standard deviationσi (known). This analysis makes it possible to assess the effect of emergency transshipment both at the level of the Average Global Profit and of the Average Global Desservice Rate. In this chapter, we consider a centralized one-echelon supply chain with two-retailers selling products and facing stochastic demand.
Algebraic Approximations to Partial Group Structures
Authors: Özer Özen
Published: March 2022

In this work, we use ‘Partial Group’ notion and we do further investigations about partial groups. We define ‘Partial Normal Subgroup’ using partial conjugation criteria and we prove few results about partial normal subgroups analogous to normal groups. Also, we define congruence relation for partial groups and via this relation, we state ‘The Quotient of Partial Group or Factor Group’. We give isomorphism theorems for partial groups. Explicitly, this is an analogous concept to group theory and our main is where differences partial groups from groups.
Early Occupational Therapy Intervention: Patients’ Occupational Needs
Authors: Schiavi Margherita , Volta Barbara , Sandri Gilda , Keeling Erica , Teresa Mascia Maria
Published: March 2022

The occupational therapy management involves the assessment of the individual’s specific needs. This kind of assessment facilitates the therapeutic relationship and boosts the person’s motivation, as he or she feels valued and heard. Early-stage collection of information about meaningful activities for the individual helps them project themselves outside the context of illness. Collecting occupational need at an early stage, permits “Engagement”, which means participating in activities even without actually doing them. An occupational therapy model called “Personal Environment Occupation Model” suggests that already at an early stage we should make the environment and occupations meaningful to the person in order to maximise the patient’s performance. An observational study on stroke patients shows how people have personal occupational needs beyond simple self-care, including productive life and leisure time, already in the subacute phase. A further study is underway to demonstrate the effectiveness of early occupational therapy intervention, including complex patients regardless of diagnosis and taking into account their need for care and disability in order to promote their participation and maximise their autonomy.
Measurement of Cerebral Circulation in Human
Authors: Moradi Sadegh , Ferdinando Hany , Zienkiewicz Aleksandra , Särestöniemi Mariella , Myllylä Teemu
Published: March 2022

In this chapter, we review state-of-the-art non-invasive techniques to monitor and study cerebral circulation in humans. The measurement methods can be divided into two categories: direct and indirect methods. Direct methods are mostly based on using contrast agents delivered to blood circulation. Clinically used direct methods include single-photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI) with contrast agents, xenon computed tomography (CT), and arterial spin labeling (ASL) MRI. Indirect techniques are based on measuring physiological parameters reflecting cerebral perfusion. The most commonly used indirect methods are near-infrared spectroscopy (NIRS), transcranial Doppler ultrasound (TCD), and phase-contrast MRI. In recent years, few more techniques have been intensively developed, such as diffuse correlation spectroscopy (DCS) and microwave-based techniques, which are still emerging as methods for cerebral circulation monitoring. In addition, methods combining different modalities are discussed and, as a summary, the presented techniques and their benefits for cerebral circulation will be compared.
Minimally Invasive Treatment of Spinal Metastasis
Authors: R. Mong Eric , K. Fahim Daniel
Published: March 2022

Advancements in the treatment of systemic cancer have improved life expectancy in cancer patients and consequently the incidence of spinal metastasis. Traditionally, open spinal approaches combined with cEBRT (conventional external beam radiation therapy) allowed for local tumor control as well as stabilization and decompression of the spine and neural elements, but these larger operations can be fraught with one complications and delayed healing as well as additional morbidity. Recently, minimally invasive spine techniques are becoming increasingly popular in the treatment of spinal metastasis for many reasons, including smaller incisions with less perioperative complications and potential for expedited time to radiation therapy. These techniques include kyphoplasty with radiofrequency ablation, percutaneous stabilization, laminectomy, and epidural tumor resection through tubular retractors, as well as minimally invasive corpectomy. These techniques combined with highly conformal stereotactic radiosurgery have led to the advent of separation surgery, which allows for decompression of neural elements while creating space between neural elements and the tumor so adequate radiation may be delivered, improving local tumor control. The versatility of these minimally invasive techniques has significantly improved the modern management of metastatic disease of the spine by protecting and restoring the patient’s quality of life while allowing them to quickly resume radiation and systemic treatment.
Lessons Learned in a Hybrid Environment
Authors: Kovatcheva Eugenia
Published: March 2022

In the last two years in isolation, the hybrid environment for education becomes the most normal way to deliver education. The well-known design techniques are not enough for new learners from distance. The common practice from face-to-face training is neither. A lot of lessons are learned. The new combined approach is based on e-learning in combination with nugget education. The design considers learning and personal users’ styles. The learning experience design takes a significant role in rethinking the course/training design in the hybrid environment. Nowadays, understanding learners’ needs is most important for training design and to motivate them.
Table Olives: Toward Mechanical Harvesting
Authors: Biton Iris , Namdar Dvora , Mani Yair , Ben Ari Giora
Published: March 2022

The major reasons for developing mechanical technologies for olive harvesting are the chronic shortage of workers for manual harvesting and increasing labor costs. To enable these technologies to operate, new table olive cultivars suitable for mechanical harvesting are necessary. The two major factors required for the shift from manual to mechanical harvesting of table olives are improved harvesting efficiency and prevention of fruit injury. Improved harvesting efficiency requires suitable pretreatment to enable fruit abscission with minimal defoliation, even when the harvesting is performed by a trunk shaker. The second requirement is prevention of external fruit color change or browning as a result of fruit injury, by development of olive cultivars with firm skin and higher resistance to the bruising caused by mechanical harvesting. This genetic adaptation to mechanical harvesting must be accompanied by efficient post-harvest processing of the olives. In this chapter, we will review the published studies regarding mechanical harvest of table olives, and attempt to identify the main issues, which still need to be studied in order to facilitate the transition from hand to mechanical harvest of table olives.
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Authors: Huyen Tran Thi
Published: March 2022

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions (SCARs). The most common causative drugs of SJS/TEN are allopurinol, carbamazepine, abacavir, phenytoin, and lamotrigine. SJS/TEN are categorized based on the percentage of epidermal detachment area: (i) SJS: less than 10%, (ii) TEN: greater than 30%, (iii) and overlapping SJS/TEN: 10–30%. The pathogenesis of SJS/TEN is not fully understood, but some immunological and genetic factors are believed to be involved. There is a strong association between some specific HLA haplotypes and drug-induced SJS/TEN, for example, HLA-B*15:02 and carbamazepine-, HLA-B*58:01 and allopurinol. CD8+ cytotoxic T cells and natural killer (NK) cells play an important role in the pathogenesis of SJS/TEN, and upon the activation, they produce cytokines, chemokines, and cytotoxic proteins, that cause extensive keratinocytes apoptosis. Systemic corticosteroid and cyclosporine are still used as the first line in the treatment of SJS/TEN, in combination with care support.
New Approach for the Evaluation of Ecological Quality in the Mediterranean Coastal Ecosystems, Case Study of Bizerte Lagoon: Marine Nematodes Functional Traits Assessment
Authors: Nasri Ahmed , Aïssa Patricia , Beyrem Hamouda , Mahmoudi Ezzeddine
Published: March 2022

Marine ecosystems have great economic and ecological value, as they provide good services and habitats for a variety of organisms. However, the marine environment is under anthropogenic stressors. The Mediterranean basin is one of the most threatened ecosystems, where urban and industrial waste is becoming a growing risk for coastal marine habitats integrity. The Bizerte lagoon represents a major coastal lagoon and is an example of such an aquatic environment continuously exposed to pollutants. Marine nematodes are the most diverse metazoans and represent an excellent model for the environmental monitoring because they can be easily sampled and maintained under experimental conditions. Nematode communities are investigated for the analysis of taxonomic diversity and ecological indices. Currently, we present here to evaluate the ecological quality based on the description of nematode assemblages using biological traits and functional groups. This relatively new approach allows obtaining insight into the status of marine coastal ecosystems.
Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic
Authors: Alsabri Mohammed , Alsakkaf Luai , Alhadheri Ayman , Cole Jennifer , Burkle Jr. Frederick
Published: March 2022

Introduction: Much of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic.

Methods: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper.

Results: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time.

Conclusion: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19.
Burnout and Post-traumatic Stress Disorder Symptoms Among Emergency Medicine Resident Physicians During the COVID-19 Pandemic
Authors: Chang Jungsoo , Ray Jessica , Joseph Daniel , Evans Leigh , Joseph Melissa
Published: March 2022

Introduction: Emergency medicine is characterized by high volume decision-making while under multiple stressors. With the arrival of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in early 2020, physicians across the world were met with a surge of critically ill patients. Emergency physicians (EP) are prone to developing burnout and post-traumatic stress disorder (PTSD), due to experiencing emotional trauma as well as the cumulative stress of practice. Thus, calls have been made for attempts to prevent physician PTSD during this current pandemic.

Methods: From July 2019–January 2020, emergency medicine (EM) resident physicians at a large, academic healthcare system were surveyed for symptoms of burnout using the Maslach Burnout Inventory (MBI). In late April and early May 2020, during the outbreak surge of coronavirus disease 2019 (COVID-19) in the Northeast USA, these same residents and the whole EM residency at the institution were again surveyed for symptoms of burnout as well as post-traumatic stress using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5). A final survey was administered to the EM residents after the COVID-19 surge had largely subsided in June 2020.

Results: Twenty-two residents participated in the pre-pandemic study and completed the MBI. Twelve (55%) completed the two follow-up MBI surveys. In the larger EM residency cohort, 31/60 residents completed the MBI and PCL-5 survey during the pandemic peak and 30/60 (50%) completed the follow-up surveys. There were no significant differences in the three MBI burnout category measures of emotional exhaustion (P = 0.49), depersonalization (P = 0.13), and personal accomplishment (P = 0.70) pre-, during, and post-COVID. Of 31 participants, 11 (35%) scored greater than 31 on the PCL-5. Two residents had scores between 21-30, interpreted as “at risk.” At greater than one month follow-up, 2/30 continued to meet criteria for a preliminary PTSD diagnosis, and five were “at risk.”

Conclusion: A significant proportion of residents (35%) experienced post-traumatic symptoms acutely during the COVID-19 pandemic crisis, potentially indicating a high prevalence of acute stress disorder in this population and increased risk of developing PTSD. However, there was no significant difference in burnout levels in this cohort before, during, or after the initial COVID-19 surge. Early screening for physicians at risk and referral for assessment and treatment may be important to mitigate pandemic-related PTSD.
Symptoms and Physical Exam Findings in Sexual Assault-related Non-fatal Strangulation
Authors: Spungen Hannah , Bryan Karen , Sachs Carolyn , Wheeler Malinda
Published: March 2022

Objective: Our goal was to investigate the frequency of specific signs and symptoms following sexual assault-related non-fatal strangulation (NFS) and to explore the interaction between assault characteristics and physical exam findings.

Methods: This retrospective observational study included all adults (>18 years) reporting strangulation during sexual assault who presented for a forensic sexual assault exam at one of six urban community hospitals contracted with a single forensic nurse agency. Demographic information, narrative elements, and physical exam findings were abstracted from standardized sexual assault reporting forms. We analyzed data with descriptive statistics and compared specific variables using chi-square testing.

Results: Of the 580 subjects 99% were female, with a median age of 27 (interquartile range 22-35 years). The most common injury location was the neck (57.2%), followed by the mouth (29.1%). We found that 19.1% of the victims had no injuries evident on physical exam and 29.8% reported a loss of consciousness. Eye/eyelid and neck findings did not significantly differ between subjects who reported blows to the head in addition to strangulation and those who did not. The time that elapsed between assault and exam did not significantly correlate with the presence of most head and torso physical exam findings, except for nose injury (P = 0.02).

Conclusion: Slightly more than half of the victims who reported strangulation during sexual assault had visible neck injuries. Other non-anogenital findings were present even less frequently, with a substantial portion of victims having no injuries documented on physical exam. The perpetrators’ use of blows to the head may account for many of the non-anogenital injuries observed, but not for the neck and eye/eyelid injuries, which may be more specific to non-fatal strangulation. More research is needed to definitively establish strangulation as the causal mechanism for these findings, and to determine whether any long-term neurologic or vascular sequelae resulted from the observed injuries.