bluuebunny/crossref_metadata_2025 huggingface dataset:
Politicizing Children’s Play: A Community Photovoice Process to Transform a School Playground
Authors: Rivas-Quarneti Natalia , Viana-Moldes Inés , Veiga-Seijo Silvia , Canabal-López Marta , Magalhaes Lilian
Published: May 2024

Importance: Contextual elements at school playgrounds compromise the right to play. An occupation-based social transformation project to foster occupational justice in play at a school playground was conducted.

Objective: To better understand barriers to and facilitators of children’s participation in occupations at the school playground to co-create actions that enable play. 

Design: A participatory methodology—Photovoice—was used. The research consisted of four phases: involving the community in the research design, community-led data generation and analysis, discussion of findings to increase the community’s awareness, and a community agenda for changing the playground.

Setting: Public primary school playground in northwest Spain.

Participants: All children (n = 450, ages 3–12 yr), families (n = 12), and teachers (n = 15) participated. A thematic analysis of visual, textual, and oral material was conducted, including member checking. 

Results: The study revealed several barriers to play, including the short recess duration, poor floor (surface) conditions, jail-like atmosphere, and violence. However, participants identified an ad hoc lending games system and playground murals advocating for children’s rights as facilitators. These findings have direct implications for improving the play environment.

Conclusions and Relevance: Conflicting priorities between children’s and adults’ desires and needs for the playground were unveiled, displaying the relevance of invisible contexts (i.e., social or institutional contexts) in shaping play opportunities. A critical occupational stance combined with a participatory and playful methodology generated space to unveil these conflicting priorities, reconcile agendas, raise awareness, and propose collective actions to transform the playground.

Plain-Language Summary: Playing is fundamental to children’s development and inclusion. This study focused on making school playgrounds better places for kids to play. Researchers found that things such as short playtimes, bad playground conditions, and violence made it tough for kids to enjoy playing, but they also discovered some good things, such as a system for borrowing games and colorful murals promoting children’ rights. These findings show that changing the playground’s physical and social environment can make a big difference for kids. By listening to kids and working together, adults and children can create playgrounds where all kids can play meaningfully and safely. Occupational therapists can promote such processes.
The evolutional aspect of change in the training conditions of neurosurgical residents
Authors: Kim Dong Hun , Kim Sang Don
Published: May 2024

Background: The Korean Neurosurgical Society’s 60th anniversary in 2022 compelled us to reflect on the changes within the education programs of neurosurgery residents. Traditional apprenticeship has witnessed a structural shift to manual-based education, and content has transitioned from time-based to competency-based education, driven further by the implementation of the 80-hour work-per-week regulation.Current Concepts: Despite reduced training hours, neurosurgery residents strive to gain more surgical participation and research opportunities while working 80 hours per week. To address this conflicting scenario, the Korean Neurosurgical Society implemented proactive measures to enhance resident education. This included the development of a competency-based training curriculum and guidelines for supervising physicians to prepare residents with the essential skills for independence. Additionally, evaluation guidelines and feedback mechanisms were established to provide objective assessments and facilitate self-improvement. Establishing operational guidelines and developing an e-portfolio would help minimize variations in educational effects among residents.Discussion and Conclusion: Failure to adapt to the changing environment, including the 80-hour work week, by maintaining outdated training methods would result in stagnation or a decline in the efficiency of resident education. Therefore, providing a unified educational curriculum and ensuring sustainable, high-quality training according to the evaluation systems of the Korean Neurosurgical Society is essential. This curriculum must be reviewed on an ongoing basis to recognize the society’s expertise and develop educational policies based on scientific evidence and the opinions of society members.
Pathogenesis and epidemiology of chronic subdural hematoma
Authors: Lee Kyeong-Seok
Published: May 2024

Background: Chronic subdural hematoma (SDH) is a common condition encountered in neurosurgical practice; however, its pathogenesis remains controversial.Current Concepts: SDH refers to blood accumulation inside the dura and is classified into acute, subacute, and chronic types. Histopathologically, acute SDH shows no neomembrane formation and the hematoma is a clot, in contrast to chronic SDH characterized by a neomembrane surrounding the liquefied hematoma. SDH is usually categorized into acute and chronic types, with subacute SDH being more similar to chronic SDH. Posttraumatic subdural lesions include acute and chronic SDH, subdural hygroma (SDG), or effusion. SDG is a blood-tinged fluid accompanied by neomembrane formation in some cases. These lesions are pathologically different from each other but may change depending on the situation.Discussion and Conclusion: Chronic SDH mainly originates from an SDG and acute SDH. SDG is usually triggered by trauma but only occurs in patients in whom sufficient potential space is available and may occur spontaneously in such cases. Therefore, SDG frequently occurs in children and in elderly patients, in men with a larger skull size, and on the left side of the body, which usually shows a wider hemisphere. Separation of the dural border cell layer causes inflammation, indicated by fibroblast proliferation and neovascularization. Conversion of an SDG into a chronic SDH or enlargement of a chronic SDH is attributable to formation of neomembranes, neovascularization, and repeated microhemorrhages from fragile capillaries. Chronic SDH is treated with removal of the hematoma to relieve the mass effect and embolization of the feeding artery for the bleeder. Outcomes of chronic SDH depend on the absorptive-expansion capacity dynamics.
Surgical treatment and recurrence of chronic subdural hematoma
Authors: Hwang Sun-Chul
Published: May 2024

Background: The incidence of chronic subdural hematoma (CSDH) is increasing owing to the rapid growth of the elderly population. CSDH causes various neurological symptoms such as cognitive impairment and motor dysfunction, which can improve with appropriate surgical management.Current Concepts: CSDH usually comprises a hemorrhagic fluid that accumulates within the subdural space and compresses the brain. Surgery is indicated if CSDH is associated with neurological symptoms and is aimed at safe and sufficient drainage of the hematoma. Currently, the recommended primary surgical method involves insertion of a draining catheter after burr hole or twist-drill trephination to facilitate drainage of the hematoma over a couple of days. Craniotomy is limited to cases of organized or calcified hematoma. The postoperative recurrence rate is approximately 10% to 20%. The same treatment method is attempted in cases of recurrence.Discussion and Conclusion: Surgical methods aim for rapid symptom relief and minimal invasiveness. Trephination and indwelling subdural catheter placement can enable immediate drainage of the hematoma and can be performed under local anesthesia. Preoperatively, it is necessary to obtain an accurate medical and medication history of elderly patients. Except in cases of emergencies, it is preferable to select the timing of the surgery only after reversal of the effects of drugs to prevent surgical complications in patients who receive anticoagulants or antiplatelet agents. Close postoperative follow-up is necessary in elderly patients because insufficient brain expansion leads to maintenance of the subdural space and is associated with a high risk of recurrence.
Endovascular surgery for chronic subdural hematoma
Authors: Hwang Gyojun
Published: May 2024

Background: Endovascular surgery is rapidly advancing and is widely used for the management of various cerebrovascular diseases. Usually, chronic subdural hematomas are treated surgically; however, endovascular surgery is recently being attempted as a new treatment option based on the pathophysiology of this condition.Current Concepts: Chronic subdural hematomas have an outer membrane derived from the dura mater. Sinusoidal capillaries in the outer membrane are a source of bleeding, which leads to hematoma growth and postoperative recurrence. Theoretically, embolization of the middle meningeal artery using endovascular procedures can prevent bleeding from the outer membrane and promote spontaneous resolution of a hematoma. Clinical studies, including recent prospective trials, have demonstrated the superior efficacy and safety of middle meningeal artery embolization over conventional treatment.Discussion and Conclusion: More clinical trials on endovascular surgery for chronic subdural hematomas are forthcoming. We expect that the results of future studies will strengthen the findings of recent prospective trials and contribute to a major shift in the management of chronic subdural hematomas.
Physeal and metaphyseal fractures of the distal radius in pediatric patients
Authors: Kim Hyung Jun , Park Hoon
Published: May 2024

Background: This article aims to summarize the available information and present treatment recommendations. The scope of this discussion is limited to physeal and metaphyseal fractures of the pediatric distal radius.Current Concepts: Pediatric distal radial fractures are common among children and adolescents. The mechanism of injury is usually a fall on an outstretched hand, and fractures typically occur during sports-related activities. Children with distal radial fractures initially present with pain, swelling, and distal forearm deformities. Plain radiographs are essential for evaluating the fracture type and degree of displacement. Complete wrist, forearm, and elbow views should also be assessed, especially for high-energy injuries, to identify ipsilateral fractures. Fractures typically involve the distal radial metaphysis or physis. Metaphyseal fractures are classified as torus, buckle, and bicortical fractures. Most displaced Salter-Harris types I and II and non-displaced metaphyseal fractures can be treated with closed reduction and casting. Operative treatment is recommended if irreducibility or soft-tissue neurovascular compromise is suspected. Operative options include closed reduction, percutaneous pinning, or open reduction, followed by pin or plate fixation. Malunion, nonunion, physeal arrest, ulnocarpal impaction, and nerve injury are possible complications of distal radial fractures in pediatric patients.Discussion and Conclusion: Metaphyseal and physeal fractures of the distal radius are common in children. Most cases are best treated with closed reduction and cast immobilization. Clinicians should be aware of delayed complications and understand how to manage them to ensure successful long-term outcomes.
Strategies to enhance public health doctor system in South Korea
Authors: Oh Su Hyun , Kim Jin Suk
Published: May 2024

Background: South Korea’s public health doctor system requires physicians to provide primary healthcare in medically underserved areas, such as rural regions, as an alternative to mandatory military service. Recently, concerns have arisen over the decline in the number of public health doctors available in these underserved areas. This study reviews issues related to the public health doctor system and proposes strategies for enhancing its management.Current Concepts: The annual number of public health doctors has steadily decreased by approximately 46.6%, from 1,962 in 2008 to 1,048 in 2022. According to the survey, the reasons behind this decline include the lengthy service period of 36 months compared to the 18-month military service, poor working conditions, low financial support, unreasonable manpower deployment, and uncertain social status.Discussion and Conclusion: Several recommendations can enhance the effectiveness of the public health doctor system. First, the mandatory service period of 36 months should be shortened, and a military training period of 1–2 months should be incorporated into the overall service duration. Second, ensuring appropriate working hours, including holidays, along with improved working conditions and reasonable financial support and compensation, is essential. Third, the role of public health doctors should shift from solely providing basic primary healthcare to acting as public health managers in local communities. Lastly, a long-term plan should be developed to establish various types of medical institutions in medically underserved regions.
Challenges and improvement opportunities in a telemedicine pilot project
Authors: Kim Jin Suk , Oh Su Hyun
Published: May 2024

Background: A pilot project for telemedicine has been underway since June 2023. However, ongoing issues have persisted since its implementation. This study aimed to review the current status and challenges of this project and recommend necessary improvements.Current Concepts: The following challenges were observed. First, the primary and incidental effects of this pilot project were not presented. It is not a small-scale project as it targets the entire population without a strict predesign. Its evaluation must have a defined implementation period. Currently, an indefinite implementation period has been proposed until the medical law is revised. Second, safety measures were found to be inadequate. Lastly, from an industrial standpoint, the government unilaterally promoted telemedicine policies.Discussion and Conclusion: Enhancements should be implemented in this telemedicine pilot project to ensure safety. First, the project objectives were clearly defined. Clear policy effects and evaluation criteria should be presented, and the project should be implemented through a rigorous policy design to verify them. Second, policy measures should be established to ensure safety. Lastly, administrative and legal improvements related to telemedicine should be implemented simultaneously.
FAKTOR RISIKO DAN PENGARUH KEPRIBADIAN PADA BUNUH DIRI DI USIA TUA
Authors: PRASETIO ADRIAN , WARDANI I.A. KUSUMA
Published: May 2024

Suicide is a health problem that contributes significantly to the suicide rate in the world. In general, suicidal behavior increases with age, but mental health and suicide screening is rarely performed in the elderly population. Not all suicide attempters in old age have a history of previous attempts. Some literature states that there are factors influencing suicidality, such as depression, physical decline, social isolation, economic problems, or certain personality traits. Maladaptive personality has a strong relationship as a risk factor for suicidal behavior due to the inability to manage stress well. At a young age, personalities with aggressive and impulsive traits such as those in Cluster B tend to have a higher risk of committing suicidal behavior. However, its role in older age groups remains unclear. This literature review aims to analyze the role of personality and suicide in old age as well as the risk factors in elderly.
ABSTRAKBunuh diri merupakan masalah kesehatan yang berkontribusi secara signifikan terhadap angka bunuh diri di dunia. Secara umum, perilaku bunuh diri semakin meningkat seiring bertambahnya usia, namun skrining kesehatan jiwa dan bunuh diri jarang dilakukan pada populasi lansia. Tidak semua percobaan bunuh diri pada usia tua memiliki riwayat percobaan sebelumnya. Beberapa literatur menyatakan bahwa ada faktor-faktor memengaruhi kecenderungan bunuh diri, seperti depresi, penurunan kondisi fisik, isolasi sosial, masalah ekonomi, atau ciri kepribadian tertentu. Kepribadian maladaptif memiliki hubungan kuat sebagai faktor risiko terhadap perilaku bunuh diri karena ketidakmampuan mengelola stres dengan baik. Pada usia muda, kepribadian dengan sifat agresif dan impulsif seperti pada kluster B cenderung memiliki risiko lebih tinggi melakukan perilaku bunuh diri. Namun, perannya pada kelompok usia tua masih belum jelas. Tinjauan literatur ini bertujuan untuk menganalisis peran kepribadian dan bunuh diri di usia tua serta faktor risikonya pada usia tua.
Surface networks in the Arctic may miss a future methane bomb
Authors: Wittig Sophie , Berchet Antoine , Pison Isabelle , Saunois Marielle , Paris Jean-Daniel
Published: May 2024

Abstract. The Arctic is warming up to 4 times faster than the global average, leading to significant environmental changes. Given the sensitivity of natural methane (CH4) sources to environmental conditions, increasing Arctic temperatures are expected to lead to higher CH4 emissions, particularly due to permafrost thaw and the exposure of organic matter. Some estimates therefore assume the existence of an Arctic methane bomb, where vast CH4 quantities are suddenly and rapidly released over several years. This study examines the ability of the in situ observation network to detect such events in the Arctic, a generally poorly constrained region. Using the FLEXPART (FLEXible PARTicle) atmospheric transport model and varying CH4 emission scenarios, we found that areas with a dense observation network could detect a methane bomb occurring within 2 to 10 years. In contrast, regions with sparse coverage would need 10 to 30 years, with potential false positives in other areas.
Viscosity of aqueous ammonium nitrate–organic particles: Equilibrium partitioning may be a reasonable assumption for most tropospheric conditions
Authors: Klein Liviana K. , Bertram Allan K. , Zuend Andreas , Gregson Florence , Krieger Ulrich K.
Published: May 2024

Abstract. The viscosity of aerosol particles determines the critical mixing time of gas–particle partitioning of volatile compounds in the atmosphere. The partitioning of the semi-volatile ammonium nitrate (NH4NO3) might alter the viscosity of highly viscous secondary organic aerosol particles during their lifetime. In contrast to the viscosity of organic particles, data on the viscosity of internally mixed inorganic–organic aerosol particles are scarce. We determined the viscosity of an aqueous ternary inorganic–organic system consisting of NH4NO3 and a proxy compound for a highly viscous organic, sucrose. Three techniques were applied to cover the atmospherically relevant humidity range: viscometry, fluorescence recovery after photobleaching, and the poke-flow technique. We show that the viscosities of NH4NO3–sucrose–H2O with an organic to inorganic dry mass ratio of 4:1 are four orders of magnitude lower than those of the aqueous sucrose under low humidity conditions (30 % relative humidity (RH), 293 K). By comparing viscosity predictions of mixing rules with those of the AIOMFAC-VISC model, we found that a mixing rule based on mole fractions performs similarly when data from corresponding binary aqueous subsystems are available. Applying this mixing rule, we estimated the characteristic internal mixing time of aerosol particles, indicating significantly faster mixing for inorganic—organic mixtures compared to electrolyte-free particles, especially at lower RH’s. Hence, the assumption in global atmospheric chemistry models of quasi-instantaneous equilibrium gas–particle partitioning is reasonable for internally mixed single-phase particles containing dissolved electrolytes (but not necessarily for phase-separated particles), for most conditions in the planetary boundary layer. This assumption may even hold for the entire troposphere at mid-latitudes and RH > 35 %.
Modelling convective cell lifecycles with a copula-based approach
Authors: Tseng Chien-Yu , Wang Li-Pen , Onof Christian
Published: May 2024

Abstract. This study proposes an algorithm designed to model convective cell lifecycles, for the purpose of improving the representation of convective storms in rainfall modelling and forecasting. We propose to explicitly model cell property inter-dependence and temporal evolution. To develop the algorithm, 165 effective convective storm events occurring between 2005 and 2017 in Birmingham, UK, were selected. A state-of-the-art storm tracking algorithm was employed to reconstruct convective cell lifecycles within each selected event. The investigation of these cell lifecycles proceeded in three stages. The initial stage involved statistically characterising individual properties of convective cells, including rainfall intensity, spatial extent at peaks, and lifespan. Subsequently, an examination of the inter-correlations amongst these properties was conducted. In the final stage, the focus was on examining the evolution of these cell properties during their lifetimes. We found that the growth and decay rates of cell properties are correlated with the cell properties themselves. Hence the need to incorporate this correlation structure into the process of sampling convective cells. To resolve the dependence structures within convective cell evolution, a novel algorithm based on vine copulas is proposed. We show the proposed algorithm's ability to sample cell lifecycles preserving both observed individual cell properties and their dependence structures. To enhance the algorithm's applicability, it is linked to an exponential shape model to synthesise spatial fields of rainfall intensity for each cell. This defines a model which can readily be incorporated into rainfall generators and forecasting tools.
Data collected using small uncrewed aircraft systems during the TRacking Aerosol Convection interactions ExpeRiment (TRACER)
Authors: Lappin Francesca , de Boer Gijs , Klein Petra , Hamilton Jonathan , Spencer Michelle , Calmer Radiance , Segales Antonio R. , Rhodes Michael , Bell Tyler M. , Buchli Justin , Britt Kelsey , Asher Elizabeth , Medina Isaac , Butterworth Brian , Otterstatter Leia , Ritsch Madison , Puxley Bryony , Miller Angelina , Jordan Arianna , Gomez-Faulk Ceu , Smith Elizabeth , Borenstein Steven , Thornberry Troy , Argrow Brian , Pillar-Little Elizabeth
Published: May 2024

Abstract. The main goal of the TRacking Aerosol Convection interactions ExpeRiment (TRACER) project was to further understand the role that regional circulations and aerosol loading play in the convective cloud life cycle across the greater Houston, Texas, area. To accomplish this goal, the United States Department of Energy and research partners collaborated to deploy atmospheric observing systems across the region. Cloud and precipitation radars, radiosondes, and air quality sensors captured atmospheric and cloud characteristics. A dense lower-atmospheric dataset was developed using ground-based remote sensors, a tethersonde, and uncrewed aerial systems (UASs). TRACER-UAS is a subproject that deployed two UAS platforms to gather high-resolution observations in the lower atmosphere between 1 June and 30 September 2022. The University of Oklahoma CopterSonde and the University of Colorado Boulder RAAVEN (Robust Autonomous Aerial Vehicle – Endurant Nimble) were flown at two coastal locations between the Gulf of Mexico and Houston. The University of Colorado Boulder RAAVEN gathered measurements of atmospheric thermodynamic state, winds and turbulence, and aerosol size distribution. Meanwhile, the University of Oklahoma CopterSonde system operated on a regular basis to resolve the vertical structure of the thermodynamic and kinematic state. Together, a complementary dataset of over 200 flight hours across 61 d was generated, and data from each platform proved to be in strong agreement. In this paper, the platforms and respective data collection and processing are described. The dataset described herein provides information on boundary layer evolution, the sea breeze circulation, conditions prior to and nearby deep convection, and the vertical structure and evolution of aerosols. The quality-controlled TRACER-UAS observations from the CopterSonde and RAAVEN can be found at https://doi.org/10.5439/1969004 (Lappin, 2023) and https://doi.org/10.5439/1985470 (de Boer, 2023), respectively.
Constructing a geography of heavy-tailed flood distributions: insights from common streamflow dynamics
Authors: Wang Hsing-Jui , Merz Ralf , Basso Stefano
Published: May 2024

Abstract. Heavy-tailed flood distributions depict the higher occurrence probability of extreme floods. Understanding the spatial distribution of heavy tail floods is essential for effective risk assessment. Conventional methods often encounter data limitations, leading to uncertainty across regions. To address this challenge, we utilize hydrograph recession exponents derived from common streamflow dynamics, which have shown to be a robust indicator of flood tail propensity across analyses with varying data lengths. Analyzing extensive datasets covering the Atlantic Europe, Northern Europe, and the continental United States, we uncover distinct patterns: prevalent heavy tails in the Atlantic Europe, diverse behavior in the continental United States, and predominantly nonheavy tails in Northern Europe. The regional tail behavior has been observed in relation to the interplay between terrain and meteorological characteristics, and we further conducted quantitative analyses to assess the influence of hydroclimatic conditions using Köppen classifications. Notably, temporal variations in catchment storage are a crucial mechanism driving highly nonlinear catchment responses that favor heavy-tailed floods, often intensified by concurrent dry periods and high temperatures. Furthermore, this mechanism is influenced by various flood generation processes, which can be shaped by both hydroclimatic seasonality and catchment scale. These insights deepen our understanding of the interplay between climate, physiographical settings, and flood behavior, while highlighting the utility of hydrograph recession exponents in flood hazard assessment.
A methodology to compile multi-hazard interrelationships in a data-scarce setting: an application to Kathmandu Valley, Nepal
Authors: Thompson Harriet E. , Gill Joel C. , Šakić Trogrlić Robert , Taylor Faith E. , Malamud Bruce D.
Published: May 2024

Abstract. This paper introduces a multifaceted methodology to identify and compile single natural hazards and multi-hazard interrelationships within the context of data-scarce urban settings, exemplified by Kathmandu Valley, Nepal. This approach integrates (i) five blended types of evidence to support a more nuanced and holistic understanding of a hazardscape where data are scarce and (ii) a 2-hour stakeholder workshop with seven participants to provide greater context to the hazards, consider their impacts through the co-production of multi-hazard interrelationship scenarios, and how this methodology could support more people-centred disaster risk reduction (DRR) strategies. We use blended evidence types, including academic literature, grey literature, media, databases, and social media, to systematically search for exemplars of single hazards and multi-hazard interrelationships that have influenced or could potentially influence Kathmandu Valley. We collated 58 sources of evidence for single hazards and 21 sources of evidence for multi-hazard interrelationships. Using these sources, our study identified 21 single hazard types across six hazard groups (geophysical, hydrological, shallow Earth processes, atmospheric, biophysical, and space/celestial hazards) and 83 multi-hazard interrelationships (12 that have direct case study evidence of previous influence in Kathmandu Valley) that might influence Kathmandu Valley. These exemplars are collated into two databases that accompany this paper. We supplement these exemplars with multi-hazard interrelationship scenarios and multi-hazard impacts developed by stakeholders engaged in DRR research and practice in Kathmandu Valley. The results illustrate the complexity of the hazard landscape, with many single hazards and multi-hazard interrelationships potentially influencing Kathmandu Valley. The research emphasises the importance of inclusive DRR strategies that recognise disaggregated impacts experienced by different social groups. This knowledge can inform the development of dynamic risk scenarios in planning and civil protection, thus strengthening multi-hazard approaches to DRR in “Global South” urban areas such as Kathmandu Valley.
Multisectoral analysis of drought impacts and management responses to the 2008–2015 record drought in the Colorado Basin, Texas
Authors: Ferencz Stephen B. , Sun Ning , Turner Sean W. D. , Smith Brian A. , Rice Jennie S.
Published: May 2024

Abstract. Drought has long posed an existential threat to society. Engineering and technological advancements have enabled the development of complex, interconnected water supply systems that buffer societies from the impacts of drought, enabling growth and prosperity. However, increasing water demand from population growth and economic development, combined with more extreme and prolonged droughts due to climate change, poses significant challenges for governments in the 21st century. Improved understanding of the cascading multisectoral impacts and adaptive responses resulting from extreme drought can aid in adaptive planning and highlight key processes in modeling drought impacts. The record drought spanning 2008 to 2015 in the Colorado Basin in the state of Texas, United States, serves as an outstanding illustration to assess multisectoral impacts and responses to severe, multi-year drought. The basin faces similar water security challenges to those across the western US, such as groundwater depletion and sustainability, resource competition between agriculture and growing urban populations, limited options for additional reservoir expansion, and the heightened risk of more severe and frequent droughts due to climate change. By analyzing rich, high-quality data sourced from nine different local, state, and federal sources, we demonstrate that characterizing regional multisector dynamics is crucial to predicting and understanding future vulnerability and possible approaches to reduce impacts to human and natural systems in the face of extreme drought conditions. This review reveals that, despite the severe hydrometeorological conditions of the drought, the region's advanced economy and existing water infrastructure effectively mitigated economic and societal impacts.
Anadolu Mandalarının İlk Üç Laktasyonlarına Ait Laktasyon Eğrisi Parametrelerinin ve Eğri Şeklinin Belirlenmesi
Authors: Şahin Aziz , Aksoy Yüksel , Ulutaş Zafer , Yıldırım Arda , Sarıkaya Öden
Published: May 2024

Bu araştırma, Anadolu Mandalarında üç laktasyonun laktasyon eğrisi parametrelerini ve laktasyon şeklini belirlemek amacıyla yürütülmüştür. Bu amaçla, Tokat ilinde 2016 yılında doğan, 2019 yılında laktasyona başlayan 521 baş mandanın 3126 test günü verim kayıtları kullanılmıştır. a parametresi 1., 2. ve 3. laktasyonlar için sırası ile 2.873, 3.776 ve 3.910 olarak tahmin edilirken, b parametresinin sırası ile 0.521, 0.324 ve 0.444, olduğu tespit edilmiştir. c parametresi 1., 2. ve 3. laktasyonlar için sırası ile 0.0096, 0.0066 ve 0.0081 olarak belirlenirken, R2 değerinin 1., 2. ve 3. laktasyonlar için sırası ile 0.966, 0.991ve 0.992 olduğu tespit edilmiştir. Islah çalışmalarında, araştırma sonucunda tahmin edilen parametrelerin kullanılması, bu sürülerde yapılacak seleksiyonun başarısını etkileyecektir.
2. AMH - DẤU ẤN SINH HỌC DỰ ĐOÁN VIỆC LẤY TINH TRÙNG THÀNH CÔNG Ở BỆNH NHÂN VÔ TINH KHÔNG DO TẮC NGHẼN: TỔNG QUAN BẰNG CHỨNG HIỆN CÓ Ở NGƯỜI
Authors: Hoàng Nguyễn Huy , Len Bùi Thị , Anh Đặng Tuấn , Anh Lê Mai , Huy Nguyễn Tiến , Anh Cao Tuấn
Published: May 2024

Tổng quan: Vô tinh không do tắc nghẽn (NOA) được coi là dạng vô sinh nam nghiêm trọng nhất. Tỷ lệ lấy được tinh trùng từ nam giới NOA sau phẫu thuật mTESE vẫn chỉ ở mức 30-60%. Trong trường hợp phẫu thuật không tìm thấy tinh trùng, có thể gây ra các tổn hại không đáng có cho người bệnh như: đau, tổn thương tinh hoàn, suy giảm nội tiết, tốn kém chi phí. . . Do đó, việc dự đoán tỷ lệ lấy tinh trùng thành công (SSR) rất quan trọng để bệnh nhân NOA đưa ra lựa chọn có nên phẫu thuật hay không?
Mục tiêu: Tìm hiểu mối liên quan giữa hormone AMH và tỷ lệ thu hồi tinh trùng của bệnh nhân NOA trải qua phẫu thuật thu tinh trùng từ tinh hoàn.
Phương pháp nghiên cứu: Tổng quan tài liệu trên PUBMED, EMBASE, CENTRAL và Web of Science. Những nghiên cứu đã được thực hiện so sánh dấu ấn sinh học AMH ở nam giới NOA trải qua phẫu thuật tinh hoàn tìm tinh trùng dương tính và âm tính.
Kết quả: Nồng độ AMH huyết thanh là một dấu ấn sinh học tiềm năng để tiên lượng tỷ lệ thu hồi tinh trùng đối với một nhóm nhỏ bệnh nhân NOA do nguyên nhân vô căn hoặc mắc hội chứng Klinefelter thuần. Tuy nhiên, chất lượng bằng chứng còn thấp do cỡ mẫu nhỏ và đa phần nghiên cứu là hồi cứu. Ngược lại, AMH tinh dịch hiện không được sử dụng như một dấu ấn sinh học hiệu quả tiên lượng tỷ lệ thu hồi tinh trùng dương tính.
Kết luận: Bằng chứng hiện có là không đủ để giúp cho các bác sĩ lâm sàng đưa ra quyết định đầy đủ và các nghiên cứu thử nghiệm lâm sàng đa trung tâm, cỡ mẫu lớn và có triển vọng hơn là rất cần thiết.
ANALYSIS OF THE IMPACT OF THE SANCTIONS NEWS ON RUSSIAN FINANCIAL MARKETS
Authors: Rychkov V.V.
Published: May 2024

The study presents a hypothesis that real-time news about the planned introduction of sanctions, adversely affects financial markets comparable to de facto imposed sanctions. The research focuses on quantitative evaluation of the relationship between news about sanction plans, their actual implementation, and the subsequent reaction of the currency, stock, and credit markets in Russia. The hypothesis that sanctions news has a negative impact, regardless of sentiment analysis, is confirmed. These news items act as a driving force for market changes, irrespective of the imposition of sanctions. Based on the calculations, the author reaches the following conclusions: 1) Western sanctions are no longer targeted and selective but aimed at maximum restriction of economic ties. 2) The non imposed sanctions of the study demonstrate that news about sanction plans alone has a negative impact and acts as a market-driving force independent of their implementation. The study utilises the Sanctions News Index (SNI), developed to assess the impact of news about sanctions on the Russian financial markets. The Granger method confirms the causal relationship between sanctions news and financial markets as measured by the SNI index. The significance of the sanctions factor, as measured by the SNI index, and its influence on the exchange rate of the Russian ruble is confirmed by constructing a regression model with this indicator as one of the independent variables. A proposed methodology has successfully identified the most impactful sanctions and evaluated their effects on financial markets. This was accomplished by performing quantitative content analysis on the SNI index. This work can be valuable for assessing the impact of sanctions on investment decision-making, and risk management, and understanding the overall mechanism, i.e., how news about potential or actual sanctions affect the economies of entire countries or regions.
An Analysis of Postgraduate Studies on Reading Culture
Authors: Değirmenci Gündoğmuş Hatice
Published: May 2024

Reading culture is the love of reading, the ability to read continuously, and the ability to read effectively and critically. The reading culture of the individuals who make up a society is a strong foundation for the future. The objective of this study was to examine postgraduate theses on reading culture according to a range of variables. A total of 23 approved postgraduate theses, 10 doctoral theses and 13 master’s theses on reading culture between 2014 and 2024 registered at the YÖK National Thesis Centre were identified. The data analysis of the theses under examination was conducted using the content analysis method, which is a qualitative research method. The research revealed that the inaugural study on reading culture at the graduate level was conducted in 2014. The majority of studies were conducted in 2023, with the highest number of studies conducted at Ankara University. Of the studies, 13 were at the master’s level and 10 were at the doctoral level. The majority of studies were conducted by supervisors holding the title of professor. All studies were conducted in Turkish, and the qualitative research model was employed. The population and sample of the studies were predominantly teachers. Upon examination of the studies, it becomes evident that the significance of the concept of reading culture has been elucidated through the examination of reading culture in Turkey from various vantages. In accordance with the findings of the study, a series of recommendations were put forth.
Estudo descritivo e comportamental dos usuários de profilaxia pré-exposição em Campo Grande, Mato Grosso do Sul
Authors: Braz Junior Roberto Paulo , Alves Gabriela Cesar , Silva Andréia Souza Pinto da , Amianti Carolina , Bandeira Larissa Melo , Castro Ana Rita Coimbra Motta e
Published: May 2024

Introdução: A epidemia do HIV representa um desafio global de saúde pública desde os primeiros casos identificados. Populações-chave são desproporcionalmente afetadas, resultando em um aumento significativo no número de casos novos no Brasil e no mundo. Com o intuito de diminuir a incidência dessa infecção, a profilaxia pré-exposição (PrEP) surgiu, em 2012, como parte das estratégias de prevenção do HIV, sendo sua eficácia diretamente relacionada à adesão. Objetivo: Estudar os principais aspectos epidemiológicos dos usuários de PrEP e as barreiras de acesso ao uso dessa profilaxia. Métodos: Trata-se de um estudo transversal realizado entre janeiro de 2021 e abril de 2022 que incluiu 140 usuários de PrEP atendidos no Centro de Testagem e Aconselhamento (CTA) de Campo Grande, Mato Grosso do Sul. Os dados sobre as características sociodemográficas e fatores associados ao abandono de PrEP foram obtidos por meio de entrevistas individuais utilizando questionário padronizado. Resultados: A maioria dos usuários de PrEP é homem-cis (92%), branco (51%), maior de 30 anos (56,5%), de orientação homossexual (76,5%) e com pelo menos 12 anos de estudos (77,5%). Cerca de 60% admitiram uso inconsistente de preservativo em relações sexuais recentes, principalmente de natureza anal. Aproximadamente 88% se veem em risco de contrair infecções sexualmente trasmissíveis (IST) no próximo ano. Quanto às novas formas de apresentação, 54% revelou que usaria “PrEP sob demanda” e 92% tem interesse no uso de “PrEP injetável”. Após 6 meses de acompanhamento, 43,6% (intervalo de confiança de 95% [IC95%] 35,5–52,0) descontinuaram o uso da PrEP, principalmente devido a mudanças no comportamento sexual (38,3%) e dificuldades de acesso a serviços de saúde (21,28%). Conclusão: O estudo ressalta a necessidade de inclusão de diferentes populações-chave e destaca a importância da PrEP como estratégia de acompanhamento contínuo para prevenção do HIV/IST, além da importância de incluir novas apresentações como opção para PrEP oral diária no Sistema Único de Saúde (SUS).
A profilaxia pré-exposição ao HIV na Atenção Primária à Saúde de Porto Alegre, Rio Grande do Sul
Authors: Egres Luciana Silveira , Pires Raphael Silva e , Silva Daila Alena Raenck da , Almeida Yasmin do Amaral de , Silva João Henrique Nagildo da , Brundo Sabrina Terezinha de Souza Gilli , Dillenburg Alessandra Mendes , Silva Gabrielle Helena Wellaussen da
Published: May 2024

Introdução: Porto Alegre mantém-se, há mais de 10 anos, nos primeiros lugares do ranking das capitais brasileiras em taxa de detecção de AIDS. Entre as estratégias de enfrentamento ao HIV/AIDS, o Ministério da Saúde propõe a conjugação de ações biomédicas, comportamentais e estruturais. No âmbito biomédico, identificando-se a profilaxia pré-exposição (PrEP) e a profilaxia pós-exposição (PEP) à infecção pelo HIV. Estudos demonstram uma correlação entre a quantidade de dispensações de PrEP nos municípios e a tendência de redução na taxa de incidência de HIV. Objetivo: Descrever a experiência do município de Porto Alegre na ampliação da PrEP nas Unidades de Saúde (US) da Atenção Primária à Saúde (APS). Métodos: Foram realizadas capacitações para os prescritores médicos e enfermeiros, pertencentes às Coordenadorias de Saúde de Porto Alegre. As turmas foram ofertadas em dois turnos a fim de viabilizar a participação dos profissionais de saúde, conforme as agendas de atendimento. Na proposta pedagógica foi incluída o Protocolo Clínico e Diretrizes Terapêuticas para PrEP, o aconselhamento e as barreiras de acesso aos serviços de saúde impostos pelo Estigma e Discriminação em relação ao HIV/AIDS. Resultados: Foram, primeiramente, identificadas 14 unidades da APS, no ano de 2022, para a realização do piloto da descentralização da PrEP. Essas foram submetidas a um processo de formação referente ao protocolo e aos fluxos da PrEP. Posteriormente, foram inseridas, na educação permanente da PrEP, a totalidade de serviços do município. Os profissionais de saúde aderiram a proposta e demonstraram-se motivados à prescrição da PrEP na APS. Conclusão: Foram capacitadas 100% das US da APS, com adesão dos profissionais de saúde à oferta da PrEP aos usuários como forma de prevenção ao HIV/AIDS. Observa-se que para o sucesso da estratégia é necessário facilitar o acesso do usuário à medicação, com a ampliação dos locais de dispensação.
Avaliação da colonização do canal cervical por microrganismos sexualmente transmissíveis em mulheres ribeirinhas do Baixo São Francisco, no interior de Alagoas, Nordeste do Brasil
Authors: Cavalcanti Eliane Aparecida Holanda , Santos Bruna Priscila dos , Santos Adriano José dos , Silva Ericlis dos Santos Silva dos Santos , Silva Rikelly Rhuana Nunes da , Wanderley Giovanna Maria Rodrigues , Lira Neto Abel Barbosa , Silva Francine Simone de Mendonça , Farias Karol Fireman de , Nascimento Cristiane Araujo
Published: May 2024

As infecções sexualmente transmissíveis (ISTs) é um problema de saúde pública, podendo ser ocasionadas por bactérias, vírus e/ou parasitos, disseminadas principalmente por meio do sexo vaginal, anal e/ou oral, e assintomáticas por algum período ou por toda vida. Acometem diferentes faixas etárias, impactando a saúde sexual e reprodutiva, podendo ter consequências graves se não tratadas. Este estudo teve como objetivo investigar a presença de microbiota patogênica em mulheres ribeirinhas do município de Piaçabuçu, Alagoas. Os dados foram coletados durante a V Expedição Científica do Baixo São Francisco, em uma Unidade Básica de Saúde (UBS). Foi também realizada a consulta ginecológica com profissionais de Enfermagem e coletadas amostras de secreção vaginal e raspado cervical, em mulheres maiores de 18 anos. A identificação dos patógenos foi por tipagem molecular, via RT-PCR para: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum e Trichomonas vaginalis. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal de Alagoas – Ufal (nº 5.818.119/CAAE 64293222.5.0000.5013). Foram atendidas 14 mulheres com idade média de 44-64 anos, das quais 28,57% (n=4) eram solteiras, 28,57% (n=4) casadas e 21,43% (n=3) divorciadas. Entre os microrganismos encontrados, Ureaplasma parvum foi de maior prevalência (28,57%, n=4), seguido pela coinfecção de Ureaplasma parvum e Mycoplasma hominis (14,29%, n=2), Mycoplasma hominis (14,29%, n=2) e coinfecção de Ureaplasma parvum e Trichomonas vaginalis (7,14%, n=1). A predominância de microrganismos oportunistas com resistência crescente a antibióticos e que impactam com problemas na gestação ou na reprodução humana alerta para a necessidade de sistemas de vigilância e monitoramento efetivos de ISTs assintomáticas na atenção primária.
Pré-natal de crianças com suspeita de sífilis congênita em hospital referência de Santa Catarina
Authors: Strapazzon Isabela Flebbe , Carvalho Emanuela da Rocha
Published: May 2024

Introdução: A sífilis congênita é reflexo da infecção gestacional não tratada adequadamente. Representa um desafio de saúde pública no Brasil e em Florianópolis, com incidências altas: 9,9 e 13,3 casos a cada 1.000 nascidos vivos em 2021, de acordo com o Ministério da Saúde. Necessita-se buscar as fragilidades sistêmicas que resultam na infecção fetal, com o pré-natal e a investigação preconizada representando objetos de esforço para prevenção. Objetivo: Descrever o pré-natal das gestações de população com suspeita de sífilis congênita. Métodos: Estudo descritivo e observacional com análise de prontuários de pacientes atendidos entre janeiro de 2021 e dezembro de 2022 por suspeita de sífilis congênita em ambulatório referência, aprovado pelo Comitê de Ética em Pesquisa da instituição sob Parecer nº 6.056.776. Resultados: Foram analisados 145 prontuários. A mesorregião, em 82,8%, foi Grande Florianópolis. A idade materna mais frequente foi de 20–34 anos (27,6%). A ocupação, em 20,7% dos casos, foi “desempregada” ou “do lar”. Em 85,5% dos casos foi realizado pré-natal, e dos registrados, 62,2% realizaram seis ou mais consultas. Testes não treponêmicos foram reagentes em 89% dos casos, enquanto em 68,3% o resultado de teste treponêmico foi ignorado. Em 37,9% dos casos foi diagnosticada sífilis no primeiro trimestre; em 22,1%, no segundo trimestre; em 16,6%, no terceiro trimestre; e em 11,7%, no parto. Em 71,7% dos casos foi iniciado tratamento; em 44,1% finalizou-se mais de 30 dias antes do parto; e em 29,7% houve registro de queda adequada de títulos. Em 31,7% foi registrado tratamento da parceria sexual. A testagem para HIV foi negativa em 36,6% dos casos, e em 51%, foi ignorada. Conclusão: Em maioria, houve número adequado de consultas pré-natais, de acordo com o Ministério da Saúde, e diagnóstico precoce da sífilis. Entretanto, houve tratamento apenas materno, próximo ao parto e sem queda adequada de títulos. Necessita-se, assim, de maior integralidade do acesso e precisão do tratamento da sífilis gestacional.
A eliminação da transmissão vertical do HIV em Niterói, Rio de Janeiro: história construída por muitas mãos
Authors: Souza Fábia Lisboa de , Oliveira Thaís Maria Jesus de , Silva Márcia Santana da , Eppinghaus Ana Lúcia Fontes , Pantoja Lídia Nazaré , Meijinhos Lana dos Santos
Published: May 2024

Introdução: O Brasil desenvolve estratégias de vigilância, prevenção e controle para eliminação da transmissão vertical (TV) do HIV e da sífilis. Objetivo: Descrever a linha de cuidado para eliminação da TV do HIV em Niterói e apresentar os indicadores da certificação em 2022. Métodos: Apresentamos a linha de cuidado para a prevenção da TV do HIV e os indicadores para a certificação em 2022. Resultados: O pré-natal (PN) ocorre nas 44 Unidades de Saúde da Família (USF), em quatro Unidades Básicas de Saúde (UBS), sete policlínicas, uma policlínica de especialidades e Hospital Universitário Antônio Pedro (HUAP), referências para o PN de alto risco. As USF cobrem 90% das Áreas de Especial Interesse Social. O TR para o HIV está na Atenção Primária à Saúde (APS) desde 2015. Há 11 Serviços de Atenção Especializada (SAE), todos com Unidades Dispensadoras de Medicamentos. Gestantes reagentes acompanham nos SAE e na APS desde 2017, indo para o PN de alto risco havendo risco obstétrico. Partos são realizados no HUAP e no Hospital Estadual Azevedo Lima. A fórmula láctea é assegurada até 12 meses de vida. Há um grupo para discussão da prevenção da TV da sífilis e do HIV desde 2009. Os indicadores para a eliminação foram: 0 casos de crianças infectadas pelo HIV por TV em 2020; cobertura mínima de quatro consultas PN, 96% em 2019 e 95% em 2020; cobertura de gestantes com pelo menos um teste para HIV no PN, 100% em 2019 e 2020; cobertura de gestantes infectadas com HIV em uso de terapia antirretroviral (TARV), 95% em 2019 e 96% em 2020; cobertura de crianças expostas ao HIV que receberam profilaxia TARV adequada, 100% em 2019 e 97% em 2020. Conclusão: É preciso sustentabilidade e qualidade no pré-natal, no parto e no puerpério para a manutenção da Certificação da Eliminação da TV do HIV e para o alcance da eliminação da sífilis congênita.