bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacto econômico das ações judiciais para o fornecimento de medicamentos no Estado de São Paulo
Authors: Simone Adriane Lopes Medeiros , Melo Daniela Oliveira de
Published: September 2019

Objective: to understand the participation of expenses with judicialized medicines in total expenditure on drugs (DTLM) in São Paulo State (SP). Methods: it was conducted an exploratory analysis of data from Sistema de Informações Gerenciais da Execução Orçamentária (Sigeo) and Sistema de Informação de Orçamento Público em Saúde (Siops) from 2010 to 2018. Results: in this period, DTLM in SP exceeded 11 billion of reais, showing a downward trend in global values and percentage share in relation to total health expenditure (from 11.32% in 2010 to 8.95% in 2018). From 2016 to 2018, 17% of DTLM were destined to lawsuits (R$ 679,935,967.31), with a growing trend. Discussion: the representativeness of judicialized drugs in DTLM warns of cost issues, but also for patient safety and sustainability of public health policies, because this list also includes new drugs, which have not been proved superior in effectiveness and safety yet, comparing to available alternatives, and/or off label use. Conclusions: the legal demands for medicines have not led to an increase in the allocation of funds for their purchase, but to competition for resources originally destinated for the pharmaceutical services policy, with a reduction in the percentage participation of medicines from SUS official lists each year.
Regulation of Settlement Relations under Civil Law in the Context of Development of the Sharing Economy
Authors: Ayusheeva I. Z.
Published: September 2019

The modern era is characterized by a rapid change in social relations, the emergence of new institutions, which has become a consequence of rapid development of technologies, their penetration into everyday life. Nowadays, measures are being taken to develop the digital economy. At the same time, the society is experiencing crisis phenomena, environmental problems, which, consequently, leads to changes in the culture of consumption of available limited resources: in the economy there is a tendency to shift from a society of consumption (consumerism) to the sharing economy. Indeed, the idea of the economy of joint use of goods and services (sharing economy, peering economy) is not a new one in itself, but it has gained new impetus in the context of the development of modern technologies, digitalization of the economy, when the creation of uniform technological platforms and marketplaces facilitates the unification and connection of an unlimited number of strangers. All this determines the relevance of the study of the features of civil law regulation of relations associated with the implementation of settlements in connection with the performance of obligations under the contracts concluded in the context of the sharing economy, determination of the possibility of using blockchain technology in this field and peculiarities of the legal regulation of relations in connection with its application. The article highlights that, at the present stage, different models of contractual relations are formed to mediate relations existing in the sharing economy, within each of these models there are peculiarities of performance of obligations, while the model of the sharing economy gives the possibility of using the blockchain technology, but its use is complicated by the lack of proper legal regulation of the relations under consideration.
The Balanced Current Special Status of the Caspian Sea under International Law
Authors: Batyr V. A.
Published: September 2019

The article explores the peculiarities of international legal regulation of the special legal status of the Caspian Sea, legal regimes created by the Convention on the Legal Status of the Caspian Sea the adoption of which in 2018 marked the establishment of a system of treaties with regard to the Caspian Sea. The Convention aims to avoid fragmentation of international legal regulation and represents the result of the codification of the most important issues of regional cooperation among the Caspian States. It is noted that the water area of the Caspian Sea is divided into internal waters, territorial waters, fishing zones, common maritime space. The delimitation of the bottom and subsoil of the Caspian Sea into national bottom sectors is carried out by the agreement between adjacent and opposite States in compliance with the modified median line. 17 principles of activity on the Caspian Sea have been established, legitimate activities and corresponding legal regimes in the Caspian Sea have been defined: exploration and exploitation of its bottom and subsoil resources; fishing, use and protection of aquatic biological resources; shipping; marine scientific research; laying of cables and pipelines; protection of the ecological system.
Problems of Harmonization of European and Russian Legislation on Defamation
Authors: Kirilenko V. P. , Alekseev G. V.
Published: September 2019

Russia’s integration into the global information space largely depends on how effectively fundamental human rights and freedoms will be protected by the current national legislation and the emerging integration law. Harmonization of Russian law with European standards of freedom of speech and protection of intangible rights of individuals and legal entities in terms of liability for defamation statements is a fundamentally important task to maintain the authority of the Russian Federation in the European political arena. The work of international human rights organizations, such as the International Press Institute, demonstrates the problems with ensuring real freedom of speech in the vast majority of European Union countries. The use of criminal sanctions for defamation offences, as well as the use of extremely large administrative fines and civil compensation, in fact, is a pan-European practice of countering not only defamation, but also any abuse of freedom of speech by the media community. Such practices could hypothetically threaten free speech, and they raise understandable concerns among the democratic public about the prospects of state institutions controlling private media. Calls for social and legal experiments in the form of regular attempts to decriminalize libel do not seem constructive. Based on the analysis of the Russian practice of bringing to responsibility for torts in the information space, it is proposed to understand defamation as any illegal dissemination of information with the aim of harming legally protected interests and to make wider use of civil liability measures in punishing such offenses. The authors propose to harmonize the European and Russian legislation on defamation through the development of uniform rules for the production of the forensic linguistic examination of the defamatory materials to substantiate evidence of the unlawful intent of delinquent.
Identification of sequences encoding for ncr-peptides and defensins in the ‘meta-assembly’ of transcriptome of pea (pisum sativum l.) Nitrogen-fixing nodules
Authors: Zorin Evgeny A. , Kliukova Marina S. , Kulaeva Olga A. , Afonin Alexey M. , Tikhonovich Igor A. , Zhukov Vladimir A.
Published: September 2019

Background. The active and careless applying of antibiotics in medicine and agriculture leads to the emergence of resistance to the existing antimicrobial drugs, which reduces the effectiveness of their use. One of the ways to solve this problem is the development of new antibiotics based on plant peptides with antimicrobial activity, for example plant defensins (which identified in all plants) and NCR peptides that are specifically synthesized in nodules of some leguminous plants.

Materials and methods. In the present study, a meta-assembly of a transcriptome was constructed based on publicly available RNA-sequencing transcriptomes of pea nodules (Pisum sativum L.). This meta-assembly was used to search for sequences encoding antimicrobial peptides.

Results. As a result, 55 and 908 unique sequences encoding defensins and NCR peptides, respectively, were identified. The recognition site for the signal peptidase was predicted and sequences were divided into the signal and mature part of the peptide. Among mature defensins, 22 peptides possess in silico predicted antimicrobial activity, and for the NCR peptides family their number was 422.

Conclusion. Sequences encoding defensins and NCR peptides expressed in nitrogen-fixing pea nodules were identified. They are candidates for testing their antimicrobial activity in vitro.
Cardiac Autonomic Modulation Behavior in Community Men with Hypertension on rest and Effort Condition
Authors: Silva Rafaella Carvalho da , Marães Vera Regina Fernandes da Silva
Published: September 2019

AbstractHeart rate variability (HRV) analysis is an important method to evaluate the modulation of autonomic nervous system on cardiac activity. The goal was to evaluate the heart rate variability behavior in hypertensive middle-aged men at rest, before and after submaximal physical test. It is a cross-sectional, analytical study with sedentary men, middle-aged (mean 48 years) and owners of clinical diagnosis of hypertension who underwent to a physical therapy evaluation, and obtainment of HRV at rest in the supine position, sitting position and before a 6-minute walk test and after it. The values of HRV indexes on time and frequency domain showed low and statistically significant (p<0.05) when analyzed and compared at rest and after the execution of the test. Conclusion: The data suggest that the studied hypertensive volunteers showed a reduction of HRV immediately after the 6-minute walk test, implying a reduction in parasympathetic modulation during this period and the consequent increase in cardiovascular risk after physical exertion, even being a submaximal test.Keywords: Physical Exertion Heart. Hypertension. Autonomic Nervous System.ResumoA análise da variabilidade da frequência cardíaca (VFC) é um importante mecanismo para a avaliação da modulação do sistema nervoso autônomo sobre a atividade cardíaca. O objetivo do estudo foi avaliar o comportamento da variabilidade da frequência cardíaca de homens de meia-idade e hipertensos na condição de repouso antes e após serem submetidos a esforço físico submáximo. Trata-se de um estudo analítico transversal, em que foram estudados homens, sedentários de meia idade (média de 48 anos) e possuidores de diagnóstico clínico de hipertensão arterial sistêmica, submetidos à avaliação fisioterapêutica e captação da VFC na condição de repouso em supino, sedestação e antes de realizar teste de caminhada de 6 minutos (TC6) e após sua execução. Os valores dos índices de VFC nos domínios de tempo e frequência estudados apresentaram-se reduzidos e estatisticamente significantes (p<0.05) quando analisados e comparados em repouso e após a execução do teste. Os dados sugerem que os hipertensos estudados apresentaram uma redução da VFC imediatamente após o TC6, inferindo uma diminuição da modulação parassimpática neste período e consequente aumento no risco cardiovascular após o esforço físico, ainda que submáximo.Palavras-chave: Esforço Físico. Hipertensão. Sistema Nervoso Autônomo.
Performans Göstergelerine Göre Sulama Şebekelerinin Değerlendirilmesi
Authors: KARTAL Sinan , DEĞİRMENCİ Hasan
Published: September 2019

Artan
dünya nüfusu karşısında doğal kaynakların daha verimli kullanımı önemli hale gelmiştir.
Artan gıda ihtiyacının karşılanması için kaynakların yönetimi açısından yeni
anlayış ve yöntemlere ihtiyaç duyulmaktadır. Su, gıda üretimi için ilk sırada
gelen kaynaktır. Tarımsal alanda kullanılan suyun yönetimi son derece
önemlidir. Sulama şebekelerinin izlenmesi ve değerlendirilmesi açısından
geliştirilen performans göstergeleri değerlendirme ve yorum açısından önemli
kolaylıklar sağlamaktadır. Yapılan bu çalışmada Akdeniz bölgesinden seçilen
Kahramanmaraş, Göksun, Andırın, Keysun ve Hancağız sulama şebekeleri, 11 yıllık
(2006-2016) veri kullanılarak çok değişkenli istatistiksel yöntemlerle
değerlendirilmiştir. Temel bileşenler analizi yapılmış, analiz sonucunda elde
edilen bileşen yükleri ile kalite indeksi hesaplanarak çıkan sonuçlara göre başarı
sıralaması yapılmıştır. Kalite indeksine göre yapılan sıralama da Kahramanmaraş
sulama şebekesi (311.96) ilk sırada yer alırken
Hancağız sulama şebekesi (-1061.53) son sırada yer almıştır. Sonuç olarak
sulama şebekelerinin başarı sıralamasına en fazla finansal ve su dağıtım
performans göstergeleri etkili olmuştur.
RISK-AVERSE STOCHASTIC ORIENTEERING PROBLEMS
Authors: ÇAVUŞ Özlem
Published: September 2019

In this study, we consider risk-averse orienteering problems with stochastic travel times or stochastic rewards. In risk-neutral orienteering problems, the objective is generally to maximize the expected total reward of visited notes. However, due to uncertain travel times or uncertain rewards, the dispersion in total reward collected may be large, which necessitates an approach that minimizes the dispersion (risk) in addition to maximizing the expected total reward. To handle this, for the orienteering problems with stochastic travel times or stochastic rewards, we suggest two different formulations with an objective of coherent measures of risk. For both problems, we conduct an experimental study using two different coherent measures of risk, which have been extensively used in the literature, and compare the results. The computational results show that, in both models suggested and under both risk measures used, the decision maker is able to obtain a tour with expected total reward being close to the expected total reward of risk-neutral solution, however with a significant decrease in the standard deviation of total reward.
A retrospective study on maternal and perinatal outcome in pregnancy requiring DJ stent and PCN during pregnancy
Authors: David Liji , Rathore Swati , Kulkarni Neeraj , Waanbah Batiston Decruse , Samuel Benedict Paul , Mukherjee Partho
Published: September 2019

Background: Gestational hydronephrosis (GH) is result of dilatation effect of the progesterone and mechanical compression of the gravid uterus. Management during pregnancy is challenging as routine radiological investigations and surgical treatments cannot be applied due to the potential harm to the fetus. Intervention is indicated in women who fail to respond to conservative management. Acute hydronephrosis and renal colic are common etiologies for loin pain, and can lead to severe form of urinary tract infection affecting perinatal outcome. Ureteric stenting and percutaneous nephrostomy (PCN) during pregnancy are safe, requiring no intra-operative imaging, and inserted under local anaesthesia. It provides good symptom relief, low complication rate, efficient and safe modality for women with refractory symptoms.Methods: A retrospective study of pregnant women admitted under obstetric units with acute hydronephrosis requiring DJ stenting and/or PCN. Aim was to evaluate the course and pregnancy outcomes in a tertiary center of Southern India over a period of five years.Results: Descriptive statistical analysis was done in 12 women with acute hydronephrosis in pregnancy. 66.7% were nulliparous and mean gestational age at admission was 31 weeks. Diagnosis was done by USG. One-fourth had pyelonephritis and calculus being the main pathology (n=9;75%).Women requiring DJ stent and PCN were 41.6% and 58.4% respectively. 41.7% had preterm labour. 66.7% delivered vaginally, birth weight was more than 2.5kg in 50%.Conclusions: Maternal and neonatal outcome mainly depends on the early diagnosis. In this study we emphasize on the importance of multidisciplinary team approach in the management of women with acute hydronephrosis. DJ stent and PCN are efficient and safe modalities in women with refractory symptoms.
TLH versus TAH: a 2 year retrospective comparative study
Authors: Dogra Anju , Kumar Vinay , Bhushan Nishu
Published: September 2019

Background: Laparoscopic hysterectomy has become a widely accepted technique worldwide, since its introduction by Reich in 1989. The aim of the study was to compare the surgical results and intra- operative and post-operative complications between total laparoscopic hysterectomy (TLH) and total abdominal hysterectomy (TAH).Methods: Authors conducted a retrospective study at SMGS hospital, GMC Jammu between October 2016 to September 2018, 126 patients who underwent TLH and 126 patients who underwent TAH, were included.Results: Authors observed that there was no significant difference between the two groups in respect to patient’s age, parity and indication of surgery. Duration of surgery was found to be longer in TLH than TAH. The length of hospital stay was less in TLH than TAH. Hb drop was more in TAH group. 25 patients of TAH were given post op blood transfusion but only 9 patients of TLH were given post op blood transfusion. The time to ambulation in patients of TLH was much shorter than TAH. Wound infection was more common in TAH as compared to TLH, 5 patients had wound infection and in 4 patients resuturing was done for wound dehiscence. In 8 patients laparoscopy was converted to laparotomy because of adhesions, vascular injury and in one case because of bowel injury.Conclusions: This study showed that TLH can be safely performed by the experienced surgeon as an alternative to abdominal hysterectomy. It offers several benefits over TAH such as smaller incision, earlier ambulation, shorter hospital stay, faster recovery time and does not increase more serious complications than TAH.
Gynaecological bacterial infections: the physical and psychosocial consequences and challenges of management in resource-limited settings
Authors: Adiri Charles O. , Nwagha Uchenna I. , Okeke Tochukwu C. , Izuka Emmanuel O.
Published: September 2019

Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding.
The comparison of USG measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion
Authors: Naidu Harshita , Hegde Nivedita , M. Anjali , Kanniga Rohini , Vasudeva Akhila
Published: September 2019

Background: The majority of women who undergo induced abortion are young and of low parity. Hence, it is desirable to look for any association effects of induced abortion with future reproductive outcomes. In this study, we aim to compare ultrasound measured cervical length in pregnant women with previous induced abortion versus those who have not had an induced abortion.Methods: This was a prospective observational study performed at tertiary care hospital. Total of 400 patients were recruited, divided into two groups. Patients with an induced abortion in previous pregnancy were included as cases and those with no history were taken as controls. Cervical length was measured by transvaginal ultrasound in all participants at 11-14, 18-22 and 28-32 weeks. Pregnancies were followed up to note incidence of spontaneous preterm delivery, preterm pre labour rupture of membranes (PPROM), threatened preterm, and second trimester miscarriage.Results: Authors have found that there was no significant difference in the cervical length of pregnant patients with or without a history of prior induced abortions.  In our study authors found that mean cervical length at 11-14weeks, 18-22 weeks, and 28-32 weeks was 3.47±0.126cm and 3.48±0.195cm; 3.44±0.296cm and 3.49±0.182cm; 3.36±0.477cm and 3.42±0.310cm respectively among cases and controls. However, there was a demonstrably increased risk of spontaneous preterm delivery, PPROM and threatened preterm in patients with a history of prior induced abortion.Conclusions: Authors conclude that previous induced abortion increases the risk of threatened preterm, PPROM, spontaneous preterm delivery in the subsequent pregnancy. But, this risk is not predictable by measuring cervical length as the mean cervical length remained the same in both the groups.
Maternal and fetal outcome of malaria in pregnancy
Authors: Palem Gowthami , Pal Sharan J.
Published: September 2019

Background: Malaria, an oldest recorded parasitic infection transmitted by mosquitoes, is one of the most devastating infectious diseases. Mangalore, government headquarters of Dakshin Kannada district in Karnataka, receives high rainfall and exhibits humid tropical environment, harboring high vector density and contributing to high incidences of malaria. The aim of the present study was to observe maternal and fetal outcome of malaria in pregnancy.Methods: This is an observational prospective study conducted from September 2014 to September 2015 at Lady Goschen Hospital, Mangalore which serves as tertiary level hospital. Study population included were pregnant women diagnosed to have malaria by rapid diagnostic test or microscopy as an outpatient or inpatient during the study period. Complications were noted in terms of maternal and foetal complications.Results: A total of 12600 pregnant women attended LGH during study period out of which 41 were positive for malaria which has a prevalence of 0.32%. Among the malaria cases, 23 cases were primigravidae and 18 were multi-gravidae. The commonest pathogen found was Plasmodium vivax accounting for 63.4%. Regarding complications maternal anaemia and thrombocytopenia accounted for 34.1% and 26.8% respectively. Pregnancy outcomes were 17% of spontaneous miscarriage, 21.8% preterm deliveries, 29.1% low birth weight babies and 2.4% perinatal deaths.Conclusions: Malaria adversely affects both pregnant female as well as fetus. It is therefore advised all patients with fever in pregnancy must have screening for malarial parasite and treated adequately by medicine and supportive care to improve the maternal and fetal outcome.
History-indicated transvaginal cerclage: results from a single-centre
Authors: Gomes Carolina C. , Almeida Diana C. , Gonçalves Elisabete , Silva Ana P.
Published: September 2019

Background: Cervical incompetence occasionally results in mid-trimester pregnancy loss, preterm labour and increased foetal morbimortality. History-indicated cerclage is proposed when obstetric history suggests cervical incompetence. The aim of this study was to evaluate the maternal-foetal outcomes following prophylactic cervical cerclage.Methods: Retrospective study reviewing data of all women undergoing transvaginal history-indicated cerclage from January 1st, 2008 to December 31th, 2017 at Centro Hospitalar Universitário do Algarve - Faro. Primary outcome: gestational age <37weeks at birth. Secondary outcomes: neonatal morbimortality and intensive care unit (NICU) admission and maternal morbidity. Data were analyzed with IBM SPSS Statistics 23.Results: A total of 12 history-indicated cerclages were performed (9 women). At first cerclage, mean maternal age, gestity, parity and live children were 27.6, 2.44, 1.11 and 0.78 (87.7% preterm), respectively. At cerclage placement, mean gestational age and cervical length were 16.1 weeks and 27.5mm. Average hospital admission was 10.7 days. In all cases McDonald technique was performed. Four hospital readmissions occurred for threatened labour. Mean gestational age at cerclage removal was 36.9 weeks (83.3% in ambulatory) and 38.9 at delivery. Average time between cerclage removal and labour was 14.5 days. Spontaneous onset of labour occurred in 75% and vaginal delivery in 83.4%. There were no reports of preterm birth, foetal admission to NICU or maternal complications. Mean number of live children after procedure was 1.58.Conclusions: Prophylactic cervical cerclage seems to improve pregnancy outcome with minimal maternal risks. However, our data suggest over inclusion of women, with unnecessary procedures, emphasizing the importance of re-evaluating inclusion criteria.
A clinical study on fetomaternal outcome in jaundice with pregnancy
Authors: Padh Jigisha P. , Shah Sapana R. , Vyas Rupa C. , Parikh Purvi M.
Published: September 2019

Background: Jaundice in pregnancy and pregnancy in women with preexisting liver disease is not very uncommon. However it takes a major toll on health of both mother and fetus, due to increased morbidity and mortality for both mother and fetus, categorizing pregnancy as a high risk one. The distribution of jaundice in pregnancy varies throughout the world, but is seen more in developing countries. The course and outcome of liver disorder in pregnancy is altered due to various hemodynamic, hormonal and immunological changes unique to pregnancy. The hepatic functions during pregnancy are affected by increase in serum estrogen and progesterone levels.Methods: This was a prospective study of 70 cases of pregnancy with jaundice admitted in the department of obstetrics and gynecology at Sheth V.S. General Hospital, Ahmedabad, Gujarat, India. The duration of study was from June 2015 to December 2018. During this period 70 patients were admitted with jaundice in pregnancy. Patients were analyzed with regards to socio demographic profile, investigations, maternal and perinatal outcome.Results: The incidence of pregnancy with jaundice in present study was 0.32%. Most common cause identified was viral hepatitis in 27 cases (38.57%) out of which 23(32.85%) cases being hepatitis E. Followed by HELLP syndrome, pre eclempsia, eclempsia in 24(34.28%) cases. 13(18.57%) cases were belonged to cholestatic jaundice of pregnancy. Rest 6(8.56%) cases belonged to malaria, portal hypertension due to liver disease etc. Out of total 70 patients 53(75.71%) women from rural area, 54(77.13%) patients were from age group of 20-29years.Maximum patients were multigravida i.e. 28 (40%) and 66(94.28%) women coming from lower middle and lower socio economic class. There were 9 maternal deaths, 5 due to DIC. Total vaginal deliveries were 40, 24 patients underwent LSCS, 4 patients had abortion, and 2 expired undelivered. Most common complication was DIC in 16(22.85%) cases and thrombocytopenia in 14(31.67%) cases. 30(42.85%) babies were LBW and 18(25.7%) babies were IUGR.Conclusions: Prompt diagnosis and accurate evaluation and multidisciplinary approach of management in pregnancy with jaundice at a tertiary care center with good NICU is helpful in reducing maternal and perinatal mortality and morbidity.
Spontaneous membranous dysmenorrhea: a rare clinical entity
Authors: Sharmila Vijayan , Thirunavukkarasu Arun Babu
Published: September 2019

Membranous dysmenorrhea is a rare painful clinical condition associated with spontaneous expulsion of the endometrium as an entire piece, retaining the shape of the uterus. Authors report a case of membranous dysmenorrhea in a 36 year old multiparous woman, who was not on any hormonal therapy. She presented with history of menorrhagia for 20 days and severe dysmenorrhea for one day. During her second day of hospital admission, she expelled a fleshy mass resembling a decidual cast. Histopathological examination was consistent with diagnosis of membranous dysmenorrhea. The etiology of membranous dysmenorrhea is not very clear and hence reporting such rare cases may aid in understanding the etiology and pathophysiology of this rare condition.
Gliomatosis peritonei arising in setting of immature teratoma of ovary: a case report
Authors: Paul Dhruba Prasad , Garg Kashish , Rakshit Ashis Kumar
Published: September 2019

A 14 years old girl presented to the gynecology OPD with pain abdomen and huge abdominal lump since 2 months. On clinical examination, a large mass of 20x15 cm size was found extended upto the xiphoid process. Serum studies showed rise of CA-125 up to 406.9U/mL and LDH up to 310U/L. USG shows right ovarian cyst of 14.8x14.1x12.8 cm with internal calcification. MRI revealed a well encapsulated mass of 21x19x17cm with solid and cystic mass and upward peritoneal extension. Exploratory laparotomy was performed with right sided salpingo- ophorectomy with infracolic omentectomy, as the omentum appeared granular. She had an uneventful post-operative recovery. Subsequently HPE showed immature teratoma NORRIS grade 3 with co-existent peritoneal gliomatosis (grade 0). She is under regular follow-up and decided to give six cycles of combination chemotherapy with BEP at regional cancer hospital.
Clinical perspective: caesarean hysterectomy for placenta accreta spectrum and role of pelvic packing
Authors: David Liji , Abraham Anuja , Regi Annie
Published: September 2019

Caesarean hysterectomy (CH) is considered the gold standard for management of morbidly adherent placenta, now termed as placenta accreta spectrum (PAS). If bleeding is not controlled following removal of uterus, it is sometimes necessary to pack the pelvis and continue monitoring with correction of bleeding and physiological parameters in operating room and intensive care unit. This now comes under the damage control approach, being driven primarily by abnormal physiology rather than anatomical reconstruction. The pelvic packs are removed after about 48 hours. This retrospective study was done in patients with antenatal diagnosis of PAS who required CH, comparing those who required pelvic packing with those who did not. The variables compared were pre-operative (clinical and radiological), intra-operative (duration of surgery, blood loss and transfusion requirements of whole blood and blood products), and the final histopathological diagnosis. Outcome variables in terms of duration of hospital stay, re-admissions, re-laparotomy and complications were also compared. Over two years, three of eight patients with PAS required pelvic packing following CH. There were no differences between the two patient groups with any of the predictor variables or outcomes other than requirement of blood products. This suggests pelvic packing is a safe and efficacious procedure in intractable haemorrhage following CH for PAS. Pelvic packing needs greater awareness amongst obstetricians as the incidence of PAS is likely to increase.
Управление показателями университета на рынке образовательных услуг
Authors: Гаранин Максим Алексеевич
Published: September 2019

Одним из ключевых показателей, определяющих востребованность университета на рынке образовательных услуг России, являются показатели приёмной кампании: среднее значение балла единого государственного экзамена абитуриентов, количество абитуриентов из числа иностранных граждан, количество обучающихся, принятых на условиях полной компенсации затрат на обучение, доля внебюджетных студентов в контингенте и др. В статье представлены результаты исследования, направленные на совершенствование системы управления показателями приёмной кампании университета. Представлен краткий обзор существующих систем поддержки принятия управленческих решений в части управления показателями приёмной кампании вуза. Выполнен анализ взаимосвязи между показателями приёмной кампании вуза. Представлен анализ показателей работы вузов России. Представлена методика управления показателями приёмной кампании университета. Представленные исследования направлены на совершенствование системы управления показателями приёмной кампании вуза, формирование системы поддержки принятия решений в части проведения приёмной кампании и формирования контрольных цифр приёма.
Человеческий капитал и социальная ответственность – источники для формирования высокоэффективной организационной культуры
Authors: Бодрова Марина Ильинична
Published: September 2019

Статья посвящена исследованию необходимых составляющих для обеспечения конкурентоспособности и развития предприятий в Российской Федерации. Автором представлен подход, основывающийся на влиянии организационной культуры на предприятии в направлении успеха. В качестве источников для формирования высокоэффективной организационной культуры определены социальная ответственность компаний и их человеческий капитал. В ходе выполнения работы автор исследуют теоретические и практические аспекты представленных источников. Уделено внимание месту нашей страны в мире по уровню развития человеческого капитала. Предложены направления развития организационной культуры в целях повышения эффективности деятельности предприятий в Российской Федерации.
Трансформация концепции управления человеком в организации
Authors: Иванова Ольга Эрнстовна
Published: September 2019

Нестабильный мир с экспоненциальным ростом объемов информации определяет изменение характера общественных отношений. Под влиянием внешней среды в сфере управления человеком в организации происходит преобразование концептов и методов решения задач с их последующей объективацией в практике. Современная трансформация концепции управления человеком происходит в VUCA-среде при активном внедрении digital-технологий. В данной трансформации выявлены открытые однозначные и многозначные преобразования. Однозначным преобразованием установлена трансформация методологии управления человеком в организации, претерпевшая изменения от экономического материализма до прагматического конструктивизма. Данным изменениям релевантна трансформация представлений о функциональной значимости человека в организации – от трудового ресурса до актора, конструирующего организационную реальность. Стохастическим преобразованием выявлена трансформация модели человека в организации, набор траекторий которой реализован экономическим и ассоциированным человеком. Однозначные и неоднозначные изменения характеризуют интеграцию сотрудников, преобразующуюся от низкой степени участия работников до гостинга.
HYPERKERATOSIS OF THE ORAL MUCOSA (LICHEN PLANUS, LEUKOPLAKIA)
Authors: Григорьев Сергей , Griroriev Sergey , Ронь Галина , Ron' Galina , Епишова Анна , Yepishova Anna
Published: September 2019

The tutorial presents the fundamental provisions of the topic "Hyperkeratoses of the oral mucosa (lichen planus, leukoplakia)." In addition, the manual contains lists of the necessary knowledge and skills of situational tasks and text development, allowing the most fully understand the topic and prepare for it.
The manual is intended for students of dental faculties, clinics, residents and dentists.
Kepemimpinan Kyai Dalam Memberdayakan Kewirausahaan Santri
Authors: Hayana Nur , Wahidmurni Wahidmurni
Published: September 2019

Pondok Pesantren have contributed a lot in national development, including in terms of creating an independent workforce. One of them is to equip santri with entrepreneurial competencies. The aim of the study was to reveal the Kyai's strategy in empowering entrepreneurship of santri, Kyai's leadership style in empowering santri entrepreneurship, and the implications of Kyai's leadership in empowering santri entrepreneurship. A qualitative approach to the type of multisite case study was applied in the study. Data was collected by conducting in-depth interviews, participant observation and documentation studies. Data analysis uses data reduction, data presentation and conclusion drawing. The technique of checking the validity of research findings using triangulation of data sources and data collection techniques. The results showed that the strategies implemented by the Kyai in empowering santri entrepreneurship were carried out by giving an example of entrepreneurship, providing field learning, giving assignments in the pesantren business unit and providing motivation; the leadership style applied is a blend of democratic, transformative and charismatic leadership styles; the implication is that santri have a spirit of entrepreneurs.
Pengorganisasian Kurikulum dan Pembelajaran pada Sekolah Kejuruan di Lingkungan Pesantren
Authors: Ali Nur
Published: September 2019

This paper explains about curriculum management activities in vocational schools within pondok pesantren (WPP). The focus of the discussion is on the orientation of the vocational school curriculum in pesantren and its implementation activities as well as how school leaders and pesantren leaders influence the curriculum implementation organization (OPK) in schools WPP.  The aim is to find the orientation, strategy and approach of OPK activities in vocational schools WPP. This research used qualitative research with a case study design. Data was collected through in-depth interviews with leaders of Islamic boarding schools, school leaders, and teachers by purposive sampling, observation, and document analysis. The conclusion of this paper is the activities of OPK have led to innovation in curriculum management and learning in schools WPP. The OPK strategy uses Collaborative-collegial management with a democratic approach based on the noble values of pesantren and professionalism.
BARIŞ MANÇO ŞARKILARININ VİKTOR FRANKL PSİKOLOJİ EKOLÜ AÇISINDAN DEĞERLENDİRİLMESİ
Authors: KESKİN Uğur
Published: September 2019

Bu makalede, Avusturyalı psikiyatr Viktor Frankl’ın sanatsal yönelişlere ilişkin bakış açısı üzerinde durulmuştur. Makalede, Frankl’ın genel anlamda sanat, özel anlamda ise müzik alanına ilişkin izah, yorum ve değerlendirmelerine yer verilmiştir. Müzik sanatının bileşenleri arasında yer alan ve müziğin söylemsel yönünü teşkil eden şarkı sözü içeriklerinin, psikolojik boyutu incelenerek, Frankl’ın bakış açısı biraz daha özele indirgenmeye çalışılmıştır. Bu kapsamda, Barış Manço’nun şarkı sözleri, Frankl’ın birincil kaynak eserleri kapsamında incelemeye konu edilmiştir. Nitel araştırma yöntemlerinden içerik incelemesi tekniğinin benimsendiği çalışmada, Frankl’ın özgün bakış açısı ekseninde değerlendirmeler yapılmıştır. Makalenin sonucunda, sanatsal çalışmaları, bilimsel çalışmalardan ayrı kılan dört temel bileşenin varlığını ileri süren Frankl’ın bu görüşünün, Manço’nun seslendirmiş olduğu şarkılar kapsamında anlamlı bir şekilde desteklenmekte olduğu belirlenmiştir. Keşifsel bir çalışma olarak bu makale, benzer bir anlayış çerçevesinde yürütülecek olan gelecek çalışmalar için katkılar sunabilecek tartışma ve değerlendirmeleri okuyucunun dikkatine sunmuştur.
KENTSEL SU YÖNETİMİ VE SUYUN FİYATLANDIRILMASI: MERZİFON İLÇESİ ÖRNEĞİ
Authors: ARMUT Selim
Published: September 2019

Bu çalışmada belediyelerde suyun sürdürülebilir şekilde yönetiminde suyun fiyatlandırılmasının öneminin gözler önüne serilmesi amaçlanmıştır. Merzifon ilçesi örneği üzerinde suyun fiyatlandırılması ilgili uygulama kapsamında yapılmıştır. Yönetim ve işletme giderleri, amortismanlar, aktifleştirilmeyen yenileme, ıslah ve tevsii masrafları ve karlılık oranı göz önüne alınarak su birim fiyatı tespit edilmiştir. Atık su toplama hizmetinin yönetilmesi için toplam sistem maliyeti hesaplanarak atık suyun fiyatlandırılması yapılmıştır.
Su birim m³ fiyatı 2017 yılı için 1,86 TL ve 2018 yılı için 2,08 TL olarak bulunmuştur. Atık su birim m³ fiyatı 2018 yılı için1,67 TL tespit edilmiştir. Değerlendirme sonuçlarına göre su ve atık su fiyatlandırılmasının yapılmasının yanında su ve atık su hizmetlerinin izleyen yıllarda sürdürülebilir biçimde yönetimi için alt yapı varlıklarına ilişkin amortismanların özel bir hesapta tutularak yenileme programlarında kullanılması gerektiği tespit edilmiştir.
KÜLTÜRDİLBİLİM VE ÇEVİRİ BAĞLAMINDA ALMANCA DEYİMLERİN ÇEVİRİSİNE BİR BAKIŞ
Authors: HALDAN Aykut , TUNA Sibel
Published: September 2019

Kültür araştırmalarına yönelik yeni yaklaşımlardan biri de kültürdilbilimdir. Kültürdilbilim, dilbilim ve kültürbilimin örtüştüğü noktada oluşan ve dilde yansıyan halk kültürünü inceleyen bilim dalı olarak tanımlanmaktadır. Bu bağlamda kültürlerin bir ürünü olan deyimlerin farklı bir dile çevirisi sorun oluşturabilmektedir. Makalenin amacını Almanca ve Türkçe deyimlerin çevirisinde, sözcüğü sözcüğüne mi yoksa her iki dilin kültürlerinde yer etmiş olan dilsel ifadelere mi göre çevirisinin yapılmış olduğu Kültürdilbilim bağlamında incelenmesi oluşturmaktadır. Çalışmanın örneklem gurubunu Fono Almanca Deyimler kitabından seçilen kırk tane deyim oluşturmaktadır. Seçilen deyimler kültürdilbilimsel bağlamda incelendiğinde deyimlerin çevirisinde erek dilin kültürüne uygun çeviri yapılıp yapılmadığı irdelenecektir.
A Recent Optimization and Advancement in the Development of Microwave-Assisted Extraction of Microbial Bioactive Compounds
Authors: Rubaiy Hassan Hadi Mehdi AL , Altemimi Ammar , Rikabi Ali Khudair Jaber Al , Anand Uttpal , Lakhssassi Naoufal
Published: September 2019

The current study aims to study the optimal fermentation conditions for producing microbial bioactive compounds. The microwave parameters consist on 2450 MHz, and 500-watt for 20, 30, and 40 seconds. The solubility of solvents was tested for the extraction of antioxidant compounds from fermented rice (Koji) by A. flavus, Ethyl acetate was the best solvent used for extraction purposes. Antioxidant properties were differentiated by blocking the oxidation of the linoleic acid with an inhibition rate of 73.13% at a concentration of 200 mg/mL, in addition to increasing its effectiveness for free radical extraction and reduction strength by increasing concentrations gradually. The bond ability to irons was lower compared to the EDTA-2Na, in addition to the obtained total content corresponding to phenolic compounds in the ethyl acetate extract of fermented rice (Koji) by A. flavus was 232.11 mg, on the basis of galic acid/mg. The stability of the antioxidant compounds of the ethyl acetate extract of fermented rice (Koji) by A. flavus was also studied; showing stability under neutral conditions, as well as at high temperatures (185 °C during two hours). However, no stability was obtained under acidic and alkaline conditions.
Development of the laser remote caliper as a method to estimate surface area and body weight in beef cattle
Authors: Core Sarah , Miller Stephen , Kelly Matthew
Published: September 2019

Linear measurements combined with surface area and volume calculations were used to develop formulas to estimate body weight (BW) in beef cattle. These measurements were evaluated directly or estimated using a laser remote caliper (LRC) and digital imaging software. Seventy-two dry, late gestation beef cows aged 3-13 years were measured and weighed Six measurements for each cow were taken; the cattle were weighed, a body condition score (BCS) was assigned, heart girth (HG), hip width (HW), and hip height (HH) were measured directly and 3 digital pictures were taken. The digital pictures portrayed three different views; side view (restrained), rear view (restrained), and side view (free-stall). Body length, HW, HH, surface area and volume were indirectly calculated from the digital images. For each view a complete (C-) formula (direct and indirect measures) and remote (R-) formula (only indirect measures) to estimate BW was developed. The R-squared values 0.7459, 0.7937, 0.8078, 0.5016, 0.611, 0.5553 were attained for C-side view free-stall, C-side view (restrained), C-rear view (restrained), R-side view free-stall, R-side view (restrained), and R-rear view (restrained). The accuracy of these formulas was 81% on average. BCS, HG and HW were the most significant factors when developing a formula for BW (p-value < 0.001). Side view (restrained) image measurements were most accurate in estimating BW. These measurements were highly correlated with the direct measurements and digital linear body measurements were not distorted (due to poor posture/positioning) as seen with the other views. The results or this study show that linear measurements collected by digital imaging methods can be a useful tool for estimating BW.
Long-term health consequences of poor nutrition during pregnancy
Authors: Miese-Looy Germaine , Rollings-Scattergood Jessica , Yeung Anna
Published: September 2019

The long-term effects of poor prenatal nutrition are becoming a matter of increasing concern throughout the world. While the consequences of inadequate caloric and/or vitamin intake during pregnancy have been well characterized, in recent years it has become clear that serious long-term adverse effects may also result from gestational nutrient imbalance, even when total caloric intake is more than sufficient to meet the demands of pregnancy. Excessive fat, carbohydrate or protein intake may permanently alter the homeostatic mechanisms in the fetus, predisposing the offspring of affected pregnancies to serious chronic diseases, including cardiovascular disease, diabetes and cancer. This review summarizes the growing literature on this subject, with particular emphasis on the lasting health-related effects of macronutrient imbalance on fetal development.
Virtual environment pedestrian training programs for children: a review of the literature
Authors: Novak Shantelle
Published: September 2019

Pedestrian injuries are among the most frequent and serious causes of injury to children. Exploration of an appropriate and effective training program is needed. Many children’s pedestrian training programs have been implemented in the past in attempts to alleviate this problem, but they have been unsuccessful in transferring the knowledge the children learned to actual behaviours exhibited. Literature suggests developing a program where children can not only learn about safe pedestrian behaviours, but be given the opportunity to discuss possible actions and outcomes with their peers under guidance of an adult. To help children in the generalization of knowledge to behaviour, training programs should also give children the chance to practice newly learned skills in a simulated environment using computer-based technology. Virtual environment training programs have been successful in the past, especially computer games, which are both educational and entertaining and thus appealing to children. According to literature, development of a virtual environment pedestrian training program appropriate for the child’s current cognitive abilities will allow them to practice safe pedestrian practices. The skills learned from such a program can directly transfer to behaviours in real-life situations, and would contribute to decreasing the prevalence of childhood pedestrian injuries.
Understanding the role of convenience in consumer food choices: a review article
Authors: Wales Mary-Ellen
Published: September 2019

It is evident that convenience plays a prominent role in the food choices of today’s consumers. A trend having begun throughout the Western world, consumer demand for convenience foods is now on the rise around the globe. The growing presence of drive-thru windows, microwave dinners, take-out meals, home delivery for groceries and internet shopping, all demonstrate the importance of convenience in determining food choices. Costa et al. have argued that convenience itself determines where, when, why, what, how, and even with whom we eat. Several studies have examined the role that convenience plays in determining food choices, in particular, studies looking at the role of convenience in relation to full meal preparation and/ or consumption.The two areas of investigation will be 1) the dimensions of convenience as a part of the meal preparation and consumption processe, and 2) the individual characteristics of consumers and how they value these dimensions.