bluuebunny/crossref_metadata_2025 huggingface dataset:
Un cas de glaucome à angle ouvert consécutif au syndrome de Posner-Schlossman
Authors: Rixon Andrew J. , Wenig Rebecca A. , Rigdon Brittany N.
Published: September 2019

Cette observation clinique présente le diagnostic et la prise en charge appropriés du syndrome de Posner-Schlossman (SPS) et de ses séquelles possibles. Le SPS se caractérise par des poussées unilatérales et récurrentes de pression intraoculaire fortement accrue. Bien que l’étiologie et la pathophysiologie de cette maladie chronique demeurent incertaines, sa durée est directement corrélée au risque de développer un glaucome secondaire à angle ouvert. Le patient et l’optométriste responsable doivent être conscients de la nécessité d’une intervention en temps opportun pendant les poussées aiguës, ainsi que du respect des soins longitudinaux pour préserver la fonction et la qualité de vie. Cette observation clinique et cet examen de cas soulignent l’impact de cette maladie.
Dry Eye
Authors: Machan Carolyn M. , Hrynchak Patricia K. , Irving Elizabeth L.
Published: September 2019

This study determined the prevalence of dry eye (DE) symptoms and clinical diagnosis over the age range of the human lifespan, the correlation of symptoms with diagnosis, and factors associated with DE. Data was abstracted from WatES, a retrospective file review (n=6397) of patient examinations at the University of Waterloo Optometry Clinic. The prevalence of DE symptoms and diagnosis were determined overall, in five year age groups and for individual symptoms. Using logistic regression, each symptom was analyzed for a significant association with DE diagnosis. Ocular and systemic factors, and common medications were analyzed for association with DE symptoms or diagnosis. Of all patients (0-93 years) 543 (8.5%) presented with DE symptoms. Prevalence within age groups was greatest for patients 30<35 (11.4 %) and 75<80 years (13.7 %). DE was diagnosed in 1140 patients (17.8%). Prevalence increased by 3.0% per year of age. No sex-related differences in meibomian gland dysfunction as a function of age were found. Less than half (43.5%) of symptomatic patients were diagnosed with DE. The following symptoms were associated with a DE diagnosis: dryness (OR= 7.56, 5.30-10.77 95% CI), injection (OR=3.62, 2.04-6.43 95%CI), burning/stinging/soreness (OR=2.67, 1.69-4.23 95%CI), and watery eyes/tearing (OR=1.66, 1.12-2.45 95%CI). Anterior blepharitis (OR=2.46, 2.05-2.95), being female (OR=1.24, 1.06-1.40 95%CI), contact lens wear (OR=1.34, 1.06-1.70 95%CI), and environmental allergies (OR=1.18, 1.00-1.41 95% CI) were statistically associated with a diagnosis of DE. In summary, specific presenting symptoms predicted DE diagnosis, DE was diagnosed in patients of all ages, and its prevalence increased steadily with age.
DEFINITION AND SYSTEM OF PRINCIPLES OF ADMINISTRATIVE AND LEGAL REGULATION OF STATE GOVERNANCE IN THE SPHERE OF ECONOMIC ACTIVITY
Authors: Bevz S. I.
Published: September 2019

This article is deals with analyze of definitions of principles, principles of law and approaches to understanding the principles of administrative law. It is emphasized that the principles of administrative law must be primary, determining; actions of participants of administrative and legal relations should be consistent with the principles of administrative law; all elements of the mechanism of administrative and legal regulation of state governance in the sphere of economic activity should function based on the principles of administrative law. Distinguish between principals of administrative law and state governance is drawn. At the same time, the principles of state governance also determine the appropriate administrative and legal regulation. It is noted that the system of principles includes the principles that are the basis for the construction of administrative regulation, its modernization and the principles of the object of such regulation, which should be ensured through administrative regulation. The latter include the principles of state governance.
It is concluded that, administrative and legal regulation in the sphere of economic activity provides for taking into account also the principles of next directions: principles of economic policy; principles of state regulatory policy; principles of information security.
It is explained that state governance in the relevant sphere is aimed at realization of economic function, economic policy of the state; state regulatory policy in the sphere of economic activity; provision of information security in the sphere of economic activity. These principles affect the content of administrative and legal regulation in a particular sphere, but they must be understood and interpreted through the prism of administrative law principles that are fundamental to administrative law.
The article states that the creation of conditions for the fulfillment of tasks defined by the Constitution of Ukraine, which is a direction of administrative and legal regulation, which permeates all other directions, should be based on the principles of administrative law.
It is proposed to highlight the basic and special principles of administrative and legal regulation of state governance in the sphere of economic activity.
TYPES OF FORM OF PUBLIC ADMINISTRATION: UPDATING DOCTRINAL APPROACHES
Authors: Bila V. R.
Published: September 2019

The article poses the question of updating approaches to types of forms of public administration.
Therelationship between legal
and organizational forms of public administration is established. The latter term is proposed to use insteadof the commonly used phrase "unlawful forms of public administration", which is used to denote those external manifestations of the activity of public administration bodies, which does not entail a direct legal consequence. The critique of the term "illegal forms of public administration" has been supported. It is stated that the perception of organizational forms as not causing legal consequences does not fully reflect the legal validity. Separate organizational forms are defined by law as the solepossible for the adoption of certain types of administrative decisions by collegiate bodies of public administration, and their non-compliance leads to the nullity of further legal form. The given group of forms of activity of the public administration has a special legal nature and significance for objectification of the legal activity
of the subjects of public administration, in connection with which such a group is proposed to be terminated as "structural forms of public administration". The given justifications of the relevant term are presented as debatable. It was emphasized that the failure of organizational forms to cause legal consequences in the field of public administration does not in any way deprive their properties of causing legal consequences in the private legal relations. It is noted that public administration can act in public-law and private law forms, and forms of public administration are only a part of public-law forms, which include other types of legal forms, the use of which is provided for by the rules of the current legislation. It was concluded that public administration as a concept of functioning of
executive bodies, local self-government bodies and their relations with civil society significantly changed the interrelationships of legal and organizational forms of public administration and strengthened them to such an extent that it is sometimes impossible to draw a clear line between these types forms.
PROSPECTS FOR THE IMPLEMENTATION OF THE EUROPEAN ADMINISTRATIVE SPACE IN UKRAINE
Authors: Boiaryntseva M. A.
Published: September 2019

In the article the author determines the peculiarities of consideration and resolution of administrative disputes in foreign countries.
The author emphasizes that the priority international and European principle of the implementation of justice is the observance of the rule of law. It has been determined that the contents of the precedents of the European Court of Human Rights testify that they not only contain substantive decisions, but also the norms whose application solves the problem of the interpretation of legal institutions, in particular, such as the principles of the administration of justice. The author stresses that the achievement of the requirements of ensuring the rule of law and the rule of law in accordance with European standards requires the definition of the limits of exercising discretionary powers by public administration bodies.
The discretionary powers of public authorities and local self-government bodies cannot be unrestricted, and national courts should determine the limits of interference in their implementation. It is substantiated that the performed characteristic of the aforementioned normative legal acts allows us to conclude that it is necessary to study the principles of the implementation of legal proceedings in the European administrative space as a conditional "benchmark" of the development of the system of administrative courts established by the current legislation. It is stressed that the recommendations that require their implementation in the current administrative-procedural legislation include the implementation of such standards for the implementation of legal proceedings as foreseen requirements for the abolition of the right to appeal in the event that a person failed to comply with part of the court decision that provided for immediate enforcement; definition of procedure for pre-trial and extrajudicial settlement of administrative
disputes. It is substantiated that borrowing from the experience of administrative tribunals established in the Anglo-Saxon judicial system, where administrative complaints are dealt with by specially authorized lawyers, is one of the possible ways of solving the problems of a significant load on the system of administrative courts of Ukraine. The author concludes that the effectiveness of the national justice system as a whole, and in particular, administrative justice, depends on the implementation and further implementation of international and foreign standards for the administration of justice.
THE EFFICIENCY OF ACTIVITIES OF PUBLIC COUNCIL IN THE AUTHORITIES OF THE EXECUTIVE AUTHORITY
Authors: Vinnytskyi O. O.
Published: September 2019

The current stage of development of Ukrainian statehood is characterized by increased attention to the issues of increasing the efficiency of the functioning of the public administration system. And this is natural because the direct link between the efficiency of the public sector and the effectiveness of the national economy of the state as a whole leads to the search and introduction of new approaches and technologies, continuous improvement of the quality of services provided to the population and satisfaction with the results of the activity of executive authorities and local self-government.
The public sector, which participates in the formation and implementation of state policy, is no exception. It is the effective work of public councils with executive authorities that will increase the level of interaction between executive authorities and civil society.
In this article, the author outlines the factors of effectiveness of the work of public councils in executive bodies, namely: the development and introduction of common standards and forms of cooperation between the public and the public administration; development of nation-wide mechanisms for the functioning of public councils in executive bodies; systematization and generalization of decisions
of public councils in executive bodies; systematic analysis of the activities of public councils and their results for public discussion; introduction of standards for public reception offices.
The author determines that the effectiveness of public councils in executive bodies is determined by assessing the effectiveness of activities under which the author proposes to understand the process of determining the quality of the subject’s activity, which is aimed at achieving the goals and tasks assigned to him, in accordance with the established competence, which allows obtaining information
for further correction of his work.
It is emphasized that the effectiveness of the activities of public councils in executive bodies depends on: creation of transparent and qualitatively formulated goals of work; development of a plan of activity aimed at achieving the goals that are the basis of the activities of public councils in executive bodies; performance of the adopted plan of activity; evaluation of achieved results; Adjusting the activities of the public council at executive bodies; creating new goals for future activities.
COMPETENCE OF THE NATIONAL POLICE IN THE FIELD OF SOCIALIZATION OF CHILD OFFENDERS
Authors: Duzhenkov M. V.
Published: September 2019

The top priority of a legal social democratic state is to ensure human rights and freedoms. Children and young people constitute a segment of the population that, for objective reasons, is most vulnerable to social problems, and therefore they require special remedies by civil society and the state. Moreover, it should be emphasized that all categories of children and young people, including those in conflict with the law, require special attention.
Probably, there are certain social patterns that contribute to the growth of social deviance of minors. The rise in deviance among minors is, first and foremost, the result of “social outsiderism”, when young people and children find themselves outside the existing society and being pushed out of it. This is a result of the disruption of normal socialization that is now of a natural nature. Nowadays, society is losing the system of social control over the process of becoming a younger generation. Institutions of socialization, such as family, school, children and youth organizations, are losing their value and some are disappearing altogether.
The process of socialization of adolescents is becoming increasingly negative in nature, and youth are more exposed to the criminal world than to the values of civil society institutions.
Absence of a complete socialization environment in society, alienation of adolescents from the main spheres of positive life activity – family, educational institution, labor collective, entertaining institutions
– are the factors that guide minors to commit crimes.
The National police have an important role in crime prevention, in social protection of children, legal education, socialization and integration of child offenders into society, therefore the competence of the National police as well as and the competency of employees involved in working with child offenders play a vital role and is a necessary part of their professional activities in the performance of their duties. However, the existence of various scientific approaches to the concept and content of the “competence” and a lack of consensus on its definition make it necessary to develop a unified approach to the interpretation of the term competence.
The article describes various approaches to the determination of the essence of competence, gives the definition of the term competence.
The article also analyzes the legal acts regulating the activities of the National police, defines itscompetence in the field of socialization of child offenders.
CUSTOMS FORMALITIES: INTERNATIONAL AND NATIONAL EXPERIENCE
Authors: Pletnova A. Ye.
Published: September 2019

In the context of the European integration processes that are currently being actively performed in Ukraine, issues of implementationand application in the field of customs-legal regulation of theconceptual-categorical apparatus used in international acts aregetting particular relevance.
The study of the legal nature of the “customs formalities” concept becomes one of the modern problems. The unification andharmonization of national legal systems in the field of customs formalities is a key problem for international cooperation in the fieldof customs.
According to the Customs Code of Ukraine, customs formalities are defined as a set of actions to be executed by the relevant personsand bodies of income and fees in order to comply with the requirements of the Ukrainian national customs legislation.
The “customs formalities” concept is often used in bilateral international agreements of interstate andintergovernmental nature inthe field of customs activities between Ukraine and other states. International agreements (customs conventions) play significant rolein the regulation of customs formalities.
According to the Kyoto Convention, customs formalities are defined as a set of actions to be performed by the relevant persons andthe customs service in order to comply with the requirements of customs legislation.
In accordance with the Istanbul Convention, customs formalities relate to obtaining from the customs authorities preliminarypermissions, the usage of privileges for the temporary importation of certain categories of goods by the relevant persons, and the impositionof prohibitions and restrictions arising from national laws and regulations.
In the Glossary of International Customs Terms, published by the World Customs Organization, customs formalities are understoodas all transactions to be performed by persons concerned and by the customs authorities in order to comply with customs legislation.
It can be concluded that Ukraine national customs legislation is on the path of adaptation to the international norms and standards.
In the field of legal regulation of international trade there are both positive moments and imperfections,which significantly complicatetransborder movements in the process of international trade.
AN ART OF PATIENT CENTRED INTERVIEW: A LITERATURE REVIEW
Authors: Karan J. Yagnik
Published: September 2019

Successful medical care requires good and mutual communication andunderstanding between a physician and a patient. For this, both individualsmust play an active role in the healing process. A physician’s responsibility ismore. 3D model has analogy to 3B model of business administration. Flowcharts of SDM in five steps are described. Statistical and opinion basedanalyses has been communicated and appropriate suggestions are alsoreported.OBJECTIVE:This literature review is conducted for gathering the knowledge and practical.Confidence, trust and faith and respect in doctor-patient relationship as tohow they influence patient satisfaction.METHOD:Various books, conference presentations and proceedings, workshop lectures,various electronic databases. Symposium lectures. Various research papers andselected full articles were reviewed.KEYWORDS:Patient centred interview, shared decision Making (SDM), Medical complexityand jargon.
Changes in substrate utilization rates during 40 min of walking within the Fatmax range
Authors: Özdemir Ç , Özgünen K , Günaştı Ö , Eryılmaz SK , Kılcı A , Kurdak SS
Published: September 2019

Background and aims

The aim of this study was to evaluate changes in fat oxidation rate during 40 min of continuous exercise and identify the intensity at the highest fat oxidation rate (Fatmax).

Methods

A total of 14 sedentary males with age, body height, weight, and BMI averages of 29.3 ± 0.7 years, 178.3 ± 1.7 cm, 81.1 ± 3.9 kg, and 25.4 ± 0.9 kg/m2, respectively, were included in the study. Fatmax was determined using an indirect calorimeter with an incremental treadmill walking test at least after 12 h of fasting. On a separate day, at least after 12 h of fasting, the participants walked for 40 min within their predetermined individual Fatmax heart rate and speed ranges.

Results

The initial fat oxidation rate was not sustained within the first 16 min of exercise and was reduced; however, carbohydrate oxidation reached a stable level after nearly 10 min.

Conclusions

In sedentary individuals, during low-intensity physical activity, fat oxidation rates may not be sustainable as expected from Fatmax testing. Therefore, when exercise is prescribed, one should consider that the fat oxidation rate might decrease in sedentary overweight individuals.
First record of Sphecodina caudata (Bremer & Grey, 1852) (Lepidoptera, Sphingidae) from Amur Oblast, with an overview of its distribution in Russia
Authors: Koshkin Evgeny S, , Bezborodov Vitaly G.
Published: September 2019

Hawk moth Sphecodina caudata (Bremer et Grey, 1853) (Lepidoptera, Sphingidae) is recorded for the Amurskaya Oblast for the first time. The new locality is situated in the extreme southeastern part of this region (3 km W Kundur village, Khingan Nature Reserve), in 308 – 420 km north-west of previously known habitats in the south of the Khabarovsk Krai. Overwiew of the distribution of S. caudata in Russia is provided.
Improving Overall Resident and Faculty Wellbeing Through Program-Sponsored Innovations
Authors: Fick Laurel , Axon Katherine , Potini Yogitha , Solik Michelle , Foster Todd
Published: September 2019

This article was migrated. The article was marked as recommended. ProblemStudies suggest that burnout and wellbeing are inversely associated, thus early identification of risk factors for burnout and targeted interventions to improve resident wellbeing could help mitigate these outcomes. However, little is known about the impact of department-sponsored wellbeing programs on improving personal physician wellbeing.ApproachOur innovation attempted to create a culture of physician wellbeing within one year (October 2016-October 2017) after discovering high levels of burnout among our Internal Medicine residents and faculty. All residents and faculty were invited to participate in programming and an internally-developed "Wellness Needs Assessment" tracked the effectiveness of our efforts. Wellness endeavors were generally low-resource/high-yield interventions and included establishing a Physician Wellbeing Committee and budget, creating a robust social media presence, and providing over thirty event-based and continuous wellness interventions throughout the year. OutcomesOver one year, our wellbeing program demonstrated improvements across all ten sub-domains of wellness, although the distribution of responses when comparing their current overall level of wellness did not reach statistical significance. A large decrease in the rate of self-reported "thoughts of self-harm" was noted. Over 90% of participating physicians felt that the "culture of wellness" in the workplace had influenced their personal wellness.Next StepsNext steps include determining which wellbeing interventions are the most effective in promoting a culture of wellness and improving personal wellbeing. We plan to determine sustainability of the program over time, growing our arsenal of effective strategies to improve culture, and determine the effectiveness of this strategy across other specialties and locations.
Treating ‘collective biologies’ through men’s HPV research in Mexico
Authors: Wentzell Emily
Published: September 2019

Medical testing assesses individual bodies, yet its effects reach beyond their boundaries. Building on insights from medical anthropology and STS regarding the co-construction of medical technologies and bodies, I investigate how heterosexual Mexican couples used men’s HPV testing to understand and assert membership in collective ‘couple’s biologies’. I analyze interviews undertaken during men’s participation in a longitudinal, observational HPV study. Men underwent annual DNA-based HPV testing, often receiving unexpected diagnoses that led couples to deal with the possibility of HPV transmission and its possible harms. I argue that these couples drew on context-specific ideologies of gender and race in their understandings of and responses to men’s test results. I show how they understood HPV positivity as a condition of the couple’s biology, mediated by what participants viewed as potentially racially innate if problematically backward gender attributes. Couples then used the experience of medical testing to live out self-consciously modern forms of gender, marriage, and self-care, which they hoped would counteract the harms of HPV. I conclude by discussing the importance of considering context-specific collective biologies, rather than just individual bodies, in the use and social scientific study of medical technology.
Ethnography in a grievance
Authors: Nading Alex
Published: September 2019

This essay discusses documentation as a critical practice that links ethnography and activism. It describes the efforts of Nicaraguan sugarcane workers to use World Bank mediation and corporate social responsibility ‘mechanisms’ to call attention to the health and environmental problems that attend plantation production. Documentation becomes essential to activism when the lines of cause and effect that link bodily conditions to ecological conditions are unclear or contested. As a form of evidence-making that blends the archival and the ethnographic, documentation helps not to isolate facts but to construct context.
Critical convergences
Authors: McKay Ramah
Published: September 2019

Thinking through two objects – a focus group and a photograph – this essay suggests that ethnographic critique is not separate from but constitutive of global health. Social science representations, from data and focus groups to ethnographic descriptions and clinical snapshots, not only analyze, unpack, or depict global health; they also constitute it as a field of intervention and to define certain spaces, particularly clinical ones, as exemplary global health sites. This co-constitutive role complicates ethnographic critiques that see their role as primarily destabilizing global health facts. Rather, by drawing on feminist approaches to ethnography and critique, I suggest that convergences between ethnographic and global health knowledge stem from historical alignments through which anthropology and global health alike emerged and have come to circulate. These convergences point to the need for a ‘non-innocent’ critique of global health that centers the disciplinary complicity between, and methodological adjacency of, social science and global health.
Правила, время и насилие в казарме: логика тотального института в переходный период
Authors: Бочаров Тимур Юрьевич
Published: September 2019

В статье анализируется повседневная жизнь российской армии. В рамках теории тотальных институтов Эрвина Гоффмана обычно выделяют такие признаки социального порядка в армии как дихотомия формальных и неформальных правил, особая организация времени, высокий уровень насилия. В отличие от подобных исследований в статье рассматриваются правила, время и насилие не как внешне заданные характеристики, а как результат языковых практик и интерпретаций самих обитателей казармы. Подобная динамичная перспектива помогает понять, почему феномен дедовщины сохраняется в армии, несмотря на изменения институциальной среды. В частности, в исследовании показывается неразрывная связь формальных правил устава и неформальных правил дедовщины, которые в определенных ситуациях являются сторонами одной медали. Особое внимание уделяется тому, как изменение военной формы способствует выстраиванию символических границ и воспроизводству статусной иерархии в армии. Далее описываются социальные практики солдат, которые позволяют материализовывать время и делать его властным ресурсом. С переходом с двухлетнего на однолетний срок службы эти практики претерпели изменения, но продолжают сохранять свое значение. Наконец, предлагается ответ на вопрос, почему многие действия, однозначно воспринимаемые во внешнем мире как насильственные, не видятся таковыми в армии. Кроме того, анализируется роль в трансформации казарменного насилия видеокамеры смартфона, постепенно становящейся атрибутом армейской жизни. В частности, показано как факт видеосъемки зачастую определяет происходящее. В основу исследования легли наблюдения автора в период прохождения срочной службы, рассказы знакомых и случайных собеседников об этом, материалы армейских форумов. Для лучшего понимания специфики российской дедовщины предлагаются кросс-культурные сравнения с внешне схожим французским феноменом bizutage периода призывной службы.
Люди. Забота. Церковь. Кто кому помогает и что из этого получается: социальная работа в православных приходах России
Authors: Творогова Светлана Викторовна
Published: September 2019

***
Proving Their Worth? The Transatlantic Trade and Investment Partnership and the Members of the European Parliament
Authors: Rosén Guri
Published: September 2019

Recent trade negotiations in the EU have provoked unprecedented levels of controversy, in particular the Transatlantic Trade and Investment Partnership (TTIP) between the EU and the US. One crucial channel for public contestation is the European Parliament (EP) which, following the entry into force of the Lisbon Treaty, has to give consent to international agreements. Thus, this article sets out to answer the question: During the dispute over TTIP, did members of the EP (MEPs) engage in the public debate, and if so, how? If they engage in debates, what characterises their engagement: Do they engage with voter concerns, do they engage in a responsive manner, and do they contribute to politicisation as quite a few feared? Building on an analysis of newspaper coverage and plenary debates in the EP, the article shows that many supporters of TTIP attempted to de-politicise the debate, while opponents most frequently evoked ‘the voice of the people’ to politicise TTIP. Thus, MEPs do not only respond to politicisation, they also attempt to make politicisation happen by evoking public concerns. The article highlights the multifaceted relationship between responsiveness and politicisation, where claims responding to voter concerns, are used both to incite contestation and alleviate it.
Transferring Circular Economy Solutions across Differentiated Territories: Understanding and Overcoming the Barriers for Knowledge Transfer
Authors: Dąbrowski Marcin , Varjú Viktor , Amenta Libera
Published: September 2019

“Learning from abroad” is a widely recognised and used means to innovate and improve strategies and policies implemented by regions and cities. However, literature on knowledge transfer and related concepts, such as policy transfer, policy mobility or lesson-drawing, highlights the limitations of this process, especially when it entails the simple transfer of (best) practices from “place A” to “place B”. Such a transfer may lead to suboptimal solutions particularly when the imported practices concern complex phenomena, involving networks of multiple actors and relying on place-specific dynamics. Departing from this critique, the article sheds light on the process of knowledge transfer in the field of circular economy, taking place between the two metropolitan regions of Amsterdam and Naples. This process is guided by an innovative methodology based on a network of (peri-urban) living labs generating eco-innovative solutions for using material waste and wastescapes as a resource in peri-urban areas. Using participant observation in knowledge transfer workshops, stakeholder interviews and surveys, it investigates how the process of co-creation of knowledge in the relational space of the networked living labs takes place thanks to the participation of stakeholders from both regions. This in turn allows for drawing conclusions on what barriers are encountered in such knowledge transfer, what makes solutions transferable across different contexts, and, finally, how the solutions are adapted as they travel from one place to another.
Managing the Transition towards Circular Metabolism: Living Labs as a Co-Creation Approach
Authors: Amenta Libera , Attademo Anna , Remøy Hilde , Berruti Gilda , Cerreta Maria , Formato Enrico , Palestino Maria Federica , Russo Michelangelo
Published: September 2019

Resource consumption and related waste production are still rapidly increasing all over the world, leading to social and environmental challenges and to the production of the so-called ‘wastescapes’. Peri-urban areas—in-between urban and rural territories—are particularly vulnerable and prone to develop into wastescapes because they are generally characterised by mixed functions and/or monofunctional settlements, as well as by fragmentation in a low-density territory that is often crossed by large infrastructure networks. Moreover, peri-urban areas are generally the selected locations for the development of plants for waste management. In this way, they are crossed by waste flows of a different nature, in a landscape of operational infrastructures and wasted landscapes. Implementing Circular Economy (CE) principles, interpreting waste and wastescapes as resources, is a way to significantly reduce raw material and (soil) resource consumption, improving cities’ metabolism. A circular approach can positively affect the spatial, social and environmental performances of peri-urban areas. However, the transition towards a CE presents many challenges. This article outlines an approach to address these challenges, presenting a co-creation process among researchers, experts and stakeholders within Living Labs (LLs) processes. LLs are physical and virtual spaces, aiming at the co-creation of site-specific eco-innovative solutions (EIS) and strategies. In the LLs, public–private–people partnerships are developed by applying an iterative methodology consisting of five phases: Co-Exploring, Co-Design, Co-Production, Co-Decision, and Co-Governance. This article presents a case study approach, analysing the co-creation methodology applied in two peri-urban living labs, located in the Metropolitan Areas of Naples (Italy) and Amsterdam (The Netherlands), within REPAiR Horizon2020 research project.
Prevalence of Hypodontia and Supernumerary Teeth in Patients Attending Private Pediatric Dental Clinic in Lebanon
Authors: Daou Maha H , Bteiche Pascale Harb , Fakhouri Jihad , Osta Nada El
Published: September 2019

Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and the lack of studies in Lebanon that document the prevalence of those anomalies, the aim of this study was to determine the prevalence of hypodontia and supernumerary teeth in patients attending a pediatric dental office and examine the associated factors. Study design: This was a cross-sectional design study. The patients were clinically examined followed by panoramic radiograph. Two calibrated investigators have examined the radiographic films and diagnosed the dental anomalies. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Tooth agenesis was diagnosed when there were no sign of crown calcification and no evidence or history of loss attributable to orthodontic treatment, caries, periodontal problems and dental trauma. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Chi-Square tests and Fisher Exact tests were performed to assess the association between outcome variables, gender and presence of medical problem. Results: 334 participants (mean age 7.31±2.17 years) were included in the study. The presence of dental anomalies was not reported as a reason for dental visits. The rate of tooth agenesis was 8.7% in the whole sample, 9.9% among boys and 7.6% among girls with no difference (p=0.442). The rate of tooth agenesis was elevated in participant with medical problems (14.5%) compared to those with no medical problem (7.0%) (p=0.041). The rate of supernumerary teeth was 0.6% among boys and 0% among girls (p=0.485). Conclusion: Oral anomalies could be detected relatively at early age. It can help in a long-term and effective treatment planning. Early diagnosis and appropriate follow-up with panoramic radiograph is extremely important to avoid maxillofacial deformity and other complications.
EFFECTS OF PARENTING BEHAVIOURS ON PHYSICAL ACTIVITY OF TODDLERS WITH CONGENITAL HEART DISEASE
Authors: Khabibullina A. R. , Khayretdinova T. B.
Published: September 2019

Aim To evaluate the effects of parenting behaviours on physical activity of toddlers after total repair of septal heart defects.

Methods 80 patients who underwent total repair of CHD in the infancy were recruited in the study. The mean age at the interviewing and medical examination was 33.5±4.28 months (boys – 32 (46.0%), girls – 48 (60.0%). The functional status of the cardiovascular system was estimated using the exercise stress testing (10 squats per 20 seconds). Parenting behaviours were evaluated using the Varga-Stolin questionnaire.

Results Adverse response to the exercise stress testing prevailed among toddlers with CHD. Recovery time did not exceed 5 minutes in both groups. None complaints in the study and control groups were recorded. Most parents of children with CHD followed authoritarian hypersocialization pattern (p = 0.046) demanding unconditional obedience and discipline as compared to parents of healthy children. More than a third of the families in the study group (38.1%) followed this behavior pattern and only six families in the control group (14.8%). Five families (18%) in the control group followed democratic behavior pattern given independence to their children. Physically inactive toddlers were more commonly found in the families with authoritarian behavior pattern.

Conclusion Authoritarian hypersocialization pattern prevailed among parents of toddlers who suffered from septal heart defects. This type of parenting behaviour affected physical activity of toddlers.
CARDIOPROTECTION IN PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION
Authors: Vereshchagin I. E. , Ganyukov V. I. , Mamchur I. N.
Published: September 2019

Aim To evaluate cardioprotective effects of combined intracoronary phosphocreatine and succinic acid administration after primary percutaneous coronary intervention (PCI) in patients with ST elevation acute coronary syndrome who were present within 12 hours of symptom onset.

Methods Seven patients with STEMI presenting within 12 hours of onset of symptoms and thrombotic occlusion of the left anterior descending artery were included in the study. Evaluation of efficiency and safety was performed with the recording of major adverse cardiac events, evaluation of the procedure success, and the rate of composite endpoints.

Results Six (85.7%) patients after primary PCI showed TIMI grade 3 flow on control coronary angiography. None complications had been reported after intracoronary administration of phosphocreatine and succinic acid. Acquired left ventricular aneurysms were found in two patients in the in-hospital period. One patient was readmitted with acute coronary syndrome without ST-segment elevation. Coronary angiography reported restenosis of the previously implanted stent. No definite increase in the left ventricular ejection fraction had been found in the in-hospital and long-term period.

Conclusion There were no evidences on definite increase in myocardial contractility. The obtained results might partially be explained by the median symptom-to-balloon time over 400 minutes.
A comparative study of Lichtenstein tension free hernioplasty with prolene hernia system hernioplasty for ingunial hernia
Authors: Chavan Shahaji , Gawade Harshad , Shah Bhushan , Kandarappa Akhil , Panchbha Sunil Vishwanath
Published: September 2019

Background: Lichtenstein tension-free hernioplasty (LTH) has become the gold standard for hernia repair. It is easy to learn and perform with minimal complications and low recurrence rate. But it deals with only superior half of the myopectineal orifice. Prolene hernia system (PHS) hernioplasty is safe, causes minimal pain and has minimal recurrence rate but is still not popular due to high cost. The aim of the study is to compare the Lichtenstein tension-free hernioplasty with hernioplasty using prolene hernia system.Methods: A total of 60 patients with inguinal hernia were equally grouped into cases (PHS) and controls (LTH). Outcome measures were compared with regards to postoperative pain, hospital stay and complications.Results: There was no significant difference in mean days of post-operative hospital stay among cases and controls. On post-operative days 1 and 3, most of the patients experienced moderate pain and by 8th post-operative day most of the patients had no pain. The pain intensity decreased with increase in post-operative days. Seroma formation was seen among 2 (6.67%) cases (PHS) group in comparison to 3 (10.0%) controls (Lichtenstein) group. Post-operative wound infection was seen among 1 (3.33%) cases (PHS) group and controls (Lichtenstein) group each. Recurrence was seen neither among patients treated with either technique.Conclusions: Prolene Hernia System mesh repair could be a suitable alternative to time honored Lichtenstein hernia repair with added advantage of strengthening the whole of myopectineal orifice, and virtually eliminating any risk of recurrence.
Prevalence of thyroid malignancy in goitre: a cross sectional study
Authors: Solomon T. Nazareth , Thetraravu Oli Punitha , Kailas C. Kiran , Jose Victor
Published: September 2019

Background: Goitre includes a heterogenous group of tumours that show considerate variability in histological appearance and biological behavior.1 As thyroid malignancy presents as any other benign condition of thyroid in its early stages, success in treatment of this condition lies largely upon early diagnosis and appropriate management. Hence this study was done to evaluate the prevalence of thyroid malignancy in goiter, their modes of presentation and the incidence of various pathological types.Methods: A hospital-based cross-sectional study involving 275 patients was conducted. Data about the patient's age, sex, clinical presentations and duration of symptoms were collected using a proforma. The functional status of the patient was assessed with thyroid function tests. Anatomy of the gland was assessed by ultrasonogram. Ultrasound guided FNAC was done to assess the cytology. Histopathological evaluation of the thyroidectomy specimen was done.Results: The prevalence of thyroid malignancy was found to be 18.1% with a female preponderance of 94%. The age of presentation was noted to be predominantly between 3rd and 5th decade with a mean age of 42.95 years. Female- male ratio was 15:1. Swelling in front of the neck was the predominant clinical presentation in 82% of patients. Among the thyroid malignancies papillary carcinoma was found to be the commonest malignancy with incidence of 90%.Conclusions: Thyroid malignancy is the commonest endocrine malignancy. Our study revealed a significant prevalence of thyroid malignancy among patients presenting with goiter between 3rd and 5th decade with a female preponderance.
Incidence of locally advanced breast cancer in women presenting to a tertiary care center
Authors: Ramani Pratha Anantha , Niharika Vadisetti Satya , Maha Lakhsmi Buddha Kanaka , Jahnavi Suvarapu , Sainath Reddy Ginni Vijay
Published: September 2019

Background: Trends for incidence of breast cancer are on the rise in India. However, regional specific epidemiological data for North Coastal Andhra Pradesh are inadequate. The study aims to stress upon the trends of the incidence and burden of locally advanced breast cancer in the region.Methods: In a retrospective quantitative study, 310 in-patients of Department of General Surgery, King George Hospital diagnosed with breast cancer whose information is in the medical records covering the calendar period from May 2014 to May 2019 were studied.Results: The number of females being admitted as in-patients for treatment of breast cancer has increased from 11.2% to 13.6% in these five years. The overall result showed that the age of breast cancer patients ranged from 28-74 years, with a mean age of 49.12±10.942. The average duration of time lag to contact with health personnel was 3.6 months for all the cases included in our study. Stage III was the most common presentation constituting 55.01% patients of the series. Most common cause for late presentation was lack of awareness (64.5%) followed by emotional reasons and cultural barriers (31.9%).Conclusions: There is an urgent need for implementation of measures to ensure early presentation as prevention of LABC is much better than cure.
A randomized controlled study comparing the outcome of laparoscopic totally extra peritoneal repair versus Desarda repair in the management of inguinal hernia
Authors: Sinha Deepika , Singh Chandra Bhushan
Published: September 2019

Background: Desarda repair is a technique of a tissue based tension free mesh free inguinal hernia repair, shown to be comparable to the standard Lichtenstein repair. Till date, no study has been done comparing Desarda repair with laparoscopic total extra peritoneal repair (TEP), hence this study was planned.Methods: The prospective randomized controlled study was done over a period of 18 months, and included a total of 50 patients, randomly allocated into 2 groups: TEP (group 1) and Desarda repair (group 2), 25 in each group, and followed up for a period of 1 year.Results: Chronic inguinodynia, including groin stiffness showed a statistically significant difference between the 2 groups (p=0.02). Foreign body sensation (16% in TEP group and none in Desarda group) and recurrence rate (12% in TEP group and none in Desarda group) did not show a significant difference. The operating time in the Desarda group (66.8±20.35 minutes) was significantly less than TEP group (78.6±11.86 minutes), with p<0.01. There was no significant difference in terms of post-operative pain scores (VAS scores) at five time points, post-operative analgesic requirement, hospital stay and return to normal daily routine activity or work and post-operative complications. Desarda repair was also found to be much more economical.Conclusions: The present study establishes the potential benefits of Desarda repair over TEP in terms of shorter duration of surgery, lesser incidence of chronic inguinodynia and lesser cost of the procedure, along with the avoidance of mesh related complications.
Oromandibular reconstruction with free fibula osteocutaneous flap after oncologic resection: retrospective analysis of surgical experience and operative outcome of 56 cases
Authors: Sharma Shobhit , Bera Sudipta
Published: September 2019

Background: Reconstruction of post oncologic resection oromandibular defect is challenging and it provides the base for subsequent radiotherapy and oromaxillary rehabilitation for functional and aesthetic outcome. Multiple reconstructive options including different free flaps exist in the present time of greater awareness, facility and expertise in the field of free tissue transfer surgery. But free fibula osteocutaneous flap (FFOCF) has been the state of art in this area. FFOCF is technically difficult but believed to be reliable even to start with and has a progressively comprehensive surgical technique and learning curve. We are presenting here our experience of FFOCF reconstruction of 56 cases over the last 3 years.Methods: 56 patients operated between 2015 to 2018 were assessed retrospectively for operative and surgical outcome.Results: Flap was successful in 54 (96.43%) cases. Re-exploration was done in 4 cases and was successful in 2 cases. Jaw shape and contour was satisfactory in 70.37% and solid food tolerance was noted in 80.35% cases. Recurrence was seen in 5 cases.Conclusions: FFOCF is a reliable reconstructive option for complex oromandibular defect with a predictable outcome. Flap harvest is reliable and contouring is comprehensive. It gives good functional and aesthetic results with high success rate. Thus this flap is truly the preferred reconstructive option for all type of oncologic oromandibular defect with micro vascular surgery facilities.