bluuebunny/crossref_metadata_2025 huggingface dataset:
BRAND LOYALTY DETERMINANTS IN THE CONTEXT OF A SOFT DRINK BRAND
Authors: FORTES VALTER M. M. , MILAN GABRIEL S. , EBERLE LUCIENE , TONI DEONIR DE
Published: September 2019

ABSTRACT Purpose: Developing and keeping customers’ loyalty in relation to the brand is a strategic requisite for well-succeeded business. Thus, our main purpose was to develop and validate a theoretical model concerning customers brand loyalty. Originality/value: We explored perceived quality, brand awareness, brand personality, and brand love as brand loyalty determinants. In this sense, the focus of this study was to analyze the impact of some brand loyalty determinant constructs. Design/methodology/approach: The study was implemented by means of a survey, applied to 284 customers of a soft drink brand from Northeast Brazil that was acquired by one of the biggest soft drink producers in the world. Data were analyzed through multivariate statistics and applying structural equation modeling technic. Findings: It was possible to evidence that there is a positive relation between the constructs brand awareness and perceived quality and positive influence of brand personality over brand awareness, as well as perceived quality over brand love. Also, evidence showed that brand love influences brand loyalty and that consumption level is a meaningful moderator of this relation.
Application of the Respondent-Driven Sampling methodology in a biological and behavioral surveillance survey among female sex workers, Brazil, 2016
Authors: Damacena Giseli Nogueira , Szwarcwald Célia Landmann , Souza Júnior Paulo Roberto Borges de , Ferreira Júnior Orlando da Costa , Almeida Wanessa da Silva de , Pascom Ana Roberta Pati , Pimenta Maria Cristina
Published: September 2019

ABSTRACT Introduction: Respondent-Driven Sampling (RDS) has been used in surveys with key populations at risk of HIV infection, such as female sex workers (FSW). This article describes the application of the RDS method among FSW in 12 Brazilian cities, during a survey carried out in 2016. Methodology: A biological and behavioral surveillance study carried out in 12 Brazilian cities, with a minimum sample of 350 FSW in each city. Tests were performed for HIV, syphilis, and hepatitis B and C infections. A social-behavioral questionnaire was also applied. Results: The sample was comprised of 4,328 FSW. For data analysis, the sample was weighted according to each participant’s network size (due consideration to the implications of RDS complex design and to the effects of homophilia are recommended). Discussion: Although RDS methods for obtaining a statistical sample are based on strong statistical assumptions, allowing for an estimation of statistical parameters, with each new application the method has been rethought. In the analysis of whole-sample data, estimators were robust and compatible with those found in 2009. However, there were significant variations according to each city. Conclusion: The achieved sample size was of great relevance for assessing progress and identifying problems regarding the prevention and treatment of Sexually Transmitted Infections. New RDS studies with more time and operational resources should be envisaged. This could further network development.
Instruments used to evaluate functional health literacy in elderly persons with chronic kidney disease: Integrative review
Authors: Lima Monique de Freitas Gonçalves , Vasconcelos Eliane Maria Ribeiro de , Borba Anna Karla de Oliveira Tito
Published: September 2019

Abstract Objective: To identify the instruments used to evaluate the functional health literacy of elderly persons with chronic kidney disease, and to assess whether they are suitable for this population. Method: An integrative review of the Lilacs, PubMed, Ibecs, Scopus and Cochrane databases was carried out in July and August 2018, seeking original articles dealing with functional health literacy and chronic kidney disease in the elderly. Results: A total of 15 articles were evaluated and seven different instruments used in the research were identified, with the Rapid Estimate of Adult Literacy in Medicine (REALM) and Test of Functional Health Literacy in Adults (TOFHLA) the most prevalent. Conclusion: The instruments identified are applicable for the elderly, but are not specific for this population. The construction and/or adaptation of new instruments is suggested considering the specific characteristics of this age group.
Vulnerability of ecosystems with Guadua angustifolia in Ecuador in light of climate changes1
Authors: Romero Mario José Añazco
Published: September 2019

ABSTRACT Guadua angustifolia bamboo is historically used by an important percentage of the rural and peri-urban population of Ecuador, especially in the construction of bridges, when events like El Niño and its consequential flooding occur. This study aimed to determine, in light of some climate change scenarios, the vulnerability rate of ecosystems where the G. angustifolia bamboo species occurs, in the coastal region of continental Ecuador. The analysis methodology, with focus on the sampled units, was based on vulnerability assessment tools for climate adaptation recommended by the Intergovernmental Panel on Climate Change.Temperature presented the highest correlation coefficient with the vulnerability rate of the ecosystems, followed by the increase in the sea level, winds and landslides. It was concluded that as the exposure and sensitivity variables increase, the adaptive capacity of ecosystems with occurence of this species decreases, and isolated plants and monoculture plantations are the most vulnerable to climate changes.
CATECISMO DO CIDADÃO: CONSTITUCIONALISMO E SOBERANIA POPULAR EM GUILLAUME DE SAIGE
Authors: Nicolete Roberta K. Soromenho
Published: September 2019

Trata-se de analisar as linguagens políticas em disputa na definição da soberania – tema caro à teoria política –, no período que antecede a Revolução Francesa, mediante a obra Catecismo do cidadão (Catéchisme du Citoyen) , de Guillaume de Saige. Escrita em 1775 (reeditada em 1787) e banida pelo Parlamento, interpreta-se tal obra (ao lado de outros escritos patriotes ) como uma resposta ao problema de legitimidade aberto durante a última Sagração, em Reims, na qual parte notável foi abolida: o momento da cerimônia em que o rei demanda consentimento do povo para governar. Por anódino que possa parecer, tal alteração litúrgica revelaria a intenção de Luís XVI de recorrer à retórica convencional da monarquia, dispensando a ritualização da eleição nacional. Cabe à teoria política analisar tais panfletos e brochuras, ainda pouco conhecidos e sobre os quais há raros estudos, sem deixar de articulá-los às análises mais sistemáticas da França setecentista para o estabelecimento das “convenções linguísticas” do período, em primeiro lugar, e, em segundo, para uma disposição crítica em relação ao passado. Isto é, não se trata de reconstituir os discursos de certo período histórico por mero diletantismo, mas porque a compreensão da distância que nos separa desse período lança luz aos fundamentos das nossas próprias linguagens políticas.
OS SENTIDOS DA PARTICIPAÇÃO PARA O PARTIDO DOS TRABALHADORES (1980-2016)
Authors: Bezerra Carla de Paiva
Published: September 2019

Nas eleições de 1982, o Partido dos Trabalhadores (PT) lança o mote: “governar com participação popular e inversão de prioridades”. Essas ideias acompanhariam o partido ao longo de sua história, porém com mudanças substantivas em como são entendidas por seus militantes e dirigentes. Mudanças essas explicitadas pelas prioridades dadas a diferentes instrumentos de políticas públicas, que vão desde a proposta de governar por Conselhos Populares, da década de 1980, até a constituição de um Sistema Nacional de Participação no governo federal, em 2014. Alegamos que há uma dinâmica relacional, em que a adoção de diferentes instrumentos de políticas públicas para a concretização da diretriz da participação simultaneamente molda e reflete as preferências ideológicas partidárias. Com base no experimentalismo de suas gestões municipais, estaduais e federal, as experiências bem-sucedidas são incorporadas ao programa partidário como exemplos a serem seguidos por outros governos petistas. A partir da análise sistemática de resoluções e publicações partidárias apresentamos como os sentidos atribuídos ao termo participação e seus vários adjetivos vão, gradualmente, se modificando, em conjunto com a escolha dos instrumentos prioritários para a implementação de políticas participativas.
Iron Chelation as a Potential Therapeutic Strategy for AKI Prevention
Authors: Sharma Shreyak , Leaf David E.
Published: September 2019

AKI remains a major public health concern. Despite years of investigation, no intervention has been demonstrated to reliably prevent AKI in humans. Thus, development of novel therapeutic targets is urgently needed. An important role of iron in the pathophysiology of AKI has been recognized for over three decades. When present in excess and in nonphysiologic labile forms, iron is toxic to the kidneys and multiple other organs, whereas iron chelation is protective across a broad spectrum of insults. In humans, small studies have investigated iron chelation as a novel therapeutic strategy for prevention of AKI and extrarenal acute organ injury, and have demonstrated encouraging initial results. In this review, we examine the existing data on iron chelation for AKI prevention in both animal models and human studies. We discuss practical considerations for future clinical trials of AKI prevention using iron chelators, including selection of the ideal clinical setting, patient population, iron chelating agent, and dosing regimen. Finally, we compare the key differences among the currently available iron chelators, including pharmacokinetics, routes of administration, and adverse effects.
The Welfare Costs of Misaligned Incentives: Energy Inefficiency and the Principal-Agent Problem
Authors: Blonz Joshua A.
Published: September 2019

In many settings, misaligned incentives and inadequate monitoring lead employees to take self-interested actions contrary to their employer's wishes, giving rise to the classic principal-agent problem. In this paper, I identify and quantify the costs of misaligned incentives in the context of an energy efficiency appliance replacement program. I show that contractors (agents) hired by the electric utility (the principal) increase their compensation by intentionally misreporting program data to deliberately authorize replacement of non-qualified refrigerators. I provide empirical estimates of the impacts of misaligned incentives on (1) the effectiveness of energy efficiency retrofits and (2) welfare. I estimate that unqualified replacements reduce welfare by an average of $106 and save only half as much electricity as replacements that follow program guidelines. The same program without a principal-agent distortion would increase welfare by $60 per replacement. The resul ts provide novel evidence of how principal-agent distortions in the implementation of a potentially beneficial program can undermine its value.
Fiscal Stimulus Under Sovereign Risk
Authors: Bianchi Javier , Ottonello Pablo , Presno Ignacio
Published: September 2019

The excess procyclicality of fiscal policy is commonly viewed as a central malaise in emerging economies. We document that procyclicality is more pervasive in countries with higher sovereign risk and provide a model of optimal fiscal policy with nominal rigidities and endogenous sovereign default that can account for this empirical pattern. Financing a fiscal stimulus is costly for risky countries and can render countercyclical policies undesirable, even in the presence of large Keynesian stabilization gains. We also show that imposing austerity can backfire by exacerbating the exposure to default, but a well-designed "fiscal forward guidance" can help reduce the excess procyclicality.
Analysis of Agglomeration Features in Municipal Units in the Perm Region
Authors:   Perm State University, Blus Pavel I. , Shestakova Nataliia О. ,   Perm State University
Published: September 2019

Introduction. A further development of local self-government is impossible with no integration and consolidation of the efforts from the stakeholders to face the social and economic challenges. This becomes the main reason for a growing academic interest towards the exploration of agglomeration processes as a form of spatial organization. Along with that, agglomeration processes are typically considered to be connected with the development of a metropolis and neighboring territories (municipal units). However, currently both the metropolises and towns are likely to be characterized by the agglomeration processes and by the trends for their development. Aims. The paper is to analyze the agglomeration features of municipal units as a spatial factor for territory development at both settlement and regional levels. Methods. The authors focus on a comprehensive approach, where agglomeration is considered to be a multi-faceted process with a set of interconnected elements. This approach reveals the integrity and a particular development vector for this process. What is more, the paper applies descriptive, structural and functional, formal-legal and analytical methods, as well as a comparative analysis. Results. The materials of Suksun and Kishert municipal regions in the Perm Region were employed in an attempt to check a hypothesis about the presence of agglomeration features in nonmetropolitan areas. The authors found that the agglomeration processes occurred between bordering territories with similar economic and social cultural conditions, natural resources and socio-economic potential as the basis for economic growth; similar infrastructure which can be mutually beneficial, including further traffic infrastructure development in the bordering areas. A socio-economic area of several Prikamye municipal units, such as Lysva city territory, Chusovskoi municipal district, Kizel, Aleksandrovsk municipal districts and Gubakha city territory, Ocher, Vereshchagino, Nytva municipal districts, was looked at as a potentially favorable environment for agglomeration formation and development. The authors found that the territories of the mentioned municipalities are not completely involved into agglomeration processes. In their turn, the existing interactions can be considered to have only some agglomeration features, but they are limited and local in their nature and do not show any synergetic effect seen in the agglomeration processes. Conclusion. Practices in city agglomeration analyses made it possible to apply the agglomeration features to reveal the territories with the prerequisites for agglomeration processes. This is the reason to think that both urban and countryside areas in Prikamye have enough possibilities to promote the agglomeration processes to improve the socio-economic development of the municipal units through consolidating efforts in preparing and implementing integration processes.
Place Image Factors in the Strategic Management of Rural Municipal Areas Development
Authors:   Samara State University of Economics, Koroleva Elena N. , Kurnikova Marina V. ,   Samara State University of Economics
Published: September 2019

Introduction. The system of strategic management of local social and economic development is being introduced in Russia. In this regard, the methodology and the relevant range of tools for grounding strategic decisions which will take into consideration key factors of local development, seem to be urgent. Russian municipal strategies usually rely on material (natural recourses, production facilities, and infrastructure) and non-material factors (labour resources and intelligent potential, cultural and historic heritage, financial capacity). However, new (creative) factors such as image, brand and place reputation are often disregarded while managing municipal development. This is particularly true for less urbanized Russian territories specializing in agriculture. Aims. The paper is to develop the methodological framework of image studies concerning municipal (local) territorial systems including the development of the relevant range of tools to identify key image-forming factors for strategic development of rural municipal areas. Methods. The study is based upon empirical data collected by the authors in 2016–2018 while holding opinion polls of residents in some municipal areas. Results. The paper presents an original definition of a place image. The authors worked out and successfully tested the range of tools which allow identifying the key image-forming factors of perspective development for rural areas as well as formulated recommendations for their use in strategic management. Conclusion. The results of the study are aimed at local self-government authorities, all key players involved into strategic planning in Russian municipal areas.
Detection of Klebsiella pneumoniae and closely related species by real-time PCR with the ZKIR system v2
Authors: Barbier Elodie , Rodrigues Carla , Depret Geraldine , Passet Virginie , Gal Laurent , Piveteau Pascal , Brisse Sylvain
Published: September 2019

Klebsiella pneumoniae (Kp) is of growing public health concern due to the emergence of multidrug-resistant and virulent strains. Taxonomically, Kp includes seven phylogroups, with Kp1 (K. pneumoniae sensu stricto) being medically prominent. Kp can be present in environmental sources such as soils and vegetation, which could act as reservoirs of animal and human infections. However, the current lack of screening methods to detect Kp in complex matrices limits research on Kp ecology. We designed a novel SYBR green real-time PCR assay, named the ZKIR assay, that targets Klebsiella pneumoniae and closely related species (phylogroups Kp1 to Kp7). Based on 48 Kp representing its phylogenetic breadth, and on 88 non-Kp strains, the ZKIR assay detected all Kp and was totally specific for Kp, as no false positive was found. We also tested this method on spiked soil microcosms after a 24 h enrichment step (in Lysogeny Broth supplemented with ampicillin 10 mg/l) and a short sample treatment. We showed that this procedure was sensitive enough to detect one single bacterium in 5 g of soil.
Modul Elektronika Berbasis Mikrokontroler sebagai Sistem Pengaman pada Mobil Terintegrasi dengan Engine Immobilizer
Authors: Goeritno Arief , Afandi Muhammad Yusuf
Published: September 2019

An electronic module based on the ATmega32 microcontroller as a security system for cars that integrated into the engine immobilizer has been created. Three main things in this study, namely programming and verification tests, making an initial security system with a minimalist structure, and validation tests. Programming for the microcontroller system through algorithm determination and syntax writing, while the verification test is done through uploading the program syntax to the Proteus application and implementing the simulation. Determining the algorithms and writing the syntax through a number of steps, namely pin configuration, variable declarations, constant declarations, initialization, main programs, retrieve and send data, and output. The simulation assisted by the Proteus application is in the form of giving two kinds of commands/inputs to the sensor, namely one input data in the form of human existence or human motion to the passive infrared receiver sensor and one input of human fingerprint initialization data to the fingerprint sensor. The simulation results according to the order of the fingerprint sensor and passive infrared receiver in the form of a display on the Virtual Terminal. The minimalist structure of the system is composed of circuit diagrams, physical forms, and integrated wiring on the ATmega32 microcontroller system. The performance of the security system is shown, that the results of monitoring when the sensor is given input "human existence (motion)", the fingerprint sensor blinks (on) and when the fingerprint sensor blinks which means ready to receive input data in the form of "Human Initialization (fingerprint)" for activating actuators and starter system on the car. Giving input commands to the sensor passive infrared receiver and fingerprint has functioned for the appointment of performance, that the initial security system has been integrated with the main security systemand attached to the car.
Pemanfaatan Fasilitas IT untuk Jaringan Pencahayaan LED di Smartroom
Authors: Manfaluthy Mauludi , Wilyanti Sinka
Published: September 2019

In this research, proposed lighting in smartroom with PoE technology (Power over Ethernet). IT facility is PoE Switch, Ethernet Cable and LAN network. Smartroom in this study is defined as meeting room in a high rise building that has LAN network. This research is motivated by many lighting lamps that use AC power, when the future use of AC source will be reduced, even with PoE switch voltage source still use AC, but can eliminate the pitch of light that still uses conventional AC. Building infrastructure systems tend to be developed towards IP protocols. An area where the electrical area becomes fully integrated into the IP network. This is made possible through the use of LED with low voltage and low current. However, in order to utilize the technical and economic advantages offered by LED Lighting Solutions, the addition of light sensor and motion as a switch will make it more complete. The results of the study obtained a cheaper cost than the use without PoE.
Edisi Lengkap Vol.15, No.12, Agustus 2019
Authors: JRE JRE
Published: September 2019

Edisi Lengkap Vol.15, No.12, Agustus 2019
Доверие в нестабильном российском обществе
Authors: Козырева Полина , Смирнов Александр
Published: September 2019

Представлен анализ динамики и проблем формирования доверия в современном российском обществе, опирающийся на данные Российского мониторинга экономического положения и здоровья населения НИУ ВШЭ (РМЭЗ НИУ ВШЭ). Основное внимание уделяется исследованию особенностей формирования и распространения обобщенного доверия, наблюдающихся на протяжении последнего десятилетия. В ходе анализа выявлены новые позитивные изменения в уровне обобщенного доверия, которые отмечены в разных социально- демографических группах, несмотря на рост неопределенности во всех сферах жизни общества. Но при этом вызывает тревогу существенное замедление этих позитивных тенденций. Авторы акцентируют внимание на факторах, содействующих и препятствующих распространению доверия в российском обществе. Подчеркивается, что к наиболее значимым факторам, способствующим росту доверия россиян к другим людям, относится повышение у них ощущения личной безопасности. Анализ обширного эмпирического материала убеждает, что обобщенное доверие выступает в качестве важнейшего условия, необходимого для упрочения демократических основ общественной жизни и дальнейшего развития гражданского общества. Вместе с тем участие в деятельности демократических институтов, добровольных организаций гражданского общества не всегда становится источником роста доверия к другим людям.
Риторика политических лидеров России и США: сравнительный анализ
Authors: Касаткин Петр , Романенко Анастасия
Published: September 2019

Статья представляет собой обобщение результатов исследования роли межкультурной коммуникации в политическом дискурсе России и США. Объектом исследования выступила межкультурная коммуникация ведущих политиков этих стран, предметом – анализ общего/различного в использовании российскими и американскими политиками речевых стратегий и тактик, выразительных средств как функциональной основы политического диалога. Национально-культурные маркеры речевых стратегий политиков рассматриваются авторами, с одной стороны, как механизмы вербального поведения политиков; с другой, как отражение выбора политиками выразительных средств, который позволяет судить о национальных ценностях и интересах России и США. Применение дискурсивного, коммуникативно- прагматического и риторического методов позволило авторам систематизировать дискурсивно-коммуникативные стратегии и тактики политиков, сопоставить национально-культурные особенности политического дискурса в России и США.
In vitro evaluation of combination effects of doxorubicin with methylxanthine fractions isolated from Bancha and Pu-erh teas against breast cancer cells
Authors: Georgiev Kaloyan D. , Slavov Iliya J. , Iliev Ivan A.
Published: September 2019

Background: In the present study we investigated the combination effects of anthracycline antibiotic, doxorubicin, with methylxanthine fractions isolated from Bancha and Pu-erh tea leaves, against MCF-7 and MDA-MB-231 breast cancer cell lines.Methods: Neutral red uptake assay was used for assessment of cytotoxicity effects and fractional effect analysis and combination index for evaluation of the combination effects.Results: Doxorubicin was used in varying concentrations by a double dilution method, whereas the methylxanthine fractions were in fixed concentrations – 100, 200, 400 or 600 μg/ml. Results have shown that methylxanthine fraction isolated from Bancha has synergic effects with doxorubicin, while methylxanthines from Pu-erh displayed antagonistic effects.Conclusions: Тhe obtained results lead us to suspect, that even minor differences in the composition of natural products can lead to significant differences in the biological activity of the product.
Retrospective study on susceptibility and resistance pattern of urinary pathogens in a tertiary care hospital
Authors: Ramu Sudha
Published: September 2019

Background: Indiscriminate and inappropriate use of antimicrobial agents (AMA) resulted in rapid emergence of antimicrobial resistance. Institutional level surveillance program to be carried out to track AMA use. The study was conducted to evaluate the prevalence of uropathogens and their susceptibility and resistance pattern in a tertiary care hospital to revise empirical therapy.Methods: Urine samples received from the inpatients and outpatients Departments of Mahatma Gandhi memorial hospital for culture sensitivity between January 2018 to December 2018 were included in this study. Data collected from the Department of Microbiology register by using WHONET software. After identification, isolates were tested for antimicrobial susceptibility by the standard Kirby Bauers diffusion method. Descriptive analysis done and results were expressed as percentage.Results: Out of 3425 samples 68.5% showed no growth, 15.5% normal flora and only 15.9% reported as culture positive. In this study the highest isolate was Escherichia coli (59%) followed by Klebsiella pneumoniae (10.6%), Enterococcus sp. (7%), Staphylococcus aureus (5%), Candid (3.6%), Acinetobactor (3%) and Pseudomonas (2.9%). Uropathogens developed resistance against penicillins, cephalosporins, macrolides and cotrimaxazole.Conclusions: This study confirms, the frequently prescribed empirical therapy drugs were less susceptible and developed resistance than less frequently prescribed and costly drugs. The current antimicrobial resistance pattern alarms the irrational and excessive use of antimicrobial agents. Hence the treating physicians should revise empirical therapy periodically based on the institutional antibiogram and resistance pattern reported from the laboratory to preserve antimicrobial source for the future generation.
Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug
Authors: Dhavalshankh Archana G. , Rajadnya Vikram A. , Patil Kedar L.
Published: September 2019

Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions.  Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.
A study of prevalence of metabolic syndrome in patients with type 2 diabetes mellitus in a tertiary care referral hospital in West Bengal
Authors: Maiti Tamoghna , Mandal Sonai , Banerjee Ratul , Das Somenath , Panda Amrita
Published: September 2019

Background: The terms "metabolic syndrome", "insulin resistance syndrome" and "syndrome X" are now used specifically to define a constellation of abnormalities that is associated with increased risk for the development of type 2 diabetes and atherosclerotic vascular disease. It is a state of chronic low grade inflammation with the profound systemic effects. Several organisations gave several criteria to diagnose it. Effective preventive approaches include lifestyle changes, primarily weight loss, diet, and exercise, the appropriate use of pharmacological agents to reduce the specific risk factors.Methods: A cross-sectional study was done to evaluate the co-morbidity profile of patients, with metabolic syndrome and correlate clinical manifestations with specific components or metabolic syndrome, at the OPD of Bankura Sammilani Medical College and Hospitals, West Bengal. American Association of Clinical Endocrinologists criteria were chosen for diagnosis.Results: 100 patients were recruited having type II diabetes mellitus. Most of the patients were male between 20-70 years and maximum was on oral hypoglycemic agent with app 40% patient was without any glycemic control. In comorbidities hypertension was highest, followed by coronary artery disease, hypothyroidism and cerebrovascular accident. Waist-hip ratio was highest in female. All of the patients were having some cardiac risk factor assessed by ECG, echocardiography and thread mill test.Conclusions: The data demonstrates that metabolic syndrome is extremely common among diabetic patients. Frequency was much higher in women than men. Obesity is a key element in causing the metabolic syndrome and this factor was also more common in women.
Efficacy of ciclesonide, budesonide and beclomethasone dipropionate in moderate persistent bronchial asthma: a comparative study
Authors: Rupa L. Mohana , A. Maduram , Nadipelly Jagan
Published: September 2019

Background: The objective of the present study was to compare the efficacy and adverse effects of ciclesonide with that of budesonide and beclomethasone dipropionate in moderate persistent cases of bronchial asthma.Methods: This was an open label, randomized parallel group study done in Government General and Chest Hospital, Hyderabad for a period of 12 weeks. Each group had 20 patients. Group A was given ciclesonide inhalational therapy 160 mcg once daily. Group B was given budesonide inhalational therapy 400 mcg twice daily. Group C was given beclomethasone dipropionate inhalational therapy 400 mcg twice daily.Results: Symptomatic improvement was observed in all three groups. At end point, mean FEV1 in ciclesonide treatment group improved by 23.84% compared with 15.24% in budesonide and 12.93% in beclomethasone treatment groups. At end point, mean FVC value in ciclesonide treatment group improved by 6.44% compared with 1.5% in budesonide and 1.06% in beclomethasone groups. Mean FEV1/FVC also improved by 16.56% in ciclesonide group compared with 13.68% in budesonide and 11.93% in beclomethasone groups. No adverse effects were reported in any of the treatment groups.Conclusions: This study showed that ciclesonide is superior to budesonide and beclomethasone in improving lung function, decreasing symptoms and need for rescue medication in moderate persistent asthma.
Evaluation of antioxidant and anti-inflammatory effects of red raspberries on chronic nicotine-induced damage: an experimental study
Authors: Selli Jale
Published: September 2019

Background: As an addictive substance, nicotine has been recognized as a risk factor to induce oxidative tissue damage, which is a main risk factor for development of lung-related diseases.  Red raspberries (Rubus idaeus L.) have been used for the treatment of several tissue damage for decreasing oxidative stress and inflammation. For this purpose, authors aimed to investigate the antioxidant and anti-inflammatory effects of raspberry on nicotine-induced lung damage in rats.Methods: 32 male Sprague–Dawley rats included in present study. The rats were divided into the following four groups, with eight rats in each group: control, raspberry 100 mg/kg, nicotine 5 mg/kg, nicotine + raspberry 100 mg/kg treated (concomitant nicotine and raspberry extract) groups. The assessment of lung structure was made on light and stereo investigator microscope, immunohistochemical analysis was performed by determining anti-Caspase-3 immunostaining.Results: The lung of the nicotine applied group exhibited emphysematous air spaces, massive congestion areas, disrupted alveoli, thickened septa and inflammatory cell infiltration. Much improvement was observed in the raspberry-treated group despite the presence of mild residual changes. Moreover, loss of massive congestion areas and decreased Caspase-3 level were detected in the raspberry-treated group.Conclusions: Our results indicate that the raspberry extract attenuate the pathological changes of nicotine in the lung rats through antioxidative and anti- inflammatory mechanisms.
Pelvic limb reconstruction failed by propeller flap resolved with microsurgery
Authors: Gómez-Mendoza Francisco Fabián , Banegas-Ruíz Rodrigo , Mendoza-Aceves Rodrigo A. , Román-Hernández Rigoberto , Porras-Méndez Christian , Valderrama-Treviño Alan I. , Uriarte-Ruíz Karen , Vejar Alba Ismael , Olivares Ulloa Rubén , Barrera-Mera Baltazar
Published: September 2019

Reconstruction of lower limb defects is a constant challenge for surgeons, the etiology of the defect can be very variable from diabetic ulcers, traffic accidents, fall from height, oncological resections and many others. Free flaps have always been an important option because it has great results in complex reconstructions in lower limbs, it is a microvascular technique, so it has a higher level of complexity. This technique is usually reserved for extensive perilesional wide defects. On the other hand, the propeller flap, which is considered less invasive and easier as it does not involve microvascular surgery. An 18-year-old patient who had a fracture of the right tibial pylon due to a 7-meter drop, who after orthopedic treatment had a defect with exposure of ostesynthesis material of 3 cm in circumference in the medial malleolus. This defect was first managed with a propeller flap complicated with necrosis at 48 hours which was treated with sub atmospheric pressure system for 5 days and later with an ultra-thin anterolateral flap of the pelvic limb. Complete pedicled propeller flap failure is very rare but, because necrosis develops distally, even partial necrosis can expose bone, tendons, or other tissue. Some surgeons consider that propeller flap placement is risky in this location, especially the distal third of the lower leg a prefer to use free flaps. Whenever any pelvic member reconstruction plan fails in the distal third, the best and safest is the use of microsurgery even with the failure of a previous micro vascular flap.
Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT
Authors: Eftekhar Maryam , Hoseini Masrooreh , Saeed Lida
Published: September 2019

Background: In vitro fertilization is an important therapy for women with polycystic ovarian syndrome (PCOS). The use of new ways of improving clinical results is yet required.
Objective: This study was aimed to investigate the efficacy of progesterone primed ovarian stimulation (PPOS) and compare with conventional antagonist protocol in PCOS.
Materials and Methods: A total of 120 PCOS women who were candidates for assisted reproductive technology treatment from August to January 2019 were enrolled in this RCT and were placed into two groups, randomly (n = 60/each). The PPOS group received 20 mg/day Dydrogesterone orally since the second day of the cycle and the control group received antagonist protocol. The pregnancy outcomes including the chemical and clinical pregnancy, the miscarriage rate, and the percent of gestational sacs/transferred embryos was compared in two groups.
Results: Number of MII oocyte, maturity rate, Number of 2 pronuclei (2PN) and serum estradiol levels on trigger day were statistically lower in PPOS group (p = 0.019, p = 0.035, p = 0.032, p = 0.030), respectively. Serum LH level on trigger day in PPOS group was higher than antagonist group (p = 0.005). Although there wasn’t sever ovarian hyper simulation syndrome in any participants, mild and moderate ovarian hyper simulation syndrome was less in PPOS group (p = 0.001). Also, the chemical and clinical pregnancy rate were higher in the antagonist group, althoughit was not statistically significant (p = 0.136, p = 0.093 respectively).
Conclusion: Our study demonstrate that PPOS does not improve chemical and clinical pregnancy rate of the infertile women with PCOS.
Key words: Progesterone, Polycystic ovarian syndrome, Controlled ovarian stimulation, Frozen-thawed embryo transfer, Pregnancy rate.
Evaluation of Integrated Health System Technology Acceptance among the users of Health Centers of Zahedan University of Medical Sciences: Iran
Authors: Khammarnia Mohammad , Setoodehzadeh Fatemeh , Peyvand Mostafa , Setayesh Amir Hossein , Rezaei Kosar , KordTamini Ayube , Vahedi Mohammad , NajmJahan Dide Mohammad , Khorram Alireza
Published: September 2019

Background: The integrated health system (IHS) entitled “SIB” was launched in 2016 aimed to electronic health record (EHR) in the field of health. Given that, in addition to deploying the system, its acceptance criteria by users has a significant effect on its effectiveness and benefits: therefore, the present study was carried out aimed to determine the acceptance rate of IHS technology in health centers.
Methods: This study as a cross-sectional survey and applied research was conducted in Zahedan University of Medical Sciences (ZAUMS) in 2017. The population in the present study consisted of all users of SIB system affiliated ZAUMS. Of these, 285 users were selected (physician, health care provider, Behvarz) in five counties affiliated with ZAUMS using multistage cluster sampling. In this study, standard technology acceptance questionnaire was used for data collection. The data were analyzed by SPSS-v22 software and analyzed using descriptive statistics, one-way Anova, T test and other related tests.
Results: About 77.9 % of users used the system for several times a day. The SIB system acceptance rate by 49.5 % of users was moderate and 38.9% of the users had excellent acceptance of this system. There was a significant relationship between the acceptance rate of SIB system among the users with age, gender, city, level of education, type of employment, place of work and organizational position (P < 0.05).
Conclusion: The results of this study show that, most users have accepted and confirmed the SIB system. Modification of the system with regional approach with the opinion and participation of specialists in comprehensive health service centers is suggested.
The Study of Factors Affecting the Job Performance of Nurses Working in Selected Teaching Hospitals in Tehran
Authors: Saberzadeh Vahid , Abdollahinia Javad , NourizadehTehrani Pedram , Asheghi Hadi , Khanjankhani Khatereh
Published: September 2019

Background: Undoubtedly, one of the most important objectives of any organization is to provide high quality and desirable goods and services that depends on the performance of human force of the organization. The performance of physicians and nurses is a very important factor in establishing and enhancing the effectiveness of services. Since nurses are the most fundamental medical staff of the hospital, the present study was performed with the aim of investigating the factors affecting the job performance of nurses working in selected teaching hospitals in Tehran in 2018.
Methods: The target group of this study included nurses working in inpatient wards of hospitals, of whom 354 individuals were selected by simple random sampling method. The intraorganizational environment questionnaire (Weisbord), five personality traits (NEO personality inventory), and Paterson’s job performance questionnaire were the three data collection tools. The study was conducted in 2018 and the data were analyzed by SPSS 20 software using descriptive statistics and artificial neural networks.
Results: In the personality traits questionnaire, neuroticism (40.22 ± 6.66) dimension had the highest and responsibility (23.94 ± 4.91) dimension had the lowest mean scores. Also in the inter-organizational environment questionnaire, communication (14.66 ± 4.52) dimension and rewards (21.33 ± 6.54) dimension had the best and worst status, respectively. Comparison of significance coefficients in neural networks showed that dimensions of agreeability (100 %) and marital status (8 %) had the highest and lowest importance in nurses’ job performance.
Conclusion: The results reveal that the dimensions of personality traits and job agreeability dimension have the most effect on the employees’ job performance. Hence, it is possible to improve staff performance by hiring people consistent with their work.
Self-care Behaviors and Influential Factors among Nurses Working in the Hospitals of Tehran
Authors: Ahmadi Batoul , Rafiemanesh Hosein , Shamlou Reza , Kor Yones , Letafat Nezhad Mozhgan , Mehtarpour Mojtaba
Published: September 2019

Background: Nurses' self-care assessment and elimination of obstacles with appropriate interventions will have a great impact on their own health as well as the recipients of health services. This study was designed to evaluate self-care status among nurses in selected hospitals in Tehran, Iran.
Methods: This cross-sectional study was carried out on 310 nurses working in Tehran University of Medical Sciences hospitals. Data were collected by a questionnaire with 70 questions that was conducted to evaluate the health level in five dimensions. Data were analyzed by using the statistical tests of MANOVA and Pearson’s correlation.
Results: The average scores of nurses' self-care in men and women were 244.1 and 245.3, respectively. The highest average score was for the supportive relationships dimension. There was a significant relationship between gender and self-care dimensions (P-value = 0.077). The average scores of self-care for nurses working in the emergency department, general department, surgical department, intensive care unit, and other sectors were 238.5, 247, 240.6, 245.6 and 251.1, respectively. There was a positive relation between supportive relationships dimension, age, and years of employment. In addition, there was a negative relation between the number of children and supportive relationships dimension (P-value < 0.05).
Conclusion: This study showed that self-care among nurses in the hospitals of Tehran University of Medical Sciences was moderately high, in a good and acceptable situation. However, there were poor scores in some areas and further study of the nurses’ self-care and its promoting strategies is still required.
SOCIAL ACTORS’ REPRESENTATION IN ONLINE MALAYSIAN NEWSPAPERS DURING ELECTIONS: A TRANSITIVITY ANALYSIS OF NEWSPAPER TEXT
Authors: Asad Saira , Binti Mohd Noor Dr. Siti Noor Fazelah , Bin Jaes Dr. Lutfan
Published: September 2019

Purpose of the study: This study aimed to find out the meaning behind the text of two streams of online newspapers in Malaysia, the present study is conducted on ‘Malaysiakini’ (independent newspaper) and ‘The News Straits Times’ (mainstream newspaper).

Methodology: The research employs Norman Fairclough (1995) Critical Discourse Analysis (CDA), which is analyzed with Halliday’s Systematic Functional Linguistics (SFL) based on social semiotics analysis (1985). Transitivity Analysis of text is based on Halliday’s work by Matthiessen (2014). Sixteen-16 (6,125 words) hard news is selected from ‘Malaysiakini’ and five-5 (2,270 words) from ‘The New Straits Times’ based on the ‘defamation’ category, which is selected from one week before elections. The selected dates of data are 3rd May till 9th May 2018. The news reports are selected on social actors’ performances i.e. Dr.Mahathir Mohamad and Najib Razak, which are based on van Leeuwen’s (2005) social semiotic framework.

Main Findings: The results show Malaysiakini has portrayed independent views and given fair portrayal to both political social actors as compared to ‘The News Straits Times’.

Applications of this study: The study can be useful in print journalism in which grammatical words’ analysis through the process of transitivity leads to determine the inclination of the newspaper towards a political party.

Novelty/Originality of this study: The study may benefit readers in existing knowledge as elections’ social actors have not been analyzed earlier grammatically.
The College Park, Maryland Tornado of 24 September 2001
Authors: Pryor Kenneth , Wawrzyniak Tyler , Zhang Da-Lin
Published: September 2019

The 24 September 2001 College Park, Maryland, tornado was a long-track and strong tornado that passed within a close range of two Doppler radars. It was the third in a series of three tornadoes associated with a supercell storm that developed in Stafford County, Virginia, and initiated 3 - 4 km southwest of College Park and dissipated near Columbia, Howard County. The supercell tracked approximately 120 km and lasted for about 126 minutes. This study presents a synoptic and mesoscale overview of favorable conditions and forcing mechanisms that resulted in the severe convective outbreak associated with the College Park tornado. Results show many critical elements of the tornadic event, including a negative-tilted upper-level trough over the Ohio Valley, a jet stream with moderate vertical shear, a low-level warm, moist tongue of the air associated with strong southerly flow over south-central Maryland and Virginia, and significantly increased convective available potential energy (CAPE) during the late afternoon hours. A possible role of the urban heat island effects from Washington, DC in increasing CAPE for the development of the supercell is discussed. Satellite imagery reveals banded convective morphology with high cloud tops associated with the supercell that produced the College Park tornado. Operational WSR-88D data exhibits a high reflectivity “debris ball” or tornadic debris signature (TDS) within the hook echo, the evolution of the parent storm from a supercell structure to a bow echo, and a tornado cyclone signature (TCS). Many of the mesoscale features could be captured by contemporary numerical model analyses. This study concludes with a discussion of the effectiveness of the coordinated use of satellite and radar observations in the operational environment of nowcasting severe convection.