bluuebunny/crossref_metadata_2025 huggingface dataset:
Sereias do asfalto, bonecas e outras bichas: apontamentos sobre cenas transviadas e violências de gênero no Brasil
Authors: Araujo Mota Junior Edinaldo
Published: April 2022

Para compreender a natureza da violência contra o feminino e seus esquemas de reprodução, tem sido crucial observar como sua inferiorização na ordem do gênero recai numa rede de violências contra mulheres, cis e transgênero, travestis, gays afeminados e pessoas não-binaries. Neste artigo, reflete-se sobre a abjeção ao feminino e suas resistências no contexto brasileiro a partir da proliferação de artistas atuais da música pop que perturbam e reelaboram os padrões e normas de gênero. Essas expressões nomeadas na pesquisa de cenas musicais transviadas, ao tensionarem valores patriarcais, misóginos e racistas, constituem engajamentos identitários e têm funcionado como um dos principais mecanismos de luta política LGBTQI. A partir da noção de cena cultural/musical, da crítica feminista dos 1980 e 1990 e dos estudos queer, propõe-se pensar como cenas transviadas negociam traumas históricos e violências sistêmicas, e reelaboram elementos da cultura dominante como contradiscursos. Entre espacialidades e imaginações, essas cenas se colocam contra a noção de esfera pública dominante. Propõe-se pensá-las como espaços contrapúblicos nos quais sujeitos interpretam suas próprias identidades, interesses e necessidades e ressignificam valores sociais e comunitarios.
Género y vacunación contra el VPH en Colombia: cuando la política pública hace daño
Authors: Baltar Moreno Adolfo , Puello-Sarabia Cielo Patricia
Published: April 2022

Desde el año 2014, centenares de niñas y mujeres adolescentes de un municipio rural de Colombia desarrollaron una enfermedad de etiología desconocida que atribuyeron a una campaña de vacunación escolar contra el Virus del Papiloma Humano (VPH). Las autoridades sanitarias, tras descartar una relación de causalidad entre la vacuna y los síntomas, trataron el caso como una sugestión colectiva, pero esta respuesta fue rechazada por las afectadas y sus familiares. El caso saltó a los medios de comunicación, se desencadenó una controversia médica y legal, y la cobertura de vacunación con este fármaco descendió drásticamente en todo el país. Este artículo presenta los resultados parciales de una investigación narrativa producida a partir de una etnografía audiovisual llevada a cabo sobre terreno con la comunidad afectada entre 2015 y 2021. Los datos recogidos han sido objeto de un análisis cualitativo-inductivo basado en el procedimiento de la teoría fundamentada. Se concluye que estamos ante un problema de salud pública singular vinculado a la aplicación de una vacuna que evidencia cómo una intervención de salud pública dirigida a las mujeres se convirtió, paradójicamente, en un ejemplo de violencia institucional y de género.
[RETRACTED] Keto X3 - A Natural Solution For Eliminating Body Fat! v1
Authors: Douglas Morris H
Published: April 2022

[RETRACTED]

it does not necessarily mean you will get vaginal yeast infections; reverse is true also.
[RETRACTED] Certified Natures CBD Gummies Reviews & Shark Tank Scam Reports v1
Authors: not provided certiednatusreviewsas
Published: April 2022

[RETRACTED]

Certified Natures CBD Gummies Reviews & Shark Tank Scam Reports
[RETRACTED] Subgenix Keto Review: It Fat Burn At Fast & It's Healthy*Buy Now* v1
Authors: not provided InierBarqa
Published: April 2022

[RETRACTED]

Subgenix Keto, helps you lose weight fast it has natural & effective ingredients best for weight loss{Buy Now On Official Website}
[RETRACTED] Sun Valley CBD Gummies [YOU WON’T BELIEVE] 8 Truth About SunValley CBD Gummies? v1
Authors: Douglas Morris H
Published: April 2022

[RETRACTED]

Concentrate on data compilation and analysis. It should be staffed with expert health researchers
[RETRACTED] Limitless Glucose1 Feel The Difference After Take This! v1
Authors: not provided ynpalukge
Published: April 2022

[RETRACTED]

Limitless Glucose1
[RETRACTED] Glucose1 For Rapid Action And Results!! (Must Read)!! v1
Authors: not provided sillesen
Published: April 2022

[RETRACTED]

Glucose1
[RETRACTED] Tiger Woods CBD Gummies: Is It Safe Or Trusted? (2022 Reviews) Side Effects & Price Tiger Woods CBD? v1
Authors: not provided TigerWoodsCBDGumm
Published: April 2022

[RETRACTED]

Tiger Woods CBD Gummies
Vaks İçeren Kompozit Atıklar için En Uygun Değerlendirme Yönteminin Seçiminde Farklı Karar Verme Tekniklerinin Kullanılması
Authors: YILMAZBİLEK Ece , GÜNKAYA Zerrin , ÖZKAN Aysun , BANAR Mufide
Published: April 2022

Vaks içeren kompozit atıklar (faz değiştirme malzemeleri, işlenmiş hazır gıda ambalajları vb.), karmaşık yapıları nedeniyle sürdürülebilir bir şekilde yönetilmeleri zor olan atık türlerindendir. En uygun değerlendirme yönteminin belirlenmesi aşamasında çevresel, ekonomik, teknik açıdan bütünsel bir yaklaşım sergilenmesi önemlidir. Bu noktada, birçok alandaki problemin çözümünde farklı kriterlerin yardımıyla en uygun alternatif seçiminin yapılabildiği Çok Kriterli Karar Verme Teknikleri (MCDM)’nin kullanımı mümkündür. Bu nedenle bu çalışmada, iki farklı MCDM yöntemi ile vaks içeren kompozit atıkların değerlendirilme yöntemi (kimyasal geri dönüşüm, mekanik geri dönüşüm, insinerasyon, piroliz ve depolama) bütünsel bir yaklaşım ile değerlendirilmiştir. Öncelikle, belirlenen kriterler (küresel ısınma potansiyeli, enerji kullanımı, sağlık etkisi, kimyasal kullanımı, işletme maliyeti, yatırım maliyeti, geri dönüştürülmüş malzeme kalitesi, teknolojik uygunluk, çevre politikalarına ve yasaya uygunluk, kaynakların korunumu) Entropi, CRITIC (Criteria Importance Through Intercriteria Correlation) ve SWARA (Step-wise weight assessment ratio analysis) metotları ile ağırlıklandırılmıştır. Her bir ağırlıklandırma metodundan elde edilen sonuçlar, MCDM yöntemleri olan ANP ve TOPSIS ile ayrı ayrı değerlendirilmiştir. Kullanılan tüm ağırlıklandırma yöntemleri ile yapılan ANP ve TOPSIS sonuçlarında piroliz alternatifinin en uygun seçenek olduğu belirlenmiştir.
Naive Bayes Sınıflandırıcısı Kullanılarak YouTube Verileri Üzerinden Çok Dilli Duygu Analizi
Authors: ŞAHİNASLAN Önder , DALYAN Hüseyin , ŞAHİNASLAN Ender
Published: April 2022

Bu çalışma, Naive Bayes sınıflandırma algoritması kullanılarak sosyal medya verileri üzerinden dünya dillerinde yapılan yorum ve paylaşımların anlaşılmasına katkıda bulunmayı amaçlamaktadır. Duygu analizi veya fikir madenciliği, doğal dil işleme konularının bir alt bölümünde yer alır ve sosyal medya üzerinde yer alan verilerin anlamlandırabilmesi sağlanır. Yapay zekâ ve makine öğrenmesi gibi konularla birlikte günümüzde son derece popüler bir alandır. Küresel bir köye dönüşen dünyada, insanlar sosyal medya araçları üzerinden görüş, düşünce ve o konu hakkında memnuniyet durumları gibi pek çok veriyi paylaşmaktadır. Anlamlandırılmayı bekleyen bu veriler üzerinden insanların duygu ve düşünceleri ortaya çıkartabilmek mümkündür. Son dönemlerde Türkçe dilinde bir takım duygu analizi çalışmalarının yapıldığı görülmektedir. Ancak dünyadaki farklı dil ve lehçelerde yapılan yorumlar üzerinden çok dilli duygu analiz çalışması sınırlıdır. Bu çalışmada, Türkçe, İngilizce, Almanca, Fransızca, Arapça, Rusça ve Korece gibi farklı dünya dillerinden YouTube yorum verileri kullanılmıştır. PHP ile elde edilen bu ham veriler üzerinden anlamsız veriler temizlenerek belirli bir kalitede veri seti elde edilmiştir. Bu yorum verilerini İngilizce'ye çevirmek için Google çeviri aracı API'sı kullanılmıştır. Duygular, PHP Niiknow kütüphanesi üzerinden Naive Bayes algoritması kullanılarak pozitif, negatif ve nötr olarak sınıflandırılır. WEKA ile yapılan veri analizinde doğru sınıflandırma oranı %65,56 olarak bulunmuştur. Bu çalışma, 15.082 veri seti ve Google Çeviri aracı tarafından desteklenen 108 dil sayısı ile sınırlıdır.
A 0.6-V 11-uW PVT tolerant DTMOS inverter based OTA
Authors: ATASOYU Mesut
Published: April 2022

This paper presents the design of a process-voltage-temperature (PVT) variation tolerant inverter-based operational transconductance amplifier (OTA) employing both a dynamic threshold MOS (DTMOS) technique and a constant voltage biasing (CVB) scheme. The proposed inverter-based OTA offers a higher bandwidth due to implemented DTMOS technique, which realizes higher input transconductance value than a conventional inverter-based OTA design. Simulation results show that the proposed OTA achieves superior slow-slow (SS) corner performance under PVT variations than the conventional inverter-based OTA while consuming only 11-uW and providing a figure of merit (FoM) of 7.0-MHz.pF/uA. As a result, DC gain and unity-gain bandwidth (UGBW) of the proposed OTA improve by 27% and 32% at SS corner under the PVT variations, respectively.
A Weakly Supervised Clustering Method for Cancer Subgroup Identification
Authors: OZCELİK Duygu , TAŞTAN Öznur
Published: April 2022

Identifying subgroups of cancer patients is important as it opens up possibilities for targeted therapeutics. A widely applied approach is to group patients with unsupervised clustering techniques based on molecular data of tumor samples. The patient clusters are found to be of interest if they can be associated with a clinical outcome variable such as the survival of patients. However, these clinical variables of interest do not participate in the clustering decisions. We propose an approach, WSURFC (Weakly Supervised Random Forest Clustering), where the clustering process is weakly supervised with a clinical variable of interest. The supervision step is handled by learning a similarity metric with features that are selected to predict this clinical variable. More specifically, WSURFC involves a random forest classifier-training step to predict the clinical variable, in this case, the survival class. Subsequently, the internal nodes are used to derive a random forest similarity metric among the pairs of samples. In this way, the clustering step utilizes the nonlinear subspace of the original features learned in the classification step. We first demonstrate WSURFC on hand-written digit datasets, where WSURFC is able to capture salient structural similarities of digit pairs. Next, we apply WSURFC to find breast cancer subtypes using mRNA, protein, and microRNA expressions as features. Our results on breast cancer show that WSURFC could identify interesting patient subgroups more effectively than the widely adopted methods.
The Use of Kalman Filter in Control The PanTilt Two-Axis Robot With Wearable System
Authors: SÖNMEZOCAK Temel
Published: April 2022

Today, the use of MEMS-based control-based unmanned aerial vehicles is becoming widespread. It is important that the systems used for the control of unmanned aerial vehicles are used sensitively. In this study, a wearable MEMS gyroscope-based headband is designed for the remote control of unmanned aerial vehicles. This system provides vibration-free control of the rotation angles of the motors in the direction of the camera connected to the 2-axis robotic pan-tilt system based on human-machine interaction. In addition, the signals produced by MEMS, the vibrations caused by electrical noise in the motors due to human interaction and environmental factors, are effectively eliminated with the Kalman filter. In this way, the images transmitted to the pilot become smoother. Therefore, it is cost-effective as it eliminates the need for additional hardware filtering structures.
Lidar-based Robot Detection and Positioning using Machine Learning Methods
Authors: YILMAZ Zahir , BAYINDIR Levent
Published: April 2022

This paper presents a machine learning-based kin detection method for multi-robotic and swarm systems. Detecting surrounding objects and distinguishing robots from these objects (kin detection) are essential in most of the multi-robotic applications. While infrared, ultrasonic, vision systems had been mainly used for applying the robot detection and relative positioning task in the literature, studies that use the Lidar-based approach is limited. The proposed method uses the Lidar sensor to discover the work area and determine the distance and the angle of all kin members relative to the observer robot. The main steps of the proposed method can be summarized as follows: 1) the Lidar distance points are read and stored as a vector with some pre-processing, 2) the acquired distance points representing different objects in the environment are separated from each other using a segmentation method, 3) in order to classify the segmented objects, the segment classification process starts with extracting five features for each object, then these features are fed to various machine learning classification algorithms to distinguish the kin robots, 4) the segments classified as a kin robot in the previous step are handled and the relative position is found for each of them. A new mobile robot prototype has been modeled and equipped with a Lidar sensor using ROS platform. Lidar has been used to collect data and four different classification methods have been tested to verify the efficiency of the method using Gazebo simulation platform.
The work of the Comprehensive Care System for Children with ASD in the Regions of the Volga Federal District
Authors: Balandina O. , Gvozd U.Y.
Published: April 2022

An ordered work to develop a system of continuous comprehensive support for people with autism spectrum disorders (ASD) is being carried out in the Russian Federation. Since 2019 the Mental Health public project aimed at the development of the social and rehabilitation support to families raising children with mental disabilities has been implemented in the Volga Federal District (VFD). The Nizhny Novgorod Region is the first area which started to implement the project, which involves 5 regions of the Volga Federal District. Objectives of the project include various processes:early detection of ASD, training of professionals in various fields of interaction with people with ASD, raising awareness of effective care practices, including those for adults with ASD, organizing the work of resource centers; provision of medical services to people with ASD and their families. Some aspects of activities of the system of comprehensive care for children with ASD in the regions of the Volga Federal District are presented. Various fac- tors of comprehensive support to families raising children with ASD are considered on the basis of statistical data. From 2018 to June 2021 the prevalence of ASD in the Volga Federal District increased by 38.8%, and the provision of assistance to children with ASD and their families increased by 8.8%. The received data make it possible to assess the effectiveness and relevance of measures to identify and accompany children and their families as well as to plan further activities to organize comprehensive care for people with ASD reasonably.
Parental Attitude in Families Bringing up Preschoolers with Autism Spectrum Disorders
Authors: Kisova V.V. , Koneva I.A.
Published: April 2022

The article presents the results of a study of the parental position in families raising children with autism spectrum disorders. The experimental program for the study of the parental position includes valid and reliable questionnaires aimed at identifying family anxiety (Family Anxiety Analysis), parental attitudes (Parent Attitude Research Instrument), family relationships (Analysis of Family Relationships), attitudes towards the child’s illness (Tool for Diagnosing of Attitudes Towards a Child’s Illness). The study sample consists of 40 parents: 20 subjects raising preschoolers with autism spectrum disorders and 20 subjects raising normally developing children. The results of the study allow us to speak about the low productivity of the parental position in families with preschoolers with autism spectrum disorders. This expressed in hyperprotection and an indulgent parenting style, in a tendency to establish symbiotic relationships and an ambivalent emotional attitude, etc. Most parents with children with autism spectrum disorders need specially organized work to correct the parental position.
Early Intervention as a Part of Support System for Children with ASD and Their Families in Perm Region
Authors: Bronnikov V.A. , Grigoreva M.I. , Vaytulevichyus N.G. , Serebryakova V.Y.
Published: April 2022

The number of children with autism spectrum disorders (ASD) and other mental disorders is increasing in the Perm Region. Currently, services for children with ASD are provided by organizations and institutions of the health, edu- cation and social services system; non-profit organizations provide support to families. The need for the development of a system of integrated support of individuals with ASD becomes more and more urgent. Technology of providing early comprehensive intervention to children with ASD and their families in the State Budgetary Institution of the Perm Region «Center for Complex Rehabilitation of Individuals with Disabiilties» is designed as a 6-month course, which includes ADOS differential diagnostic tool, M-CHAT screening test, Early Start Denver Model. Early in- tervention is seen as an essential first step in the comprehensive support to children with ASD. Further steps of the development of complex support system to children with ASD and their families in Perm Krai on the basis of creation of system of interdepartmental interaction are presented.
Implementation of Support Programs for Parents of Preschool Children with ASD
Authors: Bobrova A.V. , Dovbnya S.V. , Morozova T.Y. , Sotova E.N.
Published: April 2022

Growing number of children diagnosed with Autism Spectrum Disorder (ASD) is rising the demand for programs to help their families. The problems and difficulties faced by parents raising children with ASD are discussed. Modern research and systematic reviews of the needs of their families raising preschoolers with autism spectrum disorders (ASD) are presented, as well as the opportunities offered by participation in the support and education programs. The examples of parent education and parent-mediated programs are listed. The results of research on parent’s stress associated with the care, upbringing and education of a child with ASD are presented. Three programs which meet international standards and have evidence of effectiveness and implemented in the Nizhny Novgorod region to support parents of preschool children with ASD are described: “CST — Caregiver Skills Training”, “EarlyBird”, JASPER. The need of selecting the programs according to the actual needs of the family and the child is concluded.
Efforts to Develop Creativity in Vocational Education through a Learning Model Based on Student Research Activities
Authors: Nelmira Weni , Efi Agusti , Elida  , Adriani  , Sandra Yofita
Published: April 2022

This research was motivated by the research findings of The Global Creativity Index 2015 and The Global Innovation Index 2020 where the creativity and innovation index in Indonesia tends to be low. This was also reflected in vocational education, especially in Embroidery learning at the Padang State University (UNP) Fashion Design Study Program where the products produced are generally less creative. For this reason, efforts are needed to develop student creativity in learning. The purpose of this research was to obtain a learning model designed to encourage the development of students' creative attitudes, which is reflected in the creative products produced in learning. This research and development method uses the Plomp (2013) development model with three stages, namely the preliminary research stage, the design and develop prototype stage, and the assessment stage. The design of the learning model was validated by 5 people who were experts in their fields and tested the level of practicality in small groups and field tests. The data were analyzed using the Aiken V formula. The Learning Model Based on student research activities has been assessed as valid, and practical so that it can be used in learning, especially to develop student creativity to produce creative products in Embroidery learning. The syntax stages designed in the form of formulating general questions, integrating research, exploring ideas, designing, improvising and creating creative products, presenting and evaluating have been assessed as valid and practical and can be implemented in learning.
The Effect of Tests of Higher Levels of The Cognitive Domain in Preventing Mass Electronic Fraud in Distance Education
Authors: Rasheed Al-Khafaji Abdul- Hussain Ahmed
Published: April 2022

The research tagged with (the effect of tests of the higher levels of the cognitive domain in preventing mass electronic cheating in distance education) aims to highlight the impact of tests that are formulated according to the higher levels of the cognitive field in undermining mass electronic cheating by a large percentage in light of the COVID-19 pandemic, as the researcher adopted The experimental method in its experiment on three divisions of the second stage for students of the Arabic language department in the College of Basic Education / University of Diyala. He was alone in formulating the monthly tests for the two experimental groups that he is studying, and the final test for the semester after being presented to the teaching of the control group. 168) by (56) for each of the two experimental groups and the control group. It adopted the appropriate statistical means, and after analyzing the results statistically, the researcher concluded that the first experimental group outperformed the second experimental group in all the monthly tests and the final test, and the first and second experimental groups outperformed the control group who performed the tests in the usual format.
EKONOMİK VE KURUMSAL FAKTÖRLERİN KEİ ÜLKELERİNİN LOJİSTİK PERFORMANSINA ETKİSİ
Authors: KAHVECİ Şükran
Published: April 2022

Bu çalışmada, Karadeniz Ekonomik İşbirliği (KEİ) örgütüne üye (Arnavutluk, Azerbaycan, Bulgaristan, Ermenistan, Gürcistan, Moldova, Kuzey Makedonya, Romanya, Rusya, Sırbistan, Türkiye, Ukrayna ve Yunanistan) ülkeler için ekonomik ve kurumsal göstergelerin lojistik performans düzeyine etkisi incelenmiştir. Bu amaçla, 2007, 2010, 2012, 2014, 2016 ve 2018 yılları için GSYH, dışa açıklık net doğrudan yabancı sermaye yatırımı (DYY) girişleri ile ifade özgürlüğü ve hesap verebilirlik, hükümet etkinliği, düzenleyicilik kalitesi, hukukun üstünlüğü, yolsuzluğun önlenmesi, siyasi istikrar ve şiddetsizlik değişkenlerinin lojistik performans düzeyine etkisi tesadüfi etkili model ile araştırılmıştır. Ampirik bulgulara göre, KEİ ülkelerinde ekonomik büyüklük, dışa açıklık, hükümet etkinliği, düzenleyicilik kalitesi, hukukun üstünlüğü, yolsuzluğun önlenmesi değişkenleri, lojistik performansı pozitif yönde, net doğrudan yabancı sermaye yatırımı girişlerinin ise negatif yönde etiklelerken, ifade özgürlüğü ve hesap verebilirlik, siyasi istikrar ve şiddetsizlik değişkenlerinin ise lojistik performans düzeyini üzerinde herhangi bir etkisine rastlanmamıştır.
SAĞLIK HARCAMALARINI ETKİLEYEN FAKTÖRLERİN DİNAMİK PANEL VERİ ANALİZİ İLE İNCELENMESİ
Authors: ÇALIŞKAN Gülçin , SANİSOĞLU Yavuz
Published: April 2022

Bu araştırmanın amacı gelişmiş ve gelişmekte olan ülkelerde sağlık harcamalarının belirleyicilerini ve zaman içerisindeki değişimini incelemektir. Çalışmada 2006-2015 yılları arasında 164 ülkenin verileri yer almaktadır. Toplam sağlık harcamalarının büyüme, demografik yapı, hastalık yapısı, beslenme yapısı ve dış kaynaklar gibi faktörlerle olan ilişkisi dinamik panel veri analiz yöntemiyle incelenmiştir. Bununla birlikte kamu sağlık harcamaları ve cepten yapılan sağlık harcamaları için de benzer modeller oluşturulmuştur. Analiz sonucunda kurulan modellerin genel olarak anlamlı olduğu (p<0.05) görülmüştür. Analiz sonuçları ülkelerin geliri arttıkça toplam sağlık harcamalarının arttığını ve toplam sağlık harcamalarının yüksek gelirli ülkelerde gelir esnekliğinin 1’den büyük (β= 1.028) olduğunu göstermektedir. Sonuçlar, doğumda beklenen yaşam süresi arttıkça sağlık harcamalarının artacağını göstermektedir. Bu çalışma ile dış fonların yerel kaynaklardan sağlanan kamu sağlık harcamalarını azalttığı tespit edilmiş ve yetersiz beslenme ile bulaşıcı hastalıkların sağlık harcamaları arasındaki ilişkisi incelenmiştir. Ayrıca sonuçlar, kamu sağlık harcamalarının ve cepten yapılan sağlık harcamalarının farklı yollar izlediğini ve sağlık harcamalarının büyüme hızının ülkelerin gelir düzeylerine göre farklılık gösterdiğini ifade etmektedir.
Tumormarkers in clinical practice
Authors: Jain Ronak , Mehta Shefali , Mehta Aditi , Mehta Vishwa
Published: April 2022

Tumor markers are assuming a growing role in all aspects of cancer care, starting from screening to follow-up after treatment, and their judicious application in clinical practice needs a thorough understanding of the basics of pathophysiology, techniques of identification or testing, reasons for out-of-range levels of tumor markers, as well as the knowledge of evidence of their role in any given malignancy. These are, at the most, just an adjunct to diagnosis, and establishing a diagnosis on the basis of tumor markers alone (especially a single result) is fraught with associated pitfalls because of the problem of non-specificity. An ideal tumor marker does not exist. Detection can be done either in tissue or in body fluids like ascitic or pleural fluid or serum. Clinical uses can be broadly classified into 4 groups: screening and early detection, diagnostic confirmation, prognosis and prediction of therapeutic response and monitoring disease and recurrence. In addition to variable sensitivity and specificity, the prevalence of a particular malignancy may be a major determinant in the application of a particular test as a screening tool. Serum levels, in certain situations, can be used in staging, prognostication or prediction of response to therapy. Monitoring disease is, perhaps, the most common clinical use of serum tumor markers. Rising trend in serum levels may detect recurrence of disease well before any clinical or radiological evidence of disease is apparent ("biochemical recurrence"). Sampling should ideally be repeated after 5-6 half-lives of the marker in question (or the marker with the longest half-life if multiple markers are being considered); but if found elevated, the next sampling after 2-4 weeks, for additional evidence, may be justified.
A comparative study between emergency department provisional diagnoses and final discharge diagnoses in tertiary and quaternary health centers of India
Authors: Patel Priyanka , Ashta Kuldeep Kumar , Subramani Yamini , Ghosh Sumit Kumar
Published: April 2022

An Emergency Department (ED), or the Emergency Room (ER), is a specialized patient care facility in tertiary and quaternary health care centers dedicated to Emergency Medicine. The main function of which, is to take care of patients with immediate and emergent health issues. In view of limited literature on Emergency Medicine in India, a comparative study of the admission and discharge diagnoses was performed, as a baseline for future reference in continuous quality improvement.

A scientific endeavor dedicated to undertake a comparative study between the emergency department provisional diagnosis and the final inpatient discharge diagnosis, thus determining the diagnostic accuracy of the emergency medicine department in large health care centers of India.

A total of 3000 patients visiting the emergency department were considered and a comparative study was performed between the emergency department diagnoses and the final discharge diagnoses of these patients after admission to respective specialties.

In 81% cases the emergency department diagnoses was found to be concordant with the discharge diagnoses of the patients under study, and the concordance was found to be statistically significant.

According to our study, the initial diagnoses made by emergency department physicians were mostly consistent with the final diagnoses. The significance of a correct diagnosis in the emergency department is far reaching. A correct diagnosis of the disease in the emergency enables prompt implementation of desired management protocols facilitating better patient outcomes and favorable disease prognosis. However, our study also highlights the need for further improvement in the diagnostic protocols in the emergency department.
Psychological assessment of paramedical staff working in covid-19 ward
Authors: Aphale Manasi , Vivek Kirpekar , Sudhir Bhave , Rahul Tadke , Abhijeet Faye , Sushil Gawande
Published: April 2022

In a densely populated country like India, the COVID-19 pandemic poses a major concern in front of the already overworked healthcare workers. Paramedical staff deals with patients of COVID-19 throughout their stay in the hospital and hence these workers are susceptible to the psychological changes followed by this stressful exposure. If these symptoms are dealt with in a professional manner and if they receive proper care then their work efficiency will improve immensely.

A cross-sectional study was carried out in 65 consecutively selected paramedical staff including 50 nurses and 15 attendants. They were interviewed telephonically after taking their informed consent. Data was collected using semi-structured proforma, Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Statistical analysis was done using mean, chi square test.

Statistically significant difference was found between married and unmarried participants in total Ham-A score (mean score 7.75 in married and 3.85 in unmarried, P=0.0008); insomnia early in the night (28.57% in married and 61.36% in unmarried, P=0.033); anxiety psychic (76.19% in unmarried and 84.09% in married; P=0.004); anxiety somatic (61.9% in unmarried and 84.09% in married, P= 0.012); Somatic symptoms gastrointestinal (19.05% in unmarried and 61.36% in married, P=0.006); general somatic symptoms (28.57% in unmarried and 68.18% in married, P=0.006); HAM-D total score (mean score 2.90 in unmarried and 6.06 in married, P=0.0003).

1. Paramedical staff working in COVID-19 wards are susceptible for psychological symptoms; 2. Anxious mood was the most common symptom reported.
Utility of cartridge based nucleic acid amplification test in diagnosis of tubercular lymph nodes on fine needle aspiration and its comparison with zeihl-neelsen staining and concentration bleach method
Authors: Dhote Anjali R , Gaikwad Amrapali , Datar Sonali , Kowe B
Published: April 2022

Tuberculosis (TB) is one of the oldest disease known to humanity and among the deadliest epidemics and is in the top 10 causes of death worldwide. The incidence of tuberculosis in India has dramatically increased and contributing to it is Human Immunodeficiency Virus (HIV). Various diagnostic methods are available for detection of tubercular bacilli. Only full proof criteria for diagnosis of TB is to demonstrate the bacilli from affected tissue. This study was planned in extra pulmonary tuberculosis cases to evaluate different staining methods for demonstration of mycobacterium on FNAC material.

To evaluate efficacy of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) in the initial cytodiagnosis of Tubercular Lymphadenitis

147 clinically suspected cases of extra pulmonary tuberculosis mainly TB lymphadenitis who attended cytology OPD were selected irrespective of age and sex. FNAC was performed. Slides stained for PAP, ZN and concentration bleach. Material remained in hub was sent for CBNAAT. PAP stained slides were observed for various morphological pattern.

Six morphological patterns were observed. Positivity for acid fast bacilli by ZN staining, concentration bleach method and CBNAAT were compared. Detection of acid-fast bacilli by CBNATT was found more as compared to ZN and Concentration bleach method.
Varying zinc levels in pediatric nephrotic syndrome patients and its correlation with remission and relapse: An observational study
Authors: Mishra Nandita , Jaiswal Rahul , Shrivastava Anubha , Tiwari A D , Yadav R K , Maurya Manisha
Published: April 2022

Zinc deficiency, common in children of developing countries, leads to susceptibility to infections. Relapses in nephrotic syndrome are precipitated mostly by infections. Most of morbidity and mortality in nephrotic patients is during nephrotic range proteinuria. Management of factors which reduce duration of relapse, can decrease morbidity in pediatric nephrotic patients. We aimed to study serum zinc levels, in patients of nephrotic syndrome, at onset/relapse and at remission and tried to find out correlation between serum zinc levels and time to achieve remission.

Observational study was conducted in tertiary centre of North India over 12 months. Consecutive pediatric patients, with initial episode/relapse of NS were enrolled. Patients were treated as per standard protocol. Time taken for remission was noted. Serum zinc level was estimated first at confirmation of initial episode/relapse and then at remission. Data were summarized as mean ± standard deviation. Groups were compared by paired t test. Pearson correlation analysis was done to assess association between initial zinc level and time to attain remission.

68 patients were screened for inclusion in the study but only 49 qualified for final analysis. Serum zinc level was statistically different in all patients at enrolment and at remission. Pearson correlation analysis showed an insignificant and inverse correlation between time to remission and serum zinc level (r=0.14, p>0.05) suggesting that, as serum zinc level at enrolment decreases, the time to remission lengthens.

Zinc level at initial episode/relapse was found to have negative correlation with time to attain remission.
A cross sectional study of correlation of serum ferritin levels with NIHSS scoring scale in patients of acute ischemic stroke
Authors: G Madhu , Shivakumar Hrishikesh , Durairaj Anugraha , A C Nirmala
Published: April 2022

IStroke is one of the leading causes of mortality and morbidity in the world. The National Institutes of Health Stroke Scale (NIHSS) is one of the most common stroke scale used by neurologist around the world. Serum Ferritin is an acute phase reactant, which increases during acute conditions like inflammation and also in vascular events.

This is a study that correlates the S.Ferritin levels with NIHSS scoring scale to assess the severity of stroke, which can also be used as an adjuvant tool for better assessment of severity of stroke in patients, which further helps in improving the management of patients with stroke.

This study aims to estimate serum ferritin and the NIHSS stroke scale in patients with acute ischemic stroke, and then to correlate serum ferritin with NIHSS stroke scale.

A cross sectional study was done during the period of November 2017-May 2019 in hospitals affiliated to Bangalore Medical College & Research Institute , Bangalore on 106 patients with acute ischemic stroke at the time of admission. NCCT brain was done and Serum Ferritin levels determined for patients who fit into the inclusion and exclusion criteria. Data was analyzed using SPSS 21.0 software by descriptive statistics in the form of mean values, standard deviation and percentages. Chi Square test was used for association of qualitative variables.

There was linear increase of S.Ferritin with increase in severity of stroke ( As determined by NIHSS scoring scale). It was a found that male sex had a higher increase in S.Ferritin levels compared to females, with statistically significant correlation. It was also found that the maximum number of patients with increase in S.Ferritin levels belonged to severe stroke category.

As there was a linear increase of S.Ferritin with increase in severity of stroke (NIHSS scoring scale), we can conclude that Serum Ferritin level had a positive correlation with the severity of ischemic stroke indicating that S.Ferritin levels can also be used as an adjuvant tool for assessing the severity of stroke along with other tools and facilitate adequate and timely management of these patients.

S Ferritin can be used as a Prognostic marker in predicting the severity of Acute Ischaemic stroke.
Perception among undergraduate medical students towards health research methodology & publications in a tertiary care hospital of Assam
Authors: Ullah Md Kalim , Dutta Bhaskar J , Ullah Md Alim , Chakravarty Pinaki , Adak Karabi
Published: April 2022

Research experience gained by medical students during their under graduate tenure plays a significant role in their future endeavours in the field of medical research. The aim of the present study was to assess the level of knowledge about attitudes regarding biomedical health research and publications among medical students.

: A cross-sectional descriptive study was conducted and randomly selected among 200 undergraduate medical college students of Tezpur Medical College, Tezpur, Assam in 2018 to access the knowledge about their attitudes on health research and scientific publications. A prefix pretested proforma was employed to assess the knowledge and attitudes of the students. Informed consent was duly taken. The data thus obtained was then analyzed using MS Excel.

: Among the 200 study participants, only 70(35%) students feel confident in interpreting and writing a research paper, and 135(67.5%) students feel lack of their knowledge on research methodology and is the cause of less publication & research, while 102(51%) and 120(60%) says lack of senior’s knowledge and mentors respectability is the cause of less publication. Interestingly only 5(2.5%) participants had published in journals and 195(97.5%) says that they were never written any scientific paper. Majority of students 174(87%) had not participated in a research project (apart from mandatory academic projects). A good number students do feel that lack of funds and facilities, and mentorship are important causes of no publication and research in medical colleges.

Medical colleges should emphasize more on health research among the undergraduate students. There is a need to reform the medical curriculum with more weightage towards research methodology awareness, workshops and plannings in order toimprove the situation in the field of medical education and research.
Endometrial Fluid study for prevalence of tuberculosis by testing for diagnosis by CB NAAT culture
Authors: Gupta Mitali , Tripathi U , katare Neha , Singh Saurabh Kumar
Published: April 2022

The frequency of Genital TB is 0.69% in evolved nations and 19% in non-industrial nations. The fallopian tube is most regularly influenced followed by endometrium and cervix. It is optional to TB concentrate somewhere else in body brought about by Mycobacterium Tuberculosis. History of essential fruitlessness in a lady whose assessment uncovers no evident reason and gives family ancestry or individual history of TB emerges doubt of genital TB.

1: To study the prevalence rate and risk factors for endometrial TB in infertile females; 2: To study clinical and reproductive profile of women diagnosed with endometrial TB; 3: To study the importance of CB NAAT over other diagnostic tests in diagnosing TB.

Hospital based cross sectional study done on 100 subjects for one and a half year (June 2017 to July 2019).

Labour room. Minor OT. OPD

2-5 ml endometrial fluid was retrieved on day 1/2 of menses using pipelles cannula. It was transferred to falcon tube and CB NAAT analysis was done using cartridge.

Out of 100 cases, 4 were detected to be positive for endometrial TB. Out of them, 3 fell in age group of 30-39 years; all belonged to upper middle socioeconomic status. 3 cases had achieved menarche at >14 years of age and one had oligomenorrhoea.

Number of patients testing positive for endometrial TB by CB NAAT Culture.

Genital TB is a major cause of infertity and is generally underestimated because of asymptomatic nature of infection and diagnostic challenges. Large multicentric studies are needed to estimate the magnitude of female genital TB. Our study confirmed the usefulness of CB NAAT compared to Chest X-ray and smear microscopy for early diagnosis of suspected endometrial TB. Its simplicity, sensitivity, speed and automation makes this technique a very attractive tool for diagnosis of mycobacterial TB.
Neuro-development of high-risk newborns- An experience from rural tertiary care center of Western India
Authors: Modi Prashant , Pathak Sunil , Kanara Devangi , Rasania Manish , Shah Manasi , Patel Shailee
Published: April 2022

Neurodevelopment of an infant is affected by various factors like birth weight, perinatal events, environmental factors, psychosocial, socioeconomic condition, genetic, racial and nutritional factors, and hypoxic ischemic Encephalopathy following perinatal Asphyxia. Timely and appropriate intervention can modify many of these disabilities.

: To assess the neurodevelopmental outcome of high-risk neonates discharged from NICU.

80 Babies, discharged from NICU were followed up to the one year, and their Neurodevelopment assessment was done at 6 and 12 months of age by using DASII. Babies were diagnosed as delayed development if development quotient of < 70% was found. Associated risk factors like birth weight, gestational age at birth, perinatal events and course during NICU stay were analyzed.

: Mean DMoQ and DMeQ and overall DQ at 6 month were 81%, 82%, 81.5% and at 12 months of age 85%, 86%and 85.5% respectively. Out of 80 patients, 16(20%) babies had development delay at 6th months and 10(12.5%) at 12 months. 16(20%) babies with delayed development at 6 months had DMoQ 46.2+14.7, DMeQ 42.7 +13.8 and Mean DQ of 44.5 +14.3. 10(12.5%) babies with delayed development at 12 months had DMoQ 65.5+15.5, DMeQ 61.6+16.5 and mean DQ of 63.5 +14.1. 9 out of 10 babies having delayed development at 12 months had birth asphyxia at birth.

: We concluded that Incidence of neurodevelopment delay among high-risk infant is significantly high in babies with birth asphyxia, HIE and seizure. An appropriate follow-up program is helpful in early detection of development delay.
Thyroid dsyfunctions in down’s syndrome
Authors: Wagh Prashant S , Kashyape Subhash , Wagh Swati
Published: April 2022

Down’s syndrome is one of the common chromosomal abnormalities seen. Also means yes having thyroid dysfunctions would be better than neonatal having thyroid dysfunction. The patients having Down’s syndrome are having thyroid dysfunction and the children having down’s syndrome are at higher risk to have thyroid dysfunction and these children are having both the hypothyroidism and hyperthyroidism.

The present study aims at identifying the thyroid dysfunctions among the patients having Down’s syndrome.

: The present study is an observational study which is being conducted in tertiary care hospital from March 2018 to June 2019. In this study 80 neonatal having Down’s syndrome were being examined and the thyroid function tests are being performed on the patients for identifying the prevalence of thyroid dysfunction in patients with Down’s syndrome. The patients are being selected on the basis of inclusion and exclusion criteria.

In the present study it is being found that 56% of the patients were having normal thyroid function and 44% were having abnormal thyroid function. TSH value of the patients having abnormal thyroid function is significantly higher as compared to the patients having normal thyroid function. The mean of FT3 (pg/ml) among the patients having normal and abnormal thyroid function was found to be 2.9±0.4 and 2.5±0.9 respectively and the mean of FT4 (pg/ml) among the patients having normal and abnormal thyroid function was found to be 14.9±8.4 and 2.5±0.9 respectively 13.5±7.9.

The study concluded that there is a significant impact of down syndrome on the thyroid function and the patients having down syndrome are at higher risk of thyroid diseases as it is found that the patients having down syndrome are having abnormal thyroid function and higher TSH value.
Effect of lockdown on children during COVID-19 pandemic–A cross-sectional study
Authors: Sahoo Bishnupriya , Varshney Mohit , Khurana Ruparna , Kumar Guresh , Dhingra Himani , Richa  , Yadav Daksh , Kaur Jasleen , Kapur Satyakiran , Abrol Pankaj
Published: April 2022

: COVID-19 infection and the pandemic have crippled the global life. Direct effects of infection and its severity among children were yet to define, but its indirect effects and associated consequences were significant but largely unknown. Aim of the current study was to address the impact of lockdown on food attitude, physical activity, sleep pattern, functionality and anxiety level among children of 6-18 years age.

Cross sectional study was conducted by the help of web based performa circulated to the parents as survey. It was a predesigned structured questionnaire based upon the published study in relation to sleep, food habit, anxiety, physical activity and overall wellbeing.

Total 206 children were enrolled, with mean age of 11.54 ± 4.2 years. They grouped as those below 10yrs and 10 or above and the body weight as normal against overweight or obese. 70% of children were 10 or more and 20% being overweight or obese. The bad eating habits [AFHC, OR], poor physical activity [UKPAQ, OR] and severe anxiety [GAD-7, OR] is significantly affected among the overweight or obese group (p<0.01). Children of ≥ 10 years group showed poor physical activity [OR, p 0.05]. Parenteral concern was noted in.

Presumption of less vulnerability of children to COVID-19 needs a revision. During lockdown the poor physical activity, higher anxiety, and unhealthy diet pattern were significantly observed. Its emphasized to develop and adopt holistic approaches to guide our young generation during this uncertain COVID-19 pandemic or similar situations in future.
Evaluation of suspected adverse drug reactions of oral anti-diabetic drugs in a tertiary care hospital of Bihar, India: An observational study
Authors: Kumar Pankaj , Hameed Saajid , Kumar Manish , Mohan Lalit , Dikshit Harihar
Published: April 2022

Diabetic patients generally require life-long treatment and continuous follow up. In spite of their benefit of achieving glycemic control, there are many safety concerns with antidiabetic drugs such as gastrointestinal side effects, metabolic complications, central nervous system (CNS) symptoms, musculo-skeletal problems, genito-urinary disorders like UTI, development of peripheral oedema, weight gain etc.

To highlight pattern of Adverse Drug Reactions with use of oral anti-diabetic drugs.

All suspected Adverse Drug Reaction Reporting Form having any anti-diabetic drug as suspected cause of ADR were collected. The reported ADRs on the notification forms, after being confirmed by the physician-in-charge, were assessed for causality using WHO-UMC Causality Categories14, preventability using Modified-Schumock and Thornton scale15 and severity using Modified Hartwig and Siegel scale.

: The data from the forms was presented in tabular form and data will be interpreted by using Microsoft Excel 365 software.

Adverse drug reaction related to gastrointestinal system were most reported ADRs (41.31%). Among GI adverse events, nausea was mostly reported ADR and it was mostly associated with DPP-4 inhibitors. Hypoglycemia was most frequently observed in patients taking sulfonylureas. Causality assessment according to WHO-UMC criteria showed 61.68% ADRs had probable causality while 37.43% had possible causality and only 0.90% had certain causality. Most of the ADRs in our study were non-preventable (57.78%) & were of mild to moderate grade.

Hypoglycemia continues to be major concern in patients taking anti-diabetic medications and sulfonylureas were commonest drugs responsible for it. As anti-diabetic medication is generally taken for lifetime, the risk of development of adverse effects related to concurrent related co-morbidities of patients shouldn’t be ignored while prescribing. The physician should report these adverse effects to ADR monitoring centre, so that proper signal could be generated for the welfare of the society.