bluuebunny/crossref_metadata_2025 huggingface dataset:
Seismic Performance Evaluation of Stone Masonry Houses Constructed with Reinforced Concrete Bands
Authors: Maharjan Anju , Parajuli Hari Ram
Published: August 2020

The research work was aimed evaluating the newly built stone masonry houses with mud mortar and with the provision of horizontal reinforced concrete (R.C.) bands. Two recently built stone masonry houses of different geometry were selected, modeled, and analyzed to investigate the seismic performance of stone masonry houses constructed with horizontal bands. Linear time history analysis was used and performance of the selected buildings was checked with the help of various numerical models. The top roof displacement, maximum drift ratio, base shear, and shell stress were compared between two selected models using three earthquake time histories. The fragility curves were also developed to identify the probability of the failure of the buildings at different peak acceleration values using three earthquake time histories.
A Review on the Mechanism of Reservoir-Induced Seismicity for Nepalese Context
Authors: Joshi Umesh Raj , Maskey Ramesh Kumar , Kafle Kumud Raj
Published: August 2020

Over 90 cases of Reservoir Induced Seismicity have been recorded around the earth. The magnitude was varying from 3.0 to 6.3 on the Richter scale. A Reservoir Induced Seismicity (RIS) can increase the frequency of earthquakes in seismically active zones and cause a shock in seismically inactive zones. Nepal is situated in a seismically active zone with six large earthquakes of magnitude equal to or greater than 7.6. It increases the risk of RIS, while several storage-type hydropower projects are being proposed in Nepal. Seismic activities recorded around the Kulekhani-I reservoir could be a reservoir induced seismicity. However, consistent data of seismic events and reservoir levels during all phases of filling or drawing of water level is missing. This paper reviews the researches on seismic activities caused by reservoirs or tectonic movements, and the need for the study on the mechanism of RIS for the Nepalese context is identified.
DEVELOPMENT OF BONDING AGENT USED IN FRP STRENGTHENING SYSTEM
Authors: Abdulla Al-Safy Rawaa
Published: August 2020

Fiber Reinforced Polymer (FRP) composite is an attractive material for strengthening various civil infrastructures. The strengthening system that based on FRP composites consists of many elements. These are: strengthening material (FRP), strengthened element (concrete, steel, wood, etc) and bonding agent. The latter is the most important elements which affect the performance of the whole strengthening system. Different types of bonding agent are used based on service conditions. Epoxy-based adhesive (EBA) is the most commonly used to strengthen concrete or steel structures. Due to the limitations of the application of EBA, cement-based adhesive (CBA) is utilized as an alternative bonding agent. The CBA have been developed by modifying its properties. The modification was conducted using different powder-state materials or by magnetic water treatment. The development of bonding agent that used in FRP strengthening system is addressed in this paper in order to highlight the most modern bonding agent which consider as a promising material to employ in the actual outdoor structures.
STUDY AND ANALYSIS OF INTRA-CELL INTERFERENCE AND INTER-CELL INTERFERENCE FOR 5G NETWORK
Authors: Abdallah Jazea Najim , Abood Kadim Hayam , Hasan Sallomi Adheed
Published: August 2020

In mobile networks, such as fifth generation (5G), the appealing characteristics of the small cells, like easy deployment, affordable, and low power usage, have led to improvement of Heterogeneous Network (HetNet) technique. In HetNet, the restricted resources are usually shared by the small cells, that in turns results in an interference issue challenges. The latter may be regarded as the main barrier for appropriate HetNet performance. In this paper, both Inter Cell Interference and Intra Cell Interference are studied and evaluated for Al-Najaf governorate 5G network. The network performance was investigated before and after interference mitigation. The simulation results are dependent to evaluate the effectiveness of all approaches and schemes that are implemented to cope with both inter and intra cell interference. The simulation of the network is performed by the aid of Integrated Communications System (ICS) telecom software. In Inter-Cell Interference, in term of modulation, it obviously shows that higher modulation occupies only small portion of the covered area due to interference. The modulation scheme 64 Quadrature Amplitude Modulation (QAM) 3/4 occupies 13% from the total covered area with omni profile, while this scheme is being missed with 4-sectors profile due to interference. Intra-cell interference is materialized as Inter Carrier Interference( ICI) and Inter Symbol Interference(ISI), the effect of Cyclic Prefix( CP) on the network performance in terms of ICI is tested based on the simulation of the 3D reflection paths; for the adopted test area, the interfered area equals to 27.06% km2 according to 5.7μsec guard interval, while the interfered area is reduced to 6.42% km2 according to 11.4μsec guard interval. The interfered area is reduced by 21% due to ICI when the CP is extended from 5.7µsec to 11.4µsec. CP adopted in this work equals to (1/8), which is the mostly used.
PROTECTION LOW CARBON STEEL FROM CORROSION USING COATING PROCESS
Authors: Abdulraoof Abdulrazzaq Mohammed , Doshan Kadhim Zeyad
Published: August 2020

In this research work, samples of low carbon steel AISI 1017 subjected to shot peening process for 15 minutes. These samples were cleaned and coated with epoxy. The coating process were carried out with epoxy, epoxy mixed with alumina powder, epoxy mixed with silicon carbide powder and the last case, the steel coated with epoxy mixed with alumina and silicon carbide powders. Results showed that the corrosion resistance of steel coated with epoxy and alumina were better as compared with other samples .
URBAN PROPERTIES IN CONSTRUCTING THE FUNCTIONAL DEVELOPMENT REGIONS IN IRAQ
Authors: حافظ جواد حسين نهلة
Published: August 2020

In spite of the efforts exerted in the previous studies in limiting the regions in Iraq, but these studies were specialized in limiting regions that were closer to the traditional geographical divisions, as the standard of harmony is one of the standards used in the regional division , also administrative divisions which are not useful in specific conditions to be as main  component for limiting the developmental regions, as an issue which is to be considered, because these governorates vary in their administrative parts, and this is the problem of the study. Thus the hypothesis of the study was based on that the method followed in classifying and planning the functional regions map in Iraq, in the light of what the previous studies had stated, had depended on the standard of the topographic and social harmony, as a result it does not differ from the method which was followed in carrying out the process But the aim of the study was concerned with limiting the developmental regions in accordance with the characteristics mentioned above  included the applied aspect of the study by adopting the standards of the

discriminative properties  for the regions , which are amounting to (81) region, and which represent the urban properties, and to divide Iraq into four developmental regions, by using the factorial analysis pattern as one of the quantitative patterns in the analysis, then to find a group of the discriminative properties factors which each one of them is distinguished by and the benefit of these factors is clarified in the possibility of comparing the regions with each other, and finally the conclusions which stated the properties of each region, and its similarity with the other regions, which adds the feature of comparison among these factors, besides knowing the nature of the spatial gathering for the standards of the discriminative properties of regions, as the results of the matrix of the abstracted factors for the collection of urbanization properties, had shown the consolidation status and similarity in the urbanized properties in the southern region.
URBAN INSTALLATIONS AND THE ACTIVATION OF URBAN SPACE
Authors: حيدر الجوادي مقداد , ابراهيم محمود أسيل , جاسم عبود ايلاف
Published: August 2020

Received The ability of the arts to influence life in public places certificate great attention is unprecedented to it. There have been many attempts to invest art and culture in a set of integrated strategies, which through its vitality and strong diversity can drive the urban transformation of societies. Recently, there has been a growing interest in Environmental art works, especially Urban Installations, which represent the contemporary image of environmental art and an important and influential component of urban space, which can play an active role in the activation of neglected and undesired urban spaces. Locally, Baghdad, like other cities, suffers from neglected urban spaces that need to be activated. In the light of the revolutions and wars taking place in this city, its urban spaces have suffered from neglect. Therefore, the idea of ​​research emerged from the desire to activate and revive these spaces within contemporary urban trends and to re-activate them within the general fabric of the city by finding the appropriate relationship between art and architecture on the one hand and contemporary requirements of space users on the other. The research dealt with the definition of environmental art and its Urban Installations to build a knowledge base that contributed to the defines of the research problem, "the lack of clarity about the possibilities of Urban Installations in the activation of urban space."
MOBILE ROBOT MOTION CONTROL BASED ON CHAOTIC TRAJECTORY GENERATION
Authors: Ibrahim Majeed Ammar
Published: August 2020

This paper introduces chaotic motion control of autonomous differential drive wheeled mobile robot to cover a certain surrounded area completely and as fast as possible. The suggested method was based on utilization of chaotic logistic map to accomplish a complete coverage of entire area. The trajectory is created by a microcontroller and fed to the designed robot using the proposed chaotic trajectory generator. The designed robot was occupied with infrared sensors to avoid the unforeseen obstacles during the navigation. The mathematical model of the designed robot and the motion control strategy were described in details. Computer simulation tests as well as the practical tests by using the designed robot show satisfactory results and confirm the success of the proposed method.
TOLERANCE OF UNCERTAINTY AND EXECUTIVE DYSFUNCTION IN PEOPLE WITH PSYCHOLOGICAL TRAUMA
Authors: Lytvyn Serhii
Published: August 2020

The aim of this study was to determine the effect of tolerance of uncertainty on the executive functions in people with psychological trauma. To study the neuropsychological correlates of tolerance of uncertainty in people with psychological trauma, 55 subjects aged 21 to 66 years (25 men and 30 women) were involved. The control sample included 56 subjects aged 22–67 years (21 men and 35 women). Research methods: "New questionnaire of tolerance-intolerance of uncertainty", "Iowa Gambling Task", Clinician-Administered PTSD Scale for DSM-IV (CAPS-DX), Method of verbal-color interference (Stroop test). Results: psychological trauma causes a decrease in the level of tolerance of uncertainty (ToU), an increase in the level of intolerance of uncertainty (IoU) and an increase in the level of interpersonal intolerance of uncertainty (IIoU). ToU can be seen as a protective factor in the case of psychological trauma. ToU can alleviate the manifestations of executive dysfunction (when treating both ambivalent and indeterminate stimuli) in people with a history of psychological trauma. IoU can be considered as a psychological construct that interferes with the normal functioning of executive functions in the control group (persons without a history of psychological trauma). Psychological trauma causes an increase in the level of IIoU in a way that is not associated with executive dysfunction.
SUBMICROSCOPIC CHANGES OF STRUCTURAL COMPONENTS OF THE SPLEEN DUE TO THE ACTION OF MONOSODIUM GLUTAMATE
Authors: Harapko Tetiana , Mateshuk-Vatseba Lesia
Published: August 2020

The results of an experimental study conducted on white male rats and females of reproductive age were analyzed in order to detect submicroscopic changes in the structural components of the spleen under the action of monosodium glutamate in the dynamics. For two, four, six and eight weeks, the animals received monosodium glutamate at a dose of 0.07 g / kg body weight daily with food. Sections of the spleen were made on a UMTP-6M ultramicrotome with a diamond knife (DIATOM) and double contrast was performed according to Reynolds and uranyl acetate. Submicroscopic examinations of the organ were performed using an electron transmission microscope TEM-100. The investigated material was photodocuted using a SONY – H9 digital camera. The first violations of the structural components of the spleen are observed after two weeks, namely the expansion of intercellular spaces in both white and red pulp of the spleen, which contain vacuole-like structures, an increase in plasma cells, the cytoplasm of which is filled with dilated tubules. In dynamics with increase in duration of reception changes deepen, reaching a maximum in 8 weeks of experiment. Electron microscopy revealed that the signs of adaptive-compensatory processes by the end of the experiment lead to a loss of regenerative function.
ЧИННИКИ, ЯКІ ВПЛИВАЮТЬ НА СМЕРТНІСТЬ ХВОРИХ НА СИСТЕМНИЙ ЧЕРВОНИЙ ВОВЧАК (ПРОСПЕКТИВНЕ ДОСЛІДЖЕННЯ)
Authors: Abrahamovych Ulyana , Abrahamovych Orest , Dutka Roman , Farmaha Marta , Guta Solomiia
Published: August 2020

Вступ. Системний червоний вовчак супроводжується ураженням життєво важливих органів та систем і суттєво знижує тривалість життя хворих. Були спроби виокремити основні чинники, які погіршують прогноз хворих та збільшують ризик смерті, однак отримана інформація часто була фрагментарною, результатом аналізу лише поодиноких чинників, а деколи суперечливою.Мета дослідження. Виявити чинники, які впливають на смертність хворих на системний червоний вовчак.Матеріали й методи дослідження. У рандомізований спосіб із попередньою стратифікацією за наявністю системного червоного вовчака у проспективне дослідження залучено 294 хворих. Дослідження проводили у два етапи: перший етап, який складався з трьох послідовних кроків, де на першому кроці ми аналізували інформацію з паспорта хворих, на другому – наявність критеріїв ACR, а на третьому – наявність патогенетично асоційованих із СЧВ уражень органів, присвячений аналізу тих виокремлених на кожному кроці   чинників, які впливають на виживання хворих на СЧВ; другий етап присвячений виявленню констеляцій ознак, які найбільш вагомо впливають на ризик смерті.Результати дослідження. Чинниками, що збільшують смертність хворих на СЧВ, є чоловіча стать, вік  (молодші за 42,5 років), протеїн- та циліндрурія, судоми, лімфопенія, вовчаковий антикоагулянт, також наявність міокардиту, пневмоніту, автоімунного гепатиту, асептичного некрозу кісток та хронічного карієсу, проте найбільш вагомим є поєднання чоловічої статі, збільшеної маси тіла понад  92,5 кг та автоімунного гепатиту.
THE FIRST STAGE RECONSTRUCTION OF THE SOFT TISSUE DEFECTS OF GUNSHOT WOUNDS
Authors: І. П. Хоменко  , К. В. Гуменюк  , Є. В. Цема  , Р. М. Михайлусов  , С. В. Тертишний  , О. М. Попова
Published: August 2020

The aim. To investigate and used a multimodal diagnostic scheme during the first stage of reconstructive surgical treatment of wounded with soft tissue defects at the second level of medical care.Materials and methods. By identifying thermographic areas with gunshot wounds of the soft tissues, we observed at the second level of medical care during 4 months of 2020 (from March to July) 37 cases.Results. We used a multimodal scheme in the pre-, intra- and postoperative period helps to reduce the area of defects in 23 (62.2%) cases out of 37 against the background of restoration and preservation of microcirculation in the damaged structure, and the number of subjectively unsatisfactory military personnel in 4 (12.8%) of the total the number of wounded, a decrease in the loss of functional ability in 19 (51.2%) cases.Conclusions. The combination of dynamic digital thermography in combination with an audio doppler at the second level of medical care can improve the quality of primary surgical treatment by performing surgery with clear indications of the proposed technique; maintain a larger volume of viable tissues, reduce the area of the defect and the number of complications in the further treatment of the wounded.
PATHOGENETIC ASPECTS OF INFERTILITY IN WOMEN OF REPRODUCTIVE AGE WITH OVARIAN VARICOCELE
Authors: Astakhova O. V.
Published: August 2020

To date, the problem of reduced fertility is quite relevant. At the same time, it should be noted that the effectiveness of infertility treatment, even with the use of the latest techniques, tools and drugs does not exceed 35-40%. This can be explained by insufficient study of a number of causes that lead to impaired fertility.One of these little-known and poorly studied factors is pelvic venous plethora, in particular varicose veins of the ovaries. While anatomically similar disease in men - varicocele - is given great importance, in women, even the very existence of this pathology is controversial among some authors.All studies were conducted in compliance with the basic bioethical norms and requirements of the Declaration of Helsinki. 117 women of reproductive age (21 - 42 years) with infertility of functional genesis were examined.According to the results of the analysis, the clinical and anamnestic features of women with infertility and ovaric varicocele are increased proportion of patients with intellectual differentiation and psycho-emotional and physical stress, high frequency of infectious diseases with acyclic uterine bleeding, dysmenorrhea and premenstrual. Changes in the anatomical and functional state of the pelvic organs and venous system in women with infertility and ovarian varicocele have been established. It was found that the hormonal profile of women with infertility and ovarian varicocele is characterized by a decrease in estradiol and progesterone. A pathogenetically sound algorithm for the diagnosis and treatment of women with infertility and ovarian varicocele has been developed, which is based on clinical data and the results of instrumental methods of examination.
THE EFFECTIVENESS OF CILOSTAZOL IN PATIENTS WITH GENERALIZED ATHEROSCLEROSIS
Authors: Motsak Tetiana , Lizogub V. G.  , Kupchynska O. G.  , Bugaytsev O. O.
Published: August 2020

The aim of the study is to investigate the effectiveness of cilostazol in patients with generalized atherosclerosis (GAS).A comprehensive examination of 65 male patients with proved GAS was performed (lesions of the lower extremities, carotid, mesenteric, coronary, cerebral arteries) and 28 healthy males (comparison group - CG) aged over 60 years. Patients with GAS consisted of 2 groups: GAS1 - patients in addition to basic therapy received cilostazol (C; 100 mg 2 times per day); GAS2 - placebo. Patients with GAS showed a significant deterioration in blood flow (decrease in its volumetric blood flow - FV, increase in peak systolic velocity - PSV) in all studied arteries, episodes of myocardial ischemia according to daily ECG monitoring, decreased cognitive function (CF). In patients with GAS1 on the background of taking C observed improvement (p<0,001) blood flow in the studied arteries (increase in FV and decrease in PSV), decrease in the number and duration of episodes of myocardial ischemia (p<0,01 and p<0,05, respectively), increase distances of painless and maximum walking distance (p<0,01), improvement of CF. The data obtained indicate the effectiveness of C as part of complex therapy in patients with GAS and expediency of further research in this direction to clarify the criteria for its appointment to such patients.
INPUT- AND OUTPUT-BASED GRAMMAR INSTRUCTION IN TEACHING ENGLISH AFTER GERMAN
Authors: Danylenko Oksana
Published: August 2020

The article dwells on the peculiarities of instruction and the role of input and output for teaching English grammar to prospective teachers of foreign languages whose major and first foreign language is German. The aim of the survey is to analyze approaches to designing instruction for the second language grammar teaching and develop activities providing effective teaching of the grammar of English for the students with previous experience in learning German as their first foreign language. The emphasis is made on the usage of processing instruction for presenting target forms that entails input-based instruction as a means for transfer enhancement during grammar teaching and a model raising students’ grammar comprehension. As far as production skills constitute one of the aspects of our investigation, we investigated the role of output-based instruction. Grammar teaching deals with grammatical forms and their usage in a particular context. Thus, developing input-based and output-based grammatical activities, we suggested activities that demonstrate the grammatical form and clarify its structure, provide possibilities for comparison of grammatical structures in English and German. The proposed output-based task provides productive grammatical skills development. The focus on form is supported with tasks explicating meaning. Consequently, the connection between grammatical form and its meaning in a certain context is provided. Tasks are communicatively oriented.
ВИКОРИСТАННЯ СУЧАСНИХ МЕТОДІВ ЗАКРІПЛЕННЯ ВИВЧЕНОГО МАТЕРІАЛУ ДЛЯ РОЗВИТКУ У СТУДЕНТІВ КОМУНІКАТИВНИХ КОМПЕТЕНЦІЙ ТА НАВИЧОК КОНСУЛЬТУВАННЯ
Authors: Novykova Larysa , Bilan Olga , Kukhar Olexander
Published: August 2020

The article considers the modern approach to the consolidation of new knowledge and the formation of consulting skills of students-pharmacists, particularly the use of interactive methods and modern gadgets for homework completion to ensure the development of communicative competencies.
Study on the Administration Method of Combining Tetrandrine with Adriamycin to Reverse Drug-Resistance of Leukemia
Authors: Chen Baoan , Zhou Fang , Cheng Jian , Song Huihui , Zhu Yiqian , Shi Zheng , Chen Baoan
Published: August 2020

Increasing drug efflux pumps (P-gp) on the cell membrane due to the overexpression of MDR1 gene in
tumor cells is the main mechanism of multidrug resistance of cancer cells. P-gp belongs to the ATP-binding
cassette family and functions as a transmembrane efflux pump that translocates chemotherapy drugs from
an intracellular to an extracellular domain; thus, it is impossible to achieve efficient drug accumulation in
tumor cells. Tetrandrine (TTD) has been shown in both in vitro and in animal experiments to reverse MDR
by reducing the expression of MDR1 mRNA and P-gp. However, the effect of administration of TTD one
week before chemotherapy is not ideal in the current clinical trials. In view of the previous in vitro and
animal experiments have confirmed the effect of TTD in reversing the drug resistance of leukemia, this
study returned to the cell experiment, selected K562 and K562/ADM cell lines as the research object,
through different ADM combined with TTD administration sequences, to detect the inhibitory effect of
different administration sequences on cell proliferation and whether it affected the intracellular ADM
concentration, P- gp ATPase activity, MDR1 mRNA and P-gp expression levels, comparing the effect of
TTD combined with ADM different administration sequences on the reversal of MDR in K562/ADM cells.
We found that TTD can significantly antagonize P-gp-mediated ADM resistance by competitively binding
P-gp and down-regulating P-gp expression and we, therefore, conclude that the co-administration of TTD,
as a drug resistance reversal agent with ADM may be a better administration in the clinic.
Analysis of Clinical Features and Prognosis in Patients with Refractory/Relapsed Acute Myeloid Leukemia- Results from Our Center
Authors: Chen Bao-An , Li Xiaoyu , Wang Fei , Zhou Yixin , Chen Bao-An
Published: August 2020

Objective: To analyse the clinical features and survival of patients with refractory/relapsed acute myeloid
leukemia (AML) in our center, thus, to find out whether there is a trend of improvement in the survival of
these patients in the past years and to search for prognostic factors which are associated with patients’
survival.
Method: A total of 45 patients with refractory/relapsed AML were retrospectively reviewed. Clinical data,
including gender, age, FAB classification of AML, performance status (PS), cytogenetic and molecular
abnormities, complete remission (CR) duration, choices of treatment (whether to undergo hematopoietic
stem cell transplantation) before and after relapse. The Kaplan-Meier method and the Log-rank test were
conducted to determine the influence of those above factors on the patients’ survival.
Results: The mean survival time of the 45 patients with refractory/relapsed AML was (36.25±8.40) months
and the median follow up was (9±2.58) months. The one-year and two-years overall survival (OS) rate was
(40.6±7.5) % and (23.7±7.0) %, respectively. Univariate analysis results demonstrated that age (p<0.05)
and undergoing hematopoietic stem cell transplantation (HSCT) after relapse (p<0.01) were significantly
related to OS in these patients.
Conclusion: Age and whether to undergo HSCT after relapse are the key factors for the survival of patients
with refractory/relapsed AML in our center. HSCT is still an effective salvage therapy for patients with
refractory/relapsed AML. Our findings highlight the divergent outcomes of these patients and provide
evidence to support the importance of timely HSCT after relapse, which is beneficial for clinicians to make
clinical decisions in the future.
Predictive Factors Involved in Determining Response to Neoadjuvant Chemotherapy in Breast Cancer and Impact of Response on 5 Years Disease Free Survival and Overall Survival
Authors: Rehman Bushra , Rehman Bushra , Shakeel Osama , Rehman Sara , Khanum Naseera , Naheed Ruqaya , Abubakar M. , I. Khan Amina , M. Khan Huma , Chuadhary Zulqarnain , Parvaiz M. Asad
Published: August 2020

Objective: To evaluate all the known factors that may play a role in predicting response to Neoadjuvant
chemotherapy in breast cancer and to see impact of response on five years’ disease free survival (DFS) and
Overallsurvival (OS).
Material and Method: Data of 156 patients was reviewed retrospectively from January 2012 to December
2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received
neoadjuvant chemotherapy (NAC) and had no distant metastasis. The response was measured in term of
percentage reduction from 1st radiological size on presentation to final size on histopathology (of resected
specimen). Four groups were identified, complete responder (CR) (100% reduction), Responders (R) (>50%
reduction), Partial responder (PR) (<50% reduction) and Non-responder (NR). Relationship of predictive
factors with each response group was observed. Five year survival was noted for each response group.
Result: Median age of patients was 45 years (25-64 years). 67% of patients underwent breast conservation
surgery, while the rest underwent mastectomy. Mortality for whole group was 22%, and recurrence was
shown in 34% (Majority i.e. 26% were distant, while contralateral were 3%). Out of 156 patients, 25% of
patients were CR, 13% were NR, 23% were PR and 37% were R. Progesterone receptor negative and Grade
III tumors showed more complete responses. The Rest of the receptor types, including triple negative, initial
T and N stage and other clinical factors showed no impact on chemo-response. Survival was significantly
poor in NR group (45% OS, 40% DFS), while rest of three groups had comparable survival outcome, with
CR group having best survival outcome (86% OS, 80% DFS).
Conclusion: Most of factors studied did not show impact on achieving good chemo response, however good
chemo response did show better survival.
Using Social Media as a Dynamic Supplement to Traditional Teaching
Authors: Choudhary Abu , Anand Swati , Mehta Setu , Choudhary Abu , Bhesania Siddharth , Thaker Rishi , Peterson Stephen J , Mehta Parag
Published: August 2020

Covid-19 pandemic brought many changes in our lives and lead us to find new ways of didactic teaching.
Social distancing has forced us to create new methods of learning. Social media use is pervasive. It is not
just a means to connect with others, engage with news content, share information, and provide
entertainment; it is also a platform to learn. The use of social media in medical education has increased with
trainees, practitioners, and educators adopting these communication tools to facilitate learning, practice
improvement, and knowledge translation [1]. Resident doctors at a University-affiliated hospital started a
project of interpreting EKG using "WhatsApp" to provide an on-demand and dynamic platform to residents
where they can ask questions about EKGs and collaborate to learn from peers and experts. The experience
revealed that residents could participate in this learning exercise at their leisure while not constrained by
their patient-care requirements. While social media cannot replace traditional teaching, it can be used as a
supplemental tool to empower the students to get the skills they need to succeed. Such experiments are
successful with Twitter, YouTube and other platforms also. In recent times COVID forced us to use distance
learning using Zoom, WebEx or similar platforms.
Oncoplastic Management of a Giant Buschke Lowenstein Genital Tumor in a Nonimmunocompromised Patient
Authors: Simon Philippe , Rimbault M. , Paquier L. , Tooulou M. , Abboud N. , Simon Philippe
Published: August 2020

Buschke-Löwenstein tumor (BLT) is a rare but impressive and aggressive entity and is mostly associated
with Human Papilloma Virus (HPV) 6 or 11 infection in immunocompromised patients. It stands out
because of the importance of the recurrences and the risk of progression to a malignant tumor. The first-line
treatment remains local radical surgery. Other treatments are controversial, including radiotherapy,
chemotherapy, and immunotherapy. We report a new case regarding the management of a giant BLT in a
non-immunocompromised woman, treated in a three-staged approach, starting with a radical excisional
surgery, followed by a delayed reconstruction and then radiotherapy.
Recurrent Torticollis and Cervical Subluxation in a Pediatric Patient
Authors: A. Mazzola Catherine , Iqbal Hamail , A. Mazzola Catherine
Published: August 2020

Background: Atlantoaxial subluxation (AAS), also referred to as C1-C2 subluxation, is a misalignment of
the first two vertebrae of the cervical spine. AAS typically presents with a head tilt (torticollis) with limited
range of motion (ROM). Torticollis is quite common in infants, but in older children, torticollis may be an
indication of AAS.
Method: In this retrospective case study, the clinical history of a female pediatric patient diagnosed with
atlantoaxial subluxation presenting with recurrent torticollis is reviewed.
Result: The patient was initially diagnosed with torticollis during infancy; torticollis partially resolved.
However, after an ear infection, the child again developed torticollis secondary to Grisel’s Syndrome.
Despite undergoing physical therapy treatments, torticollis persisted. The patient was referred to
neurosurgery at age nine. AAS was diagnosed after a three-dimensional (3D) computed tomography (CT)
scan. The child was subsequently placed in halo-traction to reduce the C1-C2 subluxation. Once the
alignment was acceptable, the child was placed in a halo vest. However, even after several months of noninvasive cervical spine immobilization with a halo vest and hard cervical collar, the head tilt and cervical
subluxation recurred due to bone remodeling.
Conclusion: The diagnosis of AAS requires both a comprehensive physical examination and imaging
following presentation of torticollis. Understanding the etiology of the torticollis early on is critical in
preventing the occurrence of AAS after treatment.
Neoplastic Seeding in Abdominal Wall Following Radiofrequency Ablation of Colorectal Liver Metastasis: Case Report
Authors: Fernandes Reinaldo , Cano Renato , Steinbruck Klaus , Fernandes Reinaldo , D’Oliveira Marcelo , Basilio Luiza , Capelli Rafaela , Vasconcelos Hanna , Enne Marcelo
Published: August 2020

Colorectal liver metastasis (CRLM) is the most common lesion diagnosed in the liver worldwide and new
therapies have been proposed over the last decades. On the leading edge of these therapies, radiofrequency
ablation (RFA) has been increasingly applied for treatment these lesions. The procedure can be done by
percutaneous approach guided by CT, or during open or laparoscopic surgery. Although findings in
preliminary reports suggest that this procedure is both safe and effective, only a few studies have been
published. We present a 69-year-old female, previously submitted to two hepatic resections and one RFA
for treatment of CRLM, who developed an abdominal wall recurrence due to neoplastic seeding after RFA
procedure. In the published literature thus far, some risk factors have been associated with neoplastic
seeding following RFA, like subcapsular location, multiple electrode placements, multiple RFA treatments
and poor tumor differentiation grade. Technical features like access through normal liver substance and tract
needle ablation may play a role in mitigating the risk of this complication. Although it seems to be a safe
procedure, only a few retrospective papers have been published its rare complications and outcomes.
Nevertheless, patients with localized disease may benefit from surgical resection.
Imaging of the Diagnosis, Work-Up, and Treatment of Moyamoya Vasculopathy
Authors: Matthees N.G. , Hughes J.N. , Harwood M.L. , DiDomenico J.D.
Published: August 2020

Moyamoya disease is a complex phenomenon with many potential etiologies and can present with a variety of clinical manifestations. Imaging plays a crucial role in the diagnosis of Moyamoya disease, and the radiologist may be the first to suggest the disease. Either invasive or noninvasive
angiography can be used to establish the diagnosis, based on defined radiologic criteria. Once the diagnosis is established, cerebral perfusion imaging before and after a vasodilatory challenge can be used to assess cerebrovascular reserve. The definitive treatment for Moyamoya disease is
surgical revascularization with a goal to increase cerebral blood flow to tissues at risk. There are a variety of surgical options for revascularization in broad categories of either direct or indirect bypasses. Noninvasive imaging plays a key role in the evaluation of patients following surgical
revascularization to assess the effectiveness of surgery as well as for complications. Noncontrast CT or MR imaging can be used to evaluate for early postoperative complications. CTA can be used to assess the patency of bypass grafts. Perfusion imaging can be performed to assess the degree
of improvement in cerebral perfusion.Learning Objectives: Describe the imaging appearance of Moyamoya disease, identify typical postoperative findings after surgical revascularization, and recognize the complications of Moyamoya disease and its treatments.
Prevalence Of Musculoskeletal Disorders In Patients Undergoing Haemodialysis in a Tertiary Care Hospital: A Cross-sectional study
Authors: Jayaprakash Sanjaitha , Anap Deepak B.
Published: August 2020

Background: Chronic kidney disease (CKD) is a significant public health problem. Dialysis is the mainstream method of treatment in these patients. This causes the patients to have a monotonous and restricted daily life, joint pain, limiting their activities after treatment onset. Hence this study was carried out to find the prevalence of common musculoskeletal disorders in patients undergoing haemodialysis in a tertiary care hospital.

Method: 50 participants undergoing dialysis in a tertiary care hospital under the age group of 18-70 years diagnosed with stage V CKD were included using convenient sampling. They were assessed using Nordic Questionnaire to locate the different areas of pain.

Result: The first group consisted of 41 participants who underwent dialysis from 2- 41 months. Body regions commonly affected in the last 7 days were low back 25(60.97%); neck 21(51.21%); shoulder 15(36.58%); elbow 14(34.14%) in the extremity with arteriovenous fistula; upper back 14(34.14%); hips/thighs, knees 9(21.95); wrist/hands 7(17.07%) in the extremity with arteriovenous fistula; ankle/feet 6(14.63%). The second group consisted of 9 participants who underwent dialysis from 42-84 months. Body regions commonly affected in the last 7 days were low back 8(88.88%); upper back 7(77.77%); hip/thigh 6(66.66%); neck, knee 5(55.55%); elbow 4(44.44%) in the extremity with arteriovenous fistula; shoulder, ankle/feet, wrist/hands 3(33.33%).

Conclusion: The study concluded that the highest prevalence of musculoskeletal disorders in the participants undergoing haemodialysis was low back pain (66%) followed by neck (52%), upper back (42%), shoulder (36%), elbow (36%), hips/thighs (30%), knees (28%), wrist/hands (20%) and ankle/feet pain (18%).
Prevalence of trismus in HNF Cancer patients undergoing radiation therapy: A cross-sectional study
Authors: Naykodi Snehal Vitthal , Anap Deepak B. , Kharde Rohan , Diwate Abhijit D.
Published: August 2020

Background: Trismus is a restricted mouth opening due to the tonic contraction of muscles of mastication. It may occur mostly in HNF cancer patients undergoing radiation therapy treatment. This study was undertaken with the purpose of finding out the prevalence of trismus in patients undergoing radiation therapy. Method: 89 patients with HNF cancer patients receiving radiation therapy were included in the study. Inter incisal distance was measured using sliding digital vernier calliper. Patients with ≥ 35mm mouth opening were considered as trismus cases. Result: Out of 89 patients included 72 were diagnosed as trismus; hence the prevalence was 81%. Conclusion: Prevalence of Trismus is very high ( 81 %) in patients undergoing radiotherapy secondary to HNF cancer. Early diagnosis of trismus in these patients can help in time management and also planning of preventive strategies.
Evaluation of sweet taste sensitivity in type-II Diabetes Mellitus patients
Authors: Kumar Z. Naveen , Kumari B.N.S. Gowri
Published: August 2020

Background: The objective is to evaluate the sweet taste sensitivity among type-II diabetes mellitus patients.

Methods:  This is a cross sectional study consisted of 227 subjects (127 type-II Diabetic patients & 100 non diabetic individuals) of both the genders and age matched. Sweet taste sensitivity tests were done using different concentrations of glucose solution and compared among the diabetic patients with FBS more than 180mg/dl and diabetic patients with FBS less than 180mg/dl and also compared among the diabetic patients and non diabetic individuals.  The final concentration at which patient was able to perceive the taste was recorded. statistical analysis was done using Student’s unpaired T test. P­values of < 0.05 were considered to be statistically significant.

Results: The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245 mg/l and the mean of sweet taste sensitivity in the diabetic patients with FBS <180 mg/dl was 2249mg/l with P<0.001 which is significant. The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l with P<0.01 which is significant. the mean of sweet taste sensitivity among diabetic patients with FBS <180 mg/dl was 2249 mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l  with P>0.05 which is not significant.

Conclusion: In our study it was concluded that type-II Diabetes Mellitus patients have lesser sensitivity for the sweet taste. Loss of sensitivity leads to the increase in sugar consumption being the risk factor for worsening the disease.
Inter and Intra-rater Reliability and Validity of an instrument made in rural set up to measure Maximum Inspiratory Pressure termed as Dhiraj Maximum Inspiratory Pressure Device
Authors: Rasal Sarvesh Vivekanand , Diwate Abhijit D. , Anap Deepak B.
Published: August 2020

Background: Maximum Inspiratory Pressure (MIP) measures inspiratory force generated by respiratory muscles. MIP is measured with non-invasive pressure transducer device which has mouthpiece, pressure gauge, and dial showing readings. Respiratory muscle weakness is a common sign depicted in conditions like neuromuscular disorders, cardiovascular disease, and other respiratory pathologies which affect the individual’s lung volume and capacity. The devices available in the market to measure the MIP are costly.

Aim: This study was undertaken to find out inter-rater and intra-rater reliability and validity of therapist made instrument in rural set up to measure maximum inspiratory pressure (DMIPD).

Method: This cross-sectional study was carried out in 40 normal healthy individuals without lung diseases were recruited as per inclusion criteria. MIP values were noted by two raters using the DMIPD and were then compared between two rater values to that of the gold standard values. Validity and reliability were calculated using interclass correlation coefficients (ICC) and p-value.

Result: Statistical analysis for inter-rater reliability by Kappa using SPSS 1.000 showing almost perfect agreement as per Kappa interpretation also for intra-rater analysis an ICC value of 0.96 depicting excellent validity and Cronbach alpha value of 0.97 thereby proving it to have excellent reliability.

Conclusion: We conclude that DMIPD has excellent reliability and validity.
Barriers to implementation of hydrogen initiatives in the context of global energy sustainable development
Authors: Litvinenko Vladimir , Tsvetkov Pavel , Dvoynikov Mikhail , Buslaev Georgii
Published: August 2020

Modern trends in the global energy market linked to the Sustainable Development Goals often lead to the adoption of political decisions with little basis in fact. Stepping up the development of renewable energy sources is an economically questionable but necessary step in terms of its social and ecological effects. However, subsequent development of hydrogen infrastructure is, at the very least, a dangerous initiative. In connection with mentioned above, an attempt to examine hydrogen by conducting an integral assessment of its characteristics has been made in this article. As a result of the research conducted, the following conclusions concerning the potential of the widespread implementation of hydrogen in the power generation sector have been made: as a chemical element, it harms steel structures, which significantly impedes the selection of suitable materials; its physical and volume characteristics decrease the general efficiency of the energy system compared to similar hydrocarbon solutions; the hydrogen economy does not have the necessary foundation in terms of both physical infrastructure and market regulation mechanisms; the emergence of widely available hydrogen poses a danger for society due to its high combustibility. Following the results of the study, it was concluded that the existing pilot hydrogen projects are positive yet not scalable solutions for the power generation sector due to the lack of available technologies to construct large-scale and geographically distributed infrastructure and adequate international system of industry regulation. Thus, under current conditions, the risks of implementing such projects considerably exceed their potential ecological benefits.
Bebidas prehispánicas y novohispánicas de cacao y maíz en la Chontalpa, Tabasco
Authors: Pérez-Flores Julián , Córdova-Ávalos Víctor , CHÁVEZ-GARCÍA ELSA , HERNÁNDEZ-MALDONADO EFRÉN , Córdova-Lázaro Cristobal Enrique , Córdova-Ávalos Antonio , Hinojosa-Cuéllar José Antonio
Published: August 2020

Objetivo: Registrar las bebidas prehispánicas y novohispanas elaboradas a base de cacao y maíz, consumidas en la región de la Chontalpa, Tabasco.

Diseño/metodología/aproximación: El estudio fue realizado en comunidades rurales y urbanas de los municipios de Cunduacán, Cárdenas y Huimanguillo. Se realizó observación participativa en rituales al cacao y Día de Muertos, talleres y seis   entrevistas semi-estructuradas. Se complementó con una revisión documental. La información se analizó con una matriz de importancia para determinar la preferencia de las bebidas reportadas y consumidas por la población.

Resultados: Se registraron 29 bebidas a base de cacao y/o maíz, 22 prehispánicas  y 7 bebidas novohispánicas. De siete bebidas a base de maíz, dos son alcohólicas, consumidas en rituales. De 14 bebidas elaboradas a base de cacao y/o maíz, cinco incluyen miel, vainilla y achiote, y una bebida es solo de cacao tostado, reportada en la literatura como el chocolate amargo.  Tres bebidas son a base de cascarilla de cacao (te de cacao) y mucilago de la mazorca de cacao (atole de chaqueta). Las bebidas mayormente preferidas por la población de Tabasco son: el pozol, el polvillo de cacao, el atole de maíz y de cacao, el atole de mujer, y el chocolate amargo.

Limitaciones del estudio/implicaciones: En los rituales sacralizados al cacao está prohibido grabar, tomar fotos y videos. Lo anterior limitó contar con evidencia de fotos y audios.

Hallazgos/conclusiones: De las 29 bebidas reportadas a base de cacao y/o maíz, el pozol y polvillo con cacao son las de mayor preferencia. La primera es una bebida pre-hispánica que combina el cacao y el maíz.
Panorama de la producción y comercialización de naranja en México
Authors: Rivera-Lopez Samuel , Perales-Salvador Arturo , Del Valle-Sanchez Manuel , Caamal-Cauich Ignacio
Published: August 2020

Objetivo: analizar las variables de producción y comercialización de la naranja en el mercado mexicano.

Diseño/metodología/aproximación: se calculó la participación del mercado mexicano en el mercado mundial de naranja, la tasa de cambio de las variables de producción de este cítrico en México, la balanza comercial del cultivo en mención, el margen de comercialización productor-exportador, el consumo aparente nacional y per cápita, y el Índice de Ventaja Comparativa Revelada (IVCR).

Resultados: México posee alrededor del 8% de la superficie mundial cosechada de naranja y produce el 6% del volumen  total de este cítrico. La tasa de variación de la superficie sembrada y cosechada de este cultivo fue negativa; el volumen de producción presentó una tasa positiva de 19.13%, atribuible al alza en el rendimiento promedio por hectárea. La balanza comercial de la naranja en México tuvo saldo positivo en la mayoría de los años analizados; en 2018, Estados Unidos de América (EUA) consumió el 91.33% de las exportaciones y proveyó el 100% de las importaciones mexicanas de dicho cítrico. El consumo aparente per cápita ha sido mayor a los 35 kg. El margen de comercialización del productor con respecto al precio de exportación fue de 24.57%, mientras que, con respecto al precio del consumidor final, en el mercado nacional, fue de 26.92%. El IVCR con respecto a los EUA ha sido positivo de 2014 a 2018. 

Limitaciones del estudio/implicaciones: las bases de datos de los organismos internacionales presentan datos con retrasos de hasta dos años. No existe un repositorio de los márgenes de comercialización calculados mensualmente por el Servicio de Información Agroalimentaria y Pesquera (SIAP).

Hallazgos/conclusiones: los productores de naranja no son los principales beneficiarios del valor del comercio nacional e internacional de este fruto. El mercado mexicano presenta una ventaja competitiva en el mercado internacional de la naranja, el IVCR es positivo con respecto a EUA; sin embargo, el volumen de las exportaciones mexicanas es poco en comparación con la producción.