bluuebunny/crossref_metadata_2025 huggingface dataset:
Senam Kegel Sebagai Upaya Mengurangi Nyeri Luka Perineum Pada Ibu Nifas di Klinik Bersalin Pera Simalingkar B Medan Tahun 2022
Authors: Karo Karo Hilda Yani , Perangin angin Sri Yunita , Sihombing Faija , Chainny Rhamawan
Published: September 2022

Tears that occur in the perineum during labor or also called perineal lacerations that occur during labor with procedures such as forceps extraction, vacuum extraction, version extraction, kristeller (push on the uterine fundus) and episiotomy. Birth canal tears always provide bleeding in varying amounts. The source of bleeding can be from the perineum, vagina, cervix, and uterine rupture (uterine rupture). Birth canal tears are often found in childbirth assistance by traditional birth attendants. Delivery assistance by health workers with low risk has mild complications so that it can reduce maternal and perinatal mortality (Manuaba, 2013). Morbidity rates due to perineal lacerations include various infections and diseases that accompany pregnancy, childbirth and the puerperium (Friedman, 2012). High risk/complication is a state of deviation from normal, which directly causes morbidity and mortality for both mother and baby. There are several ways that can be used to prevent the occurrence of perineal tears due to normal delivery, including teaching the mother to often do Kegel exercises. Kegel exercises are exercises to strengthen the pelvic floor muscles before delivery, the goal is to strengthen the pelvic floor muscles, help prevent urinary incontinence problems, and can flex the perineal tissue as the baby's birth canal. So that all mothers should be motivated to move the pelvic floor muscles as little and as often as possible, slowly and quickly in the period approaching labor. The Kegel exercise procedure can be remembered and carried out with activities related to the mother's daily activities. Like when you sit in the bathroom after urinating and this is a relaxed position to contract these muscles, and when you want to sleep and under any circumstances. Doing Kegel exercises regularly can help flex the mother's perineal tissue.
PERAN GEREJA DALAM PENDIDIKAN SEKS KEPADA REMAJA DI GEREJA ANUGERAH BENTARA KRISTUS (GABK) JEMAAT HOSANA BOLUNI
Authors: Sitoki Sartini , Morente Iran , Elsin Milka , Mosooli Ermin Alperiana
Published: September 2022

Masalah yang menjadi fokus dalam penelitian ini adalah adanya realita perilaku seks bebas pada remaja di lingkungan Gereja Anugerah Bentara Kristus (GABK) Jemaat Hosana Boluni. Tujuan penelitian adalah untuk: 1) mengetahui apakah apa saja peran gereja dalam mengatasi perilaku seks bebas remaja; 2) bagaimana persepsi pengambil kebijakan dan orang tua di gereja mengenai pendidikan seks untuk mengatasi perilaku seks bebas pada remaja. Penulis menggunakan metode kualitatif deskriptif, teknik pengumpulan data menggunakan wawancara, dan data dianalisa menggunakan teknik reduksi data, penyajian data, dan penarikan kesimpulan. Setelah melakukan penelitian, penulis menemukan bahwa: Pertama, upaya yang telah dilakukan oleh gereja baru sebatas: 1) mengajarkan firman Tuhan, 2) Memberikan nasihat kepada remaja.  Kedua, secara umum pendeta, majelis gereja, dan orang tua belum memiliki kesadaran dan pemahaman yang baik mengenai pendidikan seks untuk remaja.Masalah yang menjadi fokus dalam penelitian ini adalah adanya realita perilaku seks bebas pada remaja di lingkungan Gereja Anugerah Bentara Kristus (GABK) Jemaat Hosana Boluni. Tujuan penelitian adalah untuk: 1) mengetahui apakah apa saja peran gereja dalam mengatasi perilaku seks bebas remaja; 2) bagaimana persepsi pengambil kebijakan dan orang tua di gereja mengenai pendidikan seks untuk mengatasi perilaku seks bebas pada remaja. Penulis menggunakan metode kualitatif deskriptif, teknik pengumpulan data menggunakan wawancara, dan data dianalisa menggunakan teknik reduksi data, penyajian data, dan penarikan kesimpulan. Setelah melakukan penelitian, penulis menemukan bahwa: Pertama, upaya yang telah dilakukan oleh gereja baru sebatas: 1) mengajarkan firman Tuhan, 2) Memberikan nasihat kepada remaja.  Kedua, secara umum pendeta, majelis gereja, dan orang tua belum memiliki kesadaran dan pemahaman yang baik mengenai pendidikan seks untuk remaja.
"SELF SPIRITUAL THERAPY” KRISTEN
Authors: Sudarmanto Gunaryo
Published: September 2022

Covid-19 Pandemic has created many personal problems among Christians. Christian Counsellor has not able to cover it through onsite and online ministry. Believers have to face their problem by themselves. So that they need to have ability to treat themselves by Self Spiritual Therapy. The purpose of this research is to design theological foundations in relationship with counselling pastoral principles and ESQ. To reach the aim, this research uses Qualitative approach with inductive mind and Phenomenological paradigm. The method that be used is ‘exegetic biblical theology-systematic theology’ through literature study, observation and questionnaire. The result shows that believers have ESQ that supported by Anthropological, Theological, Christological, Pneumathological, Ecclesiological, Biblical dan Eschatological approaches. Man is the image and likeness of God who have spirit, so that they able to make relationship with God. Because of sin the ability has destroyed. Christ restores the image of God through his role as the Great Therapist. The Holy Spirit applies and Christ work. He becomes Pharacletos for believers. The believers is the body of Christ. They have an unseparated relationship with Christ. So that they can tell their problems to Him. By the Biblical foundations and eschatological hope, the believers can use their faith, prayer and word of God to make Self Spiritual Therapy. Church and Christian Counsellor need to know and socialize the principles and practice Self Spiritual Therapy. They can train Counselors and bilievers.
Musiikillistettua teatteria
Authors: Jaakkola Inkeri
Published: September 2022

Hitler and Blondi: A Musicalised, Postdramatic Theatre Performance 

This article examines how music explores the central concepts of the postdramatic theatre work Hitler ja Blondi: kolmetoista laulua diktaattorille, saksanpaimenkoiralle ja pianolle (“Hitler and Blondi: Thirteen Songs for a Dictator, a German Shepherd and one Piano”), a co-production of the TTT-theatre in Tampere (premiered 19 Feb, 2020) and the Finnish National Theatre in Helsinki (fall season 2021). Due to COVID-19 restrictions several performances were postponed, and the commercial live recording was released for private use. Michael Baran’s non-linear script consists of both documentary and fictional texts throughout 13 scenes (called “songs”), a prologue and an epilogue. Some periods of the dictator’s life are narrated as monologues.  Hitler’s role is especially written for a blond, elderly Finnish actress, Seela Sella, who is Jewish herself. The music is designed and composed by Juhani Nuorvala and Juhani Liimatainen with Kyösti Kallio as sound engineer. Since the cornerstones of the performance’s structure, aesthetics and theatrical means are transcoded from musical sign system, Hitler ja Blondi is approached as a musicalised theatre work. 

The fundamental poetic idea of Hitler ja Blondi is the dialectic counterpoint between fascism and its opposing ideologies and aesthetics – represented musically through the opposed aesthetics of Richard Wagner and Karlheinz Stockhausen. Furthermore, the structure of the script resembles German Lied cycles, and the chained occurrences of Stockhausen’s Klavierstücke correspond to the recurrent refrain in rondo form. In general, the music and its large intertextual network is one of the performance’s central narrative means, and it opens up the potential for interpretation. Drawing from the recent theories and methodologies of music analysis and theatre studies, this article focuses on discussing 1) how popular songs and Stockhausen’s Klavierstücke extend the performance’s temporalities, thereby expressing the timelessness of fascism; 2) how the music presents Hannah Arendt’s view of the banality of evilness in Nuorvala’s Puolueohjelmalaulu (“The Song of Nazy Party’s Program”); and 3) how the author of this article experiences the dialectic counterpoint differently through life performance, and through the video recording.
Laajentunut viritys ja kontekstisidonnainen intonaatio
Authors: Jaatinen Jussi
Published: September 2022

Musical intonation is a complex phenomenon. It can be broadly divided into three distinct parts: a psychoacoustic stretched tuning, a context-bound distinction of harmonic and melodic intonation, and an affective characteristic intonation.  The stretched tuning, which has been verified in psychoacoustic listening experiments, where the notes above the reference (A4≈442Hz) are more up-tuned than their mathematic equal-tempered (octave ratio 2:1) counterparts and the notes below the reference are correspondingly more down-tuned, forms the basis of the tuning. Harmonic and melodic in-tuning is applied on top of this, rather than in relation to the mathematical equal temperament tuning. Characteristic intonation is used to accentuate the effects of certain intervals. Before the mainstreaming of equal temperament thinking, the separation of enharmonic tones also had a significant impact on intonation. The principle of counterbalance, proposed to stabilize orchestral tuning, is based on a stretched tuning and the fixation of tuning reference always to the middle register (A4) instead of the bass register. In this way, the downward expansion of the tuning of low register instruments allows a moderate increase in the tuning level of high register instruments. Well-tuned intonation is not a question that can be unambiguously defined. It is also influenced by learned and cultural factors, differences in musical aesthetics and neurophysiological differences in the auditory system between perceivers.
Evaluation of tropical water vapour from CMIP6 global climate models using the ESA CCI Water Vapour climate data records
Authors: He Jia , Brogniez Helene , Picon Laurence
Published: September 2022

Abstract. The tropospheric water vapour data record generated within the ESA Climate Change Initiative Water Vapour project (ESA TCWV-COMBI) is used to evaluate the interannual variability of global climate models (CMIP6 framework under AMIP scenarios) and reanalysis (ECMWF ERA5). The study focuses on the tropical belt, with a separation of oceanic and continental situations. The intercomparison is performed according to the probability density function (PDF) of the total column water vapour (TCWV) defined yearly from the daily scale, as well as its evolution with respect to large-scale overturning circulation. The observational diagnostic relies on the decomposition of the tropical atmosphere into percentile of the PDF and into dynamical regimes defined from the atmospheric vertical velocity. Large variations are observed in the patterns among the data records over tropical land, while oceanic situations show more similarities in both interannual variations and percentile extremes. The signatures of El Niño and La Niña events, driven by sea surface temperatures, are obvious over the oceans. Differences also occur over land for both trends (a strong moistening is observed in the ESA TCWV-COMBI data record, which is absent in CMIP6 models and ERA5) and extreme years. The discrepancies are probably associated with the scene selection applied in the data process. Since the results are sensitive to the scene selection applied in the data process, discrepancies are observed among the datasets. Therefore, the normalization process is employed to analyse the time evolution with respect to the mean state. Other sources of differences, linked to the models and their parametrizations, are highlighted.
Seasonal modeling analysis of nitrate formation pathways in Yangtze River Delta region, China
Authors: Sun Jinjin , Qin Momei , Xie Xiaodong , Fu Wenxing , Qin Yang , Sheng Li , Li Lin , Li Jingyi , Sulaymon Ishaq Dimeji , Jiang Lei , Huang Lin , Yu Xingna , Hu Jianlin
Published: September 2022

Abstract. Nitrate (NO3−) has been the dominant and the least reduced
chemical component of fine particulate matter (PM2.5) since the
stringent emission controls implemented in China in 2013. The formation
pathways of NO3− vary seasonally and differ substantially in
daytime vs. nighttime. They are affected by precursor emissions, atmospheric
oxidation capacity, and meteorological conditions. Understanding
NO3− formation pathways provides insights for the design of
effective emission control strategies to mitigate NO3− pollution.
In this study, the Community Multiscale Air Quality (CMAQ) model was applied
to investigate the impact of regional transport, predominant physical
processes, and different formation pathways to NO3− and total
nitrate (TNO3, i.e., HNO3+ NO3−) production in the
Yangtze River Delta (YRD) region during the four seasons of 2017.
NO3-/PM2.5 and NO3-/TNO3 are the highest in
the winter, reaching 21 % and 94 %, respectively. The adjusted gas ratio
(adjGR = ([NH3]+ [NO3−])/([HNO3]+ [NO3−])) in the YRD is generally greater than 2 in the four
seasons across most areas in the YRD, indicating that YRD is mostly in the
NH3-rich regime and that NO3− is limited by HNO3 formation.
Local emissions and regional transportation contribute to NO3−
concentrations throughout the YRD region by 50 %–62 % and 38 %–50 %,
respectively. The majority of the regional transport of NO3−
concentrations is contributed by indirect transport (i.e., NO3−
formed by transported precursors reacting with local precursors). Aerosol
(AERO, including condensation, coagulation, new particle formation, and
aerosol growth) processes are the dominant source of NO3−
formation. In summer, NO3− formation is dominated by AERO and
total transport (TRAN, sum of horizontal and vertical transport) processes.
The OH + NO2 pathway contributes to 60 %–83 % of the TNO3
production, and the N2O5 heterogeneous (HET N2O5)
pathway contributes to 10 %–36 % in the YRD region. HET N2O5
contribution becomes more important in cold seasons than warm seasons.
Within the planetary boundary layer in Shanghai, the TNO3 production is
dominated by the OH + NO2 pathway during the day (98 %) in the summer
and spring and by the HET N2O5 pathway during the night (61 %)
in the winter. Local contributions dominate the OH + NO2 pathway for
TNO3 production during the day, while indirect transport dominates the
HET N2O5 pathway at night.
Meteorological and climatological triggers of notable past and present bark beetle outbreaks in the Czech Republic
Authors: Brázdil Rudolf , Zahradník Petr , Szabó Péter , Chromá Kateřina , Dobrovolný Petr , Dolák Lukáš , Trnka Miroslav , Řehoř Jan , Suchánková Silvie
Published: September 2022

Abstract. Based on documentary evidence, a chronology of bark
beetle outbreaks in the Czech Republic from 1781 to 1963 CE was created,
continuing from 1964 through 2021 by bark beetle salvage felling data. The
spatial distribution of bark beetle events concentrates on the border
mountains of Bohemia and in the northern parts of Moravia and Silesia. The
temporal distribution of the most important bark beetle outbreaks
is concentrated in the 1830s, 1870s, 1940s–1950s, 1980s, 1990s, 2000s, and
2010s. Each of these notable calamities was analysed in detail with respect
to their spatial extent, the volume of damaged wood, and their
meteorological patterns. While meteorological triggers of the largest
outbreaks of the 19th century were attributed especially to the slow
procession of disastrous volumes of damaged wood after large windstorm
events sometimes intensified by dying trees in subsequent dry years, the
recent warming with relatively stable precipitation from the 1980s moves the
main meteorological and climatological triggers to more frequent warm and
dry meteorological patterns, acting simultaneously in interaction with
severe windstorms. The last bark beetle outbreak from 2015 was evaluated as
the most disastrous disturbance to spruce forest over the territory of the
Czech Republic in documented history. The paper also discusses uncertainties in bark beetle data, responses to past bark beetle events, and relationships between environment, climate, and bark beetle outbreaks.
Pan evaporation is increased by submerged macrophytes
Authors: Simon-Gáspár Brigitta , Soós Gábor , Anda Angela
Published: September 2022

Abstract. The topic of evaporation estimates is fundamental to
land-surface hydrology. In this study, FAO-56 Penman–Monteith equation
(FAO56–PM), multiple stepwise regression (MLR), and Kohonen self-organising
map (K–SOM) techniques were used for the estimation of daily pan evaporation
(Ep) in three treatments, where C was the standard class A pan with top
water, S was a pan with sediment covered bottom, and SM was class A pan
containing submerged macrophytes (Myriophyllum spicatum, Potamogeton perfoliatus, and Najas marina), at Keszthely, Hungary, in a
six-season experiment, between 2015 and 2020. The modelling approach
included six measured meteorological variables. Average Ep varied from
0.6 to 6.9 mm d−1 for C, 0.7 to 7.9 mm d−1 for S, and from 0.9
to 8.2 mm d−1 for SM during the growing seasons studied. Correlation
analysis and K–SOM visual representation revealed that air temperature and
global radiation had positive correlation, while relative humidity had a
negative correlation with the Ep of C, S, and SM. The results showed
that the MLR method provided close compliance (R2=0.58–0.62) with the
observed pan evaporation values, but the K–SOM method (R2=0.97–0.98)
yielded by far the closest match to observed evaporation estimates for all
three pans. To our best knowledge, no similar work has been published previously using
the three modelling methods for seeded pan evaporation estimation. The current study differs from previous evaporation estimates by using
neural networks even with those pans containing sediments and submerged
macrophytes. Their evaporation will be treated directly by K–SOM, in which
the modelling is more than the simple Ep of a class A pan filled with clean
tap water.
Research Grant Proposal Writing Course for Students in Higher Institutions
Authors: Dable-Tupas Genevieve , Toralba-Lupase Victoria , Puyana Juan C. , Găman Mihnea-Alexandru
Published: September 2022

Research grant proposals have become part of the everyday life of every scientist working in the field of life sciences. Although most early career researchers begin working on research grant proposals during their doctorate, laying the foundation of this complicated task should occur during their undergraduate training. This chapter serves as an introduction into research grant proposal writing for students enrolled in higher education and tackles subjects such as choosing a research topic and writing a successful grant application, as well as possible challenges, funding opportunities and further readings we considered appropriate for students and early career researchers.
After all the policy reform, is child support actually helping low-income mothers?
Authors: Skinner Christine , Meyer Daniel R.
Published: September 2022

The economic vulnerability of children in lone-parent families has drawn attention to child support policy. After 13 years of constant policy changes the child support system remains highly problematic and is currently undergoing an independent review. Given this, it is timely to question whether child support payments (from all types of agreements, not just Child Support Agency assessments) are actually helping lone-mother families. Or are most low-income mothers connected to men who have little capacity to pay, so that child support actually helps only moderate-income families? This article uses data from the UK Families and Children Study to examine the receipt of child support by lone mothers across the income distribution. It examines the amounts of child support received and the contribution it makes to total income packages across two major groupings: lone-mother quintile groups and poverty groups. We find that lone mothers who are already relatively better off (compared with other lone mothers in the survey) are more likely to receive child support. However, lone mothers who receive child support tend to receive similar median amounts, regardless of their income levels. Moreover, child support is a more important part of the income package for lone mothers with low incomes than for those with higher incomes.
PERAN SUPERVISI KEPALA RUANGAN DALAM MEMOTIVASI PERAWAT PADA PENCEGAHAN RISIKO JATUH DI RUMAH SAKIT
Authors: Khotimah Latifah Khusnul , Febriani Nelly
Published: September 2022

: Pencegahan risiko jatuh dalam menjaga keselamatan pasien tidak terlepas dari motivasi perawat. Perawat yang termotivasi dalam pencegahan risiko jatuh dipengaruhi oleh peran kepala ruangan dalam melaksanakan supervisi. Tujuan penelitian ini untuk menganalisa hubungan peran supervisi kepala ruangan dengan motivasi perawat dalam pencegahan risiko jatuh di Rumah Sakit Penelitian ini menggunakan menggunakan metode deskriptif analitik dengan pendekatan cross sectional. Teknik pengambilan sampling menggunakan purposive sampling sebanyak 70 perawat. Gambaran peran supervisi kepala ruangan dengan kategori baik sebanyak 48 perawat (68,6%) dan kategori kurang baik 22 perawat (31,4%). Gambaran motivasi perawat sebanyak 44 perawat (62,9%) termotivasi dan 26 perawat (37,1%) tidak termotivasi. Hasil penelitian dianalisis dengan uji Chi Square didapatkan adanya hubungan yang signifikan antara peran supervisi kepala ruangan dengan motivasi perawat dalam pencegahan risiko jatuh (p Value = 0,000). Kesimpulan penelitian ini kepala ruangan dapat terus melaksanakan evaluasi melalui kegiatan supervisi yang dapat menmbulkan motivasi perawat dalam pencegahan risiko jatuh. Rekomendasi penelitian ini diharapkan kepala ruangan senantiasa berperan untuk meningkatkan pelaksanaan supervisi yang baik agar terjadi peningkatan motivasi perawat dalam pencegahan risiko jatuh.Kata kunci: motivasi, pencegahan risiko jatuh, perawat, supervisi
Clinical Approach to Recurrent Voiding Dysfunction, Dysuria, and Pelvic Pain Persisting for at Least 3 Months
Authors: Kim Su Jin , Kim Khae Hawn
Published: September 2022

There are several patients with urination problems and urethral and pelvic discomfort. Usually, these patients’ symptoms are persistent and ambiguous; therefore, it is difficult to find underlying diseases associated with the patient’s symptoms. In addition, there are various conditions such as overactive bladder, cystitis, and interstitial cystitis/bladder pain syndrome (IC/BPS). Sometimes patients with other chronic disorders such as fibromyalgia, inflammatory bowel syndrome, and vulvodynia show urination problems and pelvic pain. Thus, a patient-centered approach is important to find the cause of chronic urination problems and pelvic pain. Moreover, IC/BPS should be considered during the diagnostic process because the clinical characteristics of IC/BPS are diverse. In this narrative review, we suggest an integral approach for the diagnosis and treatment of IC/ BPS.
Diagnostic and prognostic value of Nesfatin-1 in sepsis and septic shock
Authors: TOPRAK İlkim Deniz , ERUZUN Hasan , KUTLU Yasin , ARMAN Yücel , YUMUŞTUTAN Pembegül , AYDIN YOLDEMİR Şengül , AKARSU Murat , DİKKER Okan , TÜKEK Tufan
Published: September 2022

Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. We aimed to analyze it and determine the relationship between Nesfatin-1 levels and quick Sequential Organ Failure Assessment(qSOFA) score, renal Sequential Organ Failure Assessment (SOFA) score, and mortality in patients with sepsis and septic shock. Sixty-nine hospitalized adult patients diagnosed with sepsis and septic shock in the internal medicine department, were included in the study after approval of the Clinical Research Ethics Committee. Sepsis diagnosis was based on the detected focus of infection, positive blood cultures, and response to antibiotics. Twenty-one healthy controls matched for age and sex with these patients were also included in the study. Sixty-nine septic patients and twenty-one healthy volunteers were included in the study. Nesfatin-1 levels were compared with covariates. Nesfatin-1 levels in septic patients were lower than that of healthy controls. There was no significant difference in Nesfatin-1 between diabetic and non-diabetic subgroups. Patients with quick Sequential Organ Failure Assessment (qSOFA) score of three had a statistically significantly lower Nesfatin-1 level than those of patients with the score of zero, one, and two. Nesfatin-1 was correlated negatively with C reactive protein. We found a statistically significant difference in 1-month mortality between Nesfatin-1 levels below and over 80pg/mL. In order to use Nesfatin-1 as a biomarker in differentiating sepsis from healthy population, more comprehensive and more studies are needed. If supported by new studies, Nesfatin-1 levels below 80 pg / mL at first admission in septic patients may direct the clinician to broad-spectrum antibiotic therapy and earlier intensive care follow-up.
The relationship between disease severity and GDF-15 in individuals diagnosed with obstructive sleep apnea syndrome
Authors: BODUROGLU Yalcin , ZORLU KARAYIGIT Duygu , ILANBEY Bilal , ERTURK Arzu
Published: September 2022

Obstructive sleep apnea syndrome (OSAS) is characterized with interruption of sleep with apnea attacks and is associated with various diseases such as metabolic syndrome. GDF-15 (Growth differentiation factor 15) is a cytokine belonging to the transforming growth factor – β superfamily and it has been found to be associated with chronic heart failure, acute pulmonary embolism, and acute attacks of chronic obstructive pulmonary disease (COPD). It was aimed to evaluate the relationship between disease severity and mean GDF-15 in patients diagnosed with OSAS. Our study was carried out with 75 patients with OSAS. GDF-15 levels were checked by in the morning fasting blood test. Among the 75 patients, 27 constituted the mild, 22 constituted the moderate and 26 constituted the severe OSAS groups. The mean ages of the patients were not significantly different between groups (53.17±10, 54.61±10.2 and 53.5±11.6 respectively; p>0,05). GDF-15 levels were not significantly different between groups separately (p>0.05). There was only a weak positive relationship between GDF-15 and NREM and REM (p<0.05). In our study, it was revealed that there was no significant relationship between the OSAS severity groups and GDF-15. Our determination of a positive relationship with NREM and REM may have been related to reduction of minute ventilation experienced in OSAS-diagnosed patients, tachycardic fluctuations, their more severe nature and increased right ventricular pressure. Consequently, our current knowledge indicates that GDF-15 is not much guiding in the prediction and monitoring of OSAS severity.
MRI utilization in pediatric emergency department: An analysis over 5 years
Authors: AKÇA Ünal , AKÇA Gülfer , ÇALIŞKAN Burcu , ÇALIŞKAN Fatih
Published: September 2022

There are concerns on exposure to radiation especially in pediatric population, as magnetic resonance imaging (MRI) can be used in emergency departments and provides an imaging without radiation; its utilization has recently increased. This study aimed to evaluate MRI utilization trends in patients who underwent a MRI in a pediatric emergency department within a period of five years. Examination data of the patients admitted to pediatric emergency department between 2014 and 2018 were obtained from database of the hospital with the approval of Clinical Research Ethical Committee. Rate of MRI utilization in patients admitted to pediatric emergency department was 0.88%. There was a statistically significant increase in MRI utilization within five years (p<0.001). The rate of male patients (1.24%) who underwent MRI was significantly higher than that of female patients (0.65%) (p<0.0001). There was a statistically significant decrease in MRI utilization by age in all categories (p<0.0001). Neuroradiology imaging was the most common. Complaints at presentation and pre-diagnoses were analyzed. The results of MRI were evaluated by radiologists and 53.9% of the results were normal. The highest rate (46.1%) of MRI utilization was between 4 pm and 12 am in a day. The highest rate of MRI utilization was on Friday and the lowest rate was on Sunday. While MRI utilization has increased in pediatric patients, neuroradiology imaging is the most common type. MRI utilization in pediatric emergency department is higher in male patients and in the early ages.
Retrospective evaluation of 16 patients who underwent spinal cord stimulation
Authors: UZUNER Bora , TÜRKÖZ Dursun
Published: September 2022

The aim of this study was to examine the outcomes of patients who underwent Spinal Cord Stimulation (SCS) in our clinic. In this study, records of 16 patients who underwent SCS in the Algology and Neurosurgery Clinic of the Ministry of Health, Health Sciences University, Samsun Training and Research Hospital between 2015 and 2018 were retrospectively analysed. The pain levels of the patients before and after the procedure were evaluated with the Visual Analogue Scale (VAS). The mean age of the patients was 54.25 ± 11.45 years. After the SCS procedure, it was found that pain levels determined by the VAS decreased significantly (p < 0.001). Eleven (68.7%) patients reported that they were quite satisfied or partially satisfied after SCS, and seven patients (43.8%) underwent revision due to hardware malfunctions and post-surgical complications. Based on our study results, we believe that SCS is an effective treatment method that can be used to reduce pain.
Possible effects of some anaesthetic agents in rat hepatotoxicity: Histological and biochemical study
Authors: ANNAÇ Ebru , ULUDAĞ Öznur , DOĞAN Zümrüt
Published: September 2022

Selectively steroidal neuromuscular blocking agents, such as rocuronium, are required to maintain surgical procedures. It is a sugammadex γ-cyclodextrin-derived drug that encapsulates these drugs and reverses its effects. In the present study, it was aimed to investigate the effects of sugammadex rocuronium complex on liver and possible toxic effects on hepatocytes using histopathological and biochemical methods. In the current study, 32 adult Sprague - Dawley male rats were used. Four groups were designed as pure control, control group, sugammadex and sugammadex-rocunorium. Following the experimental procedures, liver tissues extracted from rats were stained after routine histological procedures. The images were taken from the sections for histopathological evaluation. For biochemical analysis, glutathione (GSH) and malondialdehyde (MDA) enzymes were analyzed in the liver tissues. In the group treated with the sugammadex-rocunorium complex, caspase-3 expressions were observed to be higher than in other groups. In addition, while the amount of GSH belonging to sugammadex and sugammadex-rocunorium groups decreased compared to the control group, an increase in MDA amount was found. Sugammadex-rocunorium can lead to oxidative stress in the hepatocytes. However, more studies are needed to reveal the toxic effects of sugammadex and sugammadex and rocunorium complex in the liver.
The effects of vitamin deficiencies in the first trimester on pregnancy outcomes
Authors: YILMAZ Zehra , SOYER ÇALIŞKAN Canan , DOKUZEYLUL GUNGOR Nur , YILMAZ Merve , ÇELİK Samettin , ÇELİK Sebahattin
Published: September 2022

Adequate maternal nutrition is crucial for pregnancy and fetal growth, and thereby influences pregnancy outcome. In this study, we investigate the relationship between certain vitamin levels of first trimester pregnancy and its maternal-fetal outcomes. This retrospective study was conducted between January 2020 and July 2020 by evaluating data drawn from the hospital database. Serum vitamin B12, 25OH-vitamin D, folic acid and ferritin levels were evaluated in 499 women during the first trimester of pregnancy and confounding factors were analyzed. The mean age was 27 years. The mean birth weight of newborn was 3300g. The vaginal delivery rate was 73.1% whereas caesarean delivery rate was 26.9%. Neonatal intensive care unit (NICU) was needed in 8% of newborns. Meconium was seen in 12.6% of newborns. There was a significant statistical difference between caesarean section and vaginal delivery group with respect to 25OH-vitamin D, vitamin B12, and folic acid levels(p<0.001). All three vitamins were low in first trimester in caesarean delivery group. In contrast, ferritin levels were similar between two groups. 25OH-vitamin D, folic acid and vitamin B12 levels were significantly low in the presence of meconium(p<0.001) whereas the level of ferritin was significantly high in the presence of meconium(p=.0.001). 25 OH-vitamin D (p=0.001), vitamin B12 (p<0.001) and ferritin(p<0.001) levels were significantly low in mothers of newborns hospitalized in NICU. In contrast, folic acid level was similar between two groups(p=0.066). Adequate levels of certain vitamins in the first trimester of pregnancy are crucial for a healthy pregnancy and newborn.
The effect of laparoscopy in chronic pelvic pain on quality of life
Authors: ÇALIKOĞLU Servet Şekeryapan , DOĞANAY Melike , TUĞRUL Duygu , ERSAK Burak , KOKANALI Mahmut Kuntay
Published: September 2022

Chronic pelvic pain (CPP) is a problem facing gynecologists. Laparoscopy is a minimally invasive surgical technique used for both diagnosis and treatment of CPP. This study aimed to investigate the determination of women with pelvic pain who will benefit from diagnostic laparoscopic surgery and its effect to on quality of life. A prospective designed study conducted between October 2013 - August 2015 including 90 patients at University of Health Sciences, Zekai Tahir Burak Women Health Care, Training and Research Hospital, Turkey. While 45 patients in reproductive age with complaints of non-cyclic pelvic pain for more 6 months constituted the study group, 45 patients with no active complaints who admitted for laparoscopic tubal ligation constituted the control group. Short Form-36 (SF-36) and Visual Analog Scala (VAS) Questionnaire was applied to patients in preoperative and postoperative periods. While VAS score in study group patients before surgery was 6,91±0,92, it was 4,33±1,64 after surgery (p<0.001). In addition, there were statistically significant difference between SF-36 Physical Health and SF-36 Mental Health scores before and after surgery. There was a significant improvement in quality of life in the study group. Laparoscopic approach should be preferred for direct visualization and immediate treatment in patients with CPP. Laparoscopy keeps its importance for patients with CPP, improving quality of life.
Effect of COVID-19 quarantine on patients admitted to neurosurgery outpatient Clinic individuals with COPD
Authors: ÇETİN Eyüp , AKYOL Mehmet Edip
Published: September 2022

Coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Throughout the pandemic period, numerous countries around the world have implemented nationwide isolation measures to control the spread and transmission of COVID-19. During this period, the prevalence of some physical and mental diseases have increased due to prolonged home isolation measures. In the present study, we aimed to examine the effect of the COVID-19 isolation measures imposed in Turkey on patients admitted to our neurosurgery outpatient clinic.
Neck metastasis in transglottic laryngeal carcinomas
Authors: MEHEL Dursun Mehmet , AKGÜL Gökhan , ÖZDEMİR Doğukan , ÇELEBİ Mehmet , TURGUT Nesrettin Fatih , AYDEMİR Samet , ÖZGÜR Abdulkadir
Published: September 2022

In laryngeal cancers, the first metastasis occurs in the cervical lymph nodes This study aimed to determine the levels of cervical metastatic lymph nodes in patients with transglottic laryngeal carcinoma, the effect of tumor prognostic factors on cervical lymph node metastasis. The research retrospectively examined 32 patients who underwent total laryngectomy and neck dissection, with the diagnosis of transglottic squamous cell carcinoma (SCC). Age, gender, complaint, smoking status, and other prognostic factors were evaluated. All patients underwent total laryngectomy with 63 neck dissections. Seven patients had metastatic cervical lymph nodes. Among the prognostic factors, thyroid cartilage invasion, combined perineural–perivascular invasion, subglottic extension, extralaryngeal extension, and preoperative tracheotomy procedure had statistically significant effects on neck metastasis. In conclusion; Dissection at level IIB should be reassessed to decrease morbidity due to the low prevalence of level IIB metastasis, both clinically and pathologically. In locally advanced laryngeal cancers, considering the prognostic factors, it is ideal to plan specific treatments for each patient.
The effectiveness of coagulation parameters in classifying patients and predicting mortality in Covid-19
Authors: ŞENER Gülsen
Published: September 2022

Covid-19 is a viral infection have a high pathogencitity and contagiousness that primarily targets the human respiratory system and leading to a global pandemic. Abnormal coagulation parameters are quite common in Covid-19 patients. In our study, we aimed to evaluate the relationship between coagulation function with disease severity and survival status in Covid-19 patients and the prognostic, predictive value of these parameters. Results of prothrombin time (PT), activated partial thromboplastin time (aPTT), Fibrinogen, and D-Dimer parameters at admission time of 76 Covid-19 negative healthy control with 188 confirmed Covid-19 patients, as well as death events were retrospectively analyzed. Compared with the healthy control group, higher levels of D-Dimer, PT, aPTT, fibrinogen, and CRP (p <0.001 for each) were present during admission in Covid-19 patients. The non-survivor group had higher levels of PT, D-Dimer, and CRP (p <0.001 for each) and aPTT (p =0.004), fibrinogen (p =0.019) compared to the survivor group. 28 (14.89%) of 188 Covid-19 patients lost their lives. Analysis of the ROC curve revealed that D-Dimer, Fibrinogen, PT, aPTT, and CRP had high diagnostic value in distinguishing Covid-19 patients from healthy control group, the critical group from the severe group, and non-survivors from survivors. This study shows that coagulation function is significantly impaired in patients with Covid-19 infection compared to normal patients, and as particularly marked high levels of D-Dimer, PT, aPTT, fibrinogen, and CRP are common. This condition is associated with disease severity and increased mortality. Coagulation parameters are an effective and useful marker for assessing prognosis and for the management of Covid-19 patients.
Abdominal wall endometriosis: Case-series study and a systematic review
Authors: KATIRCI Yunus , OZDEMİR Ayse Zehra , GÜLÜMSER Çağrı , GÜN Seda
Published: September 2022

Abdominal wall endometriosis (AWE) is the presence of endometrial gland and stroma in the abdominal wall that should be kept in mind in differential diagnosis of pelvic pain due to especially increased C-section rates. Between January 2000 and July 2018, MEDLINE and EMBASE databases were systematically reviewed using the search criteria "abdominal wall endometriosis," "abdominal wall endometriomas,”. Only the studies having over 20 patients were included. Case-series, case-control studies, and articles in languages other than English were excluded. Number of the patients, patients ‘age, study design, previous surgical history, most common symptom, time interval to symptoms, treatment, recurrence rate, and tumour size were investigated. In Total, 18 studies and 994 women were included in the study. Case studies, studies with less than 20 cases, non-English articles were excluded from the study. In the included studies, the numbers of minimum and maximum woman were 20 and 227, respectively. AWE significantly impairs the quality of life in reproductive age patients and is commonly seen in women with previous history of laparotomy, especially those who underwent cesarean section. Therefore, it must be kept in mind in the differential diagnosis of women who have a history of pain and a history of previous surgery.
Effects of psychological predictors on hospital discharge duration after total knee arthroplasty
Authors: ATAY İnci Meltem , ATAY Tolga , DİNÇER Recep
Published: September 2022

This study aims to evaluate the effects of somatosensorial amplification, kinesiofobia, health anxiety and depression on hospital discharge durations after knee arthroplasty. 193 patients with total knee arthroplasty were included in the study. Patients were divided into two groups due to discharge durations. Group 1 included patients who were discharged in 1 to 4 days; Group 2 included patients who were discharged in 5 to 7 days. Functional outcome was measured with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). For psychiatric evalution; a Sociodemographic form, Somatosensory Amplification Scale, Health Anxiety Inventory, Hospital Anxiety and Depression Scale and The Tampa Scale of Kinesiophobia were used. There wasn’t any significant difference in terms of WOMAC scores between Group 1 and 2 postoperatively. (Pain; p=0.666, Stiffness; p=0.349, Functionality; p= 0.145). There was a significant difference in terms of Health Anxiety Inventory and Somatosensorial Amplification scores between Group 1 and 2 (p=0.006; p=0.031). In correlation analysis Somatosensorial Amplification score was positively correlated with hospital discharge duration. There was a significant difference in terms of Tampa kinesiophobia scores between Group 1 and 2 (p<0.001). In correlation analysis there was a positive correlation between Tampa kinesiaphobia score and hospital discharge durations (r: 0.618; p: 0.000). Multiple regression analysis indicated that Tampa Scale of Kinesisophobia was the major predictive factor for hospital discharge durations. Health anxiety, Somatosensory amplification and mostly Kinesiophobia were related with longer hospitalization periods due to worse functional outcomes after total knee arthroplasty. Maladaptive psychological strategies about false bodily sensations lead a worse outcome for knee arthroplasty patients. Therapeutic programs aiming false cognitive factors would result with improved functional recovery.
中国真实有效汇率的影响因素分析
Authors: 余 筱彧
Published: September 2022

真实有效汇率是指一国商品和劳务的相对价格，作为一个具有重要意义的经济指标，它在国际市场上通常被用来衡量一个国家的竞争力。自中国入世以来，人民币汇率一直处在小幅波动之中。为了探讨人民币的长期趋势，本文以1990年至2021年的数据，运用灰色关联分析以及线性回归分析模型来研究在开放经济模型下，中国的历年真实有效汇率与国际收支经常账、国际收支资本金融账、失业率、通胀率、居民消费价格指数的长期波动趋势与相关性。本文结论显示真实有效汇率可以通过国际收支资本金融账、失业率与居民消费价格指数进行自我调节，而不易通过国际收支经常账与通胀率进行调节；本文并详细分析开放经济下的政策工具，为中国今后的汇率形成机制改革和调节内外部均衡提供了方向。
Policy Analysis of Medan City Regional Regulation Number 5 of 2012 in Issuing Building Construction Permits in Medan City
Authors: Harahap Rosniati , . Badaruddin , Kusmanto Heri
Published: September 2022

This study aims to determine policy analysis of Medan City Regional Regulation Number 5 of 2012 in issuing building construction permits in Medan City. The type of research used is a descriptive study with a qualitative approach. In this study, the selection of informants used a purposive sampling technique to determine the research subject. The steps in analyzing the data in this study were carried out through the stages of data analysis using the Miles and Huberman model consisting of data reduction, data display, and conclusion drawing. The results of research on policy analysis of Medan City Regional Regulation Number 5 of 2012 in issuing building construction permits in Medan City there are supporting and inhibiting factor which of these factors are solutions, namely providing detailed and clear conditions for managing building permits, so that people can easily complete the files that must be provided.

Keywords: Policy, Regulation, Construction
The Influence of Location, Collection Image and Employment Opportunities on Student Interest in Agro Technology Faculty Universitas Prima Indonesia
Authors: Juli Arfah Riza , Faris Salman , Pakpahan Efendy
Published: September 2022

The purpose of this study was to determine and analyze the influence of location, university image and job opportunities on student interest in studying at the Faculty of Agro Technology, University of Prima Indonesia. The total population in this study, students of the Faculty of Agro Technology, University of Prima Indonesia amounted to 89 students. While the sample in this study was saturated, namely 89 people. The sources of data in this study are primary data and secondary data. Data sources are anything that can provide information about data. Based on the source, the data is divided into two, namely primary data and secondary data. The results in this study are the location partially has a significant effect on student interest by -2.15%. Based on research conducted on students of the Faculty of Agro Technology, it can be concluded that the image of the university partially has a significant effect on student interest by 59.7%. Based on research conducted on students of the Faculty of Agro Technology, it can be concluded that job opportunities partially have a significant effect on student interest by 19.8%.

Keywords: Location Influence. Image of Higher Education, Job Opportunities, Student Interest of Faculty of Agro Technology UNPRI
Extra Role Behavior in Generation Z Employees Reviewing from Social Support, Resilience and Work Engagement Aspects
Authors: . Daryanto , Wiralaga Haryo Kuncoro , Santoso Budi
Published: September 2022

This study aims to examine the effect of social
support, resilience, and work engagement on
extra-role behavior in generation Z. This study
uses a quantitative approach with a survey
model, to explain the effect of social support
(X2), resilience (X1), and work engagement
(X3) on Extra Role Behavior (Y), using a
sample of Generation Z. The number of
respondents as many as 288 respondents, who
met the requirements and in accordance with the
research objectives, examined the behavior of
Generation Z with a population spread over big
cities in Indonesia, who are relatively new to the
world of work, the age of the respondents is
approx. age 23 to 25 years, this is according to
the reference of Generation Z, born 1996-2009
(Codrington & Sue Grant-Marshall, 2004).
Sample selection was done randomly and data
analysis using PLS Structure Equation Model
(SEM).
The results of the study found that social
support had a positive effect on work
engagement; social support has no significant
negative effect on extra-role behavior; resilience
has a significant positive effect on work
engagement; Resilience has a significant
positive effect on extra-role behavior. And
lastly, work engagement has a significant
positive effect on extra-role behavior. This study
opens the study for further research on social
support which has a negative and insignificant
effect on extra-role behavior in Generation Z.
Keywords: extra role behavior, social support,
work engagement, resilience