bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression in medical students: reviewing its prevalence, risk factors, consequences, and management in order to provide student
Authors: Wallace Brian E. , Masiak Jolanta , Pabis Matthew R.
Published: June 2021

The information regarding the state of mental health among medical students, particularly regarding depression, is a significant cause for concern. In fact, current research shows that approximately twenty five percent of medical students in the United States exhibit symptoms of a mental health disorder and some reports suggest that the rate of depression among medical students is more than twice that of the general population. Furthermore, the rate of depression has been noted to increase throughout the course of medical school although some reports suggest that the transition years from basic-to-clinical sciences yield the highest prevalence numbers. Nonetheless, the ever-increasing academic demands of medical school can create significant stress for these students who often experience subjective anxiety, which co-occurs depression, and may ultimately influence their overall health and wellbeing.
However, medical students commonly underestimate the risk of depression associated with their population and although they are taught to view mental health disorders in a manner similar to any other disease, depressed students tend to associate a certain stigma with depression when coping with their own mental health issues. As a result, medical students with depression often remain undiagnosed and undertreated despite the availability of effective medications and confidential mental health services. The increased prevalence of depression and its under-diagnosis in this population may have negative consequences that extend beyond the individual student. This paper examines the prevalence of depression among medical students, possible reasons and consequences of their limited treatment, and solutions that have been proposed to help alleviate this burden. Particular emphasis is placed on the latter in order to provide recommendations for depressed medical student counseling and treatment options within the Polish medical education system.
Tobacco smoking versus the future life partner – students’ opinions and choices
Authors: Rząca Marcin , Charzyńska-Gula Marianna
Published: June 2021

Introduction. Diagnosing the motives of young people in the choice of life partners seems significant both for widely understood public health, and for forecasting the state of health of potential families.
Aim. The purpose of the survey was to get to know students’ opinions on health behaviour of their girlfriends or boyfriends and to determine whether the fact of smoking tobacco influences the choice of the candidate for a life partner.
Material and methods. The survey was part of a pilot diagnosis of behaviour, opinions and attitudes of students with regard to health, constituting a basis for the project “Health – Promoting University”. The surveyed group consisted of 207 students from three Lublin universities: Maria-Curie Skłodowska University (UMCS), Catholic University of Lublin (KUL) and Medical University of Lublin (MU).
Results. An anonymous diagnostic survey was applied, with the use of random sampling. Thirteen percent of the surveyed women are active smokers, of which the largest group consists of psychology students, and the percentage of smoking men is 29%. Sixteen percent of women and 10% men are ex-smokers. Women more frequently than men are passive smokers. Current tobacco smokers are mostly inhabitants of cities and they are students whose both parents smoke. As many as 1/3 of partners of the surveyed students smoke tobacco. The fact that the future life partner is a smoker is significant, but there were also students for whom the fact that their current or potential partner is or would be a smoker is of no significance.
The students smoking tobacco attached to this aspect least importance, and the most importance was attached by students whose parents were both non-smokers.
Conclusions. The obtained results directly confirm the thesis that the choice of a life partner is connected with the assessment of his/her health behaviour (in this case – tobacco smoking) and can have an impact on the “health-related quality” of students’ relationships in the future and on the satisfaction of partners forming the relationships. The conducted research confirmed that among the surveyed group of students there is greater tolerance towards tobacco smoking by the partner in the case of persons who are themselves active smokers, and the necessity to undertake anti-smoking measures by universities in the form of support for students who are active and passive smokers.
Patients with systemic diseases treated with dental implants
Authors: Koszuta Agnieszka , Szymańska Jolanta , Kubić-Filiks Beata
Published: June 2021

Introduction. The success of implant prosthetic treatment of missing teeth consists in the full integration of the implant with the bone and proper functioning of denture based on it. This is significantly influenced by systemic factors.
Aim. The aim of this study was to evaluate the prevalence of systemic diseases among the patients treated with dental implants.
Material and methods. The survey was conducted among 464 patients of both sexes aged from 20 to 74 years, treated with dental implants at the Non-Public Healthcare Centre “Dental” in Tomaszów Mazowiecki. The patients answered an anonymous questionnaire. Questions concerned age, place of residence and systemic diseases.
Results. The results of the survey indicate that nearly 40% of all patients treated with dental implants were people suffering from systemic diseases, significantly more often they were persons aged 40-60 years.
Conclusions. Persons living in rural areas or small town suffering from systemic diseases often decided to have implants. In addition, the residents of the city made that decision often when they did not suffer from systemic diseases.
Rare health conditions 47: the ‘strengths model’ of care, Gorham's disease and amniotic band syndrome
Authors: Barber Chris
Published: June 2021

The purpose of this series is to highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually fewer than 1 person in every 2000 and many HCAs and nurses will encounter some of these conditions, given the high number of them. This 47th article will explore two of these conditions, Gorham's disease and amniotic band syndrome, and offer a focus on the ‘strengths-based model’ of healthcare assessment and planning.
Healthwise, Part 2. Eating a balanced diet
Authors: Nazarko Linda
Published: June 2021

The Coronavirus (COVID-19) pandemic has highlighted the importance of public health in the UK and globally. The UK's death rates and obesity rates are related; many people in the UK experience poor health because they are overweight or obese ( Lobstein, 2021 ; Mohammad et al, 2021 ). This article, the second in a series, explores how readers can remain healthy and well by eating a healthy, balanced diet.
Audit of the appropriateness and accuracy of fluid intake and output monitoring: experience in a tertiary hospital
Authors: Lim Siew Hoon , Lim Mei Ling , Aloweni Fazila Abu Bakar , Ang Shin Yuh
Published: June 2021

Background:

The current practice of fluid intake and output monitoring for hospitalised patients in one local acute care tertiary hospital was unclear and inconsistent. Inaccurate fluid balance monitoring and poor documentation can result in poor clinical outcomes.

Aim:

To provide an overview of the current practice of ordering, monitoring and documentation of patient fluid intake and output during hospitalisation.

Methods:

Electronic charts of 2199 adults were reviewed for appropriateness and accuracy of monitoring and documentation of the fluid balance records. Data retrieved for each patient included: (1) Was daily fluid balance monitoring clinically indicated? (2) Was daily fluid balance monitoring prescribed by the doctors or initiated by the nurses? (3) Was the daily fluid balance documentation accurate for the entire admission?

Findings:

Of the reviewed patients, 68% were on fluid balance monitoring, of whom 31% were prescribed by medical teams and 69% were nurse-initiated. Among patients who were receiving fluid balance monitoring, 78% were clinically indicated (35% prescribed by doctors), and 22% had no clinical indications (18% prescribed by doctors). Overall, documentation accuracy of the intake and output charts was 77%, with 100% accuracy in the oral and intravenous fluid intake, and 21% accuracy in the output documentation. Among the inaccurate documentation of monitoring with no quantifiable amount, ‘void in toilet’ was the most inaccurately documented (93.3%).

Conclusions:

It is vital to address the current disparities in hospital practice, which include prescribing fluid balance monitoring for patients without a clinical indication and documenting incomplete or poor quality information in patients' intake and output charts. Future quality improvement and research work is needed to improve patient safety and outcomes.
Bearing/Distance Problems in Mathematics: Teachers’ Construction Efficacy in the Secondary School in Plateau State, Nigeria
Authors: Bot Thomas D.
Published: June 2021

In Nigeria, most teachers among other things lack the necessary teaching skills, and mastery of subject matter for effective teaching of mathematics at the secondary school level. These deficiencies have often resulted in high and repeated failure rates in national and standard mathematics examinations. The present study investigated the ability of mathematics teachers to construct practical and realistic word problems in bearing and distance toward mitigating the deficiencies. The research methods adopted were exploratory and descriptive surveys due to the need to explore and analyze the abilities using quantitative techniques. Sample consisted of 292 (35.48%) mathematics teachers who took part in the in-service training workshop organized by the Mathematical Association of Nigeria (MAN) in Plateau state, Nigeria. Purposive sampling technique was used to select the sample that involved the workshop participants only. The instrument ‘construction of practical and realistic word problems in bearing and distance test (CPRWPBDT)’ was used for data collection while the analysis was carried out using simple percentages, mean scores and one-way ANOVA. The findings of the study among other things revealed that the mathematics teacher participants constructed practical and realistic word problems in bearing and distance within 91.67% completion rate, 70.45% of the problems constructed were within the context, at least 75% rate of correctness with little difficulties/errors was observed in sketching (65.90%), and reality (40.90%). The variations observed within the participants in the construction of the problems were statistically not significant. Thus it was recommended among other things that mathematics teachers should undergo regular in-service workshop training to help in developing essential skills themselves for constructing practical/realistic word problems in bearing and distance; and should avoid unnecessary errors for meaningful teaching and learning of bearing and distance.
A Study on the Characterization of Halophilic Microorganisms Isolated from Fermented Seafood
Authors: Jeong Ga Eul , Ganbat Dariimaa , Yeom YuJeong , Choi Bo Gyeong , Lee Han-Seung , Park Mi-Hwa , Shin Kee-Sun , Lee Yong-Jik , Lee Sang-Jae
Published: June 2021

To identify the diversity of halophilic bacteria from fermented seafoods, 86 strains were isolated and a phylogenetic analysis was carried out based on the results of 16S rRNA gene sequencing. The isolated strains were divided into 3 phyla, 7 families, 9 genera, and 24 species. Bacilli class, the main phyletic group, comprised 84.9% with 4 families, 6 genera, and 19 species of Bacillaceae, Planococcaceae, Staphylococcaceae, and Enterococcaceae. The strains were tested for amylolytic, cellulolytic, lipolytic, and proteolytic activity and 55 strains showed at least one enzyme activity. Furthermore, auxin activity was determined in two strains. These results indicate that the isolated strains have the possibility for application in the food and feed industries and of being important genetic resources in Korea.
Microvascular blood flow changes of the abductor pollicis brevis muscle during sustained static exercise
Authors: Giovannella Martina , Urtane Evelina , Zanoletti Marta , Karadeniz Umut , Rubins Uldis , Weigel Udo M. , Marcinkevics Zbignevs , Durduran Turgut
Published: June 2021

A practical assessment of the general health and microvascular function of the palm muscle, abductor pollicis brevis (APB), is important for the diagnosis of different conditions. In this study, we have developed a protocol and a probe to study microvascular blood flow using near-infrared diffuse correlation spectroscopy (DCS) in APB during and after thumb abduction at 55% of maximum voluntary contraction (MVC). Near-infrared time resolved spectroscopy (TRS) was also used to characterize the baseline optical and hemodynamic properties. Thirteen (n=13) subjects were enrolled and subdivided in low MVC (N=6, MVC<2.3 kg) and high MVC (N=7, MVC≥2.3 kg) groups. After ruling out significant changes in the systemic physiology that influence the muscle hemodynamics, we have observed that the high MVC group showed a 56% and 36% decrease in the blood flow during exercise, with respect to baseline, in the long and short source-detector (SD) separations (p=0.031 for both). No statistical differences were shown for the low MVC group (p=1 for short and p=0.15 for long SD). These results suggest that the mechanical occlusion, due to increased intramuscular pressure, exceeded the vasodilation elicited by the higher metabolic demand. Also, blood flow changes during thumb contraction negatively correlated (R=-0.7, p<0.01) with the absolute force applied by each subject. Furthermore, after the exercise, muscular blood flow increased significantly immediately after thumb contractions in both high and low MVC groups, with respect to the recorded values during the exercise (p=0.031). An increase of 251% (200%) was found for the long (short) SD in the low MVC group. The high MVC groups showed a significant 90% increase in blood flow only after 80 s from the start of the protocol. For both low and high MVC groups, blood flow recovered to baseline values within 160 s from starting the exercise. In conclusion, DCS allows the study of the response of a small muscle to static exercise and can be potentially used in multiple clinical conditions scenarios for assessing microvascular health.
Seroprevalence of anti-SARS-CoV-2 IgG antibodies in the staff of a public school system in the midwestern United States
Authors: Lopez Lilah , Nguyen Thao , Weber Graham , Kleimola Katlyn , Bereda Megan , Liu Yiling , Accorsi Emma K. , Skates Steven J. , Santa Maria John P. , Smith Kendal R. , Kalinich Mark
Published: June 2021

Since March 2020, the United States has lost over 580,000 lives to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. A growing body of literature describes population-level SARS-CoV-2 exposure, but studies of antibody seroprevalence within school systems are critically lacking, hampering evidence-based discussions on school reopenings. The Lake Central School Corporation (LCSC), a public school system in suburban Indiana, USA, assessed SARS-CoV-2 seroprevalence in its staff and identified correlations between seropositivity and subjective histories and demographics. This study is a cross-sectional, population-based analysis of the seroprevalence of SARS-CoV-2 in LCSC staff measured in July 2020. We tested for seroprevalence with the Abbott Alinity™ SARS-CoV-2 IgG antibody test. The primary outcome was the total seroprevalence of SARS-CoV-2, and secondary outcomes included trends of antibody presence in relation to baseline attributes. 753 participants representative of the staff at large were enrolled. 22 participants (2.9%, 95% CI: 1.8% - 4.4%) tested positive for SARS-CoV-2 antibodies. Correcting for test performance parameters, the seroprevalence is estimated at 1.7% (90% Credible Interval: 0.27% - 3.3%). Multivariable logistic regression including mask wearing, travel history, symptom history, and contact history revealed a 48-fold increase in the odds of seropositivity if an individual previously tested positive for COVID-19 (OR: 48, 95% CI: 4–600). Amongst individuals with no previous positive test, exposure to a person diagnosed with COVID-19 increased the odds of seropositivity by 7-fold (OR: 7.2, 95% CI: 2.6–19). Assuming the presence of antibodies is associated with immunity against SARS-CoV-2 infection, these results demonstrate a broad lack of herd immunity amongst the school corporation’s staff irrespective of employment role or location. Protective measures like contact tracing, face coverings, and social distancing are therefore vital to maintaining the safety of both students and staff as the school year progresses.
COVI-Prim survey: Challenges for Austrian and German general practitioners during initial phase of COVID-19
Authors: Siebenhofer Andrea , Huter Sebastian , Avian Alexander , Mergenthal Karola , Schaffler-Schaden Dagmar , Spary-Kainz Ulrike , Bachler Herbert , Flamm Maria
Published: June 2021

Background

Coronavirus disease 2019 (COVID-19) represents a significant challenge to health care systems around the world. A well-functioning primary care system is crucial in epidemic situations as it plays an important role in the development of a system-wide response.

Methods

2,187 Austrian and German GPs answered an internet survey on preparedness, testing, staff protection, perception of risk, self-confidence, a decrease in the number of patient contacts, and efforts to control the spread of the virus in the practice during the early phase of the COVID-pandemic (3rd to 30th April).

Results

The completion rate of the questionnaire was high (90.9%). GPs gave low ratings to their preparedness for a pandemic, testing of suspected cases and efforts to protect staff. The provision of information to GPs and the perception of risk were rated as moderate. On the other hand, the participants rated their self-confidence, a decrease in patient contacts and their efforts to control the spread of the disease highly.

Conclusion

Primary care is an important resource for dealing with a pandemic like COVID-19. The workforce is confident and willing to take an active role, but needs to be provided with the appropriate surrounding conditions. This will require that certain conditions are met.

Registration

Trial registration at the German Clinical Trials Register: DRKS00021231.
Optimizing hyperparameters of deep reinforcement learning for autonomous driving based on whale optimization algorithm
Authors: Ashraf Nesma M. , Mostafa Reham R. , Sakr Rasha H. , Rashad M. Z.
Published: June 2021

Deep Reinforcement Learning (DRL) enables agents to make decisions based on a well-designed reward function that suites a particular environment without any prior knowledge related to a given environment. The adaptation of hyperparameters has a great impact on the overall learning process and the learning processing times. Hyperparameters should be accurately estimated while training DRL algorithms, which is one of the key challenges that we attempt to address. This paper employs a swarm-based optimization algorithm, namely the Whale Optimization Algorithm (WOA), for optimizing the hyperparameters of the Deep Deterministic Policy Gradient (DDPG) algorithm to achieve the optimum control strategy in an autonomous driving control problem. DDPG is capable of handling complex environments, which contain continuous spaces for actions. To evaluate the proposed algorithm, the Open Racing Car Simulator (TORCS), a realistic autonomous driving simulation environment, was chosen to its ease of design and implementation. Using TORCS, the DDPG agent with optimized hyperparameters was compared with a DDPG agent with reference hyperparameters. The experimental results showed that the DDPG’s hyperparameters optimization leads to maximizing the total rewards, along with testing episodes and maintaining a stable driving policy.
Towards distortion-free imaging of the eye
Authors: Bedggood Phillip , Metha Andrew
Published: June 2021

The high power of the eye and optical components used to image it result in “static” distortion, remaining constant across acquired retinal images. In addition, raster-based systems sample points or lines of the image over time, suffering from “dynamic” distortion due to the constant motion of the eye. We recently described an algorithm which corrects for the latter problem but is entirely blind to the former. Here, we describe a new procedure termed “DIOS” (Dewarp Image by Oblique Shift) to remove static distortion of arbitrary type. Much like the dynamic correction method, it relies on locating the same tissue in multiple frames acquired as the eye moves through different gaze positions. Here, the resultant maps of pixel displacement are used to form a sparse system of simultaneous linear equations whose solution gives the common warp seen by all frames. We show that the method successfully handles torsional movement of the eye. We also show that the output of the previously described dynamic correction procedure may be used as input for this new procedure, recovering an image of the tissue that is, in principle, a faithful replica free of any type of distortion. The method could be extended beyond ocular imaging, to any kind of imaging system in which the image can move or be made to move across the detector.
Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019
Authors: Curado Daniel da Silva Pereira , Gomes Dalila Fernandes , Silva Thales Brendon Castano , Almeida Paulo Henrique Ribeiro Fernandes , Tavares Noemia Urruth Leão , Areda Camila Alves , da Silva Everton Nunes
Published: June 2021

Introduction

Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015.

Objective

To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019.

Methods

A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted.

Results

The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation.

Conclusion

Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.
When face masks signal social identity: Explaining the deep face-mask divide during the COVID-19 pandemic
Authors: Powdthavee Nattavudh , Riyanto Yohanes E. , Wong Erwin C. L. , Yeo Jonathan X. W. , Chan Qi Yu
Published: June 2021

With the COVID-19 pandemic still raging and the vaccination program still rolling out, there continues to be an immediate need for public health officials to better understand the mechanisms behind the deep and perpetual divide over face masks in America. Using a random sample of Americans (N = 615), following a pre-registered experimental design and analysis plan, we first demonstrated that mask wearers were not innately more cooperative as individuals than non-mask wearers in the Prisoners’ Dilemma (PD) game when information about their own and the other person’s mask usage was not salient. However, we found strong evidence of in-group favouritism among both mask and non-mask wearers when information about the other partner’s mask usage was known. Non-mask wearers were 23 percentage points less likely to cooperate than mask wearers when facing a mask-wearing partner, and 26 percentage points more likely to cooperate than mask wearers when facing a non-mask-wearing partner. Our analysis suggests social identity effects as the primary reason behind people’s decision whether to wear face masks during the pandemic.
Le frontiere del corpo. Il velo e l’identità femminile nella società multiculturale
Authors: Cagnolati Antonella
Published: June 2021

La categoria di genere ed il concetto di multiculturalismo possono convivere? Se lo chiedeva già a metà degli anni Novanta Susan Moller Okin, dando origine ad un dibattito che oggi appare di scottante attualità in conseguenza delle polemiche sul velo. In Francia la discussione procede con toni aspri che rivelano la difficoltà di far coincidere  teorie libertarie con modelli comportamentali che suscitano ostilità, rancore, diffidenza. Nella realtà la diatriba sul velo nasconde altri significati che rivelano la volontà di marcare con confini precisi l’identità, sia da un parte che dall’altra del confine socio-antropologico. La relazione vuole indagare dietro le prese di posizione per comprendere quali siano i nodi del contendere e per quale motivo le distinzioni e la xenofobia passino ancora una volta sul corpo delle donne, intesi come una trincea per la difesa di valori in opposizione. ¿La categoría de género y el concepto de multiculturalismo pueden vivir uno al lado del otro? se preguntaba a mediados de los años noventa Susan Moller Okin, dando lugar a un debate de gran actualidad como resultado de la controversia sobre el velo. En Francia la discusión se desarrolla con tonos ásperos que revelan la dificultad que existe para conciliar las teorías libertarias con los patrones de conducta que despiertan la hostilidad, el resentimiento, la desconfianza. De hecho, la controversia sobre el velo, esconde otros significados que revelan la voluntad de marcar la identidad con límites claros de un lado y del otro de la frontera socio-antropológica. El artículo tiene como objetivo investigar acerca de las posiciones adoptadas en Europa sobre el velo con el fin de comprender cuáles son los nudos de la controversia y por qué las diferencias y la xenofobia pasan una vez más por el cuerpo de la mujer, entendido como una trinchera para la defensa de valores en oposición.
Effect of Majapahit (Crescentia cujete L.) fruit powder on the immune profile of Litopenaeus vannamei after infection with Vibrio spp.
Authors: Rahmaningsih Sri , Andriani Riska , Pujiastutik Hernik
Published: June 2021

Background and Aim: The use of bioactive compounds is a promising tool to improve shrimp health regarding vibriosis. This study aimed to determine the effect of the dietary Majapahit (Crescentia cujete L.) fruit powder on the cellular immune response of vannamei shrimp (Litopenaeus vannamei) infected with Vibrio harveyi, Vibrio alginolyticus, and Vibrio parahaemolyticus.

Materials and Methods: Twelve vannamei shrimp (aged 1 month) were randomly divided into four groups (n=3). Vannamei shrimp received experimental feed with different concentrations of Majapahit fruit powder for 20 days: Group A, 0%; Group B, 3.04%; Group C, 6.08%, and Group D, 9.12%. Subsequently, vannamei shrimp was infected with V. harveyi, V. alginolyticus, and V. parahaemolyticus. The total hemocytes, total differential hemocytes (hyaline, semi-granular, and granular cells), and phagocytic activity were assessed. Data were analyzed through analysis of variance (p<0.05) using SPSS ver. 24 for Windows.

Results: Majapahit fruit powder at a dose of 3.04% increased the number of hyaline cells of L. vannamei after infection with Vibrio spp. Supplementation of the feed formula with Majapahit fruit powder at a dose of 3.04% increased the number of semi-granular and granular cells compared with the control. Furthermore, Majapahit fruit powder at doses of 3.04% and 6.08% increased the hemocytes compared with a dose of 9.12%. The phagocytic activity of L. vannamei after infection with Vibrio spp. tends to increase after supplementation with 3.04% Majapahit fruit powder.

Conclusion: This study showed that the addition of C. cujete L. powder to the feed formula increased the cellular immune response. The most effective dose ranged from 3.04% to 6.08%.
Potencial do Parque Natural Municipal das Andorinhas, Ouro Preto (MG) para o Geoturismo
Authors: Detoni Henrique , Fonseca Filho Ricardo Eustáquio
Published: June 2021

As unidades de conservação são territórios com diferentes possibilidades para o turismo. O Parque Natural Municipal das Andorinhas (PNMA), em Ouro Preto (MG), com sua paisagem de campos rupestres quartzíticos e cursos d’água recebe visitantes que buscam o ecoturismo. Contanto, o PNMA tem rica geodiversidade para a prática do Geoturismo, segmento em desenvolvimento que busca interpretar e conservar os elementos abióticos. Assim, o objetivo da pesquisa foi levantar o potencial geoturístico do PNMA. A metodologia se deu por etapas de escritório e de campo. A primeira contou com pesquisa bibliográfica e digital de Geoturismo e UC, e documental do plano de manejo do parque, além de elaboração de fichas de inventário e quantificação geoturística, a partir de Paula & Castro (2014) e Brilha (2005). Na segunda, houve trabalho de campo com inventário e quantificação de geossítios. Os resultados demonstraram que o PNMA possui significativo potencial para o uso geoturístico através das cachoeiras e mirantes, mas a falta de recursos financeiros e humanos dificulta a implantação de roteiros geoturísticos. Assim, espera-se que este trabalho possa contribuir para a sensibilização de turistas, comunidade, gestores e empresas para a importância da geoconservação via Geoturismo.
As regiões turísticas de Santa Catarina: Análise do desenvolvimento turístico regional a partir da categorização do mapa do turismo brasileiro – 2019 (MTUR)
Authors: Anjos Francisco Antônio dos , Andrade Ilário Caubi Fraga de
Published: June 2021

Santa Catarina tem destaque no cenário turístico brasileiro, tanto pela forte demanda para seus principais destinos, quanto pelo processo de regionalização que se remete às décadas de 1970 e 1980. A atual política nacional de categorização dos municípios turísticos, denominada Mapa do Turismo, teve início em 2013, com sua última atualização em 2019. A categorização faz parte do programa de Regionalização do Turismo Brasileiro. O objetivo principal deste artigo é analisar a evolução da categorização regional do turismo no Estado de Santa Catarina, a partir da categorização e regionalização referente à Política Nacional de Turismo. A pesquisa-base deste artigo teve caráter exploratório e descritivo, através de pesquisa documental. Os dados da categorização municipal foram organizados por regiões turísticas para reconhecer índices de desenvolvimento turístico regional. Foram reconhecidas regiões consolidadas, em consolidação e não consolidadas em Santa Catarina. Os índices apresentaram um panorama do desenvolvimento turístico nas regiões de Santa Catarina, reconhecendo uma região turística consolidada, cinco regiões em consolidação e sete regiões não consolidadas. A partir dos dados analisados e avaliados do turismo de Santa Catarina, percebe-se que as regiões se encontram em constantes transformações nos momentos de renovações de políticas públicas, que sinalizam a necessidade de adoção de ações de governança estratégica por parte das administrações municipais, estaduais e nacionais, frente à categorização municipal e divisão regional.
TEKNIK AUDIO FORENSIK DENGAN METODE MINKOWSKI UNTUK PENGENALAN REKAMAN SUARA PELAKU KEJAHATAN
Authors: Azwar Muhamad , Hidayat Syarif , Yudha Fietyata
Published: June 2021

Tindak pidana yang dilakukan pelaku kejahatan sedikit tidaknya terdapat barang bukti digital yang ditinggalkan berupa rekaman suara yang dihasilkan dari percakapan menggunakan telepon, algoritma dalam menganalisis suara rekaman banyak beredar di internet salah satunya algoritma KNN yang biasanya digunakan untuk klasifikasi, identifikasi dan prediksi. Penelitian ini menggunakan algoritma tersebut dengan metode Minkowski untuk melakukan pengenalan sampel suara rekaman percakapan pelaku kejahatan dengan sampel suara tersangka. Melibatkan dua responden yang berperan sebagai tersangka dan tiga responden berperan sebagai pelaku. Masing-masing responden akan melakukan dubbing (perekaman suara) dan dipotong menjadi sebelas bagian sebagai data latih dan data uji. sampel suara percakapan akan di extract menggunakan teknik MFCC untuk mendapatkan nilai spectrum yang selanjutnya akan diproses menggunakan algoritma KNN dan metode minkowski menggunakan Python. Hasil dari penelitian ini adalah dari sebelas sampel suara tersangka pertama ada beberapa sampel suara yang Identik dengan sampel suara pelaku dengan tingkat  akurasi sebesar 0.63 terlihat dari jarak terkecil yang dihasilkan karena sampel suara pelaku yang mirip dengan sampel suara tersangka pertama diperankan oleh responden yang sama. Sedangkan tingkat akurasi yang didapatkan dari tersangka kedua sebesar 0.18 karena ada dua sampel suara pelaku yang mendekati kemiripan dengan suara tersangka kedua namun diperankan oleh responden yang berbeda, algoritma KNN dengan metode Minkowski dapat digunakan untuk melakukan pengenalan rekaman suara pelaku dengan tersangka karena menghasilkan jarak terkecil yang mendekati kemiripan sehingga barang bukti berupa rekaman suara dapat dipertanggungjawabkan dalam persidangan.
PENGEMBANGAN APLIKASI INFORMATION GATHERING MENGGUNAKAN METODE HYBRID SCAN BERBASIS GRAPHICAL USER INTERFACE
Authors: Riasetiawan Mardhani , Wisnuaji Akas , Hariyadi Dedy , Febrianto Tri
Published: June 2021

Sebagian analis keamanan sistem dan jaringan komputer menyatakan aplikasi atau alat bantu pengujian berbasis Command-line Interface (CLI) sangat mempermudah pekerjaan. Namun, tidak banyak aplikasi tersebut tidak komprehensif baik cara menganalisis maupun hasil laporannya. Laporan pada proses pengujian keamanan sistem dan jaringan komputer diharapkan minimal terdiri dari dua tipe, yaitu keperluan manajemen dan tim teknis. Tulisan ini diusulkan pengembangan aplikasi atau alat bantu pengujian keamanan sistem dan jaringan komputer yang komprehensif dan memiliki laporan yang memudahkan tim manajemen dan tim teknis. Pada pengembangan ini menggunakan bahasa pemrograman Python dengan module TKInter untuk menghasilkan aplikasi berbasis Graphical User Interface (GUI). Dengan menggunakan aplikasi GUI harapannya dapat digunakan oleh siapapun. Fokus pengembangan aplikasi ini yaitu pada tahapan Information Gathering yang menggunakan metode Hybrid Scan,yaitu: Passive dan Active. Passive Scan menggunakan 11 Application Programming Interface (API) sedangkan Active Scan menggunakan Socket Module Python dan berberapa aplikasi native yang berjalan di GNU/Linux.
Continuous-Flow Left Ventricular Assist Device Explantation After More Than 5 Years of Circulatory Support and Ventricular Reconditioning
Authors: Letsou George V. , Baldwin Andrew C.W. , Civitello Andrew B. , Cohn William E. , Frazier O.H.
Published: June 2021

Continuous-flow left ventricular assist devices have proved to be effective, durable, life-saving tools in patients with end-stage heart failure. However, because of the risks associated with mechanical circulatory support (including stroke, infection, gastrointestinal bleeding, and device malfunction), the optimal goal of device therapy is myocardial recovery and device removal. Ventricular reconditioning and pump explantation after continuous-flow support have been reported; however, little is known about variables that govern the pace and degree of myocardial response in patients who experience such recovery. We describe our long-term pump-weaning strategy for a 25-year-old man who had a continuous-flow device implanted and then needed more than 5 years of support from it before developing cardiac reserve sufficient to enable pump explantation. To our knowledge, this is the longest period of uninterrupted continuous-flow device support to end in successful pump deactivation and a return to medical therapy. This case highlights the importance of actively and persistently pursuing a device-weaning strategy in all patients who need left ventricular assist device therapy.
Approche de surveillance de la population afin de détecter les nouveaux agrégats de cas de COVID-19 et y répondre
Authors: Rees Erin E , Rodin Rachel , Ogden Nicholas H
Published: June 2021

Contexte : Pour maintenir le contrôle de l’épidémie de maladie à coronavirus 2019 (COVID-19) lorsque les mesures de confinement seront levées, il sera essentiel de renforcer les mesures de santé publique alternatives. En ce qui concerne la surveillance, il sera nécessaire de détecter rapidement une grande proportion de tous nouveaux cas afin de pouvoir les isoler, et retrouver et mettre en quarantaine les personnes qui y ont été exposées. Nous présentons ici une approche mathématique qui peut être utilisée pour déterminer combien d’échantillons doivent être recueillis par unité de surface et par unité de temps pour détecter de nouveaux agrégats de cas de COVID-19 à un stade suffisamment précoce pour contrôler une éclosion. Méthodes : Nous présentons une méthode de détermination de la taille de l’échantillon qui utilise une approche de pondération relative. Compte tenu du fait que les résultats du test de diagnostic de la COVID-19 provenant de sous-populations ont contribué à détecter la maladie à un niveau de prévalence seuil pour contrôler l’éclosion, il s’agissait de 1) déterminer si le nombre prévu d’échantillons hebdomadaires fournis par la surveillance actuelle des infections virales respiratoires fondée sur les soins de santé peut fournir une taille d’échantillon déjà adéquate pour détecter de nouveaux agrégats de cas de COVID-19 et, dans le cas contraire, 2) de déterminer combien d’échantillons hebdomadaires supplémentaires étaient nécessaires à partir d’un échantillonnage volontaire. Résultats : Lors d’une démonstration de notre méthode à une fréquence hebdomadaire et à l’échelle des provinces et territoires canadiens, nous avons constaté que seuls les provinces et les territoires les plus peuplés disposaient d’un nombre suffisant de dépistages provenant des visites médicales en raison de maladies respiratoires pour détecter la COVID-19 à notre niveau de prévalence cible — qui doit être suffisamment élevé pour identifier et contrôler les nouveaux agrégats de cas. En outre, la détection de la COVID-19 est plus efficace (moins d’échantillons requis) lorsque la surveillance se concentre sur l’exigence de tests de dépistage de patients symptomatiques par les services des soins de santé. Dans les populations volontaires : plus les taux de contact sont élevés, plus le niveau de prévalence attendu est élevé, et moins il faut d’échantillons pour détecter la COVID-19 à un seuil prédéterminé. Conclusion : Cette étude présente une stratégie de surveillance ciblée, combinant des échantillons de surveillance passive et active, afin de déterminer le nombre d’échantillons à recueillir par unité de surface et par unité de temps pour détecter de nouveaux agrégats de cas de COVID-19. L’objectif de cette stratégie est de permettre une détection suffisamment précoce pour contrôler une éclosion.
Bioaérosols provenant de la respiration buccale : mode de transmission méconnu de la COVID-19?
Authors: Balasubramanian Saravanakarthikeyan , Vinayachandran Divya
Published: June 2021

Le monde entier a été touché par la pandémie de maladie à coronavirus 2019 (COVID-19), et de nombreux chercheurs se lancent dans une course pour comprendre l’évolution de la maladie et entreprendre des analyses de risque afin de formuler des stratégies de traitement efficaces. Le coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) est très transmissible par la toux et les éternuements, ainsi que par la respiration et en parlant, ce qui peut expliquer la transmission virale à partir de porteurs asymptomatiques. Les bioaérosols produits pendant la respiration buccale, un processus expiratoire chez les personnes qui respirent habituellement par la bouche, doivent être considérés, en plus des bioparticules nasales, comme un mode de transmission potentiel de la COVID-19. Les professionnels de la santé buccodentaire craignent, à juste titre, le risque d’exposition dû à la proximité du contact direct et au mode de transmission. L’objectif de ce commentaire est de résumer les recherches menées dans ce domaine et de proposer des stratégies pour limiter la propagation de la COVID-19, notamment dans les cabinets dentaires.
Démontrer la capacité du Comité consultatif national de l’immunisation à réagir rapidement aux signaux de surveillance des vaccins après leur mise sur le marché : l’expérience du Canada avec le vaccin antigrippal vivant atténué
Authors: Zhao Linlu , Young Kelsey , House Althea , Stirling Rob , Tunis Matthew
Published: June 2021

Au cours des dernières années, l’utilisation recommandée du vaccin vivant atténué contre l’influenza (VVAI) pour les enfants a évolué aux États-Unis en réponse aux preuves d’une diminution potentielle de l’efficacité du VVAI basées sur la surveillance post-commercialisation. Ces problèmes n’ont pas été observés au Canada ou ailleurs ; par conséquent, les recommandations du Comité consultatif national de l’immunisation (CCNI) du Canada et du Advisory Committee on Immunization Practices (ACIP) des États-Unis sur l’opportunité d’utiliser le VVAI ont différé pour deux saisons grippales (2016–2017 et 2017–2018). Cette rétrospective décrit comment le CCNI est parvenu à ses recommandations en réponse aux signaux post-commercialisation d’une baisse de performance des VVAI provenant des États-Unis en 2013–2014 et à nouveau en 2015–2016. L’expérience du CCNI avec le VVAI marque la première fois au Canada où une recommandation préférentielle sur l’utilisation d’un vaccin antigrippal dans un programme d’immunisation systématique a été renversée. Cette expérience souligne l’importance d’une surveillance continue des vaccins après leur mise sur le marché, d’une collaboration internationale et d’une prise en compte attentive du contexte local pour étayer les recommandations relatives aux vaccins. La capacité du CCNI à réagir rapidement aux signaux de performance des vaccins après leur mise sur le marché facilitera la réaction à des signaux similaires de surveillance après la mise sur le marché des vaccins contre la maladie à coronavirus 2019 (COVID-19).
Canada’s first indigenous physician? The story of Dr. O (1841–1907)
Authors: Hamilton Michelle A.
Published: June 2021

As a physician, temperance advocate, chairman of the Grand General Indian Council of Ontario, the Supreme Chief Ranger of the Independent Order of Foresters, and mistakenly known as a Mohawk Chief, Dr. Oronhyatekha was a well-known, larger-than-life figure in North America and internationally. Since then, his memory has faded in mainstream society. Recently, however, he has re-emerged as a person of historical significance, designated as such by Parks Canada. Now the subject of the first full-length biography, co-authors Michelle Hamilton and Keith Jamieson, have separated out the true stories of his life from apocryphal ones. Although he was much more than a doctor, what follows is the story of how Oronhyatekha, a Mohawk boy baptized Peter Martin at the Six Nations of the Grand River, tenaciously pursued his dream of becoming a physician.
Does operative experience during residency correlate with reported competency of recent general surgery graduates?
Authors: Safavi Arash , Lai Sarah , Butterworth Sonia , Hameed Morad , Schiller Dan , Skarsgard Erik
Published: June 2021

Background: Identification of attributes of residency training that predict competency would improve surgical education. We hypothesized that case experience during residency would correlate with self-reported competency of recent graduates. Methods: Aggregate case log data of residents enrolled in 2 general surgery programs were collected over a 12-month period and stratified into Surgical Council on Resident Education (SCORE) categories. We surveyed recent (< 5 yr) residency graduates on procedural competency. Resident case volumes were correlated with survey responses by SCORE category. Results: In all, 75 residents performed 11 715 operations, which were distributed by SCORE category as follows: essential-common (EC) 9935 (84.8%), essential-uncommon (EU) 889 (7.6%) and complex 891 (7.6%). Alimentary tract procedures were the most commonly performed EC (2386, 24%) and EU (504, 56.7%) procedures. The least common EC procedure was plastic surgery (4, 0.04%), and the least common EU procedure was abdomen–spleen (1, 0.1%). The questionnaire response rate was 45%. For EC procedures, self-reported competency was highest in skin and soft tissue, thor acic and head and neck (each 100%) and lowest in vascular–venous (54%), whereas for EU procedures it was highest in abdomen–general (100%) and lowest in vascular–arterial (62%). The correlation between case volume and self-reported competency was poor (R = 0.2 for EC procedures). Conclusion: Self-reported competency correlates poorly with operative case experience during residency. Other curriculum factors, including specific rotations and timing, balance between inpatient and outpatient surgical experience and competition for cases, may contribute to procedural competency acquisition during residency.
On coupled system of nonlinear Ψ-Hilfer hybrid fractional differential equations
Authors: Mali Ashwini D. , Kucche Kishor D. , Vanterler da Costa Sousa José
Published: June 2021

This paper is dedicated to investigating the existence of solutions to the initial value problem (IVP) for a coupled system of Ψ-Hilfer hybrid fractional differential equations (FDEs) and boundary value problem (BVP) for a coupled system of Ψ-Hilfer hybrid FDEs. Analysis of the current paper depends on the two fixed point theorems involving three operators characterized on Banach algebra. In the view of an application, we provided useful examples to exhibit the effectiveness of our achieved results.