bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship between Anxiety Level and Learning Achievement in Math Subject in Primary School Students
Authors: Meiliyani Rizqi
Published: May 2022

Introduction. This study aims to determine whether there is a relationship between anxiety and mathematics learning achievement in the material of volume building space in primary school students in Bantul, Yogyakarta.

Methods. This research uses quantitative research with a survey method through a correlation approach. The population in this study were students in fifth-grade of primary school in Jetis Bantul. The total participant in this study was 28 students. Measuring instruments in this study are math problems, interviews and anxiety scales. The analysis technique used in this study is with the help of the SPSS 22.0 For Windows program.

Results. The normality test calculation results show a significance on the anxiety scale of 0.200, while the mathematics learning achievement is 0.010. Based on the hypothesis test calculation using the Spearman correlation, the correlation between anxiety and mathematics learning achievement is that there is a relationship between anxiety and achievement learning math but not significant.

Conclusion. There is a relationship between anxiety and achievement in mathematics in a fifth-grade primary school student.
Management of Childhood - Onset Schizophrenia: A Literature Review
Authors: Widyawati Ika
Published: May 2022

Schizophrenia is one of the most common and well-known psychotic disorders that inhibits neurodevelopmental processes and has detrimental effects on cognitive, affective and social functions. Schizophrenia constitutes 1% of the general population, in the US there are more than 300.000 episodes of acute schizophrenia appearing per year. From epidemiolo.ical data on children and adolescents, it was found that less than 1/10.000 suffered from childhood schizophrenia, also found more in boys to adolescence, and the ratio was almost the same after adolescence as in adults. Early detection is needed so that schizophrenia that occurs especially in childhood does not develop into a chronic condition with a worsening prognosis.
The Mental Health of First-Year Medical Students in Universitas Baiturrahmah
Authors: Anissa Mutiara , Resti Rahmadika Akbar  , Anita Darmayanti  , Meta Oktora
Published: May 2022

Introduction. First-year students are a group that has experienced many changes in their lives. Studying in university requires students to be exposed to new challenges, namely academic demands, independence to meet needs and activities, and more independence in learning. Medical students have a heavier burden due to a dense curriculum, so that they will face various module exams, clinical skills, practicums, lectures, and other student organizational activities. If students are not able to adjust, then this can cause emotional mental disorders.Methods. This study was a cross-sectional design. Participants are new students of the 2020 in Faculty of Medicine, consist of the Medical Study Program and the Clinical Pharmacy Study Program. The research sample is total sampling. This research instrument uses a Self Reporting Questionnaire (SRQ). This questionnaire can measure the mental state of a person who has a 30 days time limit. Data processing using SPSS, univariate data is displayed in the form of a frequency distribution table.Results. In this study, most of the respondent have total SRQ less than 6 (80.8%). The symptoms of mental emotional disorders that are most commonly found are somatic symptoms and depressive symptoms.Conclusion. The mental health of Baiturrahmah medical students is still within the normal range, but mental health assessments need to be carried out every year.
Absence of Biological Mothers in Infancy in Children and Adolescents on Diagnosis of Mental Disorders at Ikeswar Outpatient Clinic, Prof. Dr. Soerojo Mental Hospital, Magelang
Authors: Edith Humris  , Bangun Susi Rutmalem , Bayu Soenarsana Putra  , Sak Liung  , Kornelis Ibrawansyah
Published: May 2022

Introduction. Globally, psychopathological problems in children and adolescents will become one of five problems that cause disability, morbidity, and even mortality in the next 20 years. The quality of a child's early attachment relationship is closely related to future brain and personality development. Attachment disorders are associated with the development of psychopathology in childhood and adulthood. This study aims to describe mental disorders in children and adolescents due to mothers who leave their children in infancy on Java, especially around Magelang.

Methods. The type of this research is cross-sectional, namely descriptive research. The sample in this study were all patients and their parents/guardians who came for a consultation to the Ikeswar Polyclinic,  Mental Hospital Prof. Dr.Soerojo Mental Hospital started on February 18, 2019. The examination uses the mental status determined and guided by PPDGJ III (Guidelines for Classifying the Diagnosis of Mental Disorders).

Results. Most of the research respondents was male, both in children with excellent or poor attachment. As much as 26.1% in the group with suitable attachment. The age of most respondents is ten years old. The fourth axis diagnosis regarding psychosocial and environmental problems that most respondents experienced was primary support group (family) problems

Conclusion. The attachment of the biological mother to the child at the age of fewer than two years is essential for the emotional mentality of the child at the age afterward and there is no visible picture of the difference in diagnosing mental disorders in children with suitable attachment and poor attachment.
Bipolar Type 1 Disorder Comorbid with Idiopathic Epilepsy in Children: A Case Report
Authors: Fadilah Syaiful , Fatimah Haniman
Published: May 2022

Intoduction. Bipolar disorder in children and adolescents, is a clinical disorder that causes public mental health problems that need attention. In the last decade, bipolar disorder in children and adolescents has become a field of great interest, both in the clinical field and in research, especially in terms of the diagnosis which is still controversial. This case report aims to describe type 1 bipolar disorder in children accompanied by idiopathic seizures.

Case presentations. A boy, Mr. M, 10 years old, came to the polyclinic with the chief complaint of walking around during lessons. From the autoanamnesis, the patient said that he was happy, had good achievements in school. The patient experienced a change in behavior for 1 year, which had worsened for 4 months ago. The patient walks around the school while the other students are studying, the patient can't sit still and feels bored. Patients sometimes sing while banging the table. About a week of changing behavior, the patient began to experience frequent seizures. The patient has seizures while sleeping, has seizures if during the day the patient is angry with other people or has too much activity. The patient received pharmacological therapy in the form of aripiprazole, valproic acid and lorazepam. Non-pharmacological interventions are given in the form of family psychoeducation about the disease suffered by the patient.

Conclusion. Clinical and phenomenological characteristics of bipolar disorder in children and Teenagers are unique. In connection with the presence of a unique clinical picture, it is necessary to introduce cases and treatment as early as possible.
Multidisciplinary Team Support for Psychological Aspect of Osteosarcoma Amputation in Children: A Case Report
Authors: Kristianto Budi , Yunias Setiawati
Published: May 2022

Introduction. Osteosarcoma is the most common primary bone tumor in children. The current management is the surgical method (amputation) and continued chemotherapy. When someone is expected to do this treatment, there will be various possible psychological reactions occur. This amputation condition will affect psychological symptoms both before and after the procedure.

Case presentation. A girl, Ms. D, seven years old, first grade of elementary school, planned to be amputated with a diagnosis of right tibia proximal osteosarcoma. The patient is a child the second of 3 siblings. The patient was taken to Dr. Soetomo General Hospital, after checking at the hospital in Ponorogo, then a referral was given for further treatment. Patient is referred because the swelling in the right knee is getting bigger day by day. The patient is being treated and will be planned for surgery with a diagnosis of proximal osteosarcoma right tibia. The patient is consulted by a psychiatrist for assistance considering the patient will be carried out  right leg amputation surgery.

Conclusion.Chemotherapy with various side effects will also have an effect on the psychological condition of the patient. So there is a need for full involvement multidisciplinary in dealing with pediatric patients with osteosarcoma that will be carried out amputation to obtain optimal therapeutic results.
Perancangan Model Penanganan Sampah Kota Bekasi
Authors: Nonistantia
Published: May 2022

Secara astronomi, Kota Bekasi terletak antara 106o48’28’’–107o27’29’’ Bujur Timur dan 6o10’6’’–6o30’6’’ Lintang Selatan, dan memiliki luas wilayah sekitar 210,49 km2 dengan batas-batas wilayah administrasi terdiri atas DKI Jakarta, Kabupaten Bekasi dan Kabupaten Bogor. Dalam buku Kota Bekasi dalam angka Tahun 2018, jumlah penduduk sebesar 2.436.577 jiwa, hal ini menunjukkan peningkatan 2,45 % dari tahun 2017. Ancaman yang berpeluang yakni lingkungan yang tidak sehat, tersumbatnya drainase kota dan aliran sungai yang memberikan dampak fatal yaitu banjir. Tujuan yang ingin dicapai yaitu menata sistem penanganan sampah sehingga mengurangi resiko banjir. Metode yang digunakan adalah merancang sistem bank sampah dan kegiatan pengangkutan sampah dan sedimen saluran (kegiatan pematusan). Hasil penelitian menunjukkan bahwa kegiatan pematusan sepanjang 796 m per-hari atau 23.871 km per-bulan perlu dilakukan oleh dinas teknis DBMSDA Kota Bekasi. Disimpulkan bahwa perancangan model penanganan sampah-sedimen secara sinergi baik masyarakat dari RT-RW yang berkoordinasi dengan dinas terkait dalam sistem pemerintahan Kota Bekasi, mampu mengurangi terjadinya resiko banjir
Reconfiguración teórica y normativa de las limitaciones al derecho de autor en favor de bibliotecas en el entorno digital
Authors: Pereda Mirabal Ana María
Published: May 2022

La actividad bibliotecaria en entornos digitales incide en facultades patrimoniales de autores cuyas obras se coleccionan en estas instituciones, de ahí la necesidad de encontrar un justo equilibrio entre ambos intereses. Constituye objetivo de la presente investigación fundamentar los presupuestos teóricos y normativos que deben amparar la adecuación del sistema de límites y limitaciones al derecho de autor en favor de bibliotecas en el entorno digital actual, de manera que contribuya a la reducción de las afectaciones a los autores o titulares del derecho de autor y restablezca el equilibrio que debe existir entre el derecho de acceso a la cultura y el derecho de los creadores. Los resultados se concretan en la aportación de los presupuestos teóricos y normativos necesarios para el establecimiento de un sistema de límites y limitaciones a favor de las bibliotecas en el entorno digital y en la obtención de un material bibliográfico para ser empleado como fuente de estudio y consulta, tanto en el ámbito académico de pregrado como de posgrado, ya sea por juristas, bibliotecarios, autores, y/o personal administrativo que se encarga de la materia.
Representación y representatividad sindical: La multiafiliación sindical y su trascendencia en los sindicatos minoritarios colombianos
Authors: Mejía Miranda Karen Liliana
Published: May 2022

Este artículo de reflexión presenta una revisión doctrinal, normativa y jurisprudencial del derecho de asociación sindical a partir de la multiafiliación. Al tiempo que profundiza en los criterios de representación y representatividad sindical y la forma en que puede llegar a generarse una distinción o trato diferenciado a las organizaciones sindicales minoritarias. La metodología empleada fue de tipo cualitativa cuyo principal método de recolección consistió en la revisión de fuentes primarias y la recolección de datos mediante la entrevista. A partir de allí, se realizó la construcción de redes semánticas para la generación teórica y la obtención de los resultados gracias al análisis de datos cualitativos, lo cual permitió establecer la discrepancia de criterios que existen en cuanto al límite de los derechos sindicales en las organizaciones minoritarias al interior de una empresa.
Synthesis of sulfur karrikin bioisosteres as potential neuroprotectives
Authors: Pošta Martin , Zima Václav , Poštová Slavětínská Lenka , Matoušová Marika , Beier Petr
Published: May 2022

The only known sulfur-containing karrikin, 3-methyl-2H-thiopyrano[3,4-b]furan-2-one, has been recently identified as an extremely efficient neuroprotective butenolide. Herein, we report the targeted synthesis of this compound as well as new synthetic protocols toward a class of compounds derived from 2H-furo[2,3-c]pyran-2-ones (karrikins) via bioisosteric exchange of oxygen with sulfur. In particular, we present synthetic procedures toward bioisosteres of karrikins with one or two sulfur heteroatoms incorporated into the core backbone together with evaluation of their biological activity in inhibition of acetylcholinesterase.
The Determination of the Status of Turkey in the Medical Tourism Market in Accordance with the Demands of Health Tourists
Authors: KURÇER Doğa , CİVELEK Makbule
Published: May 2022

Medical tourism is the process that people, who need surgical intervention, travel from their region to another region at the request of receiving more professional and cheaper medical services. The main purpose of this study is to provide a better understanding of consumer demand in the medical tourism market and to find out what can be done to gain a competitive advantage in the medical tourism market of Turkey in accordance with these conclusions. Medical tourism practices in the world and Turkey have been analyzed and comparisons have been made in line with this purpose. In the study, SWOT analysis has been used to reveal the current situation of Turkey by compiling the secondary data. It is found that Turkey has not yet got the share which it wants in the medical tourism market. In addition to keeping up with the technological developments in health tourism, Turkey has been also making new investments in health tourism. At the same time, there are studies that aim to develop health tourism by including it in development plans. These studies will enable health tourism to institutionalize and to be planned in a coordinated way. Considering the wealth of alternative tourism in Turkey, the increase in investments and the research of the demands of health tourists will also bring a competitive advantage. This study is important in terms of proper guidance on investments of medical tourism in Turkey, in the future.
Yiyecek-İçecek İşletmelerinde Vizyoner Liderlik Modelinin Örgütsel Bağlılık Üzerindeki Etkisi: Adana İli Örneği
Authors: ERYILMAZ Gamze , DEMİRCİ İsmail , ÖZDEMİR Fatih
Published: May 2022

Bu çalışmada, işgören tarafından algılanan vizyoner liderlik modelinin işgörenlerin örgütsel bağlılık düzeyi üzerindeki etkisinin ortaya konması amaçlanmıştır. İlgili amaç doğrultusunda Adana ilinde yer alan yiyecek-içecek işletmelerinde istihdam edilen işgörenler üzerinde uygulama gerçekleştirilmiştir. Nicel araştırma deseniyle alan araştırılması yapılmış ve kolayda örnekleme metodundan yararlanılarak elde edilen veriler anket formu yardımıyla toplanmıştır. Anket çalışması İskenderun Teknik Üniversitesi Bilimsel Araştırma ve Yayın Etiği kurulunun 14.01.2021 tarih ve E.1415 sayılı kararına göre 15.06.2021-15.10.2021 tarihleri arasında Adana’da faaliyet gösteren 450 yiyecek-içecek işletme çalışanlarına uygulanmıştır. Bu kapsamda 399 veri değerlendirilmeye alınmıştır. Analiz sonucunda genel anlamda yiyecek-içecek işletme çalışanların vizyoner liderlik algılarının örgütsel bağlılık düzeyleri üzerinde olumlu ve anlamlı yönde bir etkisinin olduğu saptanmıştır. Vizyoner liderlik boyutlardan sadece risk faktörünün çalışanların örgütsel bağlılık düzeyleri üzerinde olumlu ve anlamlı düzeyde bir etkisinin olmadığı belirlenmiştir. Elde edilen sonuçlardan hareketle yiyecek içecek işletmeleri, işletme içerisindeki yönetici vasfındaki çalışanlarının vizyonerlik özelliklerini geliştirmeye yönelik eğitimler vermeli ve düzenli olarak seminerler düzenlemelidir.
Pertanggungjawaban Perusahaan Ekspedisi Berkaitan Dengan Kelalaian Hilangnya Barang Kiriman
Authors: Nasruddin Muhammad
Published: May 2022

Tujuan penelitian ini memperoleh pemahaman mengenai pertanggungjawaban perusahaan jasa pengangkutan dan pengiriman (ekspedisi) di dalam melayani pengiriman barang konsumen sebagai pengguna jasa atas barang yang cacat, rusak dan hilang, dan bagaimana upaya hukum bagi konsumen sebagai pengguna jasa terhadap barangnya, terkait pekerjaan yang dilakukan oleh perusahaan jasa pengiriman barang (ekspedisi). Permasalahan penelitian ini adalah pertanggungjawaban perusahaan ekspedisi berkaitan dengan kelalaian hilangnya barang kiriman menyangkut hukum konsumen kerugian konsumen akibat pengiriman barang oleh perusahaan ekspedisi jasa pengangkut. Metode penelitian yang digunakan adalah penelitian normatif berdasarkan data primer serta berbagai data sekunder berupa peraturan perundang-undangan. Kesimpulan penelitian ini sebagai pertanggungjawaban pihak jasa pengangkutan atas kelalaian pengiriman barang dan solusi kerugian terhadap konsumen atas segala kerugian yang diderita sebagai pihak pengguna jasa.
Batas Minimal Usia Perkawinan Berdasarkan Undang-Undang Perkawinan Baru
Authors: Tjahyani Murendah
Published: May 2022

Regulasi terhadap perkawinan di Indonesia diatur melalui Undang-Undang Nomor 1 Tahun 1974 tentang Perkawinan dengan Peraturan Pemerintah Nomor 9 Tahun 1975 sebagai peraturan pelaksanaannya. Salah satu syarat penting dalam perkawinan berdasarkan pada Pasal 7 Undang-Undang Perkawinan. Perbedaan yang mencolok pembatasan usia perkawinan terhadap wanita yang kelak akan menjadikan seorang ibu dianggap tidak mendasar, di mana wanita tersebut harus siap matang jiwa raganya untuk berkeluarga, yang selanjutnya diharapkan akan menghasilkan generasi muda yang berkualitas. Metode penelitian ini menggunakan metode hukum normatif dengan meninjau peraturan perundang-undangan tentang perkawinan. Melalui Koalisi Perempuan Indonesia tahun 2017 ada tiga pemohon mengajukan uji materiel terhadap Undang-Undang Nomor 1 Tahun 1974 khususnya Pasal 7 ayat (1) yang berkaitan dengan pembatasan usia perkawinan. Berdasarkan Putusan Mahkamah Konstitusi RI Nomor 22/PUU-XV/2017 tersebut dijadikan bahan pertimbangan bagi pembentukan undang-undang atas perubahan undang-undang perkawinan lama, menjadi Undang-Undang Nomor 16 Tahun 2019 yang mengizinkan perkawinan pria dan wanita sudah mencapai umur sembilan belas tahun.
Perlindungan Hukum Terhadap Pengguna Aplikasi Shopee Pay Later
Authors: Permata Sherlina , Haryanto Hendra
Published: May 2022

Perdagangan digital di Indonesia mengalami perkembangan dan inovasi dari segi penyedia pelayanan pada sektor jasa keuangan. Terutama dalam sektor sistem pembayaran elektronik yang digunakan dalam bertransaksi di e-commerce. Shopee Pay Later yang merupakan fasilitas kredit ini juga termasuk ke dalam jenis Fintech atau Financial Technology dengan istilah fintech lending atau disebut juga fintech peer-to-peer lending yaitu metode pembayaran dengan sistem peminjaman secara online tanpa harus memiliki rekening bank. Dengan menggunakan metode penelitian hukum empiris peneliti menemukan kasus terkait tidak adanya perlindungan konsumen terhadap pengguna aplikasi Shopee Pay Later yaitu saudari Fitri Yeni Prihandono dengan terjadinya peretasan akun miliknya. Perbuatan tersebut melanggar Pasal 30 ayat (3) jo. Pasal 46 ayat (3) Undang-Undang Nomor 11 Tahun 2008 jo. Undang-Undang Nomor 19 Tahun 2016 Tentang Informasi dan Transaksi Elektronik. Pihak Shopee dalam perkembangannya tidak ada itikad baik dalam tanggung jawabnya kepada konsumen sebagai pelaku usaha sekaligus penyelenggara sistem elektronik. Shopee memiliki kewajiban kepada konsumennya dalam hal perlindungan konsumen sesuai ketentuan pada Pasal 4 jo. Pasal 62 Undang-Undang No. 8 Tahun 1999 tentang Perlindungan Konsumen. Shopee melanggar keamanan dari jaringan yang sudah ada di dalam ketentuan POJK No.77/POJK.01/2016 tentang Layanan Pinjam Meminjam Berbasis Teknologi dan Informasi yang merupakan dasar dari pengaturan pada sistem Pay Later.
Pendekatan Teori Criminal Thinking Pada Kasus Pembunuhan Anak Oleh Anak
Authors: Dekawati Gusti , Marbun Warasman
Published: May 2022

Tujuan penelitian ini adalah untuk mengidentifikasi atau menggambarkan suatu konsep atau untuk menjelaskan atau memprediksi suatu situasi atau solusi untuk suatu situasi yang mengindikasikan jenis studi yang akan dilakukan. Penelitian ini menggunakan metode penelitian hukum yuridis normatif yang dilakukan dengan cara meneliti berdasarkan bahan sekunder atau studi kepustakaan yang berkaitan dengan permasalahan yang akan dibahas, yaitu suatu pendekatan yang lebih menekankan pada aspek hukum positif yang menyangkut tentang tindak pidana yang dilakukan oleh anak. Berdasarkan hasil analisis didapatkan bahwa penyakit mental adalah salah satu dari banyak faktor kriminogen (faktor yang dapat menimbulkan suatu tindak kejahatan) yang mempengaruhi perilaku pelaku. Solusinya adalah kerja sama pemerintah dalam mendorong masyarakat, bersinergi mengimplementasikan Undang-Undang Nomor 35 Tahun 2014 tentang Perlindungan Anak serta bekerja sama dengan lembaga-lembaga dan pihak medis untuk melakukan sosialisasi dan edukasi inklusif secara terus-menerus mengenai gejala, identifikasi keluarga, dampak, dan perawatan delinkuensi anak, yang dalam hal ini sangat diperlukan sebagai upaya preventif mengurangi kasus tindak pidana yang dilakukan oleh anak.
HOUSE PRICE PREDICTION
Authors:   Associate Professor,  CSE, Sreyas institute of engineering and Technology, Telangana, India, Vijay Bhasker Reddy V , Chandana Burugu ,   CSE, Sreyas institute of engineering and Technology, Telangana, India, Reddy Reddy Sindhu ,   CSE, Sreyas institute of engineering and Technology, Telangana, India, Charitha Tandava ,   CSE, Sreyas institute of engineering and Technology, Telangana, India, Siripragada Sravya ,   CSE, Sreyas institute of engineering and Technology, Telangana, India
Published: May 2022

Because house prices rise every year, a mechanism to forecast future house values is required. House price prediction can help the developer determine the selling price of a house and can help the customer to arrange the right time to purchase a house. Physical conditions, concept, and location are only a few of the aspects that determine the price of a home. Usually, House price index represents the summarized price changes of residential housing. While for a singlefamily house price prediction, it needs a more accurate method based on location, house type, size, build year, local amenities, and some other factors which could affect house demand and supply. A practical and composite data pre-processing, creative feature engineering method is investigated with limited dataset and data features. This model is used to predict the house prices so as to cut down the complications faced by the customers. The present method where customers reach real-estate agents and search for houses in their budget, and should analyze whether a particular price is accurate or not. To overcome this our proposal is used. This system makes optimal use of the Machine Learning Algorithms. By extracting data from datasets of different houses, preprocessing the data and model is built using that data using Regression. The algorithm used for the model building is KNN (K Nearest Neighbor) Algorithm. This system design is modularized into various categories.
Microscopic Body Cosmological Model
Authors:   Shri. Dr. R. G. Rathod Arts and Science College, Murtizapur, Dist. Akola, (M.S.) India, Hadole S. R , Nimkar A. S ,   Shri. Dr. R. G. Rathod Arts and Science College, Murtizapur, Dist. Akola, (M.S.) India
Published: May 2022

In this paper we study Bianchi type-I cosmological model in presence of microscopic body in self-creation theory. We solve field equation by using relation B  Am ,C  An and equation of state of microscopic body. Also we discuss physical and kinematical properties and discussed stability of obtained model.
Gestational diabetes: universal or selective screening in pregnancy?
Authors:   Filantropia Clinical Hospital, Bucharest, Romania, RAGEA Carina , GICA Nicolae ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Filantropia Clinical Hospital, Bucharest, Romania, BOTEZATU Radu ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Filantropia Clinical Hospital, Bucharest, Romania, PELTECU Gheorghe ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Filantropia Clinical Hospital, Bucharest, Romania, PANAITESCU Anca Maria ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Filantropia Clinical Hospital, Bucharest, Romania
Published: May 2022

Gestational diabetes mellitus (GDM) is one of the most frequent complications of pregnancy. Despite international efforts, there is no consensus regarding the optimal method of screening and diagnosis of GDM. Some organizations propose screening only for women with high risk of GDM, while others suggest testing all pregnant women. Furthermore, there are more types of screening and diagnostic tests (one vs. two-step approach) with different glycemic thresholds. The aim of this review is to present and compare the screening and diagnosis guidelines of the most influential organizations. Additionally, this study evaluates the differences between selective and universal screening. The necessity for a consensus and for a single acceptable guideline has been repeatedly highlighted by experts in order to allow uniform clinical practice and to improve perinatal and maternal outcomes.
Evaluation of the clinical efficiency of COVID drug treatment of clinical-paraclinical parameters in a critical case of COVID-19 with severe pulmonary dysfunction after cesarean section
Authors:   Doctoral School of Biomedical Science, University of Oradea, Romania, SUGAC Bianca Laura , POP Tiberiu ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, BOROS Monica ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, HUNIADI Anca ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, VICAS Laura Gratiela ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, JURCA Tunde ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, MARIAN Eleonora ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, PALLAG Annamaria ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, MIERE (GROZA) Florina ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, STEFAN Liana ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania, MURESAN Mariana ,   Faculty of Medicine and Pharmacy, University of Oradea, Romania
Published: May 2022

On 11 March 2020 World Health Organization declared the Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS–CoV–2, 2019 – nCoV) a global pandemic. After a year, there are still many unknowns about peripartum women suffering from COVID – 19. In some pregnant women, respiratory failure can rapidly progress to acute respiratory distress syndrome (ARDS) which is requiring extracorporeal membrane oxygenation (ECMO) as a life – saving therapy. This motivated our team to report the case of a 22-year-old pregnant woman suffering from obesity, gestational hypertension with a severe COVID – 19 forms associated with ARDS. We want to highlight the potential benefits of therapeutic management, after an analysis of clinical and paraclinical parameters, especially because the patient was discharge after 40 days with no major complications. The urgent delivery, early initiation of ECMO and the complex pharmacological therapy (including Remdesivir) resulted in favorable maternal– fetal outcomes.
Nebulized heparin for burned patients with inhalation injury: a review
Authors:   Clinical Department No. 11, ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Neagu Tiberiu Paul ,   Department of Plastic, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital of Bucharest, Romania, Tiglis Mirela ,   Clinical Department No. 14, ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Anesthesiology and Intensive Care, Emergency Clinical Hospital of Bucharest, Romania, Sebe Ioana Teona ,   Clinical Department No. 11, ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Plastic, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital of Bucharest, Romania, Raducu Laura ,   Clinical Department No. 11, ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Plastic and Reconstructive Surgery, ”Prof. Dr. Agrippa Ionescu” Emergency Clinical Hospital, Bucharest, Romania, Lascar Ioan ,   Clinical Department No. 11, ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Plastic, Aesthetic and Reconstructive Microsurgery, Emergency Clinical Hospital of Bucharest, Romania
Published: May 2022

The presence of inhalation injury has a negative impact on the evolution of burned patients, being associated with increased mortality. It occurs as a direct consequence of thermal action, or secondary to the presence of respiratory irritants or absorption of toxins, and actual therapeutic management is mainly supportive. Several clinical findings are relevant to raising suspicion and guiding further examinations, fiberoptic bronchoscopy being the gold standard of diagnosis and staging. In burned patients with inhalation injuries, various reports showed that nebulized heparin (5,000 or 10,000 units) with a 4-hour administration regimen leads to improved outcome, reduces the days of mechanical ventilation and consequently the length of hospital stay, reduces pulmonary complications and improves lung function, having a safe profile, with fewer side effects.
Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis
Authors:   Doctoral School of Medicine, IOSUD Titu Maiorescu University of Bucharest, Romania, Gorecki Gabriel Petre ,   Bucur Maternity Hospital, "Sf. Ioan" Emergency Hospital, Bucharest, Romania, Moldovan Cosmin ,   Faculty of Medicine, Titu Maiorescu University of Bucharest, Romania,   General Surgery Clinic, CF1 Witting Clinical Hospital, Bucharest, Romania, Rusu Elena ,   Faculty of Medicine, Titu Maiorescu University of Bucharest, Romania, Cochior Daniel ,   Faculty of Medicine, Titu Maiorescu University of Bucharest, Romania,   General Surgery Clinic, Monza Clinical Hospital Bucharest, Romania,   Sanador Clinical Hospital, Bucharest, Romania
Published: May 2022

Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities. Material and method. Our unrandomized, prospective, multicenter, analytical study analyzed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors. Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients. Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations. Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology.
Diagnostic and therapeutic particularities in a case of familial hypercholesterolemia secundary to a new mutation in the APOB gene
Authors:   M.D. Cristian Minulescu M.D., MedLife, Bucharest, Romania, Minulescu Cristian ,   Société Francaise pour l’Etude des Maladies Héréditaires du Métabolisme, France, Petcu Nicoleta ,   Ponderas Academic Hospital, Bucharest, Romania
Published: May 2022

Throughout the hereby article I will detail the case of a five-years old patient diagnosed with a new form of familial hypercholesterolemia. This way we wish to highlight the importance of swift diagnosis of all forms of familial dyslipidaemia. A particularity of this pathology is the long amount of time when no symptoms are present, thus creating the false impression that it is a benign, and very well tolerated condition. Currently the incidence of familial dyslipidaemia is continuously increasing, posing a real public health issue, both due to the complications it displays, and the degree of disability it produces to the patients. That is why it is extremely important that the lipidic profile be included in the package of regular laboratory tests of the paediatric practice.
Pulmonary benign metastasizing leiomyoma in patient with esophageal and anorectal leiomyomatosis
Authors:   Department of Pathology, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Bacha Dhouha , Ferjaoui Wael ,   Department of Surgery, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Zran Mohamed ,   Department of Pathology, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Baccouche Seifeddine ,   Department of Surgery, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Ben Slama Sana ,   Department of Pathology, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Marzouk Ines ,   Department of Radiology, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Gharbi Lassad ,   Department of Surgery, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Lahmar Ahlem ,   Department of Pathology, Mongi Slim Hospital, University Tunis El Manar, Tunisia, Ennaifer Rym ,   Department of Gastroenterology, Mongi Slim Hospital, University Tunis El Mana, Tunisia, Bayar Rached ,   Department of Surgery, Mongi Slim Hospital, University Tunis El Manar, Tunisia
Published: May 2022

Esophageal and anorectal leiomyomatosis association is exceedingly rare. It's characterized by a benign smooth muscle cell proliferation in respectively esophageal and anorectal walls, causing circumferential thickening. To the best of our knowledge, this is the first reported pulmonary BML case associated with esophageal and anorectal leiomyomatosis in a 20-year-old female.
Water UV-shielding in the Terrestrial Planet-forming Zone: Implications from Water Emission
Authors: Bosman Arthur D. , Bergin Edwin A. , Calahan Jenny , Duval Sara E.
Published: May 2022

Mid-infrared spectroscopy is one of the few ways to observe the composition of the terrestrial planet-forming zone, the inner few astronomical units, of protoplanetary disks. The species currently detected in the disk atmosphere, for example, CO, CO2, H2O, and C2H2, are theoretically enough to constrain the C/O ratio on the disk surface. However, thermochemical models have difficulties in reproducing the full array of detected species in the mid-infrared simultaneously. In an effort to get closer to the observed spectra, we have included water UV-shielding as well as more efficient chemical heating into the thermochemical code Dust and Lines. We find that both are required to match the observed emission spectrum. Efficient chemical heating, in addition to traditional heating from UV photons, is necessary to elevate the temperature of the water-emitting layer to match the observed excitation temperature of water. We find that water UV-shielding stops UV photons from reaching deep into the disk, cooling down the lower layers with a higher column. These two effects create a hot emitting layer of water with a column of 1–10 × 1018 cm−2. This is only 1%–10% of the water column above the dust τ = 1 surface at mid-infrared wavelengths in the models and represents <1% of the total water column.
Three-dimensional Shape Explains Star Formation Mystery of California and Orion A
Authors: Rezaei Kh. Sara , Kainulainen Jouni
Published: May 2022

The new Gaia data release (EDR3) with improved astrometry has opened a new era in studying our Milky Way in fine detail. We use Gaia EDR3 astrometry together with 2MASS and WISE photometry to study two of the most massive molecular clouds in the solar vicinity: Orion A and California. Despite having remarkable similarities in the plane of the sky in terms of shape, size, and extinction, California has an order of magnitude lower star formation efficiency. We use our state-of-the-art dust mapping technique to derive the detailed three-dimensional (3D) structure of the two clouds, taking into account both distance and extinction uncertainties, and a full 3D spatial correlation between neighboring points. We discover that, despite the apparent filamentary structure in the plane of the sky, California is a flat 120 pc-long sheet extending from 410 to 530 pc. We show that not only Orion A and California differ substantially in their 3D shapes, but also Orion A has considerably higher density substructures in 3D than California. This result presents a compelling reason why the two clouds have different star formation activities. We also demonstrate how the viewing angle of California can substantially change the cloud’s position in the Kennicutt–Schmidt relation. This underlines the importance of 3D information in interpreting star formation relations and challenges studies that rely solely on the column density thresholds to determine star formation activities in molecular clouds. Finally, we provide accurate distance estimates to multiple lines of sight toward various parts of the two clouds.
MNCs and (de)globalization: New paradigm for emerging markets
Authors: Panibratov Andrei
Published: May 2022

Over the past decade, globalization has faced the number of unprecedented challenges triggered by a series of significant adverse events. With the continuous intensification of protectionism, nationalism, and de-globalization, the global economy has been withdrawing from a high-level of openness and interdependency. Trade disputes and political tensions between countries evoked further concerns of scholars about ongoing de-globalization that has been actively problematized since the end of 2010s. While many scholars expect greater risk aversion, protectionism and nationalism to be the paradigm for national economies and for multinational companies (MNCs), others oppose suggesting that the foundations of globalization have not eroded, and post-pandemic world will need even more globalization. This point grounds on the idea that the world is now and will long be fragmented and unequal, and international firms will persist as bridges that connect the fragmented reality.
Directeur de Segpa : une fonction en transformation. Quelles postures et leviers pour un établissement inclusif ?
Authors: Gout-Kravtchenko Catherine
Published: May 2022

La direction de Segpa occupe une place stratégique pour l’inclusion scolaire. À l’échelle d’un établissement scolaire, elle est à l’interface de quatre entités dont l’alliance parait nécessaire afin de créer les conditions d’un processus d’inclusion : professeurs de l’enseignement général, professeurs spécialisés, personnels de direction, élèves et leur famille. L’auteure propose dans cet article une analyse de la place du directeur ou de la directrice de Segpa à ce dessein. Dans un parcours parfois semé d’embûches, celui-ci peut lever les méfiances, les défiances, la méconnaissance et l’inquiétude envers les profils particuliers. Par des attitudes d’empathie et d’assertivité, il peut remettre chaque partie en confiance et en dignité réciproque. Ainsi peuvent être mis en place des projets exigeants, des parcours individualisés, une participation aux activités du collège, des temps coopératifs et la mixité des classes.
Risk of Peri-implant Fracture With Long Versus Short Cephalomedullary Nailing for Geriatric Patients With Intertrochanteric Femur Fracture
Authors: Sop Aaron , Kali Maher , Bishara Peter , Broce Mike , Wallace Logan , Damayanti Samanta
Published: May 2022

Intramedullary fixation using a short or long cephalomedullary nail (CMN) for treating hip fractures has gained popularity in recent years. We evaluated reoperation rates requiring device removal of short or long CMNs for patients 65 years and older. A retrospective study was performed at a level I trauma center over a 10-year period (2005–2015). Patients 65 years and older who were treated for intertrochanteric hip fractures with CMNs were included. This study included 893 patients (600 patients treated with a short CMN vs 293 treated with a long CMN). Patients in both cohorts were comparable in age, sex, and Injury Severity Score. There was no significant difference in comorbidities between the short and long CMN groups. Hospital length of stay (7.13 vs 6.88 days,
P
=.407) and intensive care unit length of stay (4.97 vs 4.63 days,
P
=.732) were not significantly different between the short and long CMN cohorts, respectively. The in-hospital mortality rate also did not vary between the 2 groups (1.3% for short CMN vs 2.7% for long CMN,
P
=.139). A significantly higher proportion of patients treated with a long CMN were discharged to a skilled nursing facility (63.4% vs 56.1%,
P
=.042). The overall reoperation rate was also comparable, 4.7% and 3.4% in the short CMN and long CMN groups, respectively (
P
=.367). No difference was found between the 2 treatment modalities (short or long CMN) for the elderly population. Both implants had similar rates of reoperation and implant failure. There is a cost consideration, with increasing length of the nail corresponding to increased cost. [
Orthopedics
. 2022;45(5):304–309.]
The Effect of Medical Education on Patient Satisfaction: An Asset or a Liability?
Authors: Sutak Alan K. , Ryan Sean P. , Hong Cierra S. , Vovos Tyler J. , Wellman Samuel S. , Jiranek William A. , Seyler Thorsten M.
Published: May 2022

Few studies have investigated the influence of trainee involvement on inpatient satisfaction scores in the postoperative joint arthroplasty setting. This study compares Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores at academic and private health care centers to assess the impact of trainees on patient satisfaction. From 2013 to 2017, 3454 HCAHPS surveys were collected at the investigating institution from patients who underwent primary total hip and total knee arthroplasty. Surveys were categorized based on the inpatient practice setting—academic hospitals included orthopedic residents and medical students who were involved in perioperative care, whereas private settings did not have trainee involvement. Patient demographics, including age, body mass index, sex, and American Society of Anesthesiologists score, were retrospectively collected. A total of 2454 HCAHPS surveys from 2 academic hospitals and 1000 surveys from a private hospital were collected. Patients at the academic hospitals were more likely to report that symptoms to look out for were clearly explained (odds ratio, 1.882;
P
=.001), whereas patients from the private hospital were more likely to report that the hospital was always quiet at night (odds ratio, 1.271;
P
=.005). The overall satisfaction score was not significantly different between the academic and private settings (78.9 vs 80.2, respectively;
P
=.111). The overall hospital satisfaction score for patients undergoing primary total hip and knee arthroplasty was not significantly different between private and academic medical facilities. Thus, this study supports the idea that training future orthopedic surgeons will not negatively impact patient satisfaction scores in a way that affects reimbursement. [
Orthopedics
. 2022;45(5):276–280.]
A Newborn with a Purulent Ocular Discharge
Authors: Ni Jeffrey , Chan Karen , Marpuri Ian , Eisenberg Jaclyn
Published: May 2022

An 11-day-old girl, who was diagnosed with Neisseria gonorrhoeae ophthalmia neonatorum, presents with a purulent ocular discharge. Although rare in regions with high implementation rates of ocular prophylaxis, ophthalmia neonatorum remains an important diagnostic consideration, especially in developing countries and areas of low socioeconomic status. In this article, we review the evolving epidemiology, diagnostic considerations, prevention, and treatment of ophthalmia neonatorum.

[
Pediatr Ann
. 2022;51(5):e206–e208.]
Children Lagging with COVID-19 Vaccination
Authors: Noor Asif , Backer Martin , Krilov Leonard R.
Published: May 2022

Children account for a growing share of coronavirus disease 2019 (COVID-19) infections in the United States. Since the widespread availability of COVID-19 vaccine in adults, there has been an upward trend of cases in children, accounting for approximately 20% of the weekly new cases. The majority (38.3%) reported in high school students age 14 to 17 years. Children are also at risk of a postinflammatory condition, known as multisystem inflammatory syndrome in children, after COVID-19. In addition, infected children could transmit the virus to vulnerable adults, contributing to ongoing pandemic. We believe that children need to be vaccinated against COVID-19 and review the available evidence.

[
Pediatr Ann
. 2022;51(5):e180–e185.]
Antimicrobial Stewardship in the Pediatric Primary Care Setting
Authors: Taylor Margaret G. , Palazzi Debra L.
Published: May 2022

Antibiotics are the most commonly prescribed medications in the pediatric outpatient setting, yet 30% to 50% of these prescriptions are deemed to be unnecessary. Outpatient antimicrobial stewardship is the concerted effort to monitor and improve antibiotic use in the community setting. The best methods of conducting antimicrobial stewardship in the outpatient setting are currently unknown, and an individualized approach is likely needed. In this review, we discuss the importance of, resources for, and research supporting outpatient antimicrobial stewardship and review ways an individual pediatric provider can further steward efforts.

[
Pediatr Ann
. 2022;51(5):e196–e201.]