bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between diabetic retinopathy and diabetic peripheral neuropathy - Neurodegenerative and microvascular changes
Authors: Rasheed Rehna , Pillai Gopal S , Kumar Harish , Shajan Adish Thayyil , Radhakrishnan Natasha , Ravindran Greeshma C
Published: November 2021

Purpose:

To determine the relationship between diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN), and their associated risk factors.

Methods:

We conducted a cross-sectional analysis on 500 patients who attended the Endocrinology department at a quaternary health care center in Kerala between November 2017 and April 2018. Patients above the age of 30 years with type 2 diabetes mellitus (DM) were included. They underwent a detailed medical history, dilated fundus examination for DR, assessment and grading of DPN, and blood investigations. Among these, 49 randomly selected patients without DR had peripapillary retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) assessed by optical coherence tomogram. RNFL and GCIPL changes in different grades of neuropathy were evaluated.

Results:

Out of 500 patients, 303 (60.6%) were males and 197 (39.4%) were females. Prevalence of DR was 48% and DPN 71.8%. Risk factors for the development of DR included duration of DM >15 years, HbA1c (glycated hemoglobin) greater than 6.5%, serum creatinine more than 1.5 mg/dl, and the presence of DPN. There was a statistically significant association between DR and DPN. There was significant thinning of GCIPL in patients with moderate to severe neuropathy without DR.

Conclusion:

There is a significant association between DR and DPN and their severities. There are early changes in inner retinal layers of diabetic patients without microvascular changes of DR. These neurodegenerative changes parallel DPN in the course of DM. Our study stresses the importance of multidisciplinary approach in the management of diabetes and its complications.
Narrative review of artificial intelligence in diabetic macular edema: Diagnosis and predicting treatment response using optical coherence tomography
Authors: Chakroborty Sandipan , Gupta Mansi , Devishamani Chitralekha S , Patel Krunalkumar , Ankit Chavan , Ganesh Babu TC , Raman Rajiv
Published: November 2021

Diabetic macular edema (DME), being a frequent manifestation of DR, disrupts the retinal symmetry. This event is particularly triggered by vascular endothelial growth factors (VEGF). Intravitreal injections of anti-VEGFs have been the most practiced treatment but an expensive option. A major challenge associated with this treatment is determining an optimal treatment regimen and differentiating patients who do not respond to anti-VEGF. As it has a significant burden for both the patient and the health care providers if the patient is not responding, any clinically acceptable method to predict the treatment outcomes holds huge value in the efficient management of DME. In such situations, artificial intelligence (AI) or machine learning (ML)-based algorithms come useful as they can analyze past clinical details of the patients and help clinicians to predict the patient’s response to an anti-VEGF agent. The work presented here attempts to review the literature that is available from the peer research community to discuss solutions provided by AI/ML methodologies to tackle challenges in DME management. Lastly, a possibility for using two different types of data has been proposed, which is believed to be the key differentiators as compared to the similar and recent contributions from the peer research community.
Distribution and risk factors of postoperative endophthalmitis in people with diabetes
Authors: Gondhale Harshal , Jaichandran VV , Jambulingam Malathi , Anand Appakkudal R , Srinivasan Sangeetha , Raman Rajiv , Sharma Tarun
Published: November 2021

Purpose:

To evaluate (i) the distribution of postoperative endophthalmitis (POE) in patients who underwent cataract surgery, (ii) risk factors in diabetic versus nondiabetic patients, and (iii) distribution of POE in those who had undergone rapid reduction of preoperative blood sugar levels versus those with normal blood sugar levels.

Methods:

Medical records were reviewed from January 1995 to July 2021. In total, 391 eyes of 391 patients who developed POE after cataract surgery were studied. Patients with POE were divided into Group A, patients with diabetes (n = 128), and Group B, patients without diabetes (n = 263), and the associations of various clinical factors in the two groups were studied. Patients with diabetes with raised random blood sugars (RBS) preoperatively were subjected to a rapid reduction of blood sugar (RBS <200 mg%) to be considered eligible for surgery. Microbiological profile of patients was examined.

Results:

The cumulative incidence of POE over 26 years was 0.09%. Those who underwent a rapid reduction in preoperative blood sugar levels had higher rates of POE (53.1%) compared with (46.9%) those with blood sugar levels under control (P = 0.486). Men with diabetes had 1.634 times higher odds of POE (P = 0.048), and those with diabetes and hypertension had 3.961 times greater odds of having POE (P < 0.001) when adjusted for age, alcohol, smoking, and socioeconomic strata and presence of posterior capsule rupture. Positive culture results were observed in 45/128 (35%) patients with diabetes and 71/263 (27%) patients without diabetes. Staphylococcus epidermidis was the most commonly identified organism and was detected in 10/45 (22%) in those with diabetes and 21/71 (29%) in those without diabetes of all the culture-positive cases.

Conclusion:

In patients with POE, the odds are greater for men with diabetes, those with a history of hypertension, as well as those who undergo a rapid reduction of preoperative blood sugar.
Adding screening for “end organ damage” to the noncommunicable disease package in primary care
Authors: Sadanandan Rajeev , Sivaprasad Sobha
Published: November 2021

There are several global and local initiatives aimed at screening for noncommunicable diseases (NCD). The fundamental health system strengthening to achieve this goal is by developing the primary care infrastructure. Most newly developed or improved primary care centers focus on maintaining an NCD register for onward reporting. However, the register is also the cornerstone for implementing systematic screening of all complications of NCDs. With epidemiologic transition, end organ damage due to NCDs is one of the most common causes of morbidity and mortality. Screening for end organ damage and early identification of treatable complications are far more impactful than waiting for self-reported symptomatic complications. Here, we show an example of how the Government of Kerala utilized the NCD register to implement a systematic diabetic retinopathy screening that allows for annual or biennial re-call in the primary care and refer treatable eye conditions to secondary care. The success of this program enabled the Government to initiate a holistic approach to screen for other complications of diabetes.
Socioeconomic status and diabetic retinopathy in India
Authors: Behera Umesh C , Brar Anand S
Published: November 2021

Socioeconomic status (SES) may influence the general health and the health-seeking behavior of an individual. Understanding the disease prevalence in different social strata may lead us to the important linkages that SES might have with diabetic retinopathy (DR). The knowledge on the prevalence of DR in the community based on their SES may help design strategies to provide affordable, last-mile care to the population most at risk of this blinding complication of diabetes mellitus. Our systematic search for population-based Indian studies found three studies in the past three decades that evaluated the effect of socioeconomic factors on the prevalence of diabetic retinopathy. The data on the prevalence in various socioeconomic strata was equivocal and the study settings were mostly urban. The parameters used to assess the SES differed among studies. This underscores the need for further research on SES-related diabetic retinopathy complications in India. Future studies should employ more robust socioeconomic scales to define the divide better.
The All India Ophthalmological Society - Academic and Research Committee pan-India diabetic retinopathy project “Fixing the missing link”: Prevalence data from West Bengal
Authors: Biswas Partha , Batra Sneha , Majji Ajit Babu , Natarajan Sundaram , Sachdev Mahipal , Verma Lalit , Sharma Namrata , Honavar Santosh G , Sinha Satyajit , Porwal Amit C , R Krishna Prasad , Bawankule Prashant , Saxena Rohit , Narayanan Raja , Raman Rajiv , Nag Subhasish , Ghosh Prajjwal
Published: November 2021

Purpose:

The aim of this study was to determine the prevalence of diabetic retinopathy (DR) and its risk factors among diabetic patients in rural and urban West Bengal (WB).

Methods:

Patients were screened in the physician’s clinic by a team of ophthalmologist, optometrist and counsellor. Demographic details, diabetic control, compliance to eye checkup, awareness regarding diabetic blindness, and visual acuity were recorded using a questionnaire. DR was graded both by indirect ophthalmoscopy and fundus photo taken with a portable fundus camera.

Results:

A total of 1553 subjects were screened over 39 camps across 14 districts of WB over 17 months. The prevalence of DR was 21.51%, with a significant difference between rural (26.55%) and urban (13.89%) areas (P < 0.01). No significant difference with gender was seen (P = 0.99). Presence and grade of DR were related to age, loss of vision, diabetic age, diabetic control, awareness of diabetic blindness and last eye checkup.

Conclusion:

This study provides the first major prevalence data from WB, and gives valuable insight regarding modifiable risk factors for DR. It is also the first DR study in India to be conducted in the physician’s clinic. The study results emphasise the need to “fix the missing link” between ophthalmologists and treating physicians to win the battle against DR.
Regional variation in diabetic retinopathy and associated factors in Spectrum of Eye Disease in Diabetes (SPEED) study in India—Report 5
Authors: Das Taraprasad , Murthy Gudlavalleti V S , Pant Hira B , Gilbert Clare , Rajalakshmi Ramachandran , Behera Umesh C ,   on behalf of the SPEED study group
Published: November 2021

Purpose:

To study the zonal variations in diabetic retinopathy (DR) and associated factors in people with known type 2 diabetes mellitus (T2DM) attending large eye care facilities in different regions of India.

Methods:

In this cross-sectional eye-care facility-based study, India was divided into five zones; large eye care facilities with a good referral base and offering an entire range of care for patients with DR were invited. First-time T2DM attendees aged ≥18 years were recruited. All subjects received a comprehensive systemic and ophthalmic examination. DR and systemic diseases were classified as per the international/national standards. Findings were compared between the zones and with the national average.

Results:

Fourteen eye-care facilities (15% public) from five zones participated. In the cohort of 11,173 people, there were more males (59%); the average age was above 45 years, and in 57%, DM had been diagnosed more than 5 years earlier. Compared with the overall study population, the proportion of people with any DR, sight-threatening DR, and blind were higher in the east zone (42.5%, 95% confidence interval [CI]: 40.2–44.8; 24.3%, 95% CI 22.3–26.3, and 11.5%, respectively); diabetic macular edema was more frequent in the south zone (12.2%, 95% CI 11.2–13.2); people with moderate-to-severe visual impairment were more in the west zone (32.1%) and higher proportion of people in the south-central zone had systemic hypertension (56.8%, 95% CI 54.8–58.9).

Conclusion:

The zonal variation in DR and related vision loss could be related to variable health-seeking behavior, availability, and confidence in the available services.
Screening for obstructive sleep apnea in a diabetic retinopathy clinic in a tertiary care center
Authors: Kaswan Rakesh , Bansal Reema , Katoch Deeksha , Dogra Mohit , Singh Ramandeep , Gupta Vishali , Dogra Mangat R. , Bansal Sandeep
Published: November 2021

Purpose:

To screen for obstructive sleep apnea (OSA) in patients presenting to diabetic retinopathy (DR) clinic and to correlate its presence with the severity of DR.

Methods:

A prospective, cross-sectional study of diabetes mellitus patients in retina clinic of a tertiary care referral center, North India (January 2019–March 2020). All were subjected to STOP-Bang Questionnaire and Epworth Sleepiness Scale (ESS) score. Patients at high OSA risk (STOP-Bang score ≥5 and ESS score ≥10) were referred to Department of Otorhinolaryngology (sleep clinic) for polysomnography. Based on Apnea Hypopnea Index (AHI), OSA was graded as mild (AHI = 5–14/h), moderate (AHI = 15–30/h), and severe (AHI >30/h). Statistical analysis was done using three models of outcome measures: (1) “No DR” versus “any DR,” (2) “Less severe DR” versus “More severe DR,” and (3) “No diabetic macular edema (DME)” versus “DME.”

Results:

Of 362 patients screened, 18 (4.97%) had OSA (11 mild, 5 moderate, and 2 severe). Though OSA did not show a significant association with various outcome measures, patients with moderate–severe OSA had higher odds in developing “any DR” (OR = 7.408; 95% CI = 0.533–102.898), “more severe DR” (OR = 1.961; 95% CI = 0.153–25.215), and “DME” (OR = 2.263; 95% CI = 0.357–14.355), on multiple logistic regression.

Conclusion:

Ours is the first screening study of OSA in DR patients in India, the diabetes capital of the world. We detected OSA in 4.97% of patients in a DR clinic, with an increased risk of “any DR,” “more severe DR,” and “DME” in the presence of moderate–severe OSA.
Assessment of optical coherence tomography angiography and multifocal electroretinography in eyes with and without nonproliferative diabetic retinopathy
Authors: Srinivasan Sangeetha , Sivaprasad Sobha , Rajalakshmi Ramachandran , Anjana Ranjit M , Malik Rayaz A , Kulothungan Vaitheeswaran , Raman Rajiv , Bhende Muna
Published: November 2021

Purpose:

To examine (i) the retinal structure and function using optical coherence tomography angiography (OCTA) and multifocal electroretinography (mfERG), respectively, in eyes with and without nonproliferative diabetic retinopathy (NPDR), (ii) and their interrelationship between retinal structure (OCTA) and function (mfERG) in the two groups independently.

Methods:

This was a prospective observational study. One hundred twenty-one eligible participants with type 2 diabetes with No DR (n = 89), or with mild or moderate NPDR (n = 32) underwent ophthalmic examination, ultrawide field-view fundus photography, OCTA, and mfERG. Group differences were assessed using a Mann–Whitney U test. Correlations were assessed using Spearman’s rho.

Results:

There were no significant differences in OCTA measures between the two groups. The mfERG P1 implicit times (rings 1–6) were significantly delayed and P1 response densities in rings 5 and 6 were significantly lower in participants with NPDR compared to those with No DR. In those with No DR, P1 implicit times in almost all rings were delayed in relation to lower vessel density and perfusion (maximum variance noted was 13%). In individuals with NPDR, the P1 response density in rings 2 and 3 showed a positive nonsignificant correlation with macular perfusion.

Conclusion:

In those with diabetes with No DR, retinal neuronal function is influenced by lower macular vessel density and perfusion. The retinal neuronal function is abnormal in individuals with NPDR compared to those with No DR and is not correlated with OCT angiometric measures, suggesting the likelihood of a different retinal structural correlate.
Spatiotemporal trends in diabetes-related mortality by school district in the state of Michigan, United States
Authors: Nurjannah Nurjannah , M. Baker Kathleen , Mashinini Duduzile Phindi
Published: November 2021

OBJECTIVES: This study examined the spatiotemporal epidemiological status of diabetes-related death in relation to school district boundaries in the state of Michigan, United States.METHODS: A retrospective observational study was conducted using death records spanning the years 2007-2014 in Michigan, with school districts as the geographic unit of analysis. Geocoding was performed for each death record. Cluster analysis used spatial autocorrelation with local Moran’s I, and spatiotemporal analysis used the Space Time Pattern Mining tool in ArcGIS Pro 2.1.RESULTS: The study revealed spatial clusters of high-high locations of diabetes-related mortality rate by school district in Michigan from 2007 to 2014. Spatiotemporal analysis showed grids with intensifying, consecutive, sporadic, and persistent hotspots of diabetes-related death in the Lansing, Royal Oak, Flint City, Berkley, Detroit City, East Lansing, South Lake, and Holt public school districts. These school districts should be prioritized for school-based diabetes prevention programsCONCLUSIONS: The study demonstrated the presence of various hotspots of diabetes-related deaths within the state of Michigan across the 8-year period of analysis. Understanding spatial and temporal hotspots could further improve our ability to evaluate diabetes burden across both time and space.
Patient-reported chronic rhinosinusitis disease control is a valid measure of disease burden
Authors: Phillips K.M. , Houssein F.A. , Singerman K. , Boeckermann L.M. , Sedaghat A.R.
Published: November 2021

Background: Disease control is an important treatment goal for chronic uncurable conditions such as chronic rhinosinusitis (CRS). The objective of this study was to determine whether patient-reported CRS disease control is a valid reflection of disease burden. Methods: Prospective longitudinal study of 300 CRS patients (35% CRS with nasal polyps, 65% CRS without nasal polyps). At enrollment and at a subsequent follow-up timepoint, all participants were asked to rate their CRS disease control as “not at all,” “a little,” “somewhat,” “very,” or “completely”, as well as to complete a 22-item Sinonasal Outcome Test (SNOT-22) and the 5-dimension EuroQol general health questionnaire from which the visual analogue scale (EQ-5D VAS) was used. Results: At enrollment and follow-up timepoints, patient-reported CRS disease control was significantly correlated with SNOT-22 and EQ-5D VAS scores. The change in patient-reported CRS disease control was significantly correlated with change in SNOT-22 and change in EQ-5D VAS scores. There was significant cross-sectional and longitudinal correlation between patient-reported control and all SNOT-22 subdomain scores. A SNOT-22 score of ≤ 25 points or lower, or an EQ-5D VAS score of ≥77 was predictive of having well - (i.e. “very” or “completely”) controlled CRS. Conclusions: Patient-reported CRS disease control is a valid measure of CRS disease burden and general QOL. A patient-reported assessment of CRS disease control could be considered as a component of a more comprehensive measure of CRS disease control.
Effects of Concrete Grades on Strength Characteristics of Metakaolin Modified Recycled Aggregate Concrete
Authors: Adebanjo A.U. , Dahunsi B.I.O. , Labiran J.O.
Published: November 2021

In this study, locally produced Metakaolin (MK) was used as an admixture in recycled aggregate concrete of grades M 25 and M 30. The content of MK varied from 0-15% at 5% intervals. The physical and mechanical properties (bulk density, specific gravity, water absorption, aggregate crushing value and aggregate impact value) of aggregates were determined, the chemical composition as well as reactivity of MK was evaluated using X-Ray Fluorescence (XRF) technique and modified Chappelle test. The workability  (slump) and strength (compressive and split tensile) properties of fresh and hardened RAC were examined relative to that of conventional concrete. The results of the experiments revealed that the specific gravity (SG), water absorption and aggregate impact value of recycled aggregates (RA) were 2.23, 5.35% and 32%, respectively. The MK used had an optimum reactivity of 2060.8 mg of Ca(OH)2 fixed at a temperature of 660 oC. The slump values for M 25 and M 30 control specimens were 72 mm and 65 mm, respectively while the slump values of MK modified RAC decreased from 67-45 mm for M 25 and 55-35 mm for M 30 as MK increased from 0-15%. The 56th-day compressive strength of the control samples was 21.73 N/mm2 for M 25 and 26.8 N/mm2 for M 30, respectively, while RAC samples ranged from 14.96 - 17.04 N/mm2 for M 25 and 20.55 - 22.67 N/mm2 for M 30 whereas the split tensile strength for the control samples was 2.71 N/mm2 and 3.06 N/mm2 for the two grades in that sequence, while those of RAC ranged from 2.26-2.49 N/mm2 for M 25 and 2.62 – 2.84 N/mm2 for M 30. Despite the fact that metakaolin modified RAC had lower strength properties than conventional concrete, the use of 10% metakaolin as a RA modifier in concrete production will provide a sustainable alternative to conventional aggregates in concrete mix design.
Modelling the Deformation of Steel-bars in Reinforced Concrete Beams Submerged in Lagoon
Authors: Akinyele J.O. , Igba U.T. , Alayaki F.M. , Kuye S.I.
Published: November 2021

Corrosion of steel and spalling of concrete in reinforced concrete elements have become a common occurrence in structures that are built around marine environment. This research investigated the effect of chloride on the steel in reinforced concrete beams. Mechanical tests such as; compressive, flexural and bond strengths were done on replicate concrete elements which were cast and buried for a maximum of one year in the Lagos lagoon. Twenty-four number of 150 mm x 150 mm x 600 mm sized reinforced concrete beams were cast for the flexural strength test, while forty-eight concrete cubes were cast for both compressive and bond strength tests, samples were cured in both lagoon and fresh water (The fresh water is for the control). A finite element program, ANSYS was used to model the deformation (deflection) of the steel reinforcement in the beams. Results showed a general reduction in compressive, flexural and bond strengths for the concrete samples buried in the lagoon, while those buried in freshwater showed an increase in strength as the concrete ages. The modelled results of the reinforcement showed a one-year deformation rate (r = 0.0181) in the steel of concrete buried in lagoon water. This value was used to estimate the future and past deformation values of these reinforcements due to chloride attack.
Cystic endometrial hyperplasia-pyometra complex in a mastectomized Boerboel bitch following tamoxifen administration
Authors: Ajadi T.A. , Okpara E.O. , Alamu A.O. , Mustapha L. , Oyenekan I.O. , Ilugbo M.O.
Published: November 2021

Tamoxifen is a non-steroidal, anti-estrogenic and selective estrogen receptor modulator commonly used as adjuvant chemotherapy in humans with breast cancer and occasionally in dogs following mastectomy. This report presents a case of cystic endometrial hyperplasia-pyometra in a dog following oral administration of the tamoxifen. A 4-year-old intact nulliparous Boerboel bitch presented at Veterinary Teaching Hospital, Federal University of Agriculture, Abeokuta. It was diagnosed with mammary carcinoma of the right cranial lumbar mammary gland. Mastectomy was performed followed by oral administration of Tamoxifen (10mg daily) for six weeks as adjunct chemotherapy. Eight weeks after, the owner reported that the bitch was lethargic, anorexic and had a purulent vaginal discharge. Abdominal ultrasound revealed cystic endometrial hyperplasia. Results of complete blood counts showed neutrophilic (absolute neutrophil count = 19.5×103/L) leukocytosis (total leukocyte count = 24.9X103/L), while bacterial culture yielded moderate growth of Staphylococcus aureus, which was sensitive to Ciprofloxacin, Ofloxacin, Sparfloxacin and Gentamycin. The bitch was treated with 400μg of Misoprostol and 500mg of Ciprofloxacin twice daily for two weeks. Ovariohysterectomy (OVH) was performed using a ventral midline approach when no significant improvement was observed from medical treatment. The dog improved significantly after ovariohysterectomy and was discharged one week after OVH. It was concluded that, although tamoxifen is routinely used as adjuvant chemotherapy following mastectomy, more research is required to evaluate its safety in intact bitches.
Contamination level and risk assessment of heavy metals in the topsoil around cement factory: A case study
Authors: Amiri Hamid , Daneshvar Ehsan , Azadi Sama , Azadi Samira
Published: November 2021

The cement industry is considered as a major source of heavy metals pollution in topsoil. This study aims at measuring the heavy metal contamination level in the vicinity of Shiraz cement factory, and assessing the ecological and environmental risks associated with the factory's activities in the surrounding topsoil. To do so, 10 samples of soil were taken from around the Shiraz cement factory at the depth of 0-10 cm and the concentration of some heavy metals including Al, Cd, Ni, and Pb was measured. Enrichment factor (EF), geo-accumulation (Igeo), and pollution load (PLI) indices were used to assess the ecological risk of heavy metals.Based on the results, the mean concentration of Al, Ni, Cd, and Pb was 6,937.14, 88.09, 1.96, and 30.74 mg/kg, respectively. The EF results showed that due to anthropogenic activities, the Ni, Pb, and Cd element has moderate, severe, and very severe enrichment in the study area, respectively. The Igeo result for Al, Ni, Pb, and Cd was -0.82, -0.17, 0.16, and 0.68, respectively, which indicates non- to slightly pollution of these heavy metals in this region. The mean PLI in the study area was 1.4 indicating the low to medium pollution of heavy metal. The results of this study can be useful in determining and investigating the environmental effects of Shiraz cement factory.
Lessons from the life of Samson on battling with harassing iniquities
Authors: Shamase Maxwell Zakhele
Published: November 2021

The story of Samson one of the Israelite judges emanating from the tribe of Dan, was a Nazirite and it is indeed an intriguing one in the book of Judges. Klein (1988) alerts us that an even superficial reading of the book demonstrates that the epic is far more biographical in nature than any of the earlier chapters tends to be. Samson’s sensual attachment to women are they stuff that legends are made of. The last glimpse we have of Samson is of a man who seemed to have put his act together. We earlier saw Samson calling on the Lord in humility. He prayed to God and God ultimately delivered him from death through a great miracle. That story ends with Samson having judged Israel for 20 years. Crenshaw (1978) contends that Samson was indeed one through whom God would “begin to deliver Israel from the hand of the Philistines” (Judges 13:5). However, after a period of peace and steadfast service, Samson sadly falls once again into his old ways. His old passions rise to the surface and Samson once again finds himself entangled in a web of sin. Samson may have been a powerful man physically, but he was to intents and purposes a moral weakling. He may have demonstrated his power time and again over the enemies of the Lord, but he was helpless against the power of his mortal flesh. It also is evident from books preceding Judges, that the wickedness of the Israelites validates Israel’s subjugation to the Philistines. Thus, we see that sin is punished and that unrighteous dealings lead a nation or an individual to destruction. As a judge, Samson was invariably unsuccessful in delivering what the Lord required of him and he thus brought destruction on himself (Bar, 2020). This article based on an exegetical methodology considered mainly historical context and it unpacks how failing to serve God ultimately leads to one battling with harassing iniquities which ultimately lead to destruction. It serves as a model of how we ought to seek to serve God in a spirit of obedience.
Analysis of the water quality index of the Escalera river applying the ICA-PE methodology in the periods 2015-2018
Authors: Alvarez Ticllasuca Adiel , Toribio Román Fernando Martin , Hilario Quispe Margaret Rosmery , Mamani Torres Lizeth , Garcia Curo Gianmarco , Diaz Dumont Jorge Rafael
Published: November 2021

The objective of the research was to apply the methodology for the determination of the ICA-PE water quality index in the Escalera river of the Huachocolpa district in the periods of 2015 and 2018, the samplings carried out were given 2 points (REsca1 and REsca2), For data collection, it was based on mathematical simulation, documentary analysis and registration, at the sampling points the concentrations of aluminum, arsenic, cadmium, copper, iron, manganese, lead and zinc were determined, these parameters exceeded the environmental quality standards. Water (ECA-AGUA) was later categorized according to the ICA-PE water quality index, of which for 2015 it was of good quality obtaining a value of 73.14 and for 2018 its quality decreased to regular reaching a value of 61.85 . The results obtained show that the quality of water is decreasing in its path that runs through the Escalera river, due to the different anthropogenic activities that take place around it, altering its quality and reducing its capacity for self-purification.
Necesidades educativas psicológicas identificadas por egresados de Medicina durante su transición preclínica-clínica
Authors: Castro de Reyes Amy Lucila
Published: November 2021

OBJETIVO: describir las necesidades educativas y psicológicas, identificadas durante su transición preclínica-clínica por egresados de Medicina en 2020, como marco para futuras intervenciones docentes. MÉTODO:investigación cuantitativa, descriptiva, transversal, muestreo no probabilístico, por bola de nieve, 54 de 105 egresados de la Facultad de Ciencias Médicas consintieron en responder el cuestionario NIEM-TPC2020, en Google Forms.RESULTADOS: 54 egresados respondieron, 30 mujeres. Para el 75% la primera rotación fue en 2017, 27.78% inició en el Hospital General San Juan de Dios, un 59.26% realizó la TPC en la rotación de Medicina Interna. Necesidades educativas: inducción al hospital, acompañamiento docente, preparación previa en actividades administrativas, afrontamiento de la muerte de pacientes, estrategias motivadoras del aprendizaje, integración teórica-práctica, apoyo de autoridades, clarificación de derechos y obligaciones. Psicológicas: cuidado de la salud mental, dignificación, valoración y reconocimiento a su labor. CONCLUSIÓN: el proceso de inducción laboral junto con el acompañamiento de los docentes son necesarios para lograr el mejoramiento del aprendizaje en contextos de trabajo durante esta transición; las estrategias docentes que permitan la adaptación en el proceso deben ir de la mano de una vigilancia constante de las actividades estudiantiles en su quehacer en el hospital.
Davranışsal, Siyasi ve Dini Faktörlerin Banka Tercihi Üzerindeki Etkisi
Authors: TEKİN Bilgehan , BASTAK Seda Nur
Published: November 2021

Literatürde yer alan çalışmalara bakıldığında, bireylerin bankacılık sistemi içerisinden yaptıkları tercihler üzerinde çok çeşitli faktörlerin etkili olduğu görülmektedir. Söz konusu faktörler kimi zaman finansal bilgi ve algı düzeyleri ve dini hassasiyetler olabildiği gibi kimi zaman fayda-maliyet unsuru, kimi zaman hizmet kalitesi, kimi zaman da bireylerin davranışsal özellikleri ve siyasi tercihleri olabilmektedir. Bu çalışmada bireylerin İslami bankacılık hakkındaki bilgi ve algı düzeylerinin yanı sıra, dini hassasiyetlerinin, davranışsal önyargılarının (kendine aşırı güven ve kayıptan kaçınma) ve siyasi bakışlarının çift bankacılık sisteminin söz konusu olduğu Türkiye’de banka tercihleri üzerindeki etkisi incelenmiştir. Çalışmada, veri toplanması amacıyla anket yöntemi kullanılmıştır. Toplanan veriler çalışmada belirlenen hipotezlerin test edilmesi amacıyla kullanılmıştır. Çalışma sonucunda kişilerin davranışsal önyargıları, siyasi tercihleri ve dini yaşantılarının yaptıkları tercihler üzerinde etkilerinin olduğu görülmüştür.
5434 VE 5510 SAYILI KANUN HÜKÜMLERİNE GÖRE KAMU GÖREVLİLERİNİN MALULİYET TÜRLERİ
Authors: YENER Mehmet Zahid , KARAKOÇ Burak
Published: November 2021

Devlet organizasyonu içerisinde bir teşkilata bağlı olarak kamu görevi ifa eden kimseler kamu görevlisi olarak ifade edilir. Kamu görevlisinin vazifesini yerine getirirken mevcut risk sonucu meydana gelen bir olay neticesinde bir zarara uğraması durumunda, zarara uğrayan kamu görevlisini koruyucu muhtelif düzenlemeler mevcuttur. İşbu düzenlemeler kamu görevlilerinin maluliyeti olarak hukuki düzlemde vücut bulmaktadır.

Çalışmamızda kamu görevlilerinin maluliyeti, 5434 sayılı Türkiye Cumhuriyeti Emekli Sandığı Kanunu ve 5510 sayılı Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu düzenlemelerine binaen incelenmiştir. Hem 5434 sayılı kanun hem de 5510 sayılı kanun hükümlerince maluliyet türleri ve şartları incelenmiş olup akabinde ise bu düzenlenmelerin karşılaştırması yapılmıştır.
Pneumoperitoneum Secondary to Pneumothorax Post-Intubation in a Patient with Difficult Airway
Authors:   Graduation Student of Medical Sciences of the Faculdade de Medicina da Universidade Cidade de São Paulo (FM-UNICID), Brazil, Agostini Camargo Giovanna De , Abreu Afrange Antônia de ,   Graduation Student of Medical Sciences of the Faculdade de Medicina da Universidade Cidade de São Paulo (FM-UNICID), Brazil, Almeida Gentile João Kleber de ,   Gastrosurgeon and General Surgeon. Specialist Titular Member of the Brazilian College of Digestive Surgery (TCBCD). Professor of Surgical of the Faculdade de Medicina da Universidade Cidade de São Paulo (FM-UNICID), Brazil
Published: November 2021

The use of mechanical ventilation can be performed in situations where patients need ventilatory support to maintain adequate oxygenation. Its inappropriate use can cause some complications, among them: pneumothorax and pneumoperitoneum. Our report describes a 28-year-old man admitted to the ICU with a diagnosis of Covid-19 requiring mechanical ventilation with orotracheal intubation due to acute respiratory failure. During the patient’s clinical evolution he presented bilateral pneumothorax with evolution and progression to secondary pneumoperitoneum, where we sought to understand the relationship between the two conditions.
Fracaso educativo y políticas públicas en México : ocho propuestas estratégicas
Authors: Peraza Guzmán Armando
Published: November 2021

La idea del fracaso educativo en México, si bien no es nueva, sí es de pleno interés público dado los tropiezos constantes que han tenido las políticas públicas implementadas desde que este fracaso se aceptó por parte del Estado y cuya reforma, que se considera más importante fue la descentralización de los años noventas con Carlos Salinas de Gortari. La nota del día siempre ha derivado de los conflictos que provocó la descentralización, dado los intereses políticos que enmarcan el manejo del presupuesto educativo, el más alto a nivel nacional, lo que ha originado una recomposición del sistema de negociaciones clientelares que se daba entre la SEP y el SNTE, al incorporar a los gobernadores de los estados en las negociaciones para el manejo de recursos, haciendo aún más complejo el proceso de implementación de las políticas educativas.
La educación ambiental en la UPN Natura RED 2001-2006
Authors: Paz Ruiz Vicente , Jiménez Medina María Luisa , Méndez Brito María Magdalena
Published: November 2021

En este libro se compilan diversas miradas sobre lo ambiental, todas navegando hacia la utopía, se pasa del discurso y la reflexión a la acción por medio de proyectos de investigación aplicada, la intervención ambiental en la educación básica aportará valores, actitudes, habilidades y destrezas para crear un mundo justo y respetuoso.
Design Thinking na Educação Ambiental: a problemática do Eucalyptus Urophylla S.T. Blake em uma escola do extremo sul baiano
Authors: Carvalho Lima Eli Shuab , Santos Oliveira Ageu , Suelen Caduda dos Santos Sindiany
Published: November 2021

O Design Thinking (DT) é uma metodologia ativa que promove o protagonismo de estudantes mediante a resolução de um desafio/problema. Objetiva-se identificar os benefícios da aplicação da metodologia Design Thinking, no estímulo e valorização do protagonismo de estudantes quanto ao debate sobre a monocultura do eucalipto (Eucalyptus urophylla S.T. Blake) em uma escola de Teixeira de Freitas, Bahia. Observou-se sistematicamente habilidades previamente definidas durante o desenvolvimento das cinco etapas do DT: Descoberta, Interpretação, Ideação, Experimentação e Evolução. Numa escala entre insatisfatória, aceitável e exemplar, seguindo a metodologia do Buck Institute For Education, O desempenho dos estudantes foi classificado como exemplar em quase todas as etapas; com exceção da habilidade proposição de ideias, classificada como aceitável. O trabalho revela a importância da utilização de metodologias ativas nas escolas para estimular o protagonismo dos jovens; valorizar saberes comum e científico; ampliar o debate de problemas socioambientais e transformar as ações dos sujeitos, pressupostos essenciais da Educação Ambiental Crítica.

 

Palavras-chave: Ensino e Aprendizagem. Investigação. Metodologias Ativas. Protagonismo dos estudantes.
percepções de docentes acerca da Educação Ambiental
Authors: Antonio Juliana Mara Antonio , Massaê Kataoka Adriana , Neumann Patricia Neumann
Published: November 2021

Considerando-se o contexto de elevada degradação socioambiental, a Educação Ambiental (EA), sob a perspectiva da Complexidade, de Edgar Morin, fornece subsídios teórico-práticos de compreensão e enfrentamento dos problemas atuais, com notável complexidade. Diante disso, este artigo tem como objetivo apresentar um comparativo entre a percepção anterior e posterior ao Curso de Formação Continuada em Educação Ambiental, sob a perspectiva da Complexidade, dos professores participantes, em relação à EA. Buscou-se, também, avaliar o curso como um todo, bem como os limites e as potencialidades da metodologia utilizada. Para isso, foram utilizados dois questionários, com questões abertas, sendo que um foi aplicado antes do curso e o outro após. Para a análise do questionário, optou-se pela teoria da Análise do Discurso, de corrente francesa, segundo Orlandi (2015). Percebeu-se que as concepções conservadora e pragmática, de início, predominaram, mas que, no decorrer do processo, houve a ampliação dessas visões, especialmente acerca dos Sete Saberes conectados à EA.
Decolonialidade Quadrinística e Educação Ambiental
Authors: Ferreira Kassiano , Montanari Giraldi Patricia
Published: November 2021

As Histórias em Quadrinhos (HQs) são detentoras de uma linguagem que combina textos e imagens as HQs possibilitam novas discussões e ampliação de compreensões sobre temáticas diversas. A discussão relaciona quadrinhos com as teorias decoloniais, para discutir temáticas voltadas às relações entre humano-natureza. A decolonialidade propõe mudanças ao partir da perspectiva do subalterno. Objetivando demonstrar como a Decolonialidade Quadrinística  contribui para novas discussões para o campo da Educação Ambiental, é realizada uma análise da HQ Contos dos Orixás, de Hugo Canuto. Com o aporte teórico-metodológico da Análise de Discurso franco-brasileira, a obra é analisada, apontando sobre possibilidades de  uma vivência harmônica e não-exploratória da natureza, entendendo a humanidade como integrante do ambiente e como as relações espirituais-mágicas que povos tradicionais possuem, reforçam esse modo de viver. Esses pontos discutidos a partir dos quadrinhos, possibilitam reflexões sobre a forma de viver, sendo importantes de serem levadas para a educação em ciências.
A pandemia como propulsora de insurgências no por vir do ensino de biologia e educação ambiental
Authors: Barzano Marco Antonio , Melo André Carneiro
Published: November 2021

No momento em que o Brasil atravessa um período de barbárie com o anúncio de mais de cento e vinte mil mortes por conta da pandemia relacionada ao Covid-19, pretendemos abordar no presente artigo um ensaio acerca dos efeitos em relação à educação ambiental articulada ao ensino de Ciências e Biologia, com o objetivo de vislumbrar e contribuir para uma educação mais humanizadora. Defendemos, com base no pressuposto epistemológico decolonial, a compreensão de que os saberes ancestrais, das comunidades tradicionais, possam produzir sentidos e significados para a construção dos currículos das margens. Desse modo, nos inspiramos na experiência de uma pesquisa desenvolvida em uma comunidade quilombola e que, a partir dela, ampliamos nosso repertório teórico e metodológico, que tem sido inspirador para outras pesquisas em andamento, além de partilharmos nossas reflexões acerca do contexto atual e daquilo que podemos contribuir para um tempo por vir.
Dinámica ecológica de las pandemias
Authors: Iván Darío Loaiza Campiño  , Flórez espinosa Gloria Marcela
Published: November 2021

La educación ambiental es un campo de conocimiento emergente en tensión y en disputa, es también un campo para el diálogo de saberes y la construcción desde la interdisciplinariedad. En este sentido la ecología como base para la comprensión de las relaciones de interdependencia que hacen posible la vida, se constituye en una posibilidad para la reflexión y comprensión de la actual crisis ambiental exacerbada por eventos como la deforestación, la contaminación de patrimonio hídrico, la injusticia social, entre otros, que favorecen la aparición de pandemias como, la fiebre hemorrágica argentina, el nipah y actualmente el covid-19.  El artículo se asume como un aporte desde la ecología para la educación ambiental ciudadana en tiempos de pandemia, presentado un marco conceptual básico sobre ecosistemas, la presencia de algunas pandemias en la historia de la humanidad y las pandemias como respuesta al deterioro ambiental ubicado en el modelo de desarrollo imperante.
Guaranização da educação em ciências:
Authors: PADILHA SCANAVACA Raíza , Antunes Eunice , CASSIANI Suzani
Published: November 2021

Este artigo se constrói a partir de uma pesquisa-ação na elaboração do Plano de Gestão Territorial e Ambiental do Morro dos Cavalos junto à comunidade Guarani. Buscamos perceber entendimentos de conceitos como: "ambiente", "natureza", "vida", "território" e práticas pedagógicas para a educação em ciências. Com isso, percebemos a necessidade de “guaranizar” a ciências para construção de novos valores civilizatórios que confrontam a colonialidade, o capitalismo e construa a busca pela liberdade de todas as formas de vida, o nhandereko Guarani, ou o "bem viver", fundido pelos povos originários da América Latina. Mudanças em "forma" e "conteúdos" são apontados como necessárias. A linguagem, a importância das palavras, dos conceitos, do corpo, do movimento, de conflitos de racionalidades que busque uma educação anti-racista e envolvida com o todo.
Entre a "oportunidade" e a passagem da "boiada"
Authors: Varallo Lima de Oliveira Roberto Dalmo , Pereira Patrícia Barbosa , Lorenzetti Leonir
Published: November 2021

Durante a reunião ministerial realizada no dia 22 de abril de 2020 o Ministro do Meio Ambiente, Ricardo Salles, proferiu um discurso que gerou intensas discussões em nível nacional e internacional. O presente artigo analisa como as mídias potencializaram a naturalização dos efeitos de sentidos sobre o agir político do discurso do Ministro Salles e as suas implicações para uma leitura crítica, indispensável para a formação de sujeitos de direitos e a promoção de alfabetização científica. O corpus de análise é composto de artigos publicados nos Jornais O Globo, Folha de São Paulo, Estadão e Zero Hora, utilizando a Análise do Discurso franco-brasileira. Na análise do discurso do Ministro propusemos o entrelaçamento dos fios dos pressupostos teóricos da Alfabetização Científica, da Educação Ambiental Crítica e da Educação em Direitos Humanos.
Educação ambiental no município de Itabaiana/SE:
Authors: Mendonça de Carvalho Diana , Da Silva Santos Professor Josivalda , Maria Santos Félix Mércia
Published: November 2021

O meio ambiente é um assunto interdisciplinar no contexto educacional. A respectiva temática é abrangente e agrega uma série de reflexões no que tange aos impactos socioespaciais e econômicos. Sendo assim, o meio ambiente não pode ser visto apenas como uma pauta socioeducacional, mas como uma meta-reflexo da educação para a promoção de mudanças no espaço-mundo vivido pela sociedade atual. Diante disso, o presente trabalho analisou a questão ambiental no município de Itabaiana sob a ótica da educação, com foco na coleta seletiva. Esse foi desenvolvido numa perspectiva empírica analítica, com base qualitativa, quantitativa e aplicativa, através de questionários aplicados junto a 340 pais de alunos da rede municipal de ensino. As atividades desenvolvidas sedimentaram um alicerce para a construção de novos valores socioambientais e éticos, assim como, contribuiu para um movimento em prol do bem comum de gerações do presente e do futuro.
Propostas curriculares de Educação Ambiental
Authors: Da Silva Lopes Eduarda , do Espirito Santo Hermel Erica
Published: November 2021

A Educação Ambiental (EA) enquanto um processo que promulga a construção de valores sociais direcionados à sensibilização, deve estar presente nos vários níveis de Ensino, perpetuando o reconhecimento das problemáticas ambientais e preparando os estudantes para o exercício de cidadão crítico e autorreflexivo. Nesse sentido, surge a investigação acerca das propostas curriculares presentes nos Projetos Pedagógicos dos Cursos de Licenciatura em Ciências Biológicas dos Institutos Federais da região Sul do país, a partir de duas categorias: Componentes curriculares relacionados à EA, de modo a compreender a forma como a EA tem sido abordada (transversal ou não) e Objetivos dos cursos (incluindo visão e valores) com base nas concepções de EA: Conservadora, Ecologia Política que mostraram-se relevantes perante as análises, e a Ecologia Social também levantada. Com isso, esperamos contribuir para reflexões que dão ênfase para a formação inicial, uma vez que discuti-la é preciso para reformular a própria prática.
importância das matas ciliares para a proteção das nascentes de água
Authors: Rodrigues Marilice Luzia , Michiko Passos Okawa Cristhiane , Fontana Felipe
Published: November 2021

Pensando na importância das nascentes de água, elaboramos e aplicamos uma sequência didática voltada para a Educação Básico-primária, que conseguisse abordar e discutir a importância das matas ciliares para a proteção das nascentes de água, mais precisamente naquelas existentes no município de Quarto Centenário, Paraná. O desígnio deste artigo é relatar, descritivamente, tal experiência de modo a apontar seus desafios e resultados mais proeminentes. Metodologicamente, aplicou-se a sequência com três momentos pedagógicos: (i) o diagnóstico da realidade observada; (ii) problematização das nascentes, pensando nos processos que causam sua degradação; (iii) o levantamento de mecanismos de superação da realidade, para forjar mudanças atitudinais aos educandos. Observamos que a sequência didática aplicada, mesmo inflexionada pela dinâmica escolar imposta pela pandemia dada pelo coronavírus, promoveu ludicidade, empregou uma linguagem adequada à faixa etária dos alunos/participantes e, de modo intrínseco à efetivação de uma Educação Ambiental, agenciou aspectos interdisciplinares.