bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional bracing in distal radius fractures: a cadaveric pilot study
Authors: van Buijtenen Jesse M , van Delft Eva AK , Rijsdijk Meza , Dobbe JGG , van der Veen Albert , Streekstra Geert J , Bloemers Frank W
Published: June 2022

Background

Extra-articular distal radius fractures are often treated by circular casting. A functional brace, however, may equally support the fracture zone but allows early mobilization of the radiocarpal joint. Since the amount of fracture movement for different types of fixation is currently unknown, a study was initiated to investigate the degree of bone displacement in extra-articular distal radius fractures fixated by regular circular casting, functional bracing, or no-fixation.

Methods

In four cadaveric arms, an extra-articular distal radius fracture was simulated and immobilized by the three ways of fixation. After creating an extra-articular distal radius fracture, the fracture was reduced anatomically and the cadaveric arm was strapped in a test frame. Hereafter, flexion, extension and deviation of the hand were then induced by a static moment of force of one newton meter. Subsequently CT scans of the wrist were performed and bone displacement was quantified.

Results

Immobilization of an extra-articular distal radius fracture by functional bracing provides comparable fixation compared to circular casting and no fixation, and shows significantly less extension-rotation displacement of the distal bone segment for the wrist in flexion and palmodorsal translation and extension-rotation for the wrist in extension.

Conclusion

Functional bracing of extra articular distal radius fractures in cadaveric arms provides significant less extension-rotation displacement in flexion and palmodorsal translation and extension-rotation in extension compared to circular casting and no fixation.
O Drama e a Ideia de Bem
Authors: Braga André
Published: June 2022

A compreensão de qual seja o papel, na filosofia de Platão, do Bem, enquanto Ideia ou Forma, sempre foi assunto dos mais debatidos em toda a sua obra. Alguns pontos são pacíficos: p. ex., o Bem é o fundamento ontológico último de toda a ética e pensamento político do fundador da Academia. Outros, embora não pacíficos, são milenarmente aceitos: a ontologia do Bem exposta em República VI e VII é o coração do pensamento platônico. E outros dados são textuais  - que é o caso dos dados dramáticos. Este artigo focará sobre um ponto específico do problema, a saber: as nuances dramáticas em meio às quais a narrativa sobre o Bem (os três símiles: Sol, Linha Dividida e Caverna) surge na obra. Com a atenção então voltada para o momentum do drama que envolve a eclosão das três famosas imagens nos livros centrais da República, procurar-se-á pensar no que significa toda a atmosfera de esquiva, forte insegurança e tergiversação que lhes atravessa. E, demorando-se sobre tais nuances ou “pistas” dramáticas, o artigo confrontá-las-á com a opinião de alguns estudiosos do tema (ADAM, 1902; CORNFORD,  1945 e 1952; ANNAS, 1997; BALTES, 1999; SANTAS, 1999; GUTIERREZ, 2003; LISI, 2003; SZLEZÁK, 2003; SHIELDS, 2011). Nesse ínterim, uma outra possibilidade interpretativa acerca do papel da narrativa sobre o Bem será sugerida.
Usos do passado em Tito Lívio
Authors: Silva Suiany Bueno
Published: June 2022

Discutiremos o papel da escrita da História em Tito Lívio e como a mesma define e consolida uma identidade romana, o ser romano. Trata-se de observar como a estrutura da narrativa aponta para a compreensão de uma História concebida como “mestra da vida” (magistra vitae), ou seja, a utilidade dos exemplos. O valor do estudo da história, em outras palavras, não reside apenas em lições específicas, mas também no exercício de como e o que se olhar desse passado. Neste sentido, ao retomar uma historiografia antiga e aplicá-la em sua escrita, Tito Lívio pretende realizar um trabalho historiográfico que realce a dignidade de seu povo, um aspecto que permite a definição dos comportamentos cívicos romanos, bem como a definição de uma latinidade romana associada às inquietações do contexto presente de Lívio à época de Augusto, durante o século I a.C. - I d.C. Compreenderemos como o discurso histórico de Lívio expressa as demandas políticas de sua contemporaneidade, a partir da relação entre discurso, memória, poder e identidade.
Os demônios de Santo Agostinho
Authors: Moraes Gerson Leite de
Published: June 2022

O presente trabalho tem por finalidade classificar e analisar as definições demonológicas em Santo Agostinho. Isto implica numa análise tanto filosófica quanto teológica do pensamento agostiniano sobre a existência dos anjos bons e dos anjos maus, denominados por ele como demônios. Além disto, pretendeu-se verificar os seus escritos sobre o Mal em seus três níveis: o metafísico, o moral e o físico. Após o cotejamento dos seus escritos foi possível verificar a construção de uma teodiceia que foi de suma importância para a cultura medieval, além é claro da fixação de uma moralidade cristã construída mediante a prática da apologética.
Pintando no céu
Authors: Da Silva André Luiz Braga
Published: June 2022

No livro VI da República de Platão, vemos que a caracterização da Ideia de Bem é feita através de uma imagem, o símile do Sol (508b12-509b10). Mas qual seria o motivo de ser este o tipo de explicação utilizada? Dentre as muitas explicações aventadas pelos exegetas, a mais célebre foi aquela que afirmou que a Ideia de Bem seria um ente tão especial, que não seria “tratável” através do discurso direto, sendo-lhe cabível apenas uma exposição imagética. O presente artigo então: i) indicará as passagens da obra que não permitem a sustentação dessa posição; ii) apontará a caracterização e a justificação de uma explicação imagética que o próprio diálogo apresenta (487e-489b); iii) averiguará se tais motivos e características são identificáveis no caso do símile do Sol.
O masculino e seu sexo na Roma antiga
Authors: Cozer Alexandre
Published: June 2022

Dentre os mais tradicionais modelos interpretativos para compreender as práticas sexuais romanas, a ideia de um cidadão masculino dominante, controlado e penetrador parece inquestionável. Nesse artigo, analisamos os discursos sobre a masculinidade criados n’O Livro de Catulo (I a.C.) e na Priapeia (I d.C.). Nosso objetivo é demonstrar que, nesse tipo de poesia e de humor, o papel masculino, desempenhado pelo eu-poético, poderia oscilar entre a mais comum ideia de uma masculinidade dominante e seu contrário. Tomando por base os questionamentos foucaultianos sobre a relação entre os discursos e a sociedade, não intencionamos propor um novo modelo para o entendimento das práticas sexuais romanas, mas apontar um caminho para observar a diversidade de maneiras com as quais esses antigos poderiam lidar com seus desejos e corpos.
Aspectos apocalípticos e sociais n‘O Pastor’ de Hermas
Authors: Silva Filipe N. , Funari Pedro Paulo A.
Published: June 2022

Este artigo discute alguns dos elementos apocalípticos apresentados na obra “O Pastor”, atribuída ao liberto Hermas. Ao reconsiderar seus aspectos filológicos quanto à datação e autoria, pretende-se, ademais, apontar caminhos para a utilização deste texto enquanto documento histórico sobre as comunidades cristãs e suas relações com o universo social do Império Romano nos primeiros séculos da Era Comum.
KAJI EKSPERIMENTAL NONWOVEN BERBAHAN SERAT DOMBA WONOSOBO SEBAGAI INSULATOR UNTUK APLIKASI ATAP
Authors: Mustafa Dody
Published: June 2022

Domba Wonosobo atau Dombos merupakan hasil persilangan antara domba lokal daerah Kejajar Kabupaten Wonosobo yang dikenal sebagai domba ekor tipis dan domba ekor gemuk dengan Domba Texel yang berasal dari Belanda. Adanya aktifitas peternakan menyebabkan adanya limbah bulu domba yang terbuang begitu saja. Hal ini menimbulkan gagasan baru untuk membuat material insulator karena Indonesia merupakan daerah tropis dan panas. Berdasarkan sifat fisik bulu domba yang memiliki densitas sangat rendah dan bulky yang dapat menahan udara dan panas yang baik. Untuk membuat material tersebut bernilai tinggi perlu dipilih metode hotpress dan semaksimal mungkin menggunakan bahan recycle atau bahan alam yang ramah lingkungan. Pembuatan material insulator ini menggunakan teknik proses nonwoven metode needle punch dan  thermal bonding sistem hot press, untuk meningkatkan daya rekat antar serat bulu dombos ditambahkan serat poliester dengan titik leleh yang rendah sebagai binder atau perekat. Penggunaan dombos pada nonwoven dengan ketebalan 20 mm pada suhu 73o C dapat menurunkan hingga temperature hingga 64.4 %, sedangkan untuk nonwoven dengan ketebalan 10 mm dapat menurunkan temperature hingga 57.5 % dan  nilai thermal konduktifitasnya lebih baik di bandingkan dengan material glasswool yaitu 54.8 % dan nonwoven waste denim 50.7 %.
اكتشاف جين جديد يساهم في الإصابة بمرض السكري ويؤثر في استقلاب الغلوكوز
Authors: تنيرة جلال , الرفاعي لينا , محمد عبد القادر
Published: June 2022

الملخص

المقدمة وهدف الدراسة: يعدّ مرض السكري من النوع الثاني مرضًا متعدد العوامل والجينات. وقد تم اكتشاف أكثر من 140 متغيرًا جينيًا وراثيًا مرتبطًا بسببية المرض، ولكنها تفسر فقط 10% من الأسباب الوراثية للسكري. لهذا، تسعى هذه الدراسة إلى استخدام نهج جديد تُحدَّد من خلاله جينات جديدة مشارِكة في فسيولوجية مرض السكري وإفراز الإنسولين. طريقة البحث: تم تحليل بيانات تسلسل الحمض النووي الريبوزي من جزر البنكرياس البشرية جُمعت من 89 متبرعًا. كما أُجريت سلسلة من التجارب الوظيفية في خلايا بيتا الحيوانية (INS-1) من الفئران للتحقق من الدور المحتمل للجين المرشح بما في ذلك تثبيط نشاطه، وإفراز الإنسولين، وحيوية الخلية، وموت الخلية المبرمج، والتعبير الجيني. النتائج: قد أظهر تحليل التعبير الجيني التفاضلي لبيانات تسلسل الحمض النووي الريبوزي أن 231 جينًا كان لها تعبير منخفض على نحو ملحوظ في جزر البنكرياس من المتبرعين المرضى بالسكري مقارنة بالأصحاء. وتم خفض عدد الجينات إلى 37 من جراء تطبيق قطع إحصائي أكثر صرامة. ومن بين تلك الجينات، تم اختيار (PPP1R1A) كجين مرشح بسبب ارتباطه القوي مع معدل السكري التراكمي، وتعبيره الجيني المرتفع في جزر البنكرياس البشرية مقارنة بباقي الجينات. وأيضًا، وُجد أن تعبير الجينات الوظيفية المهمة في خلايا بيتا مثل (INS) و(PDX1) و(GLUT2) و(INSR) انخفض على نحو كبير في الخلايا التي ثُبّط فيها نشاط (PPP1R1A). وخلصت الدراسة إلى أن (PPP1R1A) جين منظّم لوظيفة خلايا بيتا وإفراز الإنسولين، كما سلطت الضوء على قائمة من الجينات التي قد يكون لها دور وتأثير في مرض السكري.
Spontaneous bilateral pneumothorax and pneumomediastinum independent of mechanical ventilation as complications of COVID-19 pneumonia: A case report
Authors: Antony Manoj Matthew , Achappa Basavaprabhu , Victor Dsouza Nikhil , Sundar Shruti , BS Vinay
Published: June 2022

Since the beginning of the COVID-19 pandemic, several infected patients have suffered from unusual and severe complications. Among these rare complications, pneumothorax and pneumomediastinum have attracted clinical attention. Such complications might be challenging to diagnose immediately because of the atypical presentation in some cases. Accurate diagnosis is essential to ensure effective treatment. Here, we present the case of a 62-year-old male who presented with symptoms of COVID-19 acute respiratory distress. There was diffuse subcutaneous emphysema in the face, neck, shoulder, and chest wall on clinical examination. The patient was started on oxygenation via a non-rebreather mask. On further evaluation, his chest X-ray revealed bilateral peripheral opacities in the lung fields, bilateral pneumothorax, and subcutaneous emphysema, after which intercostal drainage tubes were inserted. The patient's oxygen saturation was not satisfactory, and he was switched to a high-flow nasal cannula. However, his condition deteriorated, and he was put on mechanical ventilation and inotropic support. Despite our best efforts, the patient succumbed to the disease. We want to emphasize the importance of this adverse event despite his nonsmoking history and the exclusion of positive pressure ventilation. Although benign, early diagnosis of this condition is vital, as the condition could lead to worse morbidity if left unrecognized.
Implementasi Metode Fuzzy Berbasis Internet Of Things (IoT) Untuk Peringatan Dini Banjir
Authors: Nduru Sabaruddin , Hafiz Afdal Al , Pane Deski Helsa
Published: June 2022

Indonesia adalah negara kepulauan yang secara geografis terletak di pertemuan dua lempeng benua dan berada digaris khatulistiwa oleh karena itu Indonesia memiliki iklim tropis dan curah hujan tingkat. Banyak manfaat yang didapatkan sebab letak Negara yang strategis namun ada juga dampak negative yang diterima salah satunya adalah bencana banjir yang dimana dapat mengakibatkan banyak kerugian yang ditimbulkan setelah banjir mulai dari primer, sekunder dan tersier. Salah satu jenis banjir yang sering terjadi adalah luapan air sungai banjir juga terjadi karena derasnya hujan daerah hulu dan mengakibatkan luapan air sungai pada hilir. Sistem pemrosesan dari hasil akuisisi yang didapatkan dari penggunaan kombinasi dari sensor (multi sensor) yaitu sensor yang dapat mendeteksi level air dan sensor yang mendeteksi debit air. Hasil dari proses akuisisi data sensor kemudian akan diproses dengan kecerdasan buatan fuzzy yang ditanamkan pada arduino. Sistem peringatan dini banjir berbasis internet of things (IoT). Dengan adanya peringatan dini banjir diharapkan dapat membantu penduduk mengetahui ketinggian air dan debit air melalui buzzer yang berupa bunyi dan Aplikasi Blynk memonitoring jarak jauh. Berdasarkan rancancangan alat multi sensor peringatan dini banjir metode fuzzy dibaca oleh kedua sensor water flow dan ultrasonik sebagai crisp input kemudian dilakukan proses fuzzyfication yang menghasilkan fuzzy rules kemudian dilakukan proses defuzzification sehingga mengeluarkan crisp value yang dibutuhkan. Berdasakan hasil dari pengujian maka mengimplementasikan sensor ke arduino menghubungkan beberapa pin kedua sensor ke arduino dengan benar.
Perancangan Sistem Monitoring Stok Minuman Di Vending Machine Berbasis IoT
Authors: Nasution M. Zafar Aidin , Erwansyah Kamil , Halim Jufri
Published: June 2022

Vending machine adalah perangkat yang dapat melakukan transaksi secara otomatis dengan memasukkan nominal uang tertentu ke dalam mesin, mesin dapat merespon dengan mengeluarkan item atau barang tertentu. Pada dasarnya sistem stok di dalam vending machine selama ini dilihat secara manual terkadang di beberapa lokasi yang ramai konsumen barang selalu habis dan tidak diketahui kapan habis atau lama di gantinya stok dengan yang baru hal itu akan mengurangi penjualan, hal itu akan memakan banyak waktu dan menghabiskan biaya. Berdasarkan penelitian yang telah dilakukan, didapati permasalahan terhadap monitoring stok vending machine. Untuk itu dibutuhkan sebuah inovasi modernisasi teknologi agar kualitas pemantauan dapat meningkat. Dengan mengimplementasikan Internet of Things (IoT) memungkinkan untuk memonitoring stok minuman di vending machine secara langsungÂ  adapun kombinasi dengan Esp-32 Cam yang memiliki kelebihan pada fitur Wireless Fidelity (Wi-Fi) yang memungkinkan untuk mengirimkan data dan foto melalui jaringan dengan aplikasi Blynk dengan adanya Internet of things diharapkan pihak penjual minumanÂ  dapat memantau stok minumannya dengan jarak jauh juga agar dapat mengikuti perkembangan teknologi. Perancangan sistem monitoring stok minuman di vending machine berbasis IoT hadir untuk membantu dalam pemantauan secara langsung terhadap stok minumannya dan juga dapat meningkatkan efisiensi dari pihak pengisi minuman, demi mencegah kecurangan yang memungkinkan mendapatkan kerugian terhadapt stok yang tidak sesuai isi dari permintaan.
Utilização de prebióticos para promoção de perda de peso em crianças e adolescentes com sobrepeso e obesidade: uma revisão integrativa
Authors: Braga Liana , Oliveira Karina , Almeida Nádia , Vieira Ivna
Published: June 2022

A obesidade infantil tem tomado destaque no contexto de transição epidemiológica e nutricional, requerendo a necessidade de pesquisas sobre estratégias que possibilitem a redução do peso nessa faixa etária. Dentro dessa proposta, destaca-se a utilização de frutooligossacarídeos e inulina, os quais, servindo como substratos para a microbiota intestinal, pode possibilitar a modificação do metabolismo no sentido de promover perda de peso. O presente trabalho consistiu em uma revisão integrativa, que buscou investigar os efeitos da suplementação dietética com frutooligossacarídeos e inulina sobre o peso corporal em crianças com sobrepeso e obesidade e, consequentemente, o impacto dessa terapia sobre a saúde desses indivíduos. Foram analisados sete artigos científicos, os quais avaliaram um conjunto de variáveis antropométricas e laboratoriais para verificar o desfecho da intervenção. Embora existindo o viés de poucos estudos abordarem essa temática, tem-se como conclusão a existência do potencial que frutooligossacarídeos e inulina apresentaram na promoção de perda de peso nessa população, o que é de grande valia no tocante ao estabelecimento de estratégias que reduzam o risco de obesidade na vida adulta e de suas consequências.
Factors Affecting the Achievements of Performance-Based Capitation: A Scoping Review
Authors: Aryani Ari Dwi
Published: June 2022

Abstract: Primary care facilities (FKTP) are the vanguard in the National Health Insurance Program (JKN). The implementation of performance-based capitation (Kapitasi Berbasis Kinerja or KBK) is an effort to ensure FKTP performance through capitation payment arrangements to improve patient satisfaction, quality of health services, and cost-efficiency. Although overall FKTP performances have increased, from 9,276 FKTP that carried out KBK, only 15% achieved perfect performance (100%), with only one of three KBK indicators reached, namely the non-specialist referral ratio. This study aims to review existing literatures to compile various factors that affect the achievement of KBK. Literature searches were conducted systematically in 2016-2021 using PubMed, Google Scholar, PubMed Central, Researchgate, and other sources. The keywords used are capitation, based, performance, and commitment. Literature selection produces nine articles that match the criteria for analysis. Some of the factors that affect the achievement of KBK are the availability of human resources (medical and non-medical personnel), the availability of medical devices, the availability of information systems, governance and organization, and financing. Fulfilment of these factors is needed to achieve KBK indicators.
Keywords: indicator, capitation, performance, commitment, JKN
 
Abstrak: Fasilitas Kesehatan Tingkat Pertama (FKTP) merupakan garda terdepan dalam pelayanan kesehatan Program Jaminan Kesehatan Nasional (JKN). Penerapan Kapitasi Berbasis Kinerja (KBK) merupakan upaya memastikan kinerja FKTP untuk  meningkatkan kepuasan, mutu layanan kesehatan,  dan efisiensi biaya. Meskipun secara keseluruhan kinerja FKTP mengalami kenaikan, dari 9.276 FKTP yang melaksanakan KBK hanya 15% FKTP yang mencapai kinerja 100 persen, dengan indikator KBK yang tercapai hanya satu, yaitu Rasio Rujukan Non Spesialistik. Tujuan penelitian ini untuk mengidentifikasi literatur yang ada dan mengkompilasi berbagai faktor-faktor yang berpengaruh terhadap capaian indikator KBK Program JKN. Penelusuran literatur dilakukan
secara sistematis periode tahun 2016-2021 menggunakan PubMed, Google Scholar, PubMed Central, Researchgate dan sumber lainnya. Kata kunci yang digunakan dalam penelusuran literatur adalah kapitasi, berbasis, kinerja, komitmen. Seleksi literatur menghasilkan 9 artikel sesuai kriteria untuk dianalisis. Beberapa faktor yang berpengaruh terhadap capaian KBK yaitu ketersediaan sumber daya manusia (tenaga medis dan non medis), ketersediaan sarana prasarana, ketersediaan sistem informasi, tata kelola dan organisasi serta pembiayaan. Diperlukan pemenuhan terhadap faktor-faktor tersebut agar indikator KBK dapat tercapai.
Kata kunci: indikator, kapitasi, berbasis, kinerja, komitmen, JKN
Stroke before a haematopoietic stem cell transplantation is a potential risk factor for poor response to therapy in patients with blood cancer
Authors: Polushin Alexey Yu. , Skiba Iaroslav B. , Bakin Evgeny A. , Vladovskaya Maria D. , Moiseev Ivan S. , Voznyuk Igor A. , Kulagin Alexander D.
Published: June 2022

Introduction. More than 50,000 haematopoietic stem cell transplantations (HSCTs) are performed worldwide each year to treat malignant blood cancers, solid tumours, bone marrow aplasia, primary immunodeficiency conditions, autoimmune disorders, and storage disorders. The success of HSCTs depends on many factors, including patient's past medical history.
Purpose. To assess the effect of an acute cerebrovascular accident (CVA) that occurred before the HSCT on the transplantation outcome in patients with blood cancer.
Materials and methods. We examined the results of 899 transplantations conducted between 2016 and 2018 at the R.M. Gorbacheva Research Institute for Pediatric Oncology, Haematology and Transplantation of the Pavlov First Saint Petersburg State Medical University. We analysed transplantation parameters, as well as donor and recipient characteristics. Apart from intergroup comparisons, pseudo-randomization was performed using the Propensity Score Matching method. The survival rate analysis was conducted using the KaplanMeier estimate and the log rank test.
Results. Sixteen patients (1.8%) had cerebrovascular events in their past history before the HSCT: ischaemic stroke in 0.4% of cases and haemorrhagic stroke or intracerebral haemorrhage in 1.4% of cases. Patients with a history of cerebrovascular events included more people with leukaemia (p = 0.02), had more often received an allogenic transplant (р = 0.01), the donors more often had a partial rather than a full HLA match with the recipient (р = 0.06), had a lower body mass index (р = 0.02), and a lower Karnofsky/Lansky score (р = 0.01) than patients in the control group. The presence of a cardiovascular event had a statistically significant association with reduced overall survival rate of HSCT recipients (р = 0.0012).
Conclusion. Patients with blood cancer and stroke preceding the transplantation do not typically have any 'classical' risk factors (diabetes mellitus, venous system disorders, decreased cardiac output, significant atherosclerotic changes in precerebral arteries), therefore, secondary prevention guidelines for CVA during treatment of the main disease may not be effective and cannot be relied on. This article discusses the most likely causes of CVA in patients with blood cancer. A history of CVA before HSCT may have a significant effect on the transplantation outcome, but is not a contraindication for this treatment method. Recipient selection is a very important stage in HSCT planning. A multidisciplinary team should find a balance between the indications and contraindications for performing HSCT from an unrelated donor.
Clinical assessment of patients with chronic disorders of consciousness by different medical specialists
Authors: Solovyeva Polina I. , Sinkin Mikhail V. , Talypov Alexander E. , Abzalova Dilara I. , Ramazanov Ganipa R. , Mehia-Mehia Ester D. , Bakharev Evgeniy Yu. , Popugayev Konstantin A. , Grin Andrey A.
Published: June 2022

Introduction. Clinical assessment of consciousness in patients coming out of a coma remains a topic of discussion. Monitoring these patients over time is challenging not only because of the slow fluctuations in their neurological status, but also because doctors are not fully aware of the classification of chronic disorders of consciousness (CDC), and how to use the Coma Recovery Scale-revised (CRS-R), which was specifically developed for this group of patients. In practice, most doctors use standard neurological examination to assess consciousness rather than the CRS-R. We have hypothesized that this approach leads to contradictory and poorly standardized results. Materials and methods. We investigated the level of inter-expert reliability in pairs of three medical specialists: neurologists, neurosurgeons and neurocritical care specialists (working in neurocritical care units) in the clinical assessment of consciousness. Their examination findings were compared to the CRS-R scores. Results. The inter-expert reliability was poor in all three specializations when using clinical examination to determine the degree of impaired consciousness in patients with CDC. An average level of IER (Cohen's kappa = 0.46) was found only in the neurosurgeonCRS-R pair. Conclusion. A scale with detailed criteria is different to a standard clinical examination and has a higher level of IER. Moving from subjective evaluation to a standardized CRS-R will enable medical specialists to determine a patients rehabilitation potential and predict disease progression more accurately. Educational programmes, including virtual platforms, should be developed to encompass most of the medical community.
Safety of pathogenetic therapy for multiple sclerosis during the COVID-19 pandemic
Authors: Petrov Andrey M. , Votintseva Marina V. , Stolyarov Igor D.
Published: June 2022

The safety of pathogenetic therapy for multiple sclerosis (MS) is a crucial aspect of the therapeutic strategy during the COVID-19 pandemic.
Based on our own data, obtained during the study of MS pathogenesis and safety analysis of MS disease-modifying therapies (DMTs), we hereby suggest a classification of DMTs side effects, based on their type, development, and direction of action. There is a need to thoroughly analyse adverse events caused by pathogenetic therapy, with a balanced assessment of the direct vs. adverse effects of immunosuppressive drugs.
Based on available literature, in the article, data on the effect of DMTs with various mechanisms of action on severe coronavirus infection are systematized.
Interferon- and glatiramer acetate are the safest drugs to use during the COVID-19 pandemic. Teriflunomide, dimethyl fumarate, natalizumab, ocrelizumab, fingolimod, alemtuzumab, and cladribine should be used with caution. Drugs with a minor systemic immunosuppressant effect (e.g. natalizumab) and selective immunosuppressants (e.g. ocrelizumab) are safer than drugs that cause non-selective depletion of T and B cells.
It must be stressed that the risk of MS exacerbation and progression due to untimely prescription or cessation of pathogenetic therapy can significantly exceed the potential risk of COVID-19.
Long-term safety monitoring is required for DMTs during the COVID-19 pandemic and when the epidemiological situation stabilizes.
Ecuadorian Migration Policy Analyzed from International Causality
Authors:   Universidad Regional Autónoma de Los Andes. Ecuador, Piza I.A.C
Published: June 2022

The migration issue has been an inseparable part of the international scene since the beginning of the Third Millennium, together with its possibilities for transformation and development. If the regional, national, governmental, and civil society agendas are observed, they all have approaches to the issue of international migration. States have the right to regulate movements across their borders; international cooperation aimed at reducing irregular migration contemplates both a punitive aspect related to law enforcement and a protection and human rights approach. Ecuador is one of the few countries that has the dual quality of sending and receiving migrants. Added to this situation is the reception of displaced persons from other nations, a different but complementary phenomenon to migration, which has made it the first country of refuge in Latin America and lately the country of transit. Based on the analysis through the Analytic Hierarchy Process (AHP) multicriteria decision method, it is intended to evaluate the causes of international migration, and focus them on the current context of Ecuador, in the study of an adequate migration policy.
Main types of computer crimes existing in Ecuador
Authors:   Universidad Nacional Mayor de San Marcos, Lima , Peru, Fernández D.M.M. , Vázquez M.Y.L ,   Universidad Regional Autónoma de Los Andes. Ecuador
Published: June 2022

The introduction and use of Information and Communication Technologies (ICT) have meant a vertiginous leap in scientific-technical development on a global scale, they have become an indispensable element in all facets of society. Without a doubt, the use of the Internet makes life easier for users, but those benefits become dangerous when unscrupulous people silently infiltrate to damage not only technical equipment but also the finances of individuals, companies, and governments. The objective of the investigation is to determine the main types of computer crimes existing in Ecuador, as well as the possible solutions to avoid them. Different research techniques and methods were studied, such as synthetic analytical, inductive deductive, logical historical, as well as the descriptive method, interviews, and surveys in the same way that tools such as descriptive surveys and referential research were used. To fulfill the proposed objective, the AHP Saaty and Vikor multicriteria methods were used, where the crimes with the highest probability of occurring in the country and the best techniques to combat them were obtained as conclusions.
İÇİMİZDEKİ CANAVARI EHLİLEŞTİRMEK: STEPHEN CRANE’NİN “CANAVAR” ADLI KISA ROMANININ EMPATİK BİR İNCELEMESİ
Authors: GÜRCİ Yeşim
Published: June 2022

Oldukça yeni bir araştırma alanı olan anlatımsal empati, anlatıların okuyucularda empati duygusunu teşvik etme ve geliştirmede oynadığı rolü incelemektedir. Etik ve etik eleştiri tartışmalarıyla gündeme gelen anlatımsal empati, hem etik-edebiyat arasındaki ilişkiye dair daha önce yapılmış olan çalışmaların kapsamını genişletmek hem de evrensel bir duygu olarak karşımıza çıkan ve bize insanlığımızı hatırlatan empatiyi merkeze alarak bu çalışmalara değerli bir katkı sağlamak açısından büyük önem taşımaktadır. Anlatımsal empati teorisinin ileri sürdüğü gibi, acı içinde olan veya zor şartlar altında yaşayan kişilerle empati kurabilmek için onların acılarına ilk elden tanık olmak gibi bir zorunluluk bulunmamaktadır. Kurgusal veya kurgusal olmayan bu karakterler hakkında okuyarak bile, yazar tarafından yapılmış olan tematik ve formal seçimler sayesinde okuyucular bu karakterlerle empati kurabilirler. Ancak, sadece hukuk ve ekonomi alanlarında uzmanlaşmakla kalmayıp aynı zamanda ahlak felsefesi ve etik eleştiri ile ilgili eserler kaleme almış olan ve etkili bir şahsiyet olarak kabul edilen Richard Posner gibi bazı bilim insanları, etik ve estetiğin iki zıt kutup olduğu görüşündedirler, ve bu yüzden de edebiyatın okuyucuları empati kurmaya sevk etme potansiyeline karşı çıkmaktadırlar. Bu makale, Stephen Crane’nin ünlü kısa romanı “Canavar”da kullandığı belirli anlatı araçlarını ve tekniklerini inceleyip analiz ederek, etik ve estetik arasındaki ayrılmaz bağlantıyı ve Crane’nin bu stratejik tercihlerinin okuyucularda empati gelişimine nasıl katkıda bulunduğunu ortaya koymayı amaçlamaktadır.
Nietzsche, Heidegger ve Anlam: Covid-19 Pandemisi Dönemine İlişkin Çıkarımlar
Authors: BIÇAKCI Ozan
Published: June 2022

Nietzsche points out that the noble taste of Greek lost its place to dialectic after Socrates, and thus, human beings lost their connection to their nature. After Socrates, through the exclusive use of conscious and logical language, the meaning became fixated in our society and we lost our connection to the dynamism in nature. Considering representations as meanings, in the Heideggerian sense, it should be noted that a represented object always implies a level of existence that is not limited to that representation but points to a Being of that representation. For Heidegger, in line with Nietzsche, however, there is a switch during the Hellenistic period from the understanding of “sign” as "showing for showing" to “sign” as an instrument to "designate", and that switch leads to the creation of representations between sign and its signified (hence the term "designation" with the focus instead on the signified). In today's neoliberal world, similarly, people are lost in and through representations (and even they become a representation to be consumed) and, in this way, lost in an inauthentic way of living. It is, then, not expected for the Covid-19 pandemic to lead us to the authentic way of living because the anxiety around it would be translated into fear, which is an inauthentic way of experiencing anxiety. As a solution, we should reinvent the language where the instinctual language of the real of our bodies and will would prevent the logical language from resulting in the fixation of meaning and representation.
Sonographic examination of respiratory muscles in chronic obstructive lung disease and evaluation of the relationship with clinical severity of exacerbation
Authors: Akbulut Semiha , Coşgun Zeliha , Özsarı Emine , Kalaycıoğlu Oya
Published: June 2022

Aim: This study aimed to sonographically examine the fraction of thickening in the respiratory muscles during the acute exacerbation of chronic obstructive pulmonary disease (COPD) and to determine its relationship with the clinical severity of the exacerbation.Methods: This prospective study looked at 159 people over the age of 50 who were diagnosed with COPD using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and were admitted to the hospital because they were having an acute COPD flare-up. Ultrasonography was used to measure how thick the parasternal intercostals, pectoralis major, and diaphragm muscles were in each patient.Results: Of the patients, 63 had mild, 63 had moderate, and 33 had severe exacerbations. Parasternal intercostal and pectoralis major muscle thickening fractions were significantly higher in moderate and severe exacerbations compared to mild exacerbations, while the diaphragm muscle thickening fraction was significantly lower (p
How effective is the obesity treatment on improving oxidative stress? Is there any difference between drugs?
Authors: Keskin Lezan , Şahin İbrahim , Yavuz Dilek Gogas , Yüksel Meral , Taşkapan Mehmet Çağatay
Published: June 2022

Aim: Obesity shortens the life period and decreases its quality, causing several complications. Recently, oxidative stress produced by lipid peroxydation is considered a cardiovascular risk factor. In this study, we aimed to investigate the relationship between weight loss with lipid profile, insulin resistance, and lipid peroxidation products malondialdehyde (MDA, oxidant) and paraoxonase-1 (PON1, antioxidant) levels which is protective in atherosclerosis, and to evaluate alteration on oxidative stress.Methods: Patients diagnosed as obese at the Endocrinology and Metabolic Diseases Outpatient Clinics of Inonu University Faculty of Medicine between December 2005 and February 2008 were studied. 103 patients were included in the study. Study population was divided into two treatment groups. In the first group, 120 mg of orlistat, three times daily, and in the second group, sibutramine 15 mg per day were given in addition to appropriate diet therapy. The patients were evaluated at the end of three months treatment period.Results: Dramatic changes in body weight, Body Mass Index (BMI), and waist and hip circumference were observed during the three-month evaluation in patients receiving orlistat or sibutramine. Additionally, significant improvements were measured in systolic-diastolic blood pressure levels, lipid levels, and insulin resistance. The decrease in the MDA level and the increase in the PON level were similar and significant in both patient groups.Conclusion: The treatment of obesity, aimed at reducing body weight, acts to reduce oxidative stress by increasing paraoxonase-1 activity (antioxidant) and reducing the amount of the peroxidation product malondialdehyde (oxidant), regardless of the type of medication administered.
On-site pilot testing of maturity sensors in conjunction with ambient condition monitoring device to get an insight into the concrete strength gain process
Authors: Utepov Yelbek , Zharassov Shyngys
Published: June 2022

The article demonstrates the performance of newly developed concrete maturity sensors on the construction site of residential complex “New Line” in Nur-Sultan. The sensors were mounted on the rebar of reinforced concrete structures to monitor the curing temperature of poured concrete grade M350 during 7 days. Additionally, the sensor device monitoring ambient temperature and relative humidity was set nearby. 14 cubic specimens were molded for compression test to determine the concrete strength. To get an idea on the degrees of influence of considered factors on concrete strength gain, the correlation analysis was conducted. As expected, the curing temperature showed a significant correlation with compressive strength, and its degree of influence amounted 58%. The ambient temperature with influence degree of 36% seemed to affect the concrete strength vividly. The relative humidity affected insignificantly with 6%. Based on conducted investigations the well-enough performance of maturity sensors is concluded. Moreover, there was set plans on the extension of their software solution with colored cross-correlation analysis technique.
Difference in the Standard and Novel Lipid Profile Parameters Between Patients With Alzheimer’s Disease and Vascular Dementia Stratified by the Degree of Cognitive Impairment
Authors: Zaciragic Asija , Dervisevic Amela , Valjevac Amina , Fajkic Almir , Spahic Selma , Hasanbegovic Ilvana , Jadric Radivoj , Lepara Orhan
Published: June 2022

Background: Lipids and lipoproteins are significantly involved in maintaining structural and functional components of the human brain and neurons, but their role in the development of Alzheimer’s disease (AD) and vascular dementia (VD) remains unclear. Objective: The aim of the present study was to explore the differences in the standard and novel lipid profile parameters in patients with AD and VD, stratified by the degree of cognitive impairment (CI). Methods: Present study included 66 patients with AD, 50 patients with VD, and 60 control subjects. For an evaluation of the global cognitive function the Montreal Cognitive Assessment (MoCA) test was used. In order to distinguish patients with VD from those with AD the Hachinski ischemic score was used. Plasma total cholesterol (TC), high-density lipoprotein -cholesterol (HDL-C), and triglycerides (TG) levels were determined using standard enzymatic colorimetric techniques, whereas the Friedewald formula was used to calculate low-density lipoprotein-cholesterol (LDL-C) levels. The non-traditional lipid indices such as TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C ratio were separately calculated. The differences between the groups were analyzed with the Kruskal Wallis test followed by the Mann-Whitney test or with ANOVA followed by the Tuckey posthoc test. Results: Results of the conducted study have found that the patients in AD group with moderate CI and patients in AD group with severe CI exhibited significantly lower levels of serum TC, TG, LDL-C, VLDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C and LDL-C/HDL-C compared to cognitively normal control subjects. Moreover, patients in VD group with severe and moderate CI had significantly lower level of TG compared to control group of subjects. Our results have also shown that patients in AD group with moderate CI had significantly lower level of TC, TG, LDL-C, Non-HDL-C, atherogenic index, TG/HDL-C, TC/HDL-C compared to VD patients with moderate CI. In addition, patients in AD group with severe CI had significantly lower level of TC, LDL-C, Non-HDL-C and TC/HDL-C compared to VD patients with severe CI. Conclusion: The results of this study have shown dysregulation of lipid metabolism in AD and VD patients with different degree of CI. In both moderate and in severe CI, patients with AD had lower levels of majority of standard and novel lipid parameters compared to patients with VD. Further larger prospective studies are required to elucidate the accuracy of standard and novel lipid parameters in the assessment of different degree of CI in AD and VD.
Evaluation of Periodontal Changes in Patients Before, During, and After a Fixed Orthodontic Therapy
Authors: Hadzic Sanja , Vukelic Mirjana , Pasic Enes , Jahic Indira , Muharemovic Arma , Vrazalica Lejla , Jeleskovic Azra , Nakas Enita
Published: June 2022

Background: Periodontal complications are one of the common side effects associated with orthodontic therapy. Objective: This study aimed to evaluate the periodontal changes in patients before, during, and after the therapy with a fixed orthodontic appliance. Methods: Out of 38 healthy adolescents with permanent dentition who were indicated for fixed orthodontic therapy were included in this study. Patients were selected from Class I, treated by non-extraction methods, by using conventional orthodontic braces. After their examination and treatment by an orthodontist, the patients were referred to the periodontist before the placement of a fixed orthodontic appliance. The patients underwent the application of a periodontal anamnestic-diagnostic protocol, and the clinical-radiological evaluation. After a fixed orthodontic appliance was placed, the respondents were referred to the periodontist for regular mandatory check-ups, initially, after three months, and later on–after 6 months, after 1 year and after 2 years until the end of orthodontic therapy. Results: An increase in the mean value of the Plaque Index and Sulcus Bleeding Index was found at each check-up after the placement of a fixed orthodontic appliance. There is a statistically significant difference in the presence of gingival hyperplasia found by monitoring the changes after three and six months, and after one and two years following the start of orthodontic therapy. Conclusion: The assessment of periodontal changes in patients before, during and after the completion of fixed orthodontic therapy revealed that there is a strong need for mutual and close cooperation between orthodontist and periodontist during orthodontic therapy.
Are short course corticosteroids as effective as longer course in determining days of oxygen requirement and hospital stay in patients with moderate COVID-19 disease?
Authors: Upadhyay Gunjan , Dave Darshan , Asodiya Zalak
Published: June 2022

Background: In past 2 years, COVID-19 pandemic has affected the health care system adversely. World statistics showed a huge rise in the incidence of this highly infectious disease. Abnormal and unregulated immune response was found to be the key deciding factor for the outcome of this disease. A lot of studies showed a promising role if corticosteroids as immunosuppressant agents. They reduce morbidity and mortality in patients with moderate-to-severe COVID-19 disease. However, steroid therapy comes with a huge concern in form of their adverse effects, especially on prolonged use. Optimum duration of steroid therapy is not standardized.

Aim and Objectives: The present study was carried out to determine days of oxygen requirement and duration of hospital stay in patients receiving short course steroid vis-à-vis long course steroid therapy.

Materials and Methods: A retrospective observational study was conducted in tertiary care teaching hospital after prior permission of the Institutional Ethics Committee. All patients diagnosed as having moderate COVID-19 illness with age group of 18–80 years with minimum 03 days of 6 mg dexamethasone or other equivalent steroid administration were included in the study. Patients who were living with HIV/AIDS, cancer, hepatic and renal illness, ischemic and other valvular diseases, and chronic pulmonary diseases affecting oxygenation status were excluded from the study. A total of 203 study participants were enrolled during study period (68 in short course while 135 in long course steroid group). Data were enrolled in predesigned structured and validated case record form.

Results: Short course steroid therapy was found more frequent in <60 years of age. Mean and SD of days of oxygen administration were (4.36 vs. 8.88) and (2.15 vs. 3.43) in short course and long course steroid therapy, respectively. Oxygen requirement for ≥7 days was in (10, 7.41%) patients and (45, 66.18%) patients in short course steroid group and long course steroid group, respectively. Mean and standard deviation of duration of hospital stay were (6.64, 2.87) and (11.9, 4.03) in short course and long course steroid group, respectively. Hospital stay for more than 9 days was (20, 14.81%) and (47, 69.12%) in short course and long course steroid group, respectively.

Conclusion: A positive association was found between duration of hospital stay and long course steroid therapy and was statistically significant. Similarly, a positive association between days of oxygen requirement and long course steroid therapy was found and again it was statistically significant. The study findings indicated that short course steroid therapy was found to be more effective in treatment outcome of COVID-19 illness as far as the duration of hospital stay and oxygen administration parameters are concerned.
“Flipped Classroom” teaching-learning method in medical biochemistry 1st professional MBBS students
Authors: Patel Jatin , Gamit Anil , Miahra Avanish , Chauhan Kirankumar
Published: June 2022

Background: The flipped classroom is an educational model in which the standard lecture and homework elements of a course are “reversed” or “flipped.” In the current scenario, the new teaching-learning (T-L) method like flipped classroom is an essential requirement due to shifting in medical education from teacher-centric to student-centric as a consequence of the recent changes in medical education called “Competency-Based Medical Education.” The advantage of this teaching-learning method is to motivate students for self-directed learning and provides an opportunity for students to read/view course-related material at their own pace and on their own time before the actual class. Change in T-L method in medical biochemistry is extremely important since 1st Professional MBBS students considered it as tiresome and boring subject and give it least priority in all the subjects of 1st Professional MBBS course.

Aim and Objectives: The main objective of this study is to introduce “Flipped Classroom” as an innovative teaching-learning method in medical biochemistry.

Materials and Methods: For this study, 76 students were in-rolled and randomly divided them into two equal groups. Two topics from the medical biochemistry were selected, each group given an equal chance to learn by each method, at the end of teaching-learning the MCQ test was conducted and feedback from the student was collected.

Results: In topics, the group learned the topic by flipped classroom scored more marks than the other group. The mean score of students, after the didactic lecture and flipped-classroom irrespective of the topic, were 4.43 and 5.39 marks, respectively (P < 0.001).

Conclusion: The flipped-classroom method was found useful to improve the score of the 1st Professional MBBS students in medical biochemistry subject and facilitate them to understand the topic more clearly than the didactic lecture.