bluuebunny/crossref_metadata_2025_split huggingface dataset:
Principles of Transgender Care for the Primary Care Physician
Authors: Robert Gotfried, DO, FAAFP  
Published: November 2020

The term transgender includes people whose gender identity differs from their sex assigned at birth. People identified as male at birth but possess a female gender identity are called transwomen and people identified as female at birth but experience a male gender identity are called transmen. Transgender individuals may also identify outside the binary norm.
The prevalence of transgender people who seek medical treatment has dramatically increased in recent years. Transgender individuals have a higher prevalence of mental health problems, suicidality and premature mortality risk versus the general population. However, many transgender persons avoid medical care due to perceived stigma, in conjunction with transgender-specific knowledge deficits among health care providers.
Integral to understanding transgender health is the concept of gender dysphoria. This refers to the internal conflict individuals experience due to incongruence between their birth sex and their self-perceived gender. For these individuals, the inconsistency causes significant internal conflict, often to the point that it interferes with functioning.
To address gender dysphoria, many transgender people elect to transition to a gender role that is consistent with their gender identity. These individuals opt for medical and/or surgical interventions to do so. Medical therapy incorporates the use of cross-sex hormones to facilitate the acquisition of secondary sexual characteristics consistent with the individual’s internalized identity. Many transgender people choose to undergo gender-confirming surgeries in conjunction with hormonal therapy.
Health care is transgender-affirming when it supports the patient’s inherent identity. Educating providers about this population’s unique needs can help reduce health disparities and promote respectful transgender care.
Intercropping Garlic (Allium Sativum) With Chilli (Capsicum Annuum L.) in the Haor Area of Kishoreganj
Authors: Khatun MF , Islam MS , Ali MA , Ali MO , Ahmed QM 
Published: November 2020

Haor is one of the uncertain areas for crop production and productivity in Bangladesh. Traditionally, single cropping practice in a short cropping season is the key obstacle to increase crop productivity. A study was carried out at Multi Location Testing site (MLT), Nikly under the On-Farm Research Division (OFRD), Bangladesh Agricultural Research Institute (BARI), Kishoreganj at haor area during the two consecutive Rabi seasons of 2015-16 and 2016-17 to evaluate the performance of garlic with chilli intercropping system, its productivity and economic viability. Four treatments were consisted viz., sole chilli, one row garlic in between chilli rows, double rows garlic in between chilli rows and garlic with broadcasting chilli. The highest chilli equivalent yield (28 t ha-1) was obtained from one row garlic in between chilli rows and the minimum chilli equivalent yield was (15 t ha-1) obtained in sole chilli. These intercropping practices yield increased 25-89% over the sole chilli. The highest gross return (Tk.559400 ha-1), gross margin (Tk. 428240 ha-1) and BCR (4.26) were found in one row garlic in between chilli rows and the lowest gross return (Tk. 297800 ha-1) and gross margin (Tk.188080 ha-1) were obtained from sole chilli but the lowest BCR (1.74) in double rows garlic in between chilli rows. Considering the experimental findings of two years, one row garlic in between chilli rows would be a suitable intercropping system for higher productivity and economic return.
Bangladesh Agron. J. 2020, 23(1): 75-81
Bacterial Isolates from Blind Tracheal Aspirates and Their Anti-Microbial Sensitivity: An Observational Study in ICU of a Tertiary Care Hospital in Bangladesh
Authors: Mallick Uzzwal Kumar , Islam Md Sirajul , Asaduzzaman Mohammad , Yusuf Mohammad Abdullah , Faruq Mohammad Omar 
Published: November 2020

Background: The number of organisms developing resistance to commonly used antibiotics is increasing day by day. The exact national scenario of antimicrobial sensitivity pattern is not well known in Bangladesh owing to the absence of proper guideline for prescribing antibiotics.
Aims: The aim of this study is to identify the group of organisms developing resistanceso that antibiotic policy can be formulated for the proper and effective use of antibiotics.
Settings and Design: This observational study was conducted for a period of 1 year from January 2018 to December 2018 in a tertiary care hospital in Bangladesh.
Materials and methods: This descriptive cross-sectional study was conducted in the Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from January 2018 to December 2018, using the convenient sampling technique. Tracheal secretions from patients in the intensive care unit (ICU), tested in Department of Microbiology, National Institute of Neurosciences and Hospital, were included in the study. The culture was done on blood and MacConkey agar and the sensitivity pattern was performed on Muller Hinton agar. Data were analyzed using SPSS version 23.0.
Results: Out of the microorganisms isolated from positive growth cultures, Acinetobacter (57.8%) was the most common isolate followed by Klebsiella (22.9%). Acinetobacter, pseudomonas and klebsiella had good sensitivity to colistin(87.80%, 82.40% and 77.80% respectively), where as they showed less sensitivity to higher generationcephalosporin, penicillin and aminoglycosides.
Conclusion: The commonest organism which was isolated from the endotracheal aspirate cultures were Acinetobacter, followed by Pseudomonas and Klebsiella and antimicrobial susceptibility testing showed sensitivity to Colistin, Tazobactam/piperacillin, Meropenem and aztreonam. Whereas coagulase negative staphylococci was isolated only in minority cases with highest sensitivity to vancomycin and linezolid.
Bangladesh Crit Care J September 2020; 8(2): 81-85
Pattern of Cardiovascular Diseases in Diabetic population - a seven year study in a tertiary care hospital of Bangladesh
Authors: Irfan SM Rezaul , Habib Samira Humaira , Hoque Shabnam Jahan , Mohibullah AKM 
Published: November 2020

Background: Cardiac involvement in diabetes covers a wide spectrum, ranging from asymptomatic silent ischemia to clinically evident heart failure. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. Up to 80% of diabetic patients die of macrovascular complications, including coronary artery disease (CAD), stroke, and peripheral vascular disease (PVD). CVD is the single-most important contributor, and is responsible for 17% of total mortality. Because of the growing numbers of diabetic patients and the increased mortality after their first cardiovascular event, it is critical to identify and treat risk factors early and aggressively in these patients.
Methodology: This is a retrospective observational study carried out in the Department of Cardiology BIRDEM General Hospital Dhaka Bangladesh from 2011 to2017. Total 5598 patients who were admitted to the institute between 2011 to 2017 was studied and evaluated to see the pattern of cardiovascular diseases in diabetic population.
Results: Among total 5598 patients, 50.02% were male and 49.98% were female. Majority of them were Diabetic and Hypertensive. Most of the patient having cardiovascular disease belongs to age 50-70 years. IHD was found among 1810(32.33%) patients with slightly male predominance. Different types of Cardiomyopathy were found among 330(5.8%) study population. Heart failure of different forms were present among 632 (11.28%) of patients. Different types of Arrhythmia were found among 159 (2.8%) of admitted patient. Rheumatic Vulvular Heart disease were found 64 (1.1%) of individual. Congenital Heart disease were found among 51 with ASD 36 (70.58%) followed by VSD 15 (29.42%) and PAD in 105 (1.8%).
Conclusion: This study reflects the higher incidence of Ischemic Heart Disease and higher association of Hypertensive Heart Disease in Diabetic population mostly affecting the 50-70 year age groups. This observational study also shows that the duration of hospital stay has gradually declined over the course of seven years. The incidence of Cardiomyopathy, Peripheral Vascular Disease and Heart Failure could be different in Diabetic population if wide range multicenter prospective approach would have been applied.
Bangladesh Crit Care J September 2020; 8(2): 96-101
Risk Factors of Premature Rupture of Membrane in A Tertiary Care Hospital, Bangladesh
Authors: Yeasmin Most Sabina , Uddin M Jalal , Biswas Rajat Sanker Roy , Azdar Azwad , Chowdhury Shahanara , Nourin Nishat Anjum 
Published: November 2020

Background : Premature Rupture of Membrane (PROM) is one of the most common complication of pregnancy. A woman with premature rupture of membrane is at risk of perinatal morbidity and mortality and also associated with maternal morbidity and psychological stress. Objective of this study was to determine incidence and risk factors of pregnant woman with PROM admitted in a tertiary hospital at Chattogram, Bangladesh.
Materials and methods : This prospective observational study conducted in the Department of Obstetrics and Gynaecology at Chattogram Maa-O-Shishu Hospital Medical College (CMOSHMC) Chattogram from 1stJanuary 2018 to 31st December 2018. In this period total admitted antenatal patients were 8117. Among the pregnant patients with PROM were 665 and their weeks of gestation were > 28 weeks. Data was collected by interviewer with semi structured questionnaire & check list.
Results : Incidence of PROM was 8.2%. PROM was found to be frequent (53%) in younger age group between 20-24 years. It was also commonly in primigravida (61.8%). Term PROM was higher (69.2%) than pre-term PROM (30.8%). 93.3% were singleton pregnancies, 6.4% were twins and .3% were triplets. Analysis of risk factors revealed ectiology was unknown in 46 (6.8%) low socioeconomic condition (60.6%), anaemia (45 %), lower genital tract infection (35.6%) UTI (31%) previous history of PROM (27.9%) malpresentation (15%) multiple pregnancy (6.7%) polyhydramnios (6%) history of recent coitus (12%) DM and GDM (10.5%) were commonly associated with PROM.
Conclusions : Early identification of various risk factors causing PROM and their management can prevent premature deliveries and its complications to some extent as well as serious maternal complication like Chorioamnionitis.
Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 5-8
Angiographic Pattern of Coronary Artery Stenosis in Type 2 Diabetic Patients with Acute Coronary Syndrome
Authors: Iqbal Abu Tarek , Jalil Abdul , Uddin M Jalal 
Published: November 2020

Background: Many studies were conducted in home and abroad on the subject but there is none in Chattogram region of Bangladesh. To unveil the existing situation we have conducted the study which will help better case management.
Materials and methods: Properly diagnosed 54 consecutive type 2 diabetic patients with Acute Coronary Syndrome were selected for study. The study was conducted in 2016 (One year) at a private cardiac center of Chattogram city. After adequate preparation angiography was performed with standard Judkin’s technique. Data were manually managed and statistically analyzed. Results were compared with other similar studies. Informed consent was taken from the patients and the hospital authority before conducting the study. A competent institutional review board approved the protocol.
Results: Sex of the patients were male 85% and female 15%. Age range was 30-70 years. Peak age group was 50-60 years. It was 41%. Mean age was 56±6.8 years. Multiple Vessels Disease (MVD) was the highest 39%. Commonly affected vessel was Left Anterior Descending artery (LAD) 83%.
Conclusion: Diabetes mellitus is a notorious risk factor for coronary artery disease. It causes coronary artery lesions earlier. It significantly causes acute coronary syndrome. So all measures should be taken to prevent and control diabetes mellitus.
Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 21-22
Non-Parasitic Chyluria: A Rare Experience
Authors: Ahmed Faisal 
Published: November 2020

Chyluria is the passage of chyle in the urine. The cause seems to be the rupture of retroperitoneal lymphatics into the pyelocaliceal system, giving urine a milky appearance. This condition if left untreated leads to significant morbidity because of hematochyluria, recurrent renal colic, nutritional problems due to protein losses and immunosuppression resulting from lymphocyturia.
Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 59-62
Haemoperitonium : A Rare Presentation of Choriocarcinoma
Authors: Malik Adiba , Khanom Shireen Akter 
Published: November 2020

Gestational choriocarcinoma is one of the most malignant form of group of tumors with almost 100% cure rate, developes secondary to pregnancy (Normal or ectopic) following hydatidiform mole, miscarriage or even after child birth. This starts within the uterus in the placenta but a tendency to metastasize to other parts of the body. Indicative signs are unexplained heavy and irregular uterine bleeding, raised serum b hCG, non normalization of b hCG following abortion or delivery and if it spreads, signs of metastasis. Our study presents a case of Choriocarcinoma presented with haemoperitonium, who was treated successfully with surgical and medical management. A 25 years lady Para 1+0, age of 3 years, normal delivery had an emergency admission for 2 months amenorrhoea with severe lower abdominal pain, slight vaginal bleeding suspected clinically as ruptured ectopic pregnancy. Ultrasonography suggest Invasive mole with huge peritoneal collection. After sending serum b hCG she was treated surgically and per operative findings were in favour of Choriocarcinoma which was confirmed by histopathological reports. Serum b hCG was raised and she was treated with combination (MAC protocol) chemotherapy.
Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 57-58
DIMENSI KARAKTERISTIK LAPORAN KEUANGAN PEMERINTAH
Authors: Amin Asbi , Anwar Anwar 
Published: November 2020

This research to prove the commitment of the leadership, the capacity of the financial apparatus, the implementation of the Regional Financial Accounting Standards, and the internal control function have an influence on the characteristics of government financial reports. This research is a quantitative study using primary data. The population in this study were senior auditors of the South Sulawesi Representative Audit Board using a purposive sampling technique so that the sample was sixty-eight auditors. The data were collected by using a questionnaire method. The analytical method used in testing the hypothesis is multiple linear regression analysis. The results of the study prove that the commitment of the leadership, the capacity of the financial apparatus, the application of the Regional Financial Accounting Standards, and the internal control function significantly influence the characteristics of government financial reports.Keywords: leadership commitment, the capacity of financial Apparatur, the implementation of government accounting standards, internal control, the quality of local government financial statements.
AGRESIVITAS PAJAK YANG DIPENGARUHI OLEH KOMPENSASI EKSEKUTIF, KONEKSI POLITIK, PERTUMBUHAN PENJUALAN, LEVERAGE DAN PROFITABILITAS
Authors: Riswandari Ernie , Bagaskara Kevin 
Published: November 2020

This research aims to prove that tax aggressiveness is influenced by executive compensation, political connections, sales growth, leverage, and profitability. The annual reports of BUMN & BUMS companies in the non-financial sector are secondary data used in this study and by using the purposive sampling method in selecting the sample. The method of analysis used in this study is multiple linear regression. The result shows that the executive compensation variable has a positive effect on tax aggressiveness. Political connection variables, sales growth, and leverage have a negative effect on tax aggressiveness, while the profitability variable has no effect on tax aggressiveness. Keywords: Executive compensation, political connection, sales growth, leverage, profitability, tax aggressiveness
BUDGET PARTICIPATION AND BUDGETARY SLACK: THE MEDIATING EFFECT OF AUTONOMOUS BUDGET MOTIVATION
Authors: Wafiroh Novi Lailiyul , Abdani Fadlil , Nurdin Fajar 
Published: November 2020

The purpose of our research is to provide empirical evidence of what and how participation in budgeting relates to the creation of budgetary slack conducted by managers through autonomous budget motivation. This research is expected to contribute to research and practice in the field of management accounting. Hypothetical testing is done empirically by collecting data through questionnaire dissemination surveys in various companies located in East Java. Data testing is performed with the help of the SmartPLS 3.0 app. The results of the data analysis showed that increased participation in budget preparation by managers from various departments led to a decrease in the creation of budgetary slack by managers. Nevertheless, the data test results were unable to prove that autonomous budget motivation was able to act as a mediation variable in the relationship between budget participation and budgetary slack. The results of the study indicate that only by actively participating in the budget preparation process, can directly reduce the tendency of employees to create budgetary slack without waiting for the high motivation of autonomous budgets that employees have first. Keywords: Budget participation, Budgetary Slack, Autonomous Budget Motivation
THE USE OF DIGITAL LEARNING SYSTEM TO ENGAGE UNIVERSITY STUDENTS IN LISTENING PRACTICE: A CASE STUDY FROM EFL CLASS IN INDONESIA
Authors: Erlita Yeni , Nuran Ade Aini , Saragih Anggraini Thesisia 
Published: November 2020

This preliminary research aimed at portraying the impact of Digital Learning System (DLS) implementation on student empowerment. This work used qualitative descriptive case study. First semester English students of a state university in Medan, Indonesia, negotiated to participate in the study. Grounded in dialogic interview, the results suggest that the enactment of DLS gives attractive lesson for the students. The students felt the instruction made them borderless between the students and the lecturers. Overall implementation of DLS enables students to reach minimum standardized criteria in their listening skills. Limitation and further recommendation for next research are also presented
THE IMPLEMENTATION OF S.U.R.E. APPROACH AS A MEANS OF ENHANCING STUDENT PRAGMATIC COMPETENCE
Authors: Suprijadi Dasep 
Published: November 2020

Due to the deficient pragmatic competence, pragmatic failures or even miscommunication will be produced in actual communication. Regarding those problems, S.U.R.E approach is offered to overcome in promoting learners’ pragmatic competence. This study aimed to investigate the impact of implementing S.U.R.E approach in improving students’ pragmatic competence. This study is a quantitative research embracing one group pretest-posttest design. One class participated and 33 students were taken as the sample of the study using random sampling technique. Three English native speakers evaluated the test takers’ pragmatic competence. They were called on to read the speech acts, along with the transcripts, and to indicate the rating based on the rating descriptions provided. The mean score among the three raters was assigned as the closing score. To collect the data, the students were given a pretest and a posttest. The data were then analyzed employing paired sample t-test through SPSS V.24. The result of the study showed that significance value was 0.00 of which it is lower than level of significance 0.05. Hence, the null hypothesis is rejected. This implies that the use of S.U.R.E approach has a significant effect on improving students’ pragmatic competence.
Utilizing Brief Spiritual Assessments with Clients who belong to the Church of Jesus Christ of Latter-day Saints:
Authors: Limb Gordon , Hodge David , Alboroto Richard 
Published: November 2020

In recent years social work has increasingly focused on spirituality and religion as key elements of cultural competency. The Joint Commission—the nation's largest health care accrediting organization—as well as many other accrediting bodies require spiritual assessments in hospitals and many other mental health settings. Consequently, specific intervention strategies have been fostered in order to provide the most appropriate interventions for religious clients. The Church of Jesus Christ of Latter-day Saints is the fourth largest and one of the faster growing churches in the United States. In an effort to facilitate cultural competence with clients who are members of the Church of Jesus Christ, a brief spiritual assessment instrument was developed. This mixed-method study asked experts in Church culture (N = 100) to identify the degree of cultural consistency, strengths, and limitations of the brief spiritual assessment instrument. Results indicate that the framework is consistent with Church culture and a number of practice-oriented implications are offered.
An innovative safety format for structural system robustness checking
Authors: Tur Andrei , Tur Viktar , Derechennik Stanislav , Lizahub Aliaksandr 
Published: November 2020

The estimation of structural robustness remains one of the most important stages of the design of structural systems. Recommended design strategies for the robustness assessment are based on the provisions specified in the actual EN 1991-1-7 and ISO 2394:2015. Currently, the EN 1991-1-7 and ISO2394:2015 allows the use of indirect tie-force method, but normally, non-linear pseudo-static analysis is widely used, because it is based on more realistic constitutive relations for basic variables, which enables a simulation of the real structural behaviour. Implementation of the non-linear pseudo-static analysis for the assessment of a structural system in accidental design situations requires to adopt a different approach to safety format.
The paper presents an innovative approach to safety format calibration for non-linear analysis of RC-structures subjected to accidental loads. The proposed method of the robustness estimation is based on the joint energy-saving (conversion) approach and the full probabilistic method for the estimation of a safety format for pseudo-static non-linear response of modified (damaged) structural system. The proposed probabilistic considerations are based on the Order Statistic Theory.