bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of left ventricular and atrial dimensions with moderate to severe left ventricular diastolic dysfunction (grade II and above)
Authors: Hamza Muhammad , Fatima Mishal , Masood Muhammad , Umar Masood Hafiz , Tasleem Ghazal , Ahmed Hassaan , Nadir Maha , Satti Zubair 
Published: December 2020

Introduction: Left ventricular diastolic dysfunction (DD) is an entity in which the ventricle fails to fill up properly due to impaired ventricular relaxation and/or decreased compliance. The diagnosis of diastolic dysfunction is based on a variety of parameters in doppler echocardiograpy. However, some parameters like interventricular septal thickness in diastole (IVSd), posterior wall thickness in diastole (PWd), left ventricular internal end diastolic and systolic diameters (LVIDD and LVISD) along with left atrial diameters (LAD) have yet to be evaluated for the diagnostic workup of DD.
Methods: A case control study was done in the cardiology department from patient records from 2016 to 2018. Patients were diagnosed as diastolic dysfunction grade II and above by doppler echocardiography. IVSd, PWd, LVIDD, LAD, LVISD were obtained through 2-D echocardiography.
Results: Patients with DD had greater LAD, IVSd and PWd and decreased LVIDD and LVISD as compared to control group. Overall, IVSD was the most significant predictor (OR 1.52 95%CI 1.35-1.71) of DD followed by PWd and LAD. Similarly, LAD, IVSd and PWd had higher sensitivity and specificity than LVIDD and LVIDS.
Conclusion: IVSd, LAD and PWd showed significant performance in the diagnosis of diastolic dysfunction and hence can be used as a screening and diagnostic tool in diastolic dysfunction of grade ll and above.
Keywords: Heart failure; diastolic; echocardiography; left ventricle.
Aerobic exercise affects sleep, psychological wellbeing and immune system parameters among subjects with chronic primary insomnia
Authors: M Abd El-Kader Shehab , H Al-Jiffri Osama 
Published: December 2020

Background: Chronic primary insomnia is characterized by long-term difficulties in maintaining and initiating sleep, too early waking up, poor mood, fatigue, impaired concentration and poor quality of life. Exercise training is recommended to prevent and alleviate sleep disorders.
Objective: The aim of the study was to investigate the influence of aerobic exercise training on quality of sleep, psycho- logical wellbeing and immune system among subjects with chronic primary insomnia.
Material and methods: Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 35-56 years. All participants were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, Beck Depression Inventory (BDI), Profile of Mood States(POMS), Rosenberg Self-Esteem Scale (RSES), number of CD3+,CD4+,CD8+ T cells count and CD4/CD8 ratio were measured before and at the end of the study after six months.
Results: There was a significant increase in the total sleep duration, sleep efficiency and sleep onset latency in group(A) after six months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after six months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of BDI, POMS, CD3 count, CD4 count and CD8 count decreased significantly and the mean value of RSES significantly increased in group (A) after the aerobic exercise training, while the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study.
Conclusion: Exercise training can be considered as a non-pharmacological modalty for modifying sleep quality, psycholog- ical wellbeing and immune system among subjects with chronic primary insomnia.
Keywords: Aerobic exercise; chronic primary insomnia; immune function; sleep quality; psychological wellbeing.
Bilateral paediatric cataract surgery - outcomes of 298 children from Kinshasa, the Democratic Republic of the Congo
Authors: Kilangalanga Ngoy Janvier , Stahnke Thomas , Dinkulu Serge , Makwanga Emile , Moanda Astrid , Ngweme Georgette , Mukwanseke Edith , Kundt Günther , Thiesen Frank , Hopkins Adrian , F Guthoff Rudolf 
Published: December 2020

Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness.
Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilat- eral cataract surgery with IOL implantation from 2001-2016 in Kinshasa.
Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient’s follow-up, com- plications, and visual outcomes were recorded and analysed.
Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%). Most of children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%).
Conclusion: In spite of the post conflict challenges, elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long term follow-up is poor. There is need for program strengthening in these areas.
Keywords: Paediatric cataract surgery; bilateral cataract; outcomes.
Comparison of breastfeeding self-efficacy and breastfeeding success of obese and normal-weight mothers in the early period
Authors: Ceylan Sinem , Şahin Sevil 
Published: December 2020

Background: Body mass index (BMI) of overweight and obese women is a risk factor for breast milk secretion.
Aim: This study was conducted in a descriptive and comparative way in order to identify the relation between the breastfeed- ing success and self-efficacy of obese and non-obese mothers during postnatal period and to make a comparison between the obese and non-obese group.
Methods: The study sample consisted of 113 obese and 111 non-obese mothers that met the study criteria who were hos- pitalized at the postnatal service of Health Education and Research Hospital in Ankara, September 2014-February 2015.
Result: The mean BMI of obese women prior to the pregnancy was 31.41±2.4 while it was 22.25±2.8 for the non-obese women. As the BSS scores increase among both the obese and non-obese mothers, the LATCH breastfeeding success score averages increase as well (p<0.05, r:0.613).
Conclusion: In the light of the data of, to increase the breastfeeding success among obese mothers, it is suggested that the perception of self-efficacy is enhanced, and additional consultation is provided on breastfeeding starting from the antena- tal period. The trainings given to mothers by the midwife and nurse are supported with home visits especially in the obese women in the postnatal period in order for them to breastfeeding.
Keywords: Breastfeeding success; self-efficacy; maternal obesity.
EFFECT OF NISTHUSHAYADIKWATHA AND PHALATRIKADI KWATHA IN AMLAPITHA– A RANDOMISED COMPARATIVE CLINICAL STUDY
Authors: Maumita Halder  , Prashant V Kulkarni  , Abhijit Shinde  , Binu.M.B  
Published: December 2020

Amlapitta may be a clinical entity manifesting within the Annavaha Srotas. Kashyapa and Madhava have described this disease thoroughly. Amlapitta has become quite common because of the change within the food and life styles, sophistication and a stressful life. It is characterized by Avipaka, Klama, Tiktodhgara, Amlodhgara, Gaurava, Hritkanthadaha and Aruchi indicating the Vikruthi of Pachakapitta, Kledakakapha and Samanavata. The etiological factors and therefore the symptomatology manifested relate Amlapitta to diseases mentioned under Acid Peptic Disorders. Nistushayadi Kwatha and Phalatrikadi kwatha were selected. The main objectives of the study are to study and compare the effect of Nistushayadi Kwatha and effect of Phalatrikadi kwatha in the management of Amlapitta.
A total of 40 patients who fulfilled the inclusion criteria were selected, and randomly assigned into two groups i.e., Group A and Group B, comprising of 20 patients each. Group A and Group B were administered Nistushayadi kwatha and Phalatrikadi Kwatha respectively for 30 days. Both the groups were advised Pathya Ahara. They were followed up after every 10th days. After the intervention the Samanya Lakshana of Amlapitta were observed, recorded and assessed. The overall assessment of both the groups, where group A receives Nistushyadi kwatha and group B Phalatrikadi kwatha shows promising improvement in the subjective parameters. Assessment was done using unpaired ‘t’ test between these two groups, the result was not quite statistically significant which means there is no much difference in the efficacy of these two formulation in the management of Amlapitta. Both the formulations shown nearly same outcome in the improvement of disease parameter. The reduction in the symptoms were started to be noticed by 7th day where the patients had reduction in Hrutkantha Daha, Aruchi, Kanthadaha and Angagourav. These symptoms resolved by 30th day.
A Área de Proteção Ambiental vai virar Parque? Serra do Japi e os limites do planejamento ambiental participativo
Authors: Silveira Orlando Ricardo 
Published: December 2020

A Serra do Japi é considerada o mais importante atributo natural das Áreas de Proteção Ambiental Cabreúva, Cajamar e Jundiaí (APAs CCJ), sendo um dos últimos pontos de encontro entre a Mata Atlântica e as Matas de Planalto ainda conservadas no Estado de São Paulo. Do ponto de vista natural, o Japi, em conjunto com outras serras, constituem barreiras aos ventos que sopram do Oceano Atlântico em direção ao planalto paulista, possibilitando significativa precipitação pluviométrica. Por isso, formaram-se centenas de córregos e riachos que vertem das encostas acidentadas, produzindo, conforme denominação de Aziz Nacib Ab'Sáber, um “castelo de águas” útil ao abastecimento público. Diante da vulnerabilidade ambiental e em busca da segurança hídrica, uma área de 191,70 km2 foi tombada pelo Conselho de Defesa do Patrimônio Histórico, Artístico, Arqueológico e Turístico do Estado de São Paulo. O tombamento, realizado em março de 1983, pode ser considerado o primeiro grande ato de política ambiental em prol do Japi. No ano seguinte, ainda no período da ditadura civil-militar brasileira, são criadas pelo governo de São Paulo as APAs Cabreúva, Cajamar e Jundiaí. A instituição das APAs CCJ decorreu após intensa mobilização da sociedade civil e da comunidade científica, preocupadas com os efeitos da industrialização e da urbanização na região. O processo de redemocratização das instituições brasileiras e a consequente revitalização dos movimentos sociais rurais e urbanos no país corroboraram para uma nova concepção de gestão pública e de planejamento do território com base na participação social de agentes anteriormente excluídos. É nesse sentido que o tripé democracia – ambiente – inclusão social vai ocupar um espaço privilegiado na agenda pública brasileira a partir da década de 1990. A atmosfera sociopolítica contribuiu alguns anos mais tarde, para um novo entendimento da figura jurídico-institucional das Áreas de Proteção Ambiental (Sistema Nacional de Unidades de Conservação - SNUC). Na nova redação dada às APAs, seus conselhos gestores foram definidos como arenas ou arranjos institucionais mais adequados à gestão participativa e negociação dos conflitos socioambientais presentes no território. Diante de tais perspectivas, este artigo tem como objetivo, considerando as dificuldades da gestão ambiental participativa da Serra do Japi, a discussão sobre a gestão compartilhada das APAs Cabreúva, Cajamar e Jundiaí e a proposta da criação de um parque estadual na região.
Who is Hauerwas to Interpret Scripture? A Reflection on Interpretive Authority for Protestant Hermeneutics
Authors: Sutherland Andrew W. 
Published: December 2020

ABSTRACT
Stanley Hauerwas’s approach to Scripture has met repeated resistance and charges of inconsistency, most recently from Nicholas Healy, who argues that Hauerwas’s interpretive practice contradicts his claim that right scriptural interpretation requires submission to Church authority. This article responds to Healy’s objection in order to clarify an ambiguous point in Hauerwas’s theology—how individual scriptural interpretation relates to the authority of Hauerwas’s Church—and to consider what it might offer Protestant hermeneutics that embrace a similar ecclesial turn. After briefly reviewing Hauerwas’s hermeneutic and Healy’s objection, I argue that Hauerwas’s practice is in fact consistent with his theory by virtue of a concept of authority based in conversation more than institution. In this understanding, interpretive authority becomes a matter of practical reasoning or phronesis, a vital shift I think Healy either misses or refuses. I then argue that this sense of authority effectively describes what Protestant hermeneutical appeals to interpretive authority must entail in a way that remains true to several core Protestant principles. For this reason, Protestants should embrace the shift. At the same time, however, they must provide what Hauerwas omits—greater specificity about beliefs and practices that aid such practical reasoning—lest Protestant hermeneutics further multiply ecclesial division.
Regulación legal del régimen de responsabilidad patrimonial de la administración pública en Nicaragua: un pilar en construcción
Authors: Morales Márquez Odair Marcelo 
Published: December 2020

Los particulares tienen derecho a ser indemnizados por la Administración Pública cuando sus derechos, bienes e intereses se ven lesionados por la actividad administrativa, a esto se le conoce como el principio de responsabilidad patrimonial. El presente trabajo aborda el régimen de responsabilidad patrimonial de la Administración Pública en Nicaragua y la necesidad de una regulación legal moderna que apunte a incorporar aspectos técnicos como la noción del funcionamiento de los servicios públicos, los requisitos de la lesión, el tipo de sistema y los títulos de imputación que permitan la efectiva implantación de un sistema de responsabilidad hasta ahora inactivo. Este artículo persigue aportar propuestas legales, apoyándose en el doctrina y en el Derecho Comparado de países como España y México, que sean capaces de llenar los vacíos sustantivos existentes en la materia de responsabilidad patrimonial en el ordenamiento jurídico administrativo nicaragüense, para que la seguridad jurídica y la garantía patrimonial de los administrados pueda verse reforzada.
French influence on modern diplomacy
Authors: Purevdorj Myagmardorj 
Published: December 2020

Undoubtedly, France is a country that has been shaping the school of diplomacy, institutional structure, terminology and diplomatic ranks in modern diplomacy. Diplomacy and the diplomatic service in France have an immense historical tradition, alongside it, having a large impact on development in diplomacy, not only in European states but also, throughout the world. Since the establishment of the diplomatic service, French governments prioritized their diplomatic service, strived to improve, develop it further; in addition, they extensively trained their diplomats, continuing to enhance their competencies According to theories, concepts and records of diplomacy researchers and historians, France established the foundation of modern diplomacy, its tactics and implementation; furthermore French language replaced Latin in the field of international relations, making French the main language of diplomacy from the 18th century to the present day. In this article author aims to review the contribution of the French diplomatic school to modern diplomacy and its historical impact.
Орчин үеийн дипломат ажиллагаанд үзүүлсэн Францын нөлөө
Монгол-Францын хооронд дипломат харилцаа тогтоосны 55 жилийн ойд зориулав.
Хураангуй: Орчин үеийн дипломат ажиллагааны дэг сургууль, нэр томъёо, бүтэц зохион байгуулалт, ахлах дараалал зэргийг тодорхойлж ирсэн улс бол яах аргагүй Франц юм. Францын дипломат ажиллагаа, дипломат алба нь асар их түүхэн уламжлалтайн зэрэгцээ бусад улс төдийгүй дэлхийн дипломатын хөгжилд томоохон нөлөө үзүүлсэн байдаг. Дипломат алба нь үүсгэн байгуулагдсан цаг үеэс хойш Францын үе үеийн төр засаг дипломат албаныхаа бүтэц зохион байгуулалтад ихээхэн ач холбогдол өгч, түүнийг хөгжүүлэх, үйл ажиллагааг нь илүү боловсронгуй болгох тал дээр анхаарч, дипломатчдыг бэлтгэн сургах, мэргэжлийг нь дээшлүүлэх ажлыг эрчимтэйгээр явуулж иржээ. Дипломат ажиллагааны судлаач, түүхч мэргэдийн дэвшүүлсэн онол, үзэл баримтлал, тэмдэглэл зэргээс үзэхэд орчин цагийн дипломат ажиллагааны хэв маяг, түүнийг эрхлэн явуулах арга ухаан, шинжлэх ухааны үндэс суурь нь Францаас гаралтай төдийгүй 18-р зууны үеэс эхлэн франц хэл латин хэлийг шахан олон улсын харилцаа, дипломат ажиллагааны салбарт голлох хэл болсоор өнөөдрийг хүрсэн билээ.
Энэхүү судалгааны өгүүллээрээ Францын дипломатын дэг сургуулийн орчин цагийн дипломат ажиллагаанд оруулсан хувь нэмэр болон үзүүлсэн түүхэн нөлөөг судлаж үнэлэлт дүгнэлт өгөхийг зорьлоо.
Түлхүүр үгс: Орчин үеийн дипломат ажиллагаа, дипломат алба, Францын дипломат ажиллагаа
Living the Good Life: A Conversation about Well-being, Education, and Culture
Authors: Cardinal Trudy , Lambert Louise , Lamouche Sandra 
Published: December 2020

In this paper we engage in a conversation speaking from three different perspectives and discuss the ways literature and our personal life experiences can inform policy and practice in relation to the concepts of well-being, education, and culture. We gathered around a metaphorical kitchen table, bringing to it our life experiences, as well as the literature that informed our individual research programs (positive psychology, Indigenous world view, and narrative inquiry) and we began to unpack the questions: “What role does culture play in understanding and educating for well-being and why should an education system be concerned about it?”
“It’s about Complete Incorporation”: An Interview with Barbara Hannigan
Authors: Bernstein Tamara 
Published: December 2020

In a conversation with Tamara Bernstein, Canadian soprano Barbara Hannigan discusses topics related to her musical formation and early career, significant professional relationships, and the professional voice.Hannigan describes her early decision to specialize in contemporary music as a moment of quasi-religious vocation; she recounts the artistic processes of composers George Benjamin and Hans Abrahamsen when they were writing opera roles for her, and reflects on the influence of some of her colleagues and mentors, including the late Reinbert de Leeuw and three stage directors. She elaborates on the transformative experience of performing the title character of Alban Berg’sLulu; addresses the persistent prejudice against singers who specialize in contemporary music; and comments on approaches to vibrato in both contemporary and “early” music. Her observations on the implications of ageing for an elite singer speak to the intimate physical connection of an artist to her voice, and confirm Hannigan’s fundamental commitment to singing as “complete incorporation.”
In vitro Screening of Iron Efficient Groundnut Cultivars for Calcareous Soil
Authors: Kalyan V. S. Reddy Kiran , Meena S. , Jawahar D. , Karthikeyan S. 
Published: December 2020

Aims: In the present study twenty groundnut genotypes are evaluated for their resistance to IDC and to identify feasible indicators for screening iron (Fe) efficient groundnut genotypes in calcareous soils based on the morphophysiological parameters at 45 days after sowing (DAS).
Study Design: The experiment was replicated three times with two iron treatments (+Fe and – Fe) in a randomized block design
Place and Duration of Study: Field screening of genotypes was carried during Kharif 2019 at Thondamuthur block, Coimbatore district (10°59’31.9” N 76°47’15.4 E), Tamil Nadu, India.
Methodology: The randomized field experiment was comprised of two major factors, i) Fe status (with Fe, without Fe), and ii) genotypes (twenty) with differential IDC response. Seven morpho-physiological parameters associated with IDC resistance were evaluated in groundnut genotypes.
Results: Under Fe deficit conditions, IDC efficient genotypes recorded significantly higher shoot dry weight, root dry weight, root volume, SPAD values, active Fe, catalase activity, peroxidase activity, and higher yield compared to susceptible ones because of better Fe utilization efficiency. The various morpho-physiological parameters studied showed a significant correlation with pod yield. The four genotypes viz., TAG 24, CO 7, VRI 8, and VRI-16086 were efficient under both sufficient and deficit conditions under calcareousness. The stepwise multiple regression shows the peroxidase (POD) accounts for 71 % under +Fe condition and SPAD accounted for 66 percent in -Fe in predicting the pod yield. Hence, POD and SPAD can be used as indicators for selecting Fe efficient groundnut cultivars for calcareous soil.
Conclusion: The findings indicate that SPAD values are most optimal for the initial large-scale screening of groundnut genotypes for tolerance to IDC, whereas peroxidase may be used to validate established genotypes.
Maternal brain death during pregnancy
Authors: Vives A. , Carmona F. , Zabala E. , Fernández C. , Cararach V. , Iglesias X. 
Published: July 2002

AbstractA case of a 36‐year‐old woman diagnosed brain dead secondary to pneumococcal meningitis at 27 weeks of gestation is presented. In spite of aggressive therapy, supportive intensive care was possible for only 36 h. Signs of fetal distress appeared and a cesarean section was performed. The complexity of supportive care and its ethical implications are discussed.
Law and ethics in conflict over confidentiality?
Authors: Dickens B.M , Cook R.J 
Published: July 2002

AbstractEthical principles that require the preservation of patients’ confidential information are reinforced by principles found in several areas of law, such as law on contracts, negligence, defamation and fiduciary duty. However, laws sometimes compel disclosures of medical confidences, and more often may justify or excuse disclosures. Legally contentious issues concern patients’ confidences regarding possible unlawful conduct, such as pregnancy termination, and the risk of spread of HIV and other infections. This article reviews the various legal bases of the duty of confidentiality, and legal challenges to the ethical obligation of non‐disclosure. It addresses the justifications and limits of exchange of patients’ health information among healthcare professionals and trainees, and considers legally recognized limits of confidential duties, and the scope of legitimate disclosure. An underlying theme is how to determine whether physicians are ethically justified in employing the discretion the law sometimes affords them to breach patients’ expectations of confidentiality.