bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of advanced rectal cancers: Cylindrical abdominoperineal excision of rectum
Authors: Lamichhane Nirmal , Walker Kenneth G. 
Published: June 2019

Introduction: Treatment for patients with locally advanced low lying rectal cancer differs significantly from patients with rectal cancer restricted to the mesorectum. They require multimodality treatment, including preoperative chemo-radiation and extended surgical resection. Cylindrical abdominoperineal excision of rectum (C-APER) along with possible composite pelvic organ resection is a surgical method to remove an adequate circumferential margin.
Method: Patients with the diagnosis of advanced rectal cancers over a period of 9 months are included in this study. Therapeutic approach of C-APER is taken for these patients with focus on multimodality treatment protocols to downstage the tumours and extended resections to enable complete removal of all tumour tissue with clear surgical margins. Consecutive review of cases of advanced rectal cancer to their immediate surgical outcome were done.
Results: Five patients with compromised CRM in MRI of rectum, 4 were treated with Neoadjuvant FOLFOX 6 regimen chemotherapy 3 cycles and Short course Radiotherapy. All underwent surgery 6-8 weeks after treatment. The pelvic floor was repaired with biological mesh in 1 and synthetic mesh in 4. The pathological stage of disease remained T3 and above despite neoadjuvant treatment in majority of patients but none of them had positive CRM. The wound complication rates were high in the perineum with serous discharge in almost every patient and one patient needing long term vacuum assisted dressing in the community.
Conclusion: The surgery is technically feasible with acceptable morbidity in short term with possible long term outcome of reduced loco-regional failure.
Perawatan Infeksi Saluran Pernafasan Akut (ISPA) pada Balita
Authors: Padila Padila , Febriawati Henni , Andri Juli , Dori Rujung Ali 
Published: June 2019

This study aims to determine the relationship between knowledge and attitudes of mothers with the treatment of Acute Respiratory Infection (ISPA) in children under five in the work area of ​​the Kembang Seri Public Health Center, Talang Empat District, Central Bengkulu District 2018. This type of research is an analytical survey with a cross sectional approach. The results of the univariate analysis research were obtained from 51 respondents, most of the respondents had low knowledge of 21 people (41.2%). While most of the respondents had a bad attitude as many as 27 people (52.9%). Meanwhile, the results of the bivariate analysis of the relationship between knowledge and attitudes of mothers with ARI care in toddlers with the Pearson Chi-square test showed that the p_value for knowledge and attitudes of mothers with ARI care was 0.000 ≤ α 0.005, meaning that there was a significant relationship between knowledge and attitudes of mothers with ARI care in toddlers. in the working area of ​​the puskesmas. Conclusion, the participation of parents, especially mothers, in participating in health promotion activities at the health center must be scheduled.

Keywords: Knowledge, ARI Treatment, Attitude
Ethical behavior and visual literacy in students of communication sciences
Authors: Alania Contreras Rubén Darío , Rafaele de la Cruz Mauro , Gutiérrez Gala Zayuri Karim 
Published: June 2019

Introduction.There is a need to demonstrate the correspondence between ethical behavior and aesthetic competence. Objective.Determine the relationship between ethical behavior and visual literacy in the students of Communication Sciences of the National University of the Center of Peru. Materials and methods.The correlational descriptive study, applying the Sociomoral Problems Questionnaire and the Visual Literacy Test to a sample of 70 students.ResultsThe positive, high and highly significant correlation between the variables was determined (0.752, p <0.01); Average of ethical behavior = 20.1 and visual literacy = 0.48. Discussion.In the moral chapter (40,7), research defines law and order, and the second level. Conclusion. There is a positive, high and highly significant relationship in the ethical behavior and visual literacy of the sample, however, the variables are below the ideal average.
Böbrek nakli yapılan hastaların retrospektif analizi
Authors: ERTUGRUL Gokhan 
Published: June 2019

Amaç: Bu çalışma ile merkezimiz de yapılan böbrek nakli olgularımızı
retrospektif olarak değerlendirmeyi amaçladık.Gereç ve Yöntem: Hastaların demografik özellikleri, kadavra ve canlı donör kullanım
sayıları, akrabalık durumları, hastanede yatış süreleri, postoperatif morbidite,
greft kaybı ve mortalite oranları belirlendi.Bulgular: Hastaların yaş ortalaması 37.6 ± 16.2
(3 - 67) idi, % 61.7’ si erkek ve % 38.3’ü
kadındı. Hastalarımızın % 91.7’ sine canlı vericiden böbrek nakli yapıldı. Ortalama
yatıs süresi 11 gündü. Hastaların %
8.3’ünde rejeksiyon görüldü ve greft
kaybı oranı % 3.3 idi. Mortalite oranı % 4.2 idi.

Sonuç: Son dönem böbrek yetmezliği
nedeniyle takip edilen hastalar için en etkin tedavi yöntemi böbrek naklidir.
Hasta sağlığı ve konforu açısından esas amaç böbrek nakli sayılarının arttırılması
olmalıdır.
PREVALENCE OF EYE DISORDERS IN CHILDREN PRESENTING IN OUTPATIENT DEPARTMENT WITH ASTHENOPIA
Authors: Gupta Vijayta , Bhatti Anuj 
Published: June 2019

Introduction: Asthenopia is a common complaint in school going children. The magnitude of the problem in our region is not known.
Methodology: Children (5-18 years) presenting in pediatric and ophthalmology outpatient department with symptoms (defined a proiri) were included in study. Exclusion criteria included BCVA of less than 6/9 in either eye, strabismus, ocular or systemic diseases affecting binocular vision, and using any medication that can impact accommodation or convergence. Previous day 24 hour recall method was used to assess the time spent on various activities. Subsequently, detailed refractive assessment was done.
Results: A total of 24200 children with age group 5-18 years visited outpatient department. Out of them 520 (2.1%) children had symptoms of asthenopia. The proportion of males (66.6%) was higher than female (33.4%). The proportion of children with asthenopia increased from 21% in 5-9 year group to 45% in 13-18 year group. Tearing and eye pain were the commonest presenting complaints The presence of four or more symptoms was not observed in 5-9 age group. Asthenopic children spend a mean of 4.2 hours/day on screen.
Conclusion: Asthenopia is common eye complaint in school children. It can interfare in near work, so warrants prompt treatment.
CYBERKNIFE ROBOTIC RADIOSURGERY SYSTEM
Authors: Gupta Saibya , Gupta Priya 
Published: June 2019

The latest addition to the CyberKnife product family, which was released in September 2009. This review updates the previous technical reviews of the original system version published in the late 1990s. There is a clear dose response for localized prostate cancer radiotherapy and there probablyis a radiobiological rationale for hypo-fractionation. Combining the two should maximize tumor control and increase the therapeutic ratio. Technical developments over the last decade have impacted virtually every aspect of the CyberKnife System. These developments have increased the geometric accuracy of the system and have enhanced the dosimetric accuracy and quality of treatment, with advanced inverse treatment planning algorithms, rapid Monte Carlo dose calculation, and post-processing tools that allow trade-offs between treatment efficiency and dosimetric quality to be explored. The CyberKnife can produce superior DVHs for sparing of rectum and bladder and excellent DVHs for target coverage compared with IMRT, and possesses dose heterogeneities to the same degree as IMRT plans.
Keywords: CyberKnife System; Radiosurgery; Stereotactic Body Radiation Therapy; Hypofractionation; IMRT Hetrogeneities
FORMULATION AND EVALUATION OF CONTROLLED RELEASE OSMOTIC TABLET OF CARVEDILOL PHOSPHATE
Authors: Sharma Sunny Sureshbhai , Raval Anil G 
Published: June 2019

Carvedilol Phosphate Osmotic Tablets were prepared using a Direct Compression approach. A mixture of osmogens i.e. NaCl and Mannitol was used to achieve a desired osmotic pressure in the tablets which were then coated with Cellulose Acetate polymer with PEG as a plasticizer and Povidone K30 as a pore former. Early screening batches showed drastic effect of osmogens and pore former, as well as % weight gain on drug release of the tablets. The prepared tablets were evaluated for Weight variation, Thickness, Hardness, Dissolution, and the final optimized formulation was exposed to Accelerated Stability Study. A full factorial statistical optimization was carried out on the best optimized formulation to establish the design space for selected factors i.e., NaCl and Povidone K30 against Response Dissolution. A significant effect of both factors was found on Dissolution rate, which justifies the use and rationale of the excipients
Key Words: Carvedilol Phosphate, Osmotic Tablets, Direct Compression, NaCl, Mannitol, Cellulose Acetate.
A REVIEW ON PHARMACOLOGICAL ACTIVITY OF BENINCASA HISPIDA
Authors: Ayubkhan Neha , George Dr Mathew , Joseph Dr Lincy , Sujith Dr K 
Published: June 2019

Benincasa hispida is a well-known plant and is cultivated throughout the plains of india and on the hills upto 1200 meter altitude. It is a popular vegetable crop widely used for nutritional and medicinal properties especially in asian countries. Benincasa hispida fruit has been valued as a nutritious vegetable as it provide a good source for natural sugars,organic acid, amino acid,vitamins and mineral elements. Phytochemical constituents of this plant are mannitol, triterpenoids, cucurbitin, β-sitosterin, flavanoids, glycosides, carotenes, vitamins and uronic acid. The pharmacological studies revealed that the plant exerted many pharmacological activities such as antiulcer, antihyperlipidemic, antihelmintic, antioxidant, neuropharmacological activity, diuretic activity.
Keywords: Benincasa hispida, antiulcer, diuretic, antihyperlipidemic, antihelminthic.
Psychosocial determinants of communication satisfaction in racially concordant and discordant patient-physician interactions
Authors: Assari Shervin 
Published: June 2019

Introduction: Although both socioeconomic and race- related factors both influence quality of medical encounters, it is not known how these effects differ between racially concordant and discordant medical visits. Current study investigated psychosocial determinants of physician visit satisfaction of Black adults based on racial concordance of the medical encounter. Materials and Methods: Data came from the Detroit Area Study (DAS), a community survey of adults in Michigan, United States. The current analysis included 336 Black individuals who had visited a White (n = 191) or a Black (n=145) physician in the last year. Outcome was satisfaction with the quality of communication with the doctor. Demographics (age and gender), socioeconomic staus (education and income), psychosocial factors (control beliefs and social support), race related factors (having a close White friend, negative attitudes about Blacks, discrimination), and health status (chronic disease count, self-rated health, and distress) of the patient as well as race of the doctor were measured. We used multi-group structural equation modeling (SEM) for data analysis, where the two groups were racially concordant (those who met a Black physician) and racially discordant (those who met a White physician) visits. Results: Satisfaction with physician visit was lower in racially discordant than racially concordant encounters. In racially concordant visits, high education was associated with higher satisfaction, however, racial discrimination was associated with lower satisfaction. In racially discordant visits (i.e. with a White doctor), having a White friend as well as high sense of control were associated with a higher satisfaction, while negative attitudes about Blacks was associated with lower level of satisfaction. Conclusions: Racially concordant and discordant visits have different satisfaction levels. Racially concordant and discordant visits also have different predictors of communication satisfaction among Black patients. Socioeconomic status as well as racial attitudes and experiences impact quality of communication of the Black patients with their doctors, however, these effects depend on the race of the doctor.
La revolución tecnológica y la 4 generación de los derechos humanos
Authors: Duque Pérez Santiago 
Published: June 2019

El siguiente proyecto integrador de semestre tiene como objetivo identificar cual ha La tecnología ha invadido la actividad diaria de la humanidad, ha incursionado en diferentes actividades y profesiones, y ha irrumpido en el espacio sideral. La tecnología ha impactado en forma progresiva y ascendente todo el quehacer humano, produciendo beneficios inmediatos que han redundado en mejoramiento de la calidad de vida, simultáneamente ha presentado algunas dificultades generadas, no por la misma tecnología, sino por el uso inadecuado que de ella se ha hecho. El imponderable uso de las tecnologías, en búsqueda de bienestar, crearon la necesidad de las mismas; pero, no todas las personas de una misma población han tenido acceso a ellas, percibiéndose la importancia de erigir las tecnologías como derechos, para garantizar de esta forma que todos los pobladores puedan acercarse a ellas. Entonces comienza a anunciarse una 4 Generación de los Derechos Humanos.El mundo, actualmente, ha experimentado cambios tecnológicos, que han sido de gran beneficio para la humanidad. Gracias a la evolución que ha tenido la sociedad al pasar el tiempo, personas con un audaz sentido de la observación y de la invención han proclamado la ciencia tecnológica como el futuro y respuesta a las necesidades del ser humano. Debemos agradecer la relación del hombre con la tecnología, pues esta se ha constituido como de vital importancia en la cotidianidad y en áreas de las ciencias como las son: salud, educación, agricultura, derecho, movilidad o transporte, comunicación, astronomía, entre otras.El diario vivir de la humanidad se ve impactado por la revolución de la tecnología, ha llenado espacio familiar con todo tipo de electrodomésticos, video cámaras de control y hasta circuitos de seguridad y el Global Positioning Systems(GPS) herramienta que ha sido de gran utilidad tanto en el núcleo familiar como en la vida social; ha forjado cambios en la producción y relación laboral por la mejora de herramientas, por la cualificación y alto rendimiento en la obtención de productos y servicios, y por el privilegio de la máquina en detrimento de la mano de obra; en la vida social se encuentran con el uso del tiempo libre, invirtiéndolo en diferentes actividades y espacios que también se favorecen con la tecnología, como salas de cine, casinos, tabernas, estadios, parques y otros; y sorprendidos verificamos que la tecnología también se encuentra en los lugares sagrados y de culto, en los centros de cultura: museos, bibliotecas, pinacotecas y más.
Occupational therapy: an emerging role in primary care
Authors: Chamberlain Emily , Truman Juliette , Scallan Samantha , Lyon-Maris Johnny , Pike Amanda 
Published: June 2019

BackgroundGPs in the UK are under significant pressure in delivering primary care and this has highlighted the need for workforce development. Occupational therapists (OTs) are highly skilled practitioners working across health and social care sectors. Educated at pre-registration level to work with physical and mental health issues, OTs can potentially provide valuable support to GPs. To date OTs are not routinely utilised within primary care. For over 10 years the University of Southampton OT Department has developed placements in a range of settings for students, but never previously in primary care.AimThe focus of this study was to determine whether role emerging placements in primary care enhanced the learning of OT students and to consider what can be learned about the role of occupational therapy in primary care.MethodA case study approach was used to evaluate the project. Methods of data collection for this study included: observation of small group teaching sessions and end of placement interviews with students, educators, and members of the primary care teams involved in the placements.ResultsAnalysis of the data indicates OT skills can be utilised in general practice in a number of ways, in certain areas, potentially saving face-to-face consultations with GPs.ConclusionOTs are an underutilised profession in frontline primary care. The role of OT has not been well researched as a ‘first point of contact’ healthcare professional in primary care. OTs’ broad training in mental health, physical frailty, and learning disabilities are potentially valuable to service delivery in general practice.
Medical students’ perceptions of a career in general practice
Authors: Banner Kimberley , Alberti Hugh , Stewart Jane 
Published: June 2019

BackgroundRecruitment into general practice is falling and many training programmes in the UK have unfilled training posts. In 2016 NHS England pledged to increase the number of graduates entering GP training to 50%. However in 2017 only 15.3% of foundation year 2 doctors commenced general practice.AimThis work aims to understand medical students’ perceptions of a career in general practice, and how this may affect their career intentions.MethodAs part of a larger, longitudinal study at four UK universities. First and fourth year students were invited to a focus group to discuss their perceptions of a career in general practice. The recordings were transcribed and content analysis was performed.ResultsThe perceptions discussed could be broadly grouped into three categories. ‘The GP’ highlighted students’ ideas of the GP as someone who was dedicated, could create rapport, and wanted a family life. The ‘Job of the GP’ indicated students were positive about the continuity of care the job offered, but felt the work was isolating and paperwork heavy. Finally, external factors such as denigration and the ‘GP land’ concept also had an impact on students’ perceptions.ConclusionFurther work is needed to understand how these perceptions develop, how this may impact students career intentions, and how this research could be used to improve GP recruitment. This data will form part of a wider longitudinal study, the results of which will be analysed for themes and personal narratives of the students.
Investigating the impact of case-mix on general practice cancer diagnostic outcome indicators
Authors: Gildea Carolynn , Lyratzopoulos Georgios , McPhail Sean , Swann Ruth , Abel Gary 
Published: June 2019

BackgroundThe Cancer Services profiles report indicators of cancer diagnostic activity for all English general practices. A recent study reported that several indicators were dominated by chance, with some practice-level variation explained by the practice’s age-sex profile.AimTo assess the variation explained by patient-level case-mix and whether the practice age-sex profile adequately adjusts for this.MethodFive indicators from Cancer Waiting Times (2016/17, 6050 practices) or Routes to Diagnosis (2015, 6355 practices) data were considered: Two Week Wait (TWW) conversion and detection rates, and emergency-, referred- and other-diagnosis proportions. Mixed-effect logistic regression adjusted for patient-level case-mix, using national cancer registration data on age, sex, deprivation, referral/cancer-type and, where possible, ethnicity and stage at diagnosis, with and without practice-level age-sex profile.ResultsChance explained 60–85% of practice-level variation, with the combination of chance and patient-level case-mix explaining 75% (TWW conversion rate) to 89% (emergency diagnosis proportion). For TWW conversion rate, there was considerable overlap in the variance explained by practice- and patient-level factors. For the other indicators, practice- or patient-level factors were largely independent.ConclusionChance is not synonymous with case-mix and is the dominant source of variation in single-year practice indicators. Therefore, we recommend the continued aggregation of data over multiple years. For most studied indicators, adjustment for the age-sex profile of the whole practice population is not a substitute for case-mix of individual cancer patients and so should not be used. Patient-level case-mix adjustment leads to a modest reordering of practices and so may not be a priority.
‘Just asking the question’: a qualitative study of health professionals’ experiences and perceptions of recording torture in vulnerable migrants in primary care settings
Authors: Whyatt Gemma , Cooper Max 
Published: June 2019

BackgroundA large proportion of vulnerable migrants may be survivors of torture, with complex health needs as a result; yet there is a lack of guidance or understanding of how to identify and record signs of torture. Clinical professionals in primary care are in a unique position to care for and support this patient population.AimThe primary aim of this study was to explore the primary care context of how signs of torture could be better recorded to support patients and meet their needs.MethodThis was a qualitative research study conducted through remote interviews with health professionals from a range of clinical backgrounds and experience of working with survivors of torture.ResultsTwelve health professionals participated in the study, with results analysed using applied thematic analysis. Seven themes were identified, ranging from the barriers to asking about and disclosing torture, the underlying purpose of doing so, political factors affecting this issue and various ways to potentially improve recording torture.ConclusionBefore clinical professionals can record torture, they must first ask the patient about it as survivors are unlikely to raise the topic themselves. Many clinical professionals lack the awareness or confidence to do this, thereby warranting further discussion on strategies to educate clinical professionals about torture. Accessible guidance and a simple, systematic method to identify survivors of torture which is suitable for a primary care setting is necessary, with suggestions for further research including routine enquiry and targeted screening.