Search Words Research Articles

Increasing Student Learning Activeness by Using Puzzle Media in Learning Pancasila Education at SMPN 38 Palembang

This research was motivated by the problem of low learning activeness of class VIII students in junior high schools. Students look passive, lack self-confidence, and show low learning motivation in the learning process. This research aims to increase students' learning activeness through the use of crossword puzzle and word search puzzle media in learning Pancasila Education class VIII.6 at SMP Negeri 38 Palembang. This research was carried out using the classroom action research method which was carried out over 2 cycles where each cycle consisted of 1 meeting and 1 assessment which consisted of 4 stages, namely: planning, action, reflection and evaluation. The subjects in this research were all students in class VIII.6 of SMP Negeri 38 Palembang, consisting of 15 male students and 17 female students. This research was conducted using a quantitative approach with observational data collection techniques. Observations were carried out by observing observers whose results were analyzed using percentage descriptive data analysis techniques. This research shows that the use of crossword puzzle and word search puzzle media in learning can increase the learning activity of class VIII.6 students at SMP Negeri 38 Palembang. This can be seen from the observation results obtained in the pre-cycle which show that students' learning activeness has a percentage of 49.78%, then in cycle 1 it increased by 24.66% to 74.44%, and in cycle 2 it increased by 14.40% to 88.84%. This shows that the use of crossword puzzle and word search puzzle media in learning can increase the learning activity of students in class VIII.6 SMPN 38 Palembang.

Downstream Effects of Market Changes on Inhalers: Impacts on Individuals With Chronic Lung Disease.

COPD and asthma are two of the most common chronic lung diseases, affecting over 545 million people globally and 34 million in the United States. Annual health care costs related to chronic lung disease are estimated at €380 billion in the European Union, and $24-$50 billion in the United States averaging to $4,000 in out-of-pocket costs per person in the U.S. A full-text literature search was conducted for English publications between January 1, 2005-March 18, 2024. It returned over 5,000 publications that were further narrowed using key search words, resulting in 172 peer-reviewed articles. Using their experience and subject expertise, the authors further narrowed the peer-reviewed articles to 55 that were in their opinion relevant. Also, 38 recently published industry reports and news articles specific to downstream effects of inhaler market changes and the future impact were included. The literature suggests that individuals with chronic lung disease face increased challenges with access to inhaled medication due to rising medication costs, discontinuation of branded medications, introduction of generic medications not covered by insurance, exclusionary preferred drug list tactics that force health care providers into non-medical switching of medication or devices, and ongoing medication shortages. Providers experience ongoing hurdles in prescribing appropriate inhaled medications for individuals with chronic lung disease, including increased time and costs spent on administrative tasks due to inhaler denials, a loss of patient trust, and limits on their ability to prescribe appropriate inhaled medication for individuals with chronic lung disease.

SMEs’ strategic orientation through Miles and Snow typology: a synthesis of literature and future directions

Purpose The purpose of this research is to present a systematic analysis of consequents and antecedents of strategy and performance. To acheive this, this systematic review article analyzes and synthesizes mainstream research on small and medium-sized enterprises (SMEs) where Miles and Snow typology was used for strategic orientation of the SMEs. The specific focus of the research is to develop a conceptual framework showing consequents and antecedents of the strategic orientation. Design/methodology/approach This study uses systematic literature review (SLR) method to identify, summarize and synthesize literature on Miles and Snow typology. Preferred reporting method for systematic reviews and meta-analyses to ensure adherence to systematic approach. The key words search consists of the words: “Miles and Snow”, “Miles and Snow” and “miles-snow” from Web of Science and Scopus databases for sample articles. Findings The trend of research on SMEs using Miles and Snow typology is on the rise with a shift from developed countries to the developing ones. Support for strategy-performance relationship hypotheses is overwhelming but the traditional view is in decline while new antecedent and consequent variables are being added. Mediator and moderating variables are also identified. Originality/value The SLR where a synthesis approach was applied for finding antecedents and consequent variables of strategy-performance relationship along with a presentation of conceptual framework makes this research unique. Additionally, the article presents the trends of research over the time based on timeframe, regions, methodological approaches and hypotheses support.

Konfiks Derivasi Per-/-an dalam Debat Capres-Cawapres Tahun 2024: Metode Linguistik Korpus

This research aimed to discuss the “per-/-an” confix which has undergone derivation in Indonesian. This research used the presidential and vice presidential candidate debate script number 01 as the research object studied. This research used a qualitative corpus linguistics approach. The corpus linguistic approach used in this research utilized the KORTARA (Korpus Nusantara) corpus linguistic application. The KORTARA corpus linguistic application (Korpus Nusantara) is an application that can help to collect, process and analyze linguistic data digitally. Data collection in this research utilized the affix word search feature to find specific data containing affixes. The affix word search feature was lasted by accessing the corpus menu in the KORTARA (Korpus Nusantara) application, then selecting the 2024 presidential-cawapres debate script as the object for research. Based on the research that has been carried out, 56 data were obtained on the use of the derivation confix per-/-an in the corpus of the 01 Presidential-Cawapres debate texts in 2024. The results of this research can have implications in the scientific field of morphology related to the principles of derivational development in Indonesian.

Pulse Granuloma in Esophagus; A Rare finding in Achalasia Patient: Case Report and Literature Review

Abstract Introduction/Objective Pulse granuloma is a granulomatous reaction to foreign body, most commonly to food material. This is clinically silent and incidental but may be confused for a mass like lesion. This can be found any location in gastrointestinal tract but most reported in oral cavity and colon. We herein report a rare case of pulse granuloma in esophagus with literature review of the entity. Methods/Case Report A 58-year-old male with history of achalasia, surgical history of Heller myotomy, hernia reduction, hiatoplasty, gastropexy, vagotomy, presented with recurrent stricture of the esophagogastric junction. The patient received multiple esophageal balloon dilatations in the past due to high esophageal sphincter pressure and was complicated by severe reflux associated with esophagitis and large hiatal hernia. He underwent subtotal esophagectomy due to dysphagia. Gross examination of the esophagectomy specimen showed multiple previous procedure scars and was opened to reveal firm yellow food particles impacting in the mucosa. Histological examination showed gastroesophageal junctional mucosa with ulceration and fibrosis of the muscularis propria. Pink ribbon like hyalinized foci with giant cell was found which stained negative for GMS, PAS and AFB, supporting the diagnosis of pulse granuloma. Literature search for key word ‘Pulse Granuloma’ identified thirty-five case reports from year 1977 to 2024, with most reported case in the oral cavity (14 cases, 42%). Out of ten cases reported in gastrointestinal tract, 1 case was reported in small bowel and 9 cases were reported in colon and rectum and no cases were reported in esophagus. Results (if a Case Study enter NA) NA Conclusion Our patient’s history of achalasia and dysphagia along with histopathologic findings supports diagnosis of pulse granuloma in esophagus. Although clinically silent, pulse granuloma may cause mass-like lesions and result in enlargement and stenosis. In setting of esophageal achalasia recognizing this entity is important as it can mimic malignancy and other mass-forming lesions.

Role of Plant-derived Bioactive Compounds in Potential Snakebite Envenoming: A Review

: The issue of snakebite continues to be a distinctive matter of public health in various regions across the globe, with a particular emphasis on India, where the ailment is widely prevalent. Snakebites in the country disproportionately affect rural and indigenous populations, resulting in some of the highest morbidity and mortality rates worldwide. Regrettably, in numerous tropical nations, the accessibility of antivenom is frequently postponed or restricted, thereby rendering antiserum the only targeted therapeutic alternative. Nevertheless, administering antiserum in isolation does not provide adequate safeguard against the adverse effects of venomtriggered hypersensitivity complications, which may be grave. Hence, this study aims to review the plant-derived bioactive compounds used to treat snakebites in India. This review compiles a list of medicinal plants and plant-derived bioactive compounds used in treating snakebites in India, which were reviewed from the available literature in public databases (PubMed, Science Direct, Springer, and Scopus). Search words used were 'bioactive compounds,' 'treatment for a snakebite,' 'antivenom and snakebite,' 'Medicinal plants for snakebite, and 'composition of snake venom'. : A list of 200 medicinal plants traditionally used in several countries for treating snake bites was obtained. Based on scientific data, we reviewed only 83 medicinal plant extracts and bioactive compounds obtained from various families, tested under in-vivo and in-vitro conditions to determine their neutralization potency of snakebite envenomation. In this article, we have presented a comprehensive review, judgmentally analyzed medicinal plants and their bioactive compounds for their therapeutic potential against snake envenomation, and offer a thorough discourse on diverse herbal plants employed globally for managing snakebites.

Oral Care in ICU Mechanical Ventilation Patients and Associated Pneumonia: A Literature Review

Background: Poor oral health can lead to hospital-acquired pneumonia, a serious condition that can prolong patient care and increase the risk of mortality. The bacteria found in the oral cavity of patients with periodontal disease can be particularly harmful if inhaled into the lungs. Patients who are on mechanical ventilation are at an increased risk of developing aspiration pneumonia. Objective: to investigate the effect of oral care on ventilation associated pneumonia (VAP) and various types of such care. Methods: This review article is performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature exploration was done in PubMed, Embase, and Web of Science databases for articles published between 2011 and 2023. The search words were "Mechanical ventilation, intubation, pneumonia, dental care, oral care and ICU ". Results: A total of 21 studies were included, the studies were randomized controlled trials (RCTs) or quasi-RCTs and observational studies. Twice-daily oral care with tooth brushing using purified water can significantly reduce the incidence of VAP. Oral care with chlorhexidine and brushing, as well as enhanced oral care, can also be effective in reducing the incidence of VAP. Improved education and implementation of oral care protocols with 0.12% chlorhexidine solution can significantly reduce the incidence of VAP. Conclusions: The review concludes that good oral hygiene, especially twice-daily oral care with tooth brushing using purified water, can significantly reduce the incidence of VAP in mechanically ventilated patients.

De Novo Natural Language Processing Algorithm Accurately Identifies Myxofibrosarcoma From Pathology Reports.

Available codes in the ICD-10 do not accurately reflect soft tissue sarcoma diagnoses, and this can result in an underrepresentation of soft tissue sarcoma in databases. The National VA Database provides a unique opportunity for soft tissue sarcoma investigation because of the availability of all clinical results and pathology reports. In the setting of soft tissue sarcoma, natural language processing (NLP) has the potential to be applied to clinical documents such as pathology reports to identify soft tissue sarcoma independent of ICD codes, allowing sarcoma researchers to build more comprehensive databases capable of answering a myriad of research questions. (1) What proportion of patients with myxofibrosarcoma within the National VA Database would be missed by searching only by soft tissue sarcoma ICD codes? (2) Is a de novo NLP algorithm capable of analyzing pathology reports to accurately identify patients with myxofibrosarcoma? All pathology reports (10.7 million) in the national VA corporate data warehouse were identified from 2003 to 2022. Using the word-search functionality, reports from 403 veterans were found to contain the term "myxofibrosarcoma." The resulting pathology reports were manually reviewed to develop a gold-standard cohort that contained only those veterans with pathologist-confirmed myxofibrosarcoma diagnoses. The cohort had a mean ± SD age of 70 ± 12 years, and 96% (287 of 300) were men. Diagnosis codes were abstracted, and differences in appropriate ICD coding were compared. An NLP algorithm was iteratively refined and tested using confounders, negation, and emphasis terms for myxofibrosarcoma. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the NLP-generated cohorts through comparison with the manually reviewed gold-standard cohorts. The records of 27% (81 of 300) of myxofibrosarcoma patients within the VA database were missing a sarcoma ICD code. A de novo NLP algorithm more accurately (92% [276 of 300]) identified patients with myxofibrosarcoma compared with ICD codes (73% [219 of 300]) or basic word searches (74% [300 of 403]) (p < 0.001). Three final algorithm models were generated with accuracies ranging from 92% to 100%. An NLP algorithm can identify patients with myxofibrosarcoma from pathology reports with high accuracy, which is an improvement over ICD-based cohort creation and simple word search. This algorithm is freely available on GitHub (https://github.com/sarcoma-shark/myxofibrosarcoma-shark) and is available to facilitate external validation and improvement through testing in other cohorts. Level II, diagnostic study.

Obesity and COVID-19 Severity: Dissecting the Combined Relationship, Mechanisms, Diagnostic Obstacles, Management Approaches, and Treatment Plans

Background: This review delves into the intricate relationship between obesity and COVID-19 severity, uncovering mechanistic insights such as immunological dysregulation, inflammation, and metabolic complexities. It addresses challenges in diagnosis and treatment, advocating for tailored approaches. Emphasis is placed on proper management and customized dietary interventions to mitigate severity. Methodology: Scientific data related to obesity and COVID-19 was obtained from data bases like PubMed, Scopus, google, and google scholar. The search words employed for the data search were “Mechanisms linking obesity and COVID-19”, “Inflammatory milieu,” “Immune dysregulation”, “Impact of obesity on COVID-19 Severity”, and “Dual relationship between obesity and COVID- 19”. Only relevant data related to the intricate relationship between obesity and COVID-19 severity and its management was included. Results: This paper explores the multifaceted mechanisms linking obesity to increased COVID-19 severity, including immunological dysregulation, inflammatory responses, and metabolic comorbidities. This review highlights complex problems that arise in the diagnosis and treatment of obese people with COVID-19. These problems range from precise diagnosis to individualized treatment plans. Management approaches for obese individuals with COVID-19 encompass lifestyle interventions, pharmacotherapy, and dietary considerations, each tailored to mitigate risks and improve outcomes. Additionally, treatment plans integrating multidisciplinary care, including personalized respiratory support, antiviral therapy, and thromboprophylaxis, are proposed to address the unique needs of obese patients battling COVID-19. Conclusion: The abstract underscores the complexity of this interaction, emphasizing the need for comprehensive information to guide clinical care and future research effectively.

The Effect of Using the Word Search Inquiry Model on Conceptual Understanding and Self-Efficacy in Global Warming Physics Content

The Effect of Using the Word Search Inquiry Model on Conceptual Understanding and Self-Efficacy in Global Warming Physics Content

Training for Making Wordwall Learning Media for Teachers in SMK PGRI Kuwu, Grobogan Regency

It doesn't feel like the Covid-19 pandemic that has lasted for 2 years has changed the learning model that we have known so far, namely face-to-face, although the blended learning model that combines conventional models with online learning has been introduced as an evolutionary model, but with the pandemic forcing it to happen. for teachers to immediately adapt and implement it in the schools where they teach as a need that must be met considering the demands of the community who want educators and educational institutions to be able to provide quality education in the midst of this crisis. As an affected educational institution, SMK PGRI Kuwu strives to continue to provide quality learning by applying the blended learning model (Purnomo et al., 2016). After communicating with the service team from PGRI Semarang University, consensus was obtained that the problems faced by partners could more or less be solved by implementing information technology in learning, one of which was the introduction of interactive learning media Wordwall with additional Gamification learning models (Putri, 2020). The application and learning model itself uses a Cloud system or Cloud Computing where between teachers and beneficiaries of learning or students can use information technology devices that vary depending on availability, and do not require device specifications with special and updated technology, the most important thing is the availability of internet network connectivity. Sari Yarza, 2021). Wordwall specifically can be used to create learning media such as quizzes, matchmaking, pairing, anagrams, word randomization, word search, word grouping, and several other additional features such as questions and answer results that can be printed on paper making it easier for teachers and students to document results. work as a task (Hasram, 2021). Through this introduction activity or PKM (Community Partnership Program), it is hoped that teachers and lecturers at SMK PGRI Kuwu can implement it in their learning classes, and are expected to be able to overcome the learning gap that has occurred as a result of the Covid-19 pandemic. The results of the ongoing activities in the form of mentoring and evaluation training, carried out for 3 days which were carried out in a blended manner (offline and online) with the results and responses of the activity participants showing positive indications as indicated by the reapitulation of the questionnaire results of participants' responses to this training activity which showed an average result of 3, 85 on a scale of 4 which indicates a good response or a positive response to the implementation of the training activities.

Review of triage strategies for atypical squamous cells of undetermined significance among young women.

In the present study we reviewed the existing literature regarding management approaches for ASC-US and highlight their pros and cons. The ASC-US entity emerged from Bethesda classification 2001. We conducted this review using search words ASC-US triage, ASC-US management in young women, triage tests for ASC-US, and ASC-US outcome from the English literature. We included different cervical cancer policies (American, European and for WHO) and research articles published on ASC-US in young women from the year 2001. We searched in Google Scholar, PubMed, MEDLINE (NCBI) library, Embase (Elsevier), Wiley online library as well as Cochrane library. We defined young women as aged 30 years and below. We identified 52 articles which focused on management approaches of ASC-US, seven articles focused on young women aged <30 years. Five of these articles combined ASC-US with low-grade squamous intraepithelial lesions (ASC-US/LSIL) while only two addressed ASC-US as a standalone entity. The limited number of articles restricts the evidence base supporting the adoption of triage strategies. There is yet, no consensus in the literature regarding the management of ASC-US, more so in young women below the age of 30 years. Researchers, however, agree on a few aspects, which include the necessity for applying a conservative strategy for managing ASC-US in young women, avoiding direct referral for colposcopy at the initial detection of ASC-US, and avoiding the use of human papillomavirus (HPV) testing on young women (unless living with HIV). Newer techniques such as HPV E6/E7 messenger RNA (mRNA), and dual staining p16/ki-67, may serve as better triage to identify cases of HPV persistence and integration which may subsequently lead to preinvasive or invasive lesions.

Architecture and anatomy of executive processes: evidence from verbal fluency and Trail Making Test in 2009 stroke patients.

The few voxel-wise lesion-symptom mapping (VLSM) studies aimed at identifying the anatomy of executive function are limited by the absence of a model and by small populations. Using Trail Making Test (TMT) and verbal fluency and a model of their architectures, our objective was to identify the key structures underlying two major executive processes, set-shifting and strategic word search. We applied a validated VLSM analysis to harmonized cognitive and imaging data from 2009 ischemic stroke patients as a part of the Meta VCI Map consortium. All contrast analyses used an adjusted threshold with 2000 Freedman-Lane permutations (p ≤ 0.05). The TMT parts A and B were associated with structures involved in visual-spatial processing, the motor system, the frontal lobes, and their subcortical connections. Set-shifting depended on the left dorsomedial frontal region. Both semantic and phonemic fluency tests depended on verbal output abilities and processing speed with similar slopes in different languages. The strategic search process depended on Broca's area, F2 and related tracts, temporal and deep regions. Lastly, the lesion map of set-shifting did not overlap with those of strategic word search processes. Our results identify the anatomical substrates of two main executive processes, revealing that they represent only a specific subpart of previously reported structures. Finally, our results indicate that executive functions depend on several specific, anatomically separable executive processes mainly operating in various parts of the frontal lobes.

A dearth of disability-related competencies in Accreditation Council for Graduate Medical Education's Milestones 2.0.

Despite the high prevalence of disability and the frequency with which people with disabilities encounter the health care system, physicians report inadequate knowledge regarding caring for their patients with disabilities. To determine the number and type of disability-related competencies in the Accreditation Council for Graduate Medical Education's Milestones 2.0. Cross-sectional analysis of publicly available data to identify, via key word search, the presence of disability-related competencies using disability-related terms derived from the World Health Organization's International Classification of Functioning Disability and Health. Accreditation Council for Graduate Medical Education's Milestones 2.0. N/A INTERVENTIONS: N/A MAIN OUTCOME MEASURE: Presence of disability-related competencies. Over one-third (37.5%) of specialties had zero disability-related competencies. Nineteen (59.4%) included an Interpersonal and Communication Skills Milestonethat mentions disability as a potential barrier to communication. No specialties had Systems-Based Practice or Practice-Based Learning and Improvement disability-related competencies. Physical medicine and rehabilitation (PM&R) had six disability-related competencies, preventive medicine occupational and environmental medicine had three, and otolaryngology and transition year each had two. A minority of medical and surgical specialties had disability-related competencies outside of the Interpersonal and Communication domain. With the rising prevalence of disability and the lack of physicians with expertise in the care of people with disability, the time is now to integrate disability competencies into residencies, especially for the primary care specialties.

An AI-assisted terahertz reconfigurable metamaterial in standard 180-nm CMOS

For large-scale terahertz (THz) reconfigurable metamaterials (RM), each unit element needs to be controlled by an independent voltage source. This leads to a huge solution space for control words to achieve the required RM performance specification. In this paper, we propose a fast AI-assisted control-word generation scheme to reduce the computation cost of electromagnetic (EM) simulations (Forward Model) and to speed up iterations for control word searches (Inverse Model). We demonstrate the effectiveness of our models by designing and fabricating a 12 × 9 RM array with a Bi-layer Bi-Split-Ring Resonator structure (B-BSRR) in standard 180 nm CMOS technology. The terahertz RM can be electrically reconfigured, providing active metamaterials with an amplitude modulation depth of around 0–1.7 dB at 0.49 THz. The results show that our Forward Model can predict the S-parameters between 100 GHz and 800 GHz with a mean absolute error of 0.61 dB. Our method is more than 200 times faster than traditional full-wave simulation methods. The Inverse Model can generate required control words within a 1.3 dB error margin in less than 200 iterations.

Simulation and training for pediatric colorectal surgery and anorectal malformation: a scoping review.

To study the published literature for various models used for simulation and training in the field of pediatric colorectal surgery. A PubMed search was conducted for studies of simulation models in anorectal malformation on 24 March 2024 with the search words 'simulation pediatric colorectal surgery' followed by another search on 'simulation AND anorectal malformation' that gave 22 and 14 results, respectively (total 36). After removing 4 duplicate publications, 12 were found relevant to simulation and training in colorectal diseases. One publication relevant to the topic was added from literature, thirteen articles were studied. Of these, 5; 1; 4; and 3 were on inanimate models; animate model; 3D reconstructions; and training, respectively. Simulation models are available for posterior sagittal anorectoplasty. The same inanimate model was used in five articles. The animate model was based on a chicken cadaver. 3D models have been made for personalized preoperative assessment and to understand the imaging in anorectal malformation. One 3D model was made by regeneration of organoid epithelium. Training modules were made to evaluate surgical dissection, standardize surgical techniques, and improve proficiency. Simulation models are an important tool for teaching the steps of surgery and discussing the nuances of operative complications among mentors and peers. With advances in this field, the development of high-fidelity models, more training modules, and consensus on surgical techniques will benefit surgical training.

Relação entre a exposição ocupacional a Radiação Ionizante em Trabalhadores da Saúde e o desenvolvimento de Cancro de Mama

Introduction Every year more than 2.3 million cases of breast cancer are registered, making it the most common type of cancer among adults. The association between breast cancer and occupational factors is an issue that has been studied in the literature since the beginning of the 18th century. Technological developments have allowed a more in-depth study of the relationship between breast cancer and occupational factors such as exposure to chemicals, pesticides, metals and also sources of exposure to ionising and non-ionising radiation.The aim of the present literature review is to complete an update on the scientific knowledge about the relationship between occupational exposure to ionising radiation in healthcare workers and the development of breast cancer. Methodology A research was carried using Medline with the PubMed search engine and Elsevier with the Science Direct search engine. The search words used were a combination of breast cancer, occupational exposure, ionizing radiation and healthcare workers. A research was also carried out in the Revista Portuguesa de Saúde Ocupacional, using the terms “Breast Cancer” and “Ionizing Radiation”. Discussion/Conclusions Current literature is not unanimous about the specific clinical and pathological features of breast cancer possibly linked to occupational settings. Healthcare professionals such as radiology technicians, nurses, orthopaedic surgeons and interventional cardiologists are especially vulnerable to this type of exposure, particularly to ionising radiation. However, some studies have pointed to a difficulty in establishing a causal relationship between these factors due to the number of variables involved, such as the duration and intensity of exposure and the influence of other risk factors. Changes in equipment, procedures and protective measures have resulted in lower doses in recent years, which means that the risk of breast cancer is low at current levels of occupational exposure to ionizing radiation. Keywords: breast cancer, occupational exposure, ionizing radiation, healthcare workers, occupational medicine and occupational safety.

Zoledronic acid: challenges and pitfalls amid rehabilitation in primary osteoporosis and beyond

Zoledronate (or zoledronic acid) represents a standard (guideline-based) approach in the area of anti-resorptive medication (namely, an annual 15-minute perfusion of 5 mg for os-teoporosis treatment), while the same drug (with doses/regimes variations) is used for other bone metabolic conditions such as Paget’s disease of the bone or skeleton metastasis originating from different cancers. The objective of this narrative review was to highlight the most recent published data with respect to zoledronic acid use as part of the complex clinical management amid primary osteoporosis in addition to other osteo-metabolic clin-ical entities. This was a research based on exploring PubMed database with respect to the search words “zoledronic acid” and “primary osteoporosis”. We included highly relevant (from the clinical perspective), English-published, full-length articles that have been re-cently published (between January 2023 and March 2024). From 249 results, 31 articles met the inclusion timeline criteria across the 15-month analysis and the final results were based on data provided from 16 articles. Important insights concern not only the zoledronic acid administration, the efficacy and the safety profile, but, also, an extension on daily indications with concern to diabetic bone disease, liver osteodystrophy, osteogen-esis imperfecta or Paget’s disease of the bone. Keywords: osteoporosis, rehabilitation, zoledronic acid, DXA, hypercalcemia, bone, surgery, prosthesis, Paget’s disease of the bone, liver osteodystrophy

Micronutrients in Adverse Pregnancy Outcomes

About 10 to 20% of reported pregnancies have complications like spontaneous abortion (SA), preeclampsia (PE), preterm birth (PTB), and fetal growth restriction (FGR); 60% are attributed to maternal nutritional alterations. Multiple micronutrients (MMN) are supplemented in the antenatal period, but no proper validation/guidelines are available regarding dosing/time, the need for initiation, and the duration of supplementation. Studies have reported adverse pregnancy complications related to the overuse/unwanted use of multiple micronutrient supplementations during pregnancy. Identifying the exact population requiring supplementation is necessary to prevent its abuse. This article attempts to review the impacts of micronutrient deficiency/supplementation in cases of SA, FGR, and gestational diabetes mellitus (GDM), preterm delivery and PE. The study used a literature search using PubMed, Google Scholar, Mendeley, and Scopus Databases using search words pregnancy, spontaneous abortion, gestational diabetes mellitus (GDM), fetal growth restriction (FGR), preterm delivery, preeclampsia (PE) or “adverse pregnancy” associated with minerals, micronutrients, or supplementation. The review also considered in-house literature databases, a single-window search at Kasturba Medical College (KMC) Health sciences library, MAHE (Manipal Academy of Higher Education). The figures included in the study were created by Biorender.com. Micronutrients play multiple roles during pregnancy and fetoplacental growth stimulating growth hormone secretion, Lysyl oxidase (LOX), involved in the crosslinking between collagen and elastin in the amniotic membrane, downregulation of interleukin (IL)-1 alpha, IL-1 beta, IL-4, IL-6, Il-10, IL-12, tumor necrosis factor (TNF)-alpha and several chemokines involved in hypertension, immune-inflammatory pathways, attenuate insulin resistance, structural development of neurons and glia. Over-supplementation has led to complications such as spontaneous abortion and gestational diabetes mellitus. Since there is a lack of standardization concerning micronutrient supplementation during pregnancy, there is a need for systematic study related to the role of micronutrients during each trimester of pregnancy to optimize its supplementation and to prevent hazards associated with its abuse.

Relación entre meditación, regulación emocional y expresión vocal

Introduction: The voice is an indicator of emotional states, influenced by factors such as vagal tone, breathing and heart rate variability. This study explores these factors and their relationship with emotional regulation and meditative practice as a self-regulation technique. Purpose: To investigate the difference in vocal characteristics and heart rate variability in experienced (EM) and novice (NM) meditators before and after a meditation practice and in non-meditators - control group (CG), before and after a control test. Methods: 3 x 2 quasi-factorial study. Three groups were evaluated (experienced meditators EM; novice meditators NM; and control group CG, non-meditators) at two points in the experimental manipulation - before and after a meditation session for meditators, and before and after a word search task for the control group. The fundamental frequency, jitter, shimmer, harmonic-to-noise ratio and the first (F1), second (F2) and third (F3) formants of the vowel [a]; heart rate variation (SDNN, RMSSD, LF/HF, SD1 and SD2); anxiety state and vocal self-perception, were investigated, before and after the intervention. Results: The EM group achieved optimal vocal tract relaxation. The NM and CG groups showed changes in F1. Long-term meditative practice was associated with a large difference in F3, SDNN and SD2 in heart rate variation. Conclusion: The results suggest that meditation practice influences vocal expression and emotional reaction, and that experience in meditation practice favors this relationship.