bluuebunny/crossref_metadata_2025 huggingface dataset:
قياس وتحليل العوامل المؤثرة في التوازن المالي للمصارف دراسة تحليلية على عينة من المصارف المدرجة في بورصة عمان للأوراق المالية للمدة (2000-2021)
Authors: يوسف رواء أحمد
Published: November 2024

يهدف البحث الى اختبار العوامل ( المتغيرات ) التي يكون لها القدرة على تحقيق التوازن المالي اكثر من غيرها من العوامل الاخرى في المصارف التجارية ، باستخدام عينة من (12) مصرف تجاري مدرج في بورصة عمان للأوراق المالية للمدة من (2000-2021) وقد تم اختيار مؤشرات مالية لقياس التوازن المالي هي مؤشر ( القدرة الائتمانية ، ومؤشر الربحية ، مؤشر السيولة ، مؤشر كفاية راس المال ومؤشر المرونة المالية ) واستخدام المنهج الوصفي و التحليلي للبيانات و المعلومات الواردة في القوائم المالية للمصارف المبحوثة ، كما استخدم اسلوب التحليل العاملي واستخدام البرنامج الاحصائي (SPSS) لاختبار الفرضية و الاجابة عن التساؤل المتعلق بمشكلة الدراسة و الوصول الى الاهداف ، كما توصل البحث الى مجموعة من النتائج أهمها بينت نتائج التحليل صحة الفرضية التي تشير بان هناك مجموعة من العوامل التي تؤثر على قدرة المصارف المبحوثة في تحقيق التوازن المالي اذ اتضح تفاوت في تأثير مؤشرات التوازن المالي على المركز المالي للمصارف، كما قدم البحث مجموعة من التوصيات اهمها: ضرورة قيام  المصارف بتنويع المحفظة الاقراضية وتجنب مشاكل التركز الائتماني الذي يؤثر على التوازن المالي للمصارف في حالة زيادة القروض المتعثرة.
AN EVALUATION AND EXAMINATION OF SOFTWARE-DEFINED NETWORKS AND ITS ROUTING ENHANCEMENTS
Authors:   Research Scholar Department of Computer Science  KPR College of Arts Science and research,  Coimbatore-641407, India, Kalaivani S.
Published: November 2024

: Software-Defined Networking (SDN) has enabled the creation of sophisticated, adaptable, and customizable network management solutions. It enables the centralized management and flexible adjustment of routing by utilizing its decoupled architecture. Therefore, efficient routing is essential in SDN to improve network performance, scalability, and efficiency. While conventional models primarily emphasize heuristic and metaheuristic methods, recent progress has incorporated Machine Learning (ML) techniques into some of these models providing adaptive and intelligent solutions to routing challenges. These ML-enhanced models specifically target problems related to delay, traffic congestion and efficient use of resources. This survey provides a comprehensive analysis of different routing strategies in SDN with a specific emphasis on the subset of approaches that incorporate ML techniques. We evaluate the influence of ML on network performance, emphasizing their benefits and constraints, and examine the difficulties and future prospects in using ML for SDN routing. The survey concludes with suggestions for enhancing routing efficiency and network performance by employing advanced techniques selectively.
Physical Therapy Utilization Prior to Biceps Tenodesis or Tenotomy for Biceps Tendinopathy
Authors: McDevitt Amy , Cleland Joshua , Hiefield Paisley , Bravman Jonathan , Snodgrass Suzanne
Published: November 2024

Introduction

Surgery for the management of individuals with long head of the biceps tendon (LHBT) tendinopathy is common. Little is known about physical therapy (PT) utilization prior to surgery. The purpose of this review was to investigate the use of PT prior to biceps tenodesis and tenotomy surgeries by assessing the number of visits and the types of interventions. A secondary objective was to report on themes of PT interventions.

Methods

A retrospective observational cohort study design was used to analyze medical records and report on patient visits, procedure codes based on active or passive interventions, and themes of interventions utilized by PT.

Results

Patient records (n=308) were screened for eligibility, n=62 (20.1%) patients attended PT prior to surgery. The median number of PT visits was four (IQR=3.5), and 39/62 (63%) patients had four or more visits to PT. Active interventions were used in 54.5% (533/978) of the codes billed; passive interventions were used in 45.5% (445/978) of the codes. There was high utilization of therapeutic exercise [93.4% (498/533) of active procedure codes] including muscle performance/resistance, functional activity, motor control and stretching. Manual therapy [84.3% (375/445) of passive procedure codes] included soft tissue mobilization, non-thrust manipulation (glenohumeral joint and cervical spine) and thrust manipulation (thoracic spine).

Conclusions

PT was not commonly utilized prior to undergoing biceps tenodesis and tenotomy surgery. Further research is needed to understand the reasons for low utilization.

Level of Evidence

3b
Intra-rater and Inter-rater Reliability of the KangaTech (KT360) Fixed Frame Dynamometry System During Maximal Isometric Strength Measurements of the Knee Flexors.
Authors: Woolhead Ellie , Partner Richard , Parsley Megan , Jones Ashley
Published: November 2024

Background

Fixed-frame dynamometry systems are used worldwide to assess isometric strength in both general and athletic populations. There is currently a paucity of published work where reliability estimates for fixed-frame dynamometry systems have been estimated. The aim of this study was to determine the inter-and intra-rater reliability of the KangaTech (KT360) fixed frame dynamometry system when measuring maximal isometric strength of the knee flexor muscles.

Study Design

Inter and intra-rater reliability single cohort study.

Methods

Twenty healthy university-level athletes (age= 21.65 ± 3 years, weight= 74.465 ± 30kg, height= 170.1 ± 7.0cm) took part in two testing sessions where two raters collected data during a 90° hip and knee flexion protocol. Participants performed each test twice, building to a maximal isometric contraction holding over a 5 second period with 30 second rest between sets. Data were checked for normality using a Shapiro-Wilk test. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Finally, a Bland-Altman analysis was used to determine the levels of agreement for intra-and inter-rater measurements.

Results

High levels of agreement were demonstrated between left and right knee flexion as 95% of the differences were less than two standard deviations away from the mean. ‘Almost perfect’ intraclass correlation coefficient (ICC) values were demonstrated (Knee flexion: Inter-rater: Left, 0.99; Right, 0.99; Intra-rater: Left, 0.99; Right:0.99). Standard error of measurement (SEM) for inter-and intra-rater strength ranged from 0.26-0.69 kg, SEM% ranged from 1.34-2.71% and minimal detectable change (MDC) ranged from 1.14-2.31kg.

Conclusion

Overall, high level of inter-and intra-rater reliability were demonstrated when testing maximal isometric knee flexion. Therefore, the KT360 fixed frame dynamometry system may be considered a viable tool for measuring maximal isometric contraction of the knee flexors when repeat measures are required in clinical settings.

Level of Evidence

3b
The Regional Representative Council (DPD RI) and Checks and Balances in Indonesia's Legislative Process
Authors: Cipto Handoyo Benediktus Hestu
Published: November 2024

This study aims to analyze the function of the House of Regional Representatives of the Republic of Indonesia (DPD RI) in the legislative process and the checks and balances mechanism within Indonesia's constitutional system. The background of this research stems from the limited authority of DPD RI in the legislative process, especially when compared to the House of Representatives (DPR RI), despite its vital role as a regional representation body advocating for regional interests in law-making. The urgency of this writing lies in addressing the imbalance of power between the executive and the legislature, as well as between the central government and the regions. Using a normative legal research method, this article examines the role of DPD RI in the discussion of bills, its interactions with DPR RI, and its contributions to maintaining the checks and balances system. The findings indicate that the DPD RI faces significant challenges in influencing the legislative process, although opportunities exist for strengthening its role. The study concludes that legislative reforms and capacity building for DPD RI are crucial to enhance the effectiveness of the checks and balances mechanism, thereby strengthening Indonesia's democratic system. The novelty of this research lies in its emphasis on practical strategies for empowering DPD RI within the national legislative framework.
IMPORTANCIA DEL LIDERAZGO AMBIDIESTRO EN EMPRESAS CON MODELOS DE ECONOMÍA CIRCULAR: BIBLIOMETRÍA
Authors: Bernal Olga-Vélez , Gómez-Bayona Ledy , Moreno-López Gustavo
Published: November 2024

Los modelos de economía circular se han desarrollado em el mundo, aportando a los temas de sostenibilidad organizacional, aportando a los indicadores de crecimiento y rentabilidad por medio de la innovación, para ello, es necesario que las organizaciones desarrollen capacidades dinámicas de adaptación, absorción e innovación, y todo esto no sería posible sin un Liderazgo ambidiestro, es decir, un liderazgo transaccional a la vez que se aplica un liderazgo transformacional.
 
Objetivo: El objetivo de este estudio es analizar por médio de um estúdio bibliométrico, la influencia del liderazgo ambidiestro em modelos de economia circular, con el objetivo de detectar aspectos que actualmente están siendo investigados, así como las brechas de conocimiento relacionadas com estas temáticas.
 
Marco Teórico: Los principales conceptos que sustentan la investigación, son: el  liderazgo ambidiestro conformado por el liderazgo transacional y el liderazgo transformacional, los modelos de negocio, la economía circular y la sostenibilidad.
 
Método: La metodología adoptada para esta investigación comprende un estudio cualitativo y el método un análisis bibliométrico, utilizando para su diagramación la herramienta PRISMA. La recolección de datos fue realizada en la base de datos SCOPUS para documentos entre los  años 2020-2023, donde finalmente se obtuvieron 60 artículos, los cuales son visualizados en el Software VOSviewer.
 
Resultados y Discusión: Los resultados obtenidos revelaron el comportamento y evolución de las variables analizadas, los términos crecientes, decrecientes y emergentes, y se discuten las temáticas a la luz del marco teórico, destacando las implicaciones y relaciones identificadas.
 
Implicaciones de la investigación: Se discuten las implicaciones prácticas y teóricas de esta investigación, proporcionando información sobre cómo los resultados pueden aplicarse o influir en las prácticas en el campo de las ciencias administrativas. Estas implicaciones podrían abarcar las ciencias sociales y ambientales.
 
Originalidad/Valor: Este estudio contribuye a la literatura al determinar no solo las variables crecientes, decrecientes y emergentes, sino también las variables ausentes, siendo brechas de conocimiento para futuras investigaciones. La relevancia y valor de esta investigación se evidencian en la caracterización de los artículos de la ecuación de búsqueda, así como el análisis realizado entre las variables del estudio, lo que implica un conocimiento a profundidad de las temáticas que se están investigndo y las que se deben estudiar, identificando nuevas investigaciones que permitan la generación de conocimiento y su aplicación em las ciências administrativas.
Effect of Strategic Change on Performance of Media Firms in Nairobi Kenya
Authors: Mukeya Winnie , Wanjere Dishon , Simon Mamadi
Published: November 2024

Purpose: Given the rapidly evolving media landscape in Nairobi, Kenya, which presents a unique opportunity to explore the impact of strategic change on organizational performance, this study addresses the effectiveness of various change strategies thereby offering valuable insights for media managers and policymakers striving to enhance the resilience and growth of media enterprises in Nairobi.
Design/Methodology/Approach: Employing descriptive and correlational research design, the study used closed ended questionnaires with a sample of 122 departmental heads out of a target population of 176 departmental heads from 6 major media firms in Nairobi; Nation Media Group, Standard Group, Royal Media Services, Mediamax Network Limited, Radio Africa Group and Capital Group Limited. The departmental heads for editorial, technical, sales and marketing, administrative and public relations formed the target and sample. Simple random sampling and stratified sampling techniques were adopted. Data was analyzed using descriptive and inferential statistics. Data was presented using tables.
Findings: Strategic Change significantly affected performance in media firms P 0.00<0.05. This suggests that strategic change variables had a significant effect on performance of media firms hence rejection of null hypothesis.
Implications/Originality/Value: The study recommends that media firms should adopt a systematic change management strategy to facilitate seamless transitions and cultivate leadership abilities at all levels to enable leaders to proficiently initiate and oversee changes.
Applied Behavior Analysis for Teachers
Authors: Alberto Paul , Troutman Anne , Axe Judah B. ,   Simmons University, Boston, Massachusetts, USA
Published: November 2024

Análisis aplicado de conducta para maestros, el mítico texto que durante 40 años ha sido el manual de referencia sobre el uso de aplicaciones conductuales en el aula, se edita por primera vez en español. El libro te muestra cómo utilizar los principios del análisis de conducta para crear tu propia receta hacia el éxito educativo. Lleno de prácticas educativas basadas en la evidencia, estrategias concretas y ejemplos divertidos que podrás identificar con tu práctica docente. El texto te ofrece además poderosos métodos para el manejo eficaz y ético de conductas desafiantes en el aula.
Behçet xəstəliyində inferior vena cava sindromu
Authors: Cəfərov R.Z.
Published: November 2024

Behçet xəstəliyi (BX) təkrarlayan oral aft, genital ulser və üveitlə xatakterizə olan, çoxlu orqan tutulumu göstərən xronik iltihabi və multisistemik bir xəstəlikdir. BX-nin xüsusi laborator göstəricisi yoxdur və bu səbəblə klinik əlamətlərə əsaslanaraq diaqnoz qoyulur. Klinik simptomların vaskulyar tutulumun nəticəsində meydana gəldiyi qəbul edilir. Arterial və venoz sistemin bütün ölçüdə olan damarlarını tutabilir. BX-də venoz tutulum daha çox rast gəlinir. Arteriyal tutulum daha az rast gəlinməsinə baxmayaraq daha ciddi nəticələr doğurur. Bu səbəbdən, nadir qarşılaşılan klinik təcrübəmizi təqdim edirik.
Demensiyanın diaqnostika və müalicəsi üzrə klinik protokol
Authors: İsmaylov Fuad
Published: November 2024

Demensiya – koqnitiv funksiyanın enməsi ilə xarakterizə olunan baş beynin qazanılmış xəstəliyidir. Yaddaşın pisləşməsi əksər hallarda demensiya formasında olur, lakin koqnitiv funksiyaların pisləşməsi yaddaşla məhdudlaşmır (yəni, icraedici funksiyalar, diqqət, dil, sosial qavrama və təfəkkür, psixomotor sürət, görmə-perseptiv və görmə-məkan qabiliyyətlərinin pisləşməsi qeydə alınır). Koqnitiv zəifləmə normal qocalma ilə əlaqəli deyil və insanın gündəlik həyat fəaliyyətində sərbəstliyə əhəmiyyətli dərəcədə mane olur.
Mövcud simptomlar düşüncənin pozulması, deliriy nəticəsində psixi vəziyyətin dəyişməsi, intoksikasiya, kəsilmə sindromu, digər psixi pozuntularla (məsələn, şizofreniya və ya digər ilkin psixi pozuntular, depressiv pozuntu) izah edilmir.
Mövcud sübutlara əsaslanaraq, koqnitiv zəifləmənin beyinə, travmaya, qidalanma çatışmazlığına, müəyyən maddələrin və ya dərman preparatlarının xronik istifadəsinə yaxud ağır metallar və ya digər zəhərlərin təsirilə yaranan nevroloji və ya tibbi vəziyyətə aid olduğu ehtimal edilir.
Kəskin piyelonefrit
Authors: Seyidov Nabil
Published: November 2024

Sidik yolları infeksiyalarına (SYİ) sistit (sidik kisəsinin /aşağı sidik yollarının infeksiyaları) və piyelonefrit (böyrəklərin/yuxarı sidik yollarının infeksiyaları) aiddir. SYİ-nin patogenezi nəcis florasından gələn uropatogenlərin sidik kanalı və ya uşaqlıq yolu girişində artıb çoxalması ilə başlayır. Daha sonra bu uropatogenlər sidik kanalı boyunca sidik kisəsinə qalxır. Piyelonefrit isə patogenlərin sidik axarları ilə böyrəklərə qalxması zamanı inkişaf edir. Piyelonefrit bakteremiya nəticəsində törədicilərin bilavasitə böyrəklərə keçməsi nəticəsində də yarana bilər. Bəzi hallarda piyelonefritin səbəbi limfa düyünlərindən böyrəyə keçən bakteriyalardır.
Kod İnsult: təklif olunan xəstəxanadaxili protokol
Authors: Seyidov Nabil
Published: November 2024

“Kod İnsult” protokolu kəskin reperfuziya terapiyasından (venadaxili tromboliz və / və ya endovaskulyar trombektomiya) faydalana biləcək insultlu pasientlərin müalicəsini sürətləndirmək üçün hazırlanmışdır. Protokolda insult bölməsinin (şöbəsinin) komandasının erkən cəlb edilməsi və pasientin müalicənin aparıla biləcəyi insult şöbəsinə (radioloji görüntüləmədən keçərək) sürətli hospitalizasiyasına və müvafiq müalicə tədbirlərinin başlanmasına imkan verən təxirəsalınmaz tibbi yardım üzrə fəaliyyətlər təsvir edilib. Protokola əsasən insult şöbəsi (mərkəzi) olan xəstəxanalarda 24/7 qaynar xətt və ya teletəbabət sisteminin, habelə nevroloq və neyrogörüntüləmə imkanlarının əlçatan olması ciddi əhəmiyyət kəsb edir.
USSR AND AFGHANISTAN: MILITARY-DIPLOMATIC AND ECONOMIC RELATIONS IN 1953-1963
Authors:   Russian State University for the Humanities, Khristoforov Vasilii S.
Published: November 2024

Based on the previously unknown documents from the Russian state and departmental archives, and also on scientific literature, the activities of the Soviet diplomats and intelligence officers to intensify the military-diplomatic and economic relations between the USSR and Afghanistan in 1953–1963 are analyzed. It is shown how, in the context of the Cold War and the confrontation between the USSR KGB and the U.S. CIA, the Soviet intelligence in Afghanistan managed to obtain reliable information about the foreign and domestic policy of the local government and to contribute to the implementation of Moscow’sforeign policy course. Itis documented why the Soviet-Afghan relations began to rapidly improve from the second half of 1955. The research shows the participation of the Soviet military specialists in the reorganization of the Afghan army and in its rearmament, the delivering process of modern military equipment (tanks, aircrafts). In addition, the Soviet Union at that time provided a large-scale economic assistance to Afghanistan: dozens of important national economic facilities were built (hydroelectric power stations, irrigation complexes, airfields, roads, power lines, car repair plants and workshops). It is concluded that during that period, informal leadership in the political and economic spheres for influence in Afghanistan belonged to Moscow.
WORLDVIEW PRIORITIES OF THE FUTURE GREEK CATHOLIC METROPOLITAN ANDREY SHEPTYTSKY IN THE INITIAL PERIOD OF HIS PUBLIC ACTIVITY
Authors:   Lomonosov Moscow State University, Borisenok Yurii A. , Pshenichnyi Aleksandr M. ,   Lomonosov Moscow State University
Published: November 2024

The paper examines the information deposited in the sources and connected with the youth worldview of Count Roman Sheptytsky, later the Greek Catholic Metropolitan Andrey (1865–1944). An attempt has been made to analyze the data on this topic, going right back to the childhood of the future hierarch. The statements contained in the recollections of Roman’s mother, Zofia Szeptycka, are compared with the facts evidenced by the Sheptytskys’ family correspondence of the period under review. In addition to the direct statements of the young count and his mother relating to his worldview, attention is paid to the information that indirectly proves this, in particular, the data on Roman’s participation in various student associations. When describing the atmosphere of Breslau University of which Sheptytsky was a student, the topic of the nature of the “alien” structure is touched upon. In this regard, the foundations of the confrontation between the Catholics and the Socialists in the Grand Duchy of Poznań are outlined. In particular, a comparison was made between the Catholic and the Socialist doctrines of the society. The article explicates the nature of Sheptytsky’s participation in the activities of the Philaret brotherhood at Jagiellonian University. The significance of the public change in 1885 of the national self-identification of the future metropolitan is revealed. The conclusion is made about the Sheptytsky’s worldview priorities in the described period.
PUBLIC DIPLOMACY AS A TOOL FOR IMPLEMENTING THE FOREIGN POLICY OF THE VATICAN: AN ANALYSIS OF THE STRATEGIC NARRATIVE OF POPE FRANCIS I
Authors:   Russian State University for the Humanities, Simonov Pavel K.
Published: November 2024

Modern scientific research shows that religion increasingly determines the way of life of the societies where traditional confessions have become widespread. The social transformations in the developing and developed states caused by economic modernization and migration processes, as well as the ineffectiveness of the governance models used by the political elites are mentioned as reasons. The world religions adapt to the modern situation and try to influence the socio-political processes. This is also characteristic of the Vatican, the city-state that administers the Roman Catholic Church. An important goal of the Vatican policy over the past decade is to raise the profile of the Catholic Church beyond its traditional sphere of influence. Through the analysis of the strategic narrative of Pope Francis I, the article considers the public diplomacy of the Vatican as a tool to implement its foreign policy. The purpose of the research is to determine the uniqueness of the strategic narrative of the Vatican’s public diplomacy during the early pontificate of Francis I, aimed at transforming the image of the Roman Catholic Church and strengthening its relations with the faithful abroad. Emphasizing the pontiff’s dual role as head of a sovereign state and head of the Roman Catholic Church, the study uses the frame analysis to identify the key ideas articulated in the pontiff’s rhetoric. The results of the analysisshow that Pope Francis I’sspeechesto the public in the early years of his pontificate were based on the ideas of collective responsibility, universal values, and a call to action. An integrated reflection on these three frameworks suggests that the RCC’s public diplomacy efforts go far beyond the Catholic audiences.
CANADIAN-RUSSIAN COOPERATION IN THE FIELD OF ARCTIC EXPLORATION IN THE 1990S AND 2000S
Authors:   Russian State University for the Humanities,, Kasenkov Vasilii I.
Published: November 2024

This article describes the interaction between Russia and Canada on the development of the Arctic space. The role of the Arctic in the conditions of an actively changing climate is very important both for the Arctic states that have direct borders with the region and for the whole world in general. The author analyzes the actions of the two countries in the period from the 1990s to the early 2000s. Gorbachev’s reforms, along with the active position of the Canadian government, made it possible to start cooperation on humanitarian issues even before the collapse of the USSR. The 1990s were marked by the active formation of a number of legal agreements on cooperation between Russia and Canada, as well as other Arctic states. In 1996, the Arctic Council was founded, an organization designed to ensure the sustainable development of the region. The progressive improvement of the relations between the two largest Nordic countries began to stagnate after 2006, with the coming to power of the Conservative Party led by S. Harper. The purpose of this article is to analyze the intergovernmental process between the Russian Federation and Canada aimed at the development of the Arctic region. The novelty of this work lies in the fact that, despite the presence in the domestic historiography of the studies on the topic, the article is the first attempt of a generalized scientific research of the Canadian-Russian cooperation in the development of the Arctic.
POLITICAL AND ECONOMIC DIMENSIONS OF THE SINO-EUROPEAN RELATIONS AT THE PRESENT STAGE: THE MAIN TRENDS AND PROSPECTS
Authors:   Moscow State Institute of International Relations, Lupaltsova Anna I.
Published: November 2024

The relations between China and the EU are one of the defining tracks for the further development of the international order. In the last few years, they are characterized by an increasing tension, since there are confrontational trends in the political interaction, along with the robust trade and economic development. In addition, the third parties have a decisive influence on the China-EU relations. The article attempts to determine the current state of the Sino-European relations, as well as to consequently make a forecast of their further development. The methods of the retrospective and comparative analysis are used to systematically compare and evaluate the Sino-European relations in their development, and also to identify the patterns characterizing them. A discourse analysis of the statements of the European and Chinese political figures is used as an auxiliary mechanism. The author highlights such tendencies as the degradation of the relations, primarily in the political sphere, the strengthening of economic interdependence, the development of the bilateral relations with the EU member states, rather than with the supranational bodies of the integration association. In addition, it is suggested that the influence of the various structural factors leads to a significant increase in the rivalry between China and the European Union. The author concludes that the Sino-European relations will be determined to a greater extent by their relationship with the third parties, and the current trends will continue to develop, increasing the degradation of the political interaction between Beijing and Brussels
PRIORITIES FOR THE DEVELOPMENT OF U.S. ENERGY POLICY IN 2012-2023
Authors:   Lomonosov Moscow State University, Sidorova Elizaveta S.
Published: November 2024

The shale revolution of the early 21st century has radically changed the energy image of the United States, turning the country into one of the largest exporters of hydrocarbons. Such significant transformations could not but affect how Washington positions itself in the global energy market and how it defines its national interests in this sphere. The article is dedicated to the juxtaposition between the approaches of the last three administrations to this issue. Despite the fact that a significant body of domestic and foreign research focuses on the persistent desire of each new political leadership to maximally distance itself from its predecessors, a consistent analysis of the strategic documents on the development of the U.S. fuel and energy complex, as well as on the specifics of building relations with other actors of the international energy system, allows us to make a conclusion that Washington’s policy is based on the constant imperative of achieving resource self-sufficiency and gaining a dominant position in the global market. Such a circumstance indicates the evolutionary nature of the changes in the 2012–2023 US energy doctrine, and it occurred in full compliance with the global leadership mentality which is typical for the country.
La referencia a los pobres: efecto de sentido en tres sexenios de gobierno mexicano desde las representaciones sociales y el análisis crítico del discurso
Authors: Martínez-Treviño Elena Slovenia
Published: November 2024

¿Qué aparece en nuestro pensamiento con la frase “los pobres”? Quizá imágenes, escenas, eslóganes, diversos constructos mentales con los cuales dar sentido a esa evocación. Para proponer esta cuestión en el campo de las ciencias sociales, hago la pregunta a propósito de la consigna del actual Gobierno: “Por el bien de todos, primero los pobres”. El reconocimiento de los pobres como sujetos de atención prioritaria justifica este trabajo, y si bien en esa evocación aparecería el fenómeno de la pobreza, por razones de espacio acoto el análisis al conjunto de personas a quienes desde el ámbito gubernamental se les nombra “pobres”.
Apuntes sobre los mecanismos de acceso a la representación política para grupos en situación de vulnerabilidad en los procesos electorales de 2021 y 2024
Authors: Huerta-Alderete Aldo
Published: November 2024

El proceso electoral 2023-2024 tuvo un carácter excepcional por una multiplicidad de factores. La consolidación de la hegemonía de un partido en la Cámara de Diputados, el Senado de la República, congresos locales, gubernaturas y ayuntamientos cambió sustancialmente el mapa electoral. Sin embargo, un elemento clave que pasa desapercibido es la postulación de personas adscritas a grupos históricamente excluidos: indígenas, afromexicanas, personas con discapacidad, con orientación sexual e identidad de género (OSIG) no normativas.
CONSERVATION AND ARCHIVING MEDICAL RECORDS IN SELECTED HOSPITALS IN YAOUNDÉ
Authors: Agbor Dr. Michael Ashu , C Tchweguem , S Zing , L.P Fonkoueng Nguichou , Che B Ndikum , Nchifor A Menguih , P Lindondo
Published: November 2024

Introduction: Medical records play an important role in the storage and recall of patient’s information, patient’s follow-up, research, teaching, public health policy making and as a medico-legal tool, but less emphasis has been placed on its role in health care delivery. The objective of the study was to appraise the methods of conservation and archiving of medical records in hospitals in the city of Yaoundé.Methodology: A descriptive cross-sectional study was done in the hospitals of Yaoundé between January to June 2023. The Data which was collected from medical record clerks using a self-administered and pre-tested questionnaire included: The profile of the health institution, personal information of the clerks, strategies put in place for the protection of medical records and obstacles in archiving.Results: Twenty hospitals in the city of Yaoundé participated in the study. The public sector represented 65% of the health facilities, 45% had been existing between 21 and 40 years, with a median of 24.5 years. In 70% of the cases, medical records archiving system had been existing between 1 and 10years. In 65% of cases, the conservation of archived records was mainly done at the different services with the paediatric service being the most represented (16.2%). In 87.5% of cases, the means of archiving used was the paper file classified on shelves (73.5%); of which (52.2%) were archived in alphabetical order. The obstacles to archiving medical records were mainly the lack of qualified personnel (82.4%) and the lack of storage space (80.1%).Conclusion: Many obstacles were observed. These results suggest actions to be generated both by the Cameroonian State and by the leaders of private health facilities in order to improve the management of medical records.
TECHNIQUES TO SOLVE UNIFORM THIRD DEGREE EQUATION HAVING FOUR VARIABLES
Authors: Nagarajan Thiruniraiselvi , Mayilrangam Gopalan
Published: November 2024

Each article should be accompanied by an abstract of up to 250 words in English, which should mention all the principal facts and conclusions set forth in the paper. A similar abstract in Hindi language may be added, but this is not required. The homogeneous cubic equation with four unknowns given by is studied for obtaining its non-zero distinct integer solutions. Substitution technique and factorization method are utilized to determine the same.
SOCIO-CULTURAL STUDY OF GOPALI CASTE OF NEPAL: A CASE STUDY IN MACHHEGAUN, CHANDRAGIRI 9, KATHMANDU, NEPAL
Authors: Kafle Dol Raj , Ghimire Taranath , KC Tej Bahadur
Published: November 2024

The Gopali caste, a subgroup within the Newar community, has a unique socio-cultural heritage that remains under-researched and underrepresented. This study examines the social and cultural conditions of the Gopali caste in Ward No. 9 of Chandragiri Municipality using a qualitative approach. Data was collected from primary sources such as on-site observation, participant observation, focus group discussions, and interviews, and secondary sources including books and online materials. The findings reveal that the Gopalis, who migrated from the Mathura region of India around 3,500 years ago, have historically maintained unique social and ritual practices while living in seclusion. Today, Gopali settlements are primarily in the southwestern Kathmandu Valley and Makwanpur district. Despite diversifying into various occupations, they face limited participation in Nepal's administrative and political processes. This research underscores the importance of recognizing the Gopalis as a separate ethnic group to preserve their cultural heritage. Future research should focus on detailed ethnographic studies to document their traditions and explore ways to integrate the Gopalis into Nepal's broader socio-political landscape while preserving their distinct identity.
Sepsis, an Ancient Threat and Today's Challenge for Global Health
Authors: Alberto Laura
Published: November 2024

Sepsis is a longstanding, deadly health issue affecting 49 million people and causing 11 million deaths annually, with stark disparities in care access between low- and high-income countries. Despite treatment advances, diagnosis and care remain challenging, and adherence to protocols varies widely. Survivors often face lasting health issues, especially in resource-limited regions where post-sepsis care is lacking. To address these gaps, the Global Sepsis Alliance’s 2030 agenda emphasizes political action, healthcare readiness, societal involvement, research, and preventive measures like sanitation and vaccination. Achieving a “world free of sepsis” depends on coordinated global efforts and expanded roles for healthcare workers.
Investigating Inappropriate Discontinuations of Enteral Nutrition Related to Gastric Residual Volume in Critically Ill Patients: A Retrospective Observational Descriptive Study
Authors: Aikawa Gen , Nobushima Daiki , Hiki Takahiro , Sakuramoto Hideaki , Unoki Takeshi
Published: November 2024

Background: Gastric residual volume (GRV) is measured by nurses in clinical practice as a simple method to assess gastrointestinal intolerance. Nutrition therapy guidelines recommend avoiding enteral tube feeding (ETF) discontinuation if GRV is < 500 mL.
Aim: This study aimed to clarify the status of inappropriate ETF discontinuation related to GRV in critically ill patients.
Methods: Patients who were ventilated for more than 48 hours in the intensive care unit of a university hospital in 2021 were retrospectively surveyed, and data were collected up to 2 weeks after admission. ETF discontinuation data were collected and categorized as planned or unplanned. The reasons for unplanned discontinuation were further categorized into high GRV, symptoms, and conditions. The reasons and the amount of GRV were analyzed descriptively. Inappropriate ETF discontinuation related to GRV was defined as ETF discontinuation for a GRV of < 500 mL.
Results: ETF was discontinued in 10% (270 events / 2,600 orders) of critically ill patients. Unplanned discontinuations accounted for 37% (99/270) of discontinuations, with GRV being the most common reason (43%), followed by nausea and vomiting (8%), and hemodynamic instability (8%).
Conclusions: Thirty-seven percent of ETF discontinuations in critically ill patients were unplanned, and 42% of these were inappropriate ETF discontinuations related to GRV. Research results and guideline recommendations need to be disseminated clearly to make more healthcare providers aware of the GRV criteria for discontinuing ETFs.
Conceptual Model of Sepsis as a Dysregulated Host Response: Depicting Directionality of Immunologic and Metabolic Dysregulation.
Authors: Graham Julie , Scruth Elizabeth
Published: November 2024

Background
Mortality from Sepsis continues to remain high in hospitalized patients worldwide. Previously, the conceptual model of sepsis was based on the systemic inflammatory immune response syndrome, an adaptive model. In 2016, a new definition of sepsis was proposed as a dysregulated host response to infection, however until now, no model has been proposed elucidating what immunologic mechanisms are dysregulated.
Aim
We sought to propose a new model of sepsis to elucidate evidence-based immunologic and metabolic mechanisms which are dysregulated in sepsis.
Methods
Evidence in the literature comparing and contrasting sepsis before and after the 2016 consensus definition of sepsis was reviewed for themes. Themes from research published post 2016, were described connecting immunologic and metabolic mechanisms in sepsis. This information further informed earlier research that has been published by the primary author.
Results
A new conceptual model of sepsis was developed to elucidate the current definition of sepsis as a dysregulated host response, incorporating themes uncovered in sepsis research post 2016.
Conclusion
The model proposed here supports clinicians in applying the current definition of sepsis to a physiological model. This can benefit clinicians by offering new ways of recognizing sepsis, and researchers by recommending a physiologic model to advance sepsis research.
Keywords: Sepsis, sepsis model, immunologic dysregulation, metabolic dysregulation
Identification and Validation of an Instrument to Measure Physicians‘and Nurses' Knowledge, Attitudes, and Practices Regarding Antibiotic Resistance and Antimicrobial Stewardship
Authors: Zainaghi Irene , Cilluffo Silvia , Lusignani Maura
Published: November 2024

Background: In Italy, the presence of a suitable instrument to measure the knowledge, attitudes, and practices of intensive care physicians and nurses with respect to antibiotic resistance and antimicrobial stewardship could not be identified
Objectives: To validate the Italian version of the Ashiru-Oredope tool used by the European Centre for Disease Prevention and Control (ECDC) in 2019 to investigate intensive care nurses' and physicians' knowledge, attitudes, and practices (KAP) regarding antibiotic resistance.
Methods:  Content validity was assessed using the Item-Content Validity Index (I-CVI), Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score, Scale Level-Content Validity Index/Average (S-CVI/Ave) score, and Average Content Validity Ratio (CVR). Multiple correspondence analysis (MCA) was then carried out together with cluster analysis (CA) to check the correspondence of the items with the eight subdivision domains of the scale.  
Results: The final version consisted of 55/60 deemed relevant items, with Item-Content Validity Index (I-CVI) scores ranging from 0,625 to 1. The Scale Level-Content Validity Index/Universal Agreement (S-CVI/UA) score was 0.43; the Scale Level-Content Validity Index/Average (S-CVI/Ave) 0.90. The mean CVR of the scale was 0.43. The inter-rater reliability (Cohen's K) was between good and excellent. The combination of MCA and CA confirmed the correspondence of the items with the domains.
Conclusion: The Italian version is a reliable and valid instrument for investigating antibiotic resistance and antimicrobial stewardship among Italian intensive care nurses and physicians.
Evaluation of tumor-infiltrating lymphocytes as a predictive biomarker of recurrence in patients with ductal carcinoma in situ of the breast
Authors: Pasetto Camila Vitola , Aguiar Fernando Nalesso , Peixoto Marcella Bassan , Dória Maíra Teixeira , Mota Bruna Salani , Maesaka Jonathan Yugo , Filassi José Roberto , Goncalves Rodrigo
Published: November 2024

Objective: The objective of this study was to evaluate the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence. Methodology: This is a retrospective cohort study with patients diagnosed with DCIS and treated at the University of São Paulo. We included women over 18 years old with a diagnosis of DCIS who underwent treatment from January 2007 to December 2020. Male patients, patients with a diagnosis of invasive or microinvasive disease in the anatomopathological examination of the surgical specimen, or patients with a history of any neoplasm were excluded. The main outcome was survival analysis according to the quantification of TILs, adjusted for potential confounders. Two pathologists evaluated TILS in the sample with the highest tumor representation and numerically quantified it as a percentage. Kaplan-Meier curves, log-rank tests, and Cox regression models were used to evaluate survival. Chi-square tests were used to evaluate the association between categorical variables. Results: A total of 283 patients met the eligibility criteria. The mean follow-up was 77.2 months, with a recurrence rate of 9.2%. The mean age of patients was 55 years. Clustered amorphous microcalcifications were the most prevalent mammographic presentation. The most frequent histological and IHC features were cribriform presentation (73%) and ER positivity (86%), respectively. We observed that tumors with focal necrosis (HR 6.4 [1.39–34.71] p=0.018) or comedo necrosis (HR 4.53 [1.34–15.28] p=0.015) had higher risks of recurrence. Patients with a percentage value of TILs, greater than or equal to 17% also had a higher risk of recurrence (HR 2.97 [95%CI 1.17–7.51] p=0.02). These patients were mostly under 65 years of age (OR 0.45 [95%CI 0.21–0.97] p=0.049). In a multivariate model, CN and TILs>17% remained significantly associated with recurrence (p=0.034 and p=0.035, respectively). Conclusion: In our cohort, the high value of TILs (>17%) and the presence of CN were independently associated with DCIS recurrence.
The alarming level of sexual dysfunction among Brazilian women with early breast cancer undergoing adjuvant endocrine therapy
Authors: Suzuki Daniele Assad , Resende Heloisa , Santos Danielle Laperche dos , Arakelian Netto Renata , Signorini Poliana Albuquerque , Nogueira-Rodrigues Angélica , Rosa Daniela Dornelles
Published: November 2024

Objective: This study aimed to determine the frequency of sexual dysfunction among women with early breast cancer on adjuvant endocrine therapy and to explore its relationships with patients’ clinical and social characteristics and healthcare insurance. Methodology: Women with a history of early-stage ER+ invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months and at least one sexual intercourse in the previous 4 weeks were evaluated for sexual dysfunction with the Female Sexual Function Index questionnaire. Demographic and clinical information was reviewed from medical records. Data collection was done with the RedCap software, and statistical analyses were performed on the software R (R Core Team (2022). Results: From June 2021 to March 2024, 774 patients were recruited in 15 institutions. The mean age was 56.8 years, 38.8% were premenopausal, and 65.1% received chemotherapy. The mean duration of endocrine treatment was 3.7 years. Only 315 (54%) out of 774 patients in this study had a sexual intercourse in the previous 4 weeks before evaluation and were included in the analysis. Sexual dysfunction was found in 252 (89%) participants with active sex life. Age was significantly associated with sexual dysfunction with women >40 years old having higher rates (95.3%) compared with younger patients (10%, p=0.01). Patients without sexual dysfunction had significantly higher EORTC QLQ C30 domain scores. ET duration between 2 and 5 years vs. <2 years, higher vs lower education level, EORTC QLQ-BR23 breast symptoms, and sexual functioning higher scores were significantly associated with the occurrence of sexual dysfunction in multivariate analysis (p<0.05). Conclusion: Sexual dysfunction is a great concern for women. In our study, only 56.37% of women evaluated had sexual intercourse in the previous 4 weeks, and of those women, 89% reported sexual dysfunction. This is a major health problem and strategies to improve this issue are crucial.
Analysis of the Magee 3 equation for assessing prognosis in breast cancer treatment
Authors: Vazquez Thais Perez , Gonçalves Rodrigo , Aguiar Fernando Nalesso , Mota Bruna Salani , Cristófalo Milena Martello , Baracat Edmund Chada , Filassi Jose Roberto
Published: November 2024

Objective: In the treatment of breast cancer, along with molecular tests, tools such as Residual Cancer Burden (RCB) and Magee equations (ME) are used for prognosis. Linked to the OncotypeDX recurrence score, ME3 also predicts pathological complete response. Our objective is to evaluate the relationship of ME3 with overall survival (OS) and disease-free survival (DFS) and estimate the association between RCB and ME3. Methodology: This retrospective cohort study was carried out at the Cancer Institute of the State of São Paulo of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (ICESP/HCFMUSP) including patients with HER2-negative and HR-positive BC undergoing chemotherapy neoadjuvant treatment (NCT) from January 2011 to December 2017. OS and DFS analyses were performed using the Kaplan-Meier method and the log-rank test. ME3 scores were categorized into low (31). The association between these categories and the RCB categories was assessed using the chi-square test. Results: We enrolled 143 women (mean age: 50.3 years, range: 25–85 years). Pre-NCT, 55.2% had tumors >5 cm, and 35% had no axillary lymph node involvement (N0). The median OS time was 71.5 months, with a longer OS (43 months) observed for low ME3 values. A statistically significant association was found between ME3 and OS (HR=4.56, 95%CI 1.35–15.43, p=0.015), which was not observed for DFS (HR=2.33, 95%CI 1.06–5.13, p=0.036). Regarding RCB scores, 88.1% had moderate (RCB-II, 42.7%) or extensive (RCB-III, 45.4%) residual tumor burden. For ME3, 37.1% had a low value and 53.8% had an intermediate value. An inverse association was identified between RCB and ME3, a statistically significant relationship (χ2 =39.3215, p=0.000). Conclusion: ME3 demonstrated a statistically significant association with RCB and OS and could serve as an alternative to Oncotype Dx in resource-limited countries.
Integrated health technological solution for the resolution of breast cancer screening actions: Itaberaí Project
Authors: Silva Douglas Euclides de , Freitas-Júnior Ruffo , Rodrigues Danielle Cristina Netto , Corrêa Rosangela da Silveira , Freitas Paola Ferreira de , Borges Marcus Nascimento , Soares Leonardo Ribeiro
Published: November 2024

Objective: This study aimed to present the technological solution of the ITABERAÍ Project, characterizing a set of services and applications to integrate actions from the registration of study participants to the follow-up of altered cases. Methodology: The technological solution involves integrating the mobile application (Rosa App) with the web system (RosaWatch). The App was developed for use by the Community Health Workers (CHW), in collecting data on study participants, and the system was created for the follow-up of altered cases, from suspicion to diagnostic confirmation and initiation of treatment, and is used by coordinators of the National Health Strategies (NHS), regulation, specialists, and participating study centers. The graphical interface of the App was developed in Dart/Flutter, and the Backend was written in Python/Flask for the creation of the application programming interface (API), responsible for communication between the database and the application. For the relational database, MySql is used. The web system was designed in Python/Flask, and for HTML pages, CSS/Bulma and Javascript were used. For analysis and interpretation, the database is exported to the RedCap Platform. Results: Currently, there are 98 users, all of whom have received training for the use of the technological platforms, with good acceptance and high rates of proper completion. So far, 3101 women have been randomized, with 1607 (51.8%) in the control group and 1494 (48.2%) in the intervention group; of these, 235 (15.7%) have already completed Cycle 2 of the trial. The App is in version 1.8, and the web system is in version 1.1. Conclusion: The technological solution proved to be an important strategy for consolidating information and facilitating the follow-up of altered cases identified by both CHW and NHS. It is user-friendly and effective for data collection, storage, and export for analysis, which contributes to the resolution of actions for breast cancer screening and the improvement of public policies.