bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual and Reproductive Health Needs of Adolescent Secondary School Girls in Bayelsa State
Authors: I.W. Helen , E.N. Efeunu
Published: December 2021

Introduction- Pinpointing sexual and reproductive health needs from the students` perspective is a key step towards prevention of avoidable global adolescents` death and promotion of health. The purpose of this article was to explore the sexual and reproductive health needs of adolescent secondary school students in Bayelsa State. Method- A descriptive qualitative design was adopted for this study using the purposive sampling technique with a sample of 10 participants in one public secondary school. The Source of data was a semi-structured interview guide and a voice recorder. Data was analyzed thematically in six sequential steps. Findings- Two (2) themes, sexual and reproductive health needs of adolescents, methods of sexual health dissemination and five (5) sub-themes emerged. Conclusion- Findings indicate that the public-secondary school adolescent girls require education on; menstrual cycle, prevention of sexually transmitted infections, Human Immuno-Deficiency Virus /Acquired Immune Deficiency Syndrome, as well as on appropriate use of different types of contraceptives from established centres for sexual and reproductive health services. To ensure the public secondary school girls have access to the services and utilize the services, this study recommends the dare need to adopt different methods to disseminate sexual and reproductive health information to reach the secondary school girls to prevent avertable illnesses and deaths.
Weak Institutions and Poor Governance in Nigeria: A Socio-Legal Perspective
Authors: C.J.S. Azoro , C.A. Onah , Q.O. Agulefo
Published: December 2021

The Nigerian state as a governance template has been dominated by the vexatious problem of underdevelopment since post-colonial history. Good governance and development as an intertwine concept have largely been elusive, rather, poor governance has dominated the Nigerian society, resulting from leadership problems, pervasive corruption, the existence of multiple centres of loyalty base regime, ethnic and religious interest among others, all indicative of weak, underperforming or non-performing institutions of government. This paper made an in-depth inquiry into the correlation between weak institutions and poor governance, highlighting the Nigerian situation. It critically analyzed the concept of good governance as the opposite of poor governance. This paper found that unless the Nigerian state cures itself of the malaise of weak institutions and procures a situation where both the leaders and the led imbibe the ethos of good governance, it will continue to struggle with the burden of poor governance and the concomitant lack of social development it breeds in the society.
Historical-Geographical Overview of the Territories Occupied after 2008 Russo-Georgian War
Authors: SOSİASHVİLİ Giorgi
Published: December 2021

In the current paper, we try to showcase the historical - geographical overview of the Russian occupied territories in Shida Kartli. Apart from this, we also try to showcase the ancient Georgian toponyms, hydronyms and oikonyms of Didi Liakhvi gorge, and how the transformation of which into Ossetian onomastic units started from the time the Soviet government came to power in the country. In the first half of the XV century, the Machabels feudal kingdom was established in Didi Liakhvi Gorge. The influence of Machabeli’s also extended to Dvaleti and Zhgele Gorges. “Samachablo” was bordered by Ksani Saeristavo (Dukedom) estates from the east. The nobility of Pavlenishvili, Amilakhvari and Kherkheulidze were bordered on the south and south-west and on the north-west Racha Saeristavo. According to one relatively late (1886) document and map attached to it, which give us an idea of the estates owned by the descendants of Abesalom Machabeli (Davit’s son). To the west, it was separated from the Tsereteli estates in Racha Mazra. The northern border followed river Terg and main ridge of the Caucasus. According to the above mentioned map, Machabeli estates were bordered on the north by Tergi district and Vladikavkazi district. In the North Caucasus Machabeli owned an integral part of Georgia from ancient times - Dvaleti, where Ossetians settled later. The Dvals occupy an area of about 500 km2 from the left bank of the river Tergi - to the head of the Ardon, in Nar - Mamisoni Cave and six Gorges (Zakha, Nara, Zramaga, Zrogo, Zhgele and Kasri). Dvaleti was included in the flock of Nikozi Bishop. Most of the toponyms, anthroponyms, ethnonyms common in Dvaleti are of Georgian origin. In 1843 at the initiative of Russian government, “Ossetian District” was created, which administratively entered in Tbilisi province. However, in the territory of historical Dvaleti, the so-called “Nari district” was established, which was transferred to Tergi district in 1859 and because of this an important territory, that was historically part of Georgia (approximately 500 m2) was artificially removed from our country and the historical part of Georgia - Dvaleti was annexed to Ossetia (actually - Russia).
Anti-State Policy of Ossetians Residing in Georgia in 1918-1921
Authors: MGHEBRİSHVİLİ Aleksandre
Published: December 2021

On May 26, 1918, adoption of the Act of Independence, which established the Democratic Republic of Georgia by the National Council, has been the most significant event in Georgia’s history. The First World War crisis and 1917 revolution incited nations, occupied by empire, to restore sovereignty. Georgia was one among these few. Georgia was declared as independent republic, governed by the national council, and soon after, most of European countries recognized its independence. Despite its short run, the first democratic republic had a fundamental impact on the history of Georgia. It was the only country from South Caucasus, where the Red Army failed to seize the power without fierce opposition. Georgians’ relentless resistance was fed by anti-Bolshevik attitude. Democratic, humanistic course, equality in development and striving to build democratic country, ethnic tolerance and acceptance of European values were reflected in the act of independence and late, in the constitution. Although Georgian government always tried to respectfully apply status of minor ethnic group - Ossetians within the legal and state framework, unfortunately state could not always manage it. Generally, Ossetians, migrated to Georgia, had never have ethno- political or ethnoterritorial entity before socialization. “South Ossetia” as a concept of Ossetian settlement in mountainous Shida Kartli was fabricated over period of time after Russian Empire had annexed Georgian Kingdom. The idea was unjustified and unacceptable but well-designed and profitable for the Russian Empire. Ossetian separatism had revealed its nature from the very first day of Georgian independence. Deep-rooted Russian threat towards the Caucasus has always endangered integration of Georgia within European family. Constant and unquenched desire to stir up conflicts in Georgia, among Caucasus countries, was generated in Russian Empire and later was successfully and methodologically inherited by Soviet Russia. This approach had been deliberately destroying Caucasus platform and becoming part of European family seemed as a disappearing dream. However, Georgia was determined to be among European countries and sometimes was winning battles. One of those wins was an election of Catholicos-patriarch in September 1917, an event, which paved the road toward independence. But in 1921, Georgia was occupied thus new era of dreadful existence had started for the country.
Spatial Resolution and Frequency Characteristics for Dose Modulation on the TrueBeam Medical Accelerator
Authors: Vasiliev V. N. , Smyslov A. Yu.
Published: December 2021

Purpose: To study the spatial resolution achievable by dose modulation in a water phantom using a multi-leaf collimator, jaws and their combination. To estimate the power spectrum density of the useful signal (dose distribution) and statistical noise, evaluate the frequency interval containing the useful signal.

Material and methods: Using the Gafchromic EBT2 radiochromic film, nested squares dose patterns formed in a water-equivalent phantom by 6 and 15 MV photon beams of the TrueBeam medical accelerator, jaws, a multi-leaf collimator, and a combination of these devices were measured. Dose response to step function (ESF) data was extracted from the penumbra and the linear photon source dose response function (LSF) was calculated. To move to frequency domain, fast Fourier transform was performed over the obtained datasets, as well as over individual LSF peaks, and then power spectra densities were calculated. The Nyquist frequency associated with data sampling was 1.42 mm-1, the Hann window was used to minimize leakage effect.

Results: The shape of the obtained LSF peaks was approximated by a sum of two Gaussian distributions with the same center positions but different widths. The LSF peak width at half maximum (FWHM) was 1.7-3.9 mm depending on the modulation device. No significant difference was observed in the peak widths at energies of 6 and 15 MV. In most cases, the width of the peak along the X-axis was wider than along the Y-axis. The power spectrum of the useful signal had a maximum near zero frequency, a 50 % level was near 0.09 mm-1 and its high frequency limit was about 0.4 mm-1. Above this value, only the spectrum of statistical noise was recorded, uniformly distributed over frequency.

Conclusion: The obtained values of the LSF peak width in the range 1.7-3.9 mm characterize the ability of dose modulation by the considered devices or their combination, which can be significant for treatment of small targets (less than 3-4 cm), where these limits of spatial resolution can be reached. The obtained relationships in frequency domain can be used for optimal removal of statistical noise using Wiener filters from profiles or two-dimensional dose distributions.
Mathematical Modeling of Uniform and Nonuniform Malignian and Normal Tissues Irradiation. Mathematical Analysis of the Tumour Grid Irradiation
Authors: Klepper L. Ya.
Published: December 2021

Purpose: On base created mathematical model (MM) modified Veybull distribution, intended for NTCP calculation, depending on irradiated volume V and uniform irradiation dose D, to develop the MM, which allows to realize transition from nonuniform dose in tissue to the equivalent, uniform identical dose. To research the hypothesis, under what condition lumpy sharing dose in system tumors+normal tissues will be more efficient, than uniform dose.

Material and Methods: Lumpy sharing dose are described as a differential histogram dose-volume (DDVH). The MM for calculation transition lumpy distribution of the absence of the beam complication probability (ACPr) in tissue is designed. It was used for MM conclusion, which allows to calculate transition values of the Adequate Dose (AD) of the uniform irradiation tissues, which use brings about ACPr in tissues.

Results: On base of the suggestions and proved affirmation MMs are received, which allow for lumpy distribution of local NTCP values, presented as a DHDV, to calculate transition values ACPr, as well as select from it MM for reduction of the lumpy sharing dose. On base created MM question was explored, in what case tumors and normal tissue through a grid irradiation will be more effective than uniform irradiation.

Conclusion: The transition from lumpy sharing doses in tissues to equivalent uniform dose present the significant interest for the RT planning efficiency. Their study is necessary, where the radiation of biosubjects is influenced.
Extracranial Dose and the Risk of Radiation-Induced Malignancy after Intracranial Stereotactic Radiosurgery: is it Time to Establish a Therapeutic Reference Level?
Authors: Paddick I. , Cameron A. , Dimitriadis A.
Published: December 2021

Background. To measure extracranial doses from Gamma Knife Perfexion (GKP) intracranial stereotactic radiosurgery (SRS) and model the risk of malignancy after SRS for different treatment platforms.

Methods. Doses were measured for 20 patients undergoing SRS on a GKP at distances of 18, 43 and 75 cm from the target, corresponding to the approximate positions of the thyroid, breast and gonads respectively. The National Cancer Institute (NCI) RadRAT calculator was used to estimate excess lifetime cancer risk from this exposure. Five different age groups covering childhood and younger adults were modelled for both sexes.

Results. Extracranial doses delivered during SRS with the GKP were a median 0.04 %, 0.008 % and 0.002 % of prescription dose at 18 cm, 43 cm and 70 cm from the isocentre respectively. Comparison with the literature revealed that the extracranial dose was lowest from GKP, then linacs equipped with micro-multileaf collimators (mMLC), then linacs equipped with circular collimators (cones), and highest from Cyberknife (CK). Estimated lifetime risks of radiation-induced malignancy in the body for patients treated with SRS aged 5–45 years were 0.03 0.88 %, 0.36–11 %, 0.61–18 % and 2.2–39 % for GKP, mMLC, cones and CK respectively.

Conclusions. We have compared typical extracranial doses from different platforms and quantified the lifetime risk of radiation-induced malignancy. The risk varies with platform. This should be taken into account when treating children and young adults with SRS. The concept of a therapeutic reference level (TRL), similar to the diagnostic reference level (DRL) established in radiology, is proposed.
The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonization Group Recommendations for Сontouring of OARs
Authors: Bondarenko A. V. , Lebedeva Zh. S. , Litvinov A. P.
Published: December 2021

QUANTEC report summarized the data of the dose constrains for critical structures in radiotherapy. The authors of this report determined that one of the obstacles to obtaining meaningful data on tolerant doses was inconsistency in the nomenclature of names. And inconsistencies in the guidelines for contouring the organs at risk increase the variability in contouring. Eliminating these inconsistencies increases the speed and safety of the workflow within each individual healthcare facility and improves the accuracy and reliability of the data underlying the dose limits that are developed. The standardization of terminology facilitates the integration of dosimetry data, the creation of various templates and scripts to automate the creation of a prescription for the RT course for similar cases, and the automation of reports. It helps to train the systems supporting artificial intelligence. AAPM report TG-263 resolved the nomenclature problem, however, different anatomical boundaries of different organs were still hidden under the same names in various large research centers. In 2020 The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonization Group published an article. It summarized the many years of work by the scientific radiotherapy community to standardize the approach to delineating the OARs. This article provides an overview of the article key points and provides links to outline guides.

A special attention it was paid to clarifying the anatomical boundaries of such OARs: heart, femoral heads, skin, individual structures of the gastrointestinal tract and substructures of the eye.
Dictionary of Abbreviations in Medical Radiology, Medical Physics and Radiation Safety
Authors: Narkevich B. Ya. , Ryzhov S. A. , Ratner T. G. , Moiseev A. N.
Published: December 2021

Based on the analysis of numerous literary sources and the authors' many years of their own experience in medical physics and medical radiology, a dictionary of abbreviations (abbreviations) that are most often used in scientific publications, guidelines, regulatory documents in these areas of high-tech medicine has been developed. The dictionary contains abbreviations in English, which are usually not deciphered in English-language publications, as well as abbreviations in Russian with the corresponding English abbreviations, if only they are available in scientific and educational literature. The dictionary is intended both for use in professional education, including postgraduate education, and for medical physicists, radiation diagnosticians and radiation oncologists working in radiological medical organizations.
Gagasan tentang Peradaban: Syarah Pemikiran HOS. Tjokroaminoto
Authors: Lutfillah Novrida Q. , Fauzi Ahmad , Asmuni Iskandar E. , Jaya Hendra , Syifa Ibnu
Published: December 2021

Buku ini dibuka dengan sebuah prolog Menuju Peradaban Utama: Perspektif H.O.S. Tjokroaminoto yang disampaikan oleh Ari Kamayanti dengan memberikan ulasan bagi kelima bab dan kelima pensyarah, yang ditutupnya dengan sebuah simpulan bahwa keberadaan dimensi-dimensi serta peleburannya untuk mencapai peradaban utama dapat dipahamkan melalui pendidikan, akan tetapi di-perlukan sebuah struktur pemerintahan yang mampu mendukung terjadinya percepatan hijrah. Di semua dimensi kehidupan, kebijakan penguasa yang sadar/ me-nembah gusti adalah suatu keharusan. Diperlukan sebuah aksi konkrit yang harus mulai dilakukan untuk sebuah percepatan bagi peradaban dan masa depannya.
Intellectual Capital and Firm Performance across Pakistani Industries
Authors: Ahmad Muhammad , Rus Rohani Mohd
Published: December 2021

This study sheds light on the differences in intellectual capital (IC) efficiencies across non-financial sectors in Pakistan and determines the relationship between IC and firm performance. The study used sample of 155 non-financial firms from the manufacturing and service industries of Pakistan for the period 2009-2018. This study contributes to IC research by applying modified value-added intellectual capital (MVAIC) model with relationship to firm performance (return on assets and Tobin’s Q) of Pakistani non-financial firms which was overlooked by the previous researchers. In addition, to deal with endogeneity, the dynamic panel generalized methods of moments regression is applied to test the relationship between IC and performance. Findings provide evidence that different sectors in non-financial industries manage IC components differently. IC increases both market-based performance and accounting-based performance of Pakistani firms. Among all IC components, human capital efficiency is an important determinant of firm performance. The implication can provide help managers and investors to understand the IC to increase the firm performance.
Life and the World Around: Theme of Subjugation of the Downtrodden and Approaches in Indian culture as Revealed in My India
Authors: Dr Archana K. Deshmukh
Published: December 2021

This paper is a descriptive work and is an attempt to study Jim Corbett’s approach, as an Indo-Anglian writer, towards the theme of caste related subjugation in the colonial era. Jim Corbett is one of the few Anglo-Indian writers, who through his non-fictional narrative reveals minute observation of the customs, traditions and rituals of Indian culture. Short stories based on real-life characters offer, as one of the major themes, a glimpse of the suffering and subjugation and taboo associated with the life of the untouchables. He understands the role of caste system in India and is aware of its relevance in shaping the destiny of a person. Corbett’s concern is not only class and caste conscious, but also socially relevant and the delineation of the anguish of the underprivileged is poignant and significant. He is sensitive towards their struggle and gives the message of equality and humanity. He is a moralist, who preaches the lesson of humanity.
Quest for Revolt in Joothan by Omprakash Valmiki
Authors: Prof. S. Ranga
Published: December 2021

Omprakash Valmiki, like other writers of autobiographies, articulates the Dalit confrontation in his renowned story, Joothan. He describes every aspect of his disturbing social experiences, unfolding his complete life. Thus, Omprakash Valmiki's Joothan is about the voyage of Dalit discrimination and social boycott. The Valmiki kin is under pressure for schooling and position in the social order. In the meantime, it is also the fairy-tale of a Dalit family unit in search of self-esteem and identity in the Indian Hindu society. Omprakash Valmiki portrayed his life as an untouchable and Dalit in the newly self-governing India. The tale of Joothan refers to scraps of food left on a plate; this is meant for waste and animals. India's untouchables have been obligatory to acknowledge and eat leftovers for centuries, and these terms encompasses the pain, humiliation and poverty of the group of people enforced to survive at the underneath of India's societal pyramid. Although untouchability was abolished in 1949, But Dalits is being unrelenting to face prejudice, economic deficiency, aggression and mockery. Even after attaining Independence, the Dalits had to struggle a long time to get education; Joothan takes it seriously. Valmiki shares his daring resist to escape a prearranged life of steady physical and mental agony and his transformation into a speaking subject under the influence of the great Dalit political manager, BR Ambedkar. An article of the long silenced and long denied sufferings of Dalits, Joothan is a key role to the archives of Dalit history and a proposal for a radical transform of humanity and human consciousness. Dalits are being unrelenting to face unfairness, economic deprivation, hostility and ridicule. This paper is trying to portray the Quest for Revolt in Omprakash Valmiki’s Joothan.
Rejuvenating Karayala: An Endangered Folk Theatrical Form of Himachal Pradesh
Authors: Manoj Thakur
Published: December 2021

This paper deals with karayala, a folk theatrical form of Himachal Pradesh. This form is basically a ritual, performed in the name of a local deity called Biju/Bijeshwar. It is a night long ritual consisting of minimum three and maximum four episodes (swaangs) and each one is followed by a musical interlude comprising singing and dancing. Karyala is an impromptu theatrical form. There are no women actors and only men play female roles. Surprisingly, till date women are not allowed to play female roles. It deals with range of themes and most of them aim at reforming society by employing techniques like mimicry, caricature, satire, paradox, pun and word play. The paper seeks to introduce karayala to larger audience. In the crisis of the present context and particularly owing to onslaught of media multiplicity, we have lost karayala’s past as none for a long while cared to document it due to urbanization, people’s indifference and media charged environment that has threatened its existence. At present it is alive in people’s memory and is necessitated by rituals to avert divine wrath; nevertheless, its space stands largely invaded by media today. The future of this folk theatrical form seems bleak unless we take effective measures to revive/ retrieve it.
Reformation of Culture through Language and Translation
Authors: Sneha Kannusamy
Published: December 2021

This research paper sheds light on the reformation of culture through language and translation. It introduces the definitions of language, culture, and translation.  It further explains the relationship between culture, language, and translation concerning the scholarly papers. The phenomenon by which the culture is built by different languages linking to the way we emote feelings and thoughts, which is achieved through the process of translation. This paper shows the study of how the culture gets reformed through language and translation getting even more transformed structurally in the upcoming generations. The reformation is seen not only in non-fictional works but also traces the fictional plays and novels that are cited with authentic references. Limitations such as not translating the words with accurate meaning may give the pessimistic approach but how it promotes people in learning varied concepts of language getting introduced to vast culture is dealt detail. This paper also deals with cultural refinement through linguistic anthropology and postcolonialism. This study shows the level of consciousness of people towards language and translation giving allowance to get introduced to particular cultures that promotes unity with examples. The language reflects culture, providing the study of refinement in language mirroring the culture, hence proving literacy is directly connected with the culture in education. The translation is the best influencer taking its turn of shifting people from one culture to taste another. To build up a valid society, the need for inculcating in-depth knowledge of language and culture through translation helps in building the culture for posterity.
Patriarchy and Inequality in Bharti Kirchner’s Sharmila’s Book and Pastries: A Novel of Desserts and Discoveries
Authors: Dr. N. Sumathi
Published: December 2021

Literature produced by men was a prejudiced one and focused mainly on the might of men and feebleness of female members. This was resisted by women writers and they started shattering the prejudiced views of men and gave a proper solution to it. Moreover, they violated the sanctities of women as mere service renders and broke the stereotyped images of women as the classical Sita or Kannagi who were projected as submissive partners having no identity of their own. It is only through the writings of women writers, the real identity of the women was recognized and they became equal partners at home and in the society. This awakening was highly instrumental in turning the dark pages of the history of literature and spread brightness and happiness everywhere. At present, gender inequality has gained global attraction and this has resulted in the production of vast literature.
Religious Philosophy of Guru Nanak: Literary Speculation
Authors: Dr. Anupama D. Mujumdar
Published: December 2021

India has been a land of diverse culture and traditions. When we say culture it includes many things like language, social customs, food habits, religion and so on. Of this religion seems to be the most influential factor in the life of an individual. It is something which lends meaning and purpose to our life. It is that which binds human beings to the Divine. And this bond can be established through the practise of Bhakti. The concept of Bhakti is an old one. It emphasises devotion to the personal God. Bhakti movement is an important development in the cultural history of India which originated in the south. The saints of Bhakti movement preached personal devotion to God as a means of attaining Salvation. They made use of local language to spread the ideology of Bhakti. Guru Nanak is one of the most influential saints of the Bhakti movement. In his teaching he incorporated ideas both from Hinduism as well as Islam. He revealed the truth of monotheism, importance of the recitation of God’s name with utmost devotion, need of a Guru for salvation. He tried to bridge the gap between the two communities of Islam and Hinduism and eradicate social problems by focusing on the truth of monotheism and the concept of equality.
The ‘Changing Status’ of Women w.r.t. Gentrified Urban Spaces of Mumbai
Authors: Dr. Deepali Bhide
Published: December 2021

Reinforcement of inequality and rise in human conflict across society, culture, political economy and gender relations is a characteristic feature of globalisation which is an apparent process of development. This inequality becomes more evident in a globalising city like Mumbai because the capitalist expansion within Mumbai has been defragmented and worrisome. Girangaon in Mumbai (spread over E, F and G wards within MCGM- Municipal Corporation of Greater Mumbai) is a case reflecting a similar inconsistency because this is a core area which has been undergoing so called urban renewal since the closure of cotton textile mills since 1980s. More livelihood opportunities in Mumbai have been created in the informal tertiary sector as compared to the formal traditional occupations. Urban poverty, income disparities and deprivations are issues which remain unaddressed.  Women who are an important part of the urban economy and who remain behind the veils when it comes to assessment and calculation of real income are not left behind from this brunt. The present paper therefore is an attempt to understand the participation and contribution of women in Mumbai’s economy. It also tries to study whether there has been any change in the socio-economic status of women from Girangaon especially with two important processes- closure of mills and the initiation of gentrification. For this purpose a questionnaire survey was conducted in Girangaon and the collected data has been analysed qualitatively to understand the dynamics of capital and gender relations.
Applicability of Ancient Myths and Cultures used in the play Yayati
Authors: Dr. Uzma Khanam
Published: December 2021

Girish Karnad was among the most prolific playwrights of modern India. He took birth in the reign of British India, witness the independence of our country, learnt from the motherland of English, came back to his motherland only to become English poet, but ended up writing plays only in his native language, using the core of Indian origin in his pen. He had the best farsightedness of life which he projected very sharply in his plays. Each of his plays are enriched with the diverse forms of Indian cultures and myths. Although, it has never been mentioned of him studying psychology in a professional manner but his plays has always has the capacity of comforting or at least focusing the flaws of mankind. The main objective of this research paper is to highlight the ancient myths and culture used in one of the Karnad's play Yayati, and its relevancy in the present scenario.
From Alienation to Assimilation: Exploring Jhumpa Lahiri’s The Namesake
Authors: Dr. Padmini Sahu
Published: December 2021

Jhumpa Lahiri’s novel The Namesake is a kaleidoscope of the different shades of the individual relationships, the conflicts and confusions of the characters along with the cultural dilemma of the immigrants. The novel explores the diasporic conflict of the hyphenated identities of Indian-Americans. The immigrants in the novel live a confused existence as Indian-American, American-Indian and Overseas-Born-Indian. Being a foreigner is a sort of lifelong pregnancy for Ashima- a perpetual wait, a constant burden and an on-going responsibility. The novel focuses on cross-cultural conflicts, trauma and aspirations of the two generations of expatriates, Ashoke and Ashima who are not inclined towards getting Americanised, while Gogol and Sonia, the second-generation migrants face the intense pressure to be loyal to the old world and fluent to the new.
Gender Discrimination and Marital Discord in Shashi Deshpande’s The Dark Holds No Terrors
Authors: Ayesha Tasnim
Published: December 2021

Gender discrimination is a universal issue that results in women’s predicament. From time immemorial women become victims of gender disparities. It starts with one’s own family. The present paper explores the crisis of gender discrimination and marital discord in the life of the protagonist in particular and Indian women in general.  As a Child Sarita, the Protagonist tolerates gender discrimination and as a grown-up after her marriage due to marital discontentment. In this paper, many gender issues are explored which in due course of time decrease the moral spirit of women and make them weak and subordinate.  Although Sarita is an educated and economically independent woman still she silently suffers. When it crosses limits she raises her voice to assert her self-esteem.
The Dynamics of Binodini’s Character in Rabindranath Tagore’s Chokher Bali
Authors: Prerna Raj
Published: December 2021

Chokher Bali is considered as one of the best-known works of Rabindranath Tagore. The novel is a character-based work which is completely progressive in its essence. Binodini, the protagonist, is personification of intellect, grace, femininity, commitment and skills. She is a woman of desire in spite of being a widow. She is dreamer but at the same time deeply attached with her roots and reality. The dynamics of her character, the subtle nuances which she depicts are the epitome of aesthetic development in a character for the need of the plot. She rebels and out rightly rejects the paradigm of widowhood set by the patriarchy. The way Tagore portrays her character even the negatives, the flaws, the shortcomings in Binodini, appear to be very natural and spontaneous. Widowhood is all about seclusion and loneliness and the character of Binodini is all about debunking and shattering the myths related to widowhood. This paper is an attempt to focus on the artistic character of Binodini and realism attached with her aspirations.
Representation of the Namasudras in Literature
Authors: Joylal Das  , Dr. Kulanand Yadav
Published: December 2021

In Bengali Dalit literature, the Namasudra writers and poets play a crucial role in combating the complete social margsinalization of Dalits, their movements, iconography, experiences, and worldview. According to Manohar Mouli Biswas, “It is a counter cultural movement that has been aiming to undo the age-old caste ridden oppressions against the dalits by representing their lives, deprivations, struggles, histories and promoting their culture and liberation through literature” (Biswas XXV). There have recently been many books written by Dalit Namasudra authors, some of which have been published in English. Using these archives and texts, we may now see the Dalit Namasudras from a different perspective, one that previously would not have been possible through the use of traditional historical archives and writings. Among them mentionable are Manohar Mouli Biswas’s Amar Bhubane Ami Benche Thaki translated as Surviving in My World, Manoranjan Byapari’s Itibritte Chandal Jiban translated as Interrogating My Chandal Life, Dr. Manoranjan Sarkar’s Ekjan Daliter Atmakatha, Jatin Bala’s Sikar Chenra Jiban and so on. This article attempts to rebuild the alternate history of the Namasudras by deconstructing the standard material on the subject using historical and literary analysis.
Public health priority setting: A case for priority to the worse off in well-being during the COVID-19 pandemic
Authors: Horn Sindre August , Barra Mathias , Norheim Ole Frithjof , Solberg Carl Tollef
Published: December 2021

In Norway, priority for health interventions is assigned on the basis of three official criteria: health benefit, resources, and severity. Responses to the COVID-19 pandemic have mainly happened through intersectoral public health efforts such as lockdowns, quarantines, information campaigns, social distancing and, more recently, vaccine distribution. The aim of this article is to evaluate potential priority setting criteria for public health interventions. We argue in favour of the following three criteria for public health priority setting: benefit, resources and improving the well-being of the worse off. We argue that benefits and priority to the worse off may reasonably be understood in terms of individual well-being, rather than only health, for public health priority setting. We argue that lessons from the COVID-19 pandemic support our conclusions.
Keywords: COVID-19, Prioritarianism, Priority Setting, Public Health, Severity
Importance of individualized diagnosis and treatment in refractory epilepsy associated with intellectual disability
Authors: Bezerra Rebeka Ellen de Alencar , Correia Agda Yasmim Ferreira , Rolim Héryka Wanessa do Nascimento , Costa Júlia Ondrusch de Moraes , Rocha Maressa Ferreira de Alencar , Tavares Palloma Abreu , Marcolino Alinne Beserra de Lucena
Published: December 2021

Background: Epilepsy is a complex neurological disorder, that affects 0.5 to 1% of the population, with a diversified etiology, but with emphasis on its relation with genetics. Despite there are several therapies to treat it, in some cases, this variety is still insuficiente, featuring refractory epilepsy, frequent in people with intelectual disabilities (ID). Objectives: To analyze the scientific production about refractory epilepsy and ID. Methods: Integrative literature review that searched for international articles in the Virtual Health Library (VHL), using the keywords “Intellectual disability” AND “Refractory epilepsy” with the filter: “full text”. Results: From the 27 articles found, 2 were excluded for escaping the theme, having 25 articles as a final corpus and 2 thematic axes identified: (I) Genetic aspects related to ID and refractory epilepsy and (II) Therapeutic interventions in these patients. According to studies, refractory epilepsy in people with ID is related to mutations in some genes, such as: PCDH19, FMR1, TDP2, GABRB2 and SLC9A6. As for therapies for these patients, drugs such as stiripentol, lacosamide and benzodiazepines have been used, in addition to other interventions such as vagus nerve therapies, responsive neural stimulation, ketogenic diet, immunotherapy and resection surgery. Conclusions: The ID association with refractory epilepsy is strongly linked to genetic mutations, being essencial the genetic diagnosid to individualize the treatment and overcome insuficiente therapies for this epilepsy, especially in patients with associated ID, who tend to have a reduced life quality, having as primary objective the improvement of it.
Pain and dysfunction in amiotrophic side sclerosis
Authors: Sousa Danielle Antoniazzi Kirscht Auermann D'Allembert Costa , Gonçalves Julia Magalhães Waybe , Rangel Marcela Ferreira de Andrade , Paula Igor Roque de , Alencar Mariana Asmar
Published: December 2021

Background: Amyotrophic Lateral Sclerosis (ALS) is a progressive disease characterized by degenerative symptoms of motor neurons. Pain has been described as a frequent symptom and is associated with a negative impact on the life of the person with ALS, however it is often neglected in clinical practice. There is a need for a better understanding of its characteristics and its relationship with the clinical and functional aspects of ALS. Objective: To investigate the occurrence and characteristics of pain in individuals with sporadic ALS and to verify the association between pain and clinical, functional and mobility aspects. Design and setting: This is an exploratory cross-sectional study carried out at the Neuromuscular Diseases Clinic of HC / UFMG, located in Belo Horizonte, Minas Gerais, Brazil. Methods: Aspects about pain (occurrence, intensity, duration and location), mobility (turning in bed, sitting and standing, standing and walking) and functionality (ALSFRS-R) were evaluated. A descriptive and comparative analysis was carried out between the groups and a binary logistic regression analysis. SPSS was used and the significance level was 5%. Result: 51 people (56.9 ± 11.3 years) were evaluated. A total of 62.7% reported pain. Predominant characteristics of pain: chronic (n = 29; 90.6%), moderate intensity (n = 20; 62.5%), in the leg (n = 12; 37.5%), 50% in more than one location . The population in pain was composed of: women (p = 0.038), longer illness time (p = 0.001), worse results in the ability to sit and stand (p = 0.033), stand up (p = 0.024) and walk ( p = 0.001) and worse score in the ALSFRS-R (p = 0.021). In the present study, regression showed that the inability to walk functionally increases the chance of pain in ALS patients by 5.3 times. Conclusion: Pain is a frequent symptom among people with ALS, and a greater functional limitation seems to be associated with its presence. It is important that future studies investigate this relationship better.
Use of atorvastatin on pacients with chronic subdural haematoma: an integrative review
Authors: Evangelista Nathan Isaac Grassi , Traldi Matheus Antonio , Sousa Bianca de Oliveira , Zanotti Emanuella Campaner , Chocair Arthur Dal Fabbro , Mescolote Mariellen Andrade , Pinaf Vitor de Oliveira , Maehara Maria Eduarda Shono , Contarin Nicole Galvão , Grande Guilherme Henrique Dalaqua
Published: December 2021

Background: Chronic subdural hematoma (CSDH) tends to occur more commonly in elderly patients, usually develops after mild head trauma and the common treatment is surgical. Objective: To evaluate the effect of treatment with atorvastatin compared to surgical intervention in elderly people with CSDH. Design and setting: we performed an integrative review of studies available in four databases from 2010 to 2020. Methods: Studies were considered eligible for this review if they were randomized controlled trials comparing the use of atorvastatin treatment to surgical treatment associated with drainage trepanation in elderly patients diagnosed with CSDH. Results: titles and abstracts were screened and 20 articles of those were selected to be fully read, of which 4 remained. To Sheng Qui et al (2017) and Chan et al (2016), the use of atorvastatin may be beneficial in the management of CSDH, so that the volume of the hematoma reduced from 48.70 ± 20.38 to 16.64 ± 14.28mL with a sample size of 22 in the first month of oral atorvastatin. Min Xu et al. (2016) and Wang et al. (2013), with a sample of 22, found improvements in 85.7% and 95.7% of patients with CSDH in terms of volume and neurological deficits presented. Conclusion: The treatment with atorvastatin appears to be safe and effective for CSDH compared to surgical intervention in the elderly. However, further studies are necessary to validate the results and, thus, to put the evidence into practice.
Fetal surgery in the context of myelomeningocele: repercussions and prognosis
Authors: Balestra Amanda Fernandes de Sousa Oliveira , Teles Flávia Pascoal , Martins Karine Felipe
Published: December 2021

Background: Myelomeningocele (MMC) is a congenital malformation of neural tube closure. The clinical picture comprises sensory and motor deficits at the point of spinal cord injury and below, in addition to ventriculomegaly, which requires ventriculo-peritoneal drains (DVP). Exposure of nervous tissue to amniotic fluid and trauma to the uterine wall, generates secondary damage. Intrauterine correction is the gold standard for MMC and aims to reduce organic and functional sequelae, improving the patient’s neurological prognosis. Objectives: The objective of this work is to identify the impact of fetal surgery against MMC. Methods: An integrative literature review was carried out based on articles selected from the Google Scholar and Scientific Eletronic Library Online databases. Results: The benefits of intrauterine neurosurgery outweigh the harm, based on maternal complications. Such maternal risks are: oligohydramnios, spontaneous rupture of the membrane, uterine dehiscence, premature birth, infections, blood transfusion, acute lung edema and contraindication for vaginal delivery due to uterine scarring. For the child, all the studies analyzed showed the same gains, extremely significant when compared to postnatal surgery: better cognitive development, greater probability of walking without using orthoses, less need for DVP. The gains from the fetal surgery technique go beyond the postnatal intervention. Conclusions: Therefore, the importance of early intrauterine treatment, in a properly equipped place and by qualified professionals, is reiterated, offering comprehensive care to pregnant women, preventing potential impasses and aiming at a better prognosis and quality of life for the child.
Garcin syndrome by giant cell lung tumor
Authors: Yamashita Emilly Sayuri , Silva Júnior Hilton Mariano da
Published: December 2021

Context: Garcin syndrome is the presence of at least seven ipsilateral cranial nerves palsy, absence of long tract motor or sensory disturbance and intracranial hypertension, and skull base osteoclastic injury. Case report: A 46-year-old woman presented left hypoesthesia. One week later she developed left palsy peripheral facial, the Bell’s palsy. Then, she manifested left deafness and diplopia. The MRI revealed an extra axial lesion in left pre-pontine area. She reported weight loss of 11 kg in 4 months and denied smoking. Palpable lymph nodes were noted on left cervical chain. Neurological examination revealed left cranial nerves V, VI, VII, VIII, IX, X, XI and XII paralysis. Tonus, strength and sensitivity were normal in 4 limbs. After four months, another MRI exhibited an extra axial tumor along the meninges. Chest CT showed an ill-defined left lower lobe lesion. The biopsy revealed a giant cell lung carcinoma (GCC), with cervical bones and encephalus metastasis. She underwent a WBRT radiotherapy. After seven sessions, she presented a cardiorespiratory arrest with death. Conclusion: We can conclude that Garcin syndrome rare condition can have a GCC metastasis involvement. GCC is common um male and smokers. This is the first report of Bell’s palsy as a primary manifestation of GCC, and is also the first case that GCC have Garcin syndrome association. We can assume GCC is a etiology of Garcin syndrome and Bell’s palsy, including in non-smokers.
Use of glucocorticoids in acute spinal cord injuries: a last decade analysis
Authors: Pinto Guilherme Dantas Campos , Wanderley Gabriela Arcoverde , Cruz Gustavo Sales Santa , Alves Luís Eduardo Nobrega Nogueira , Horta Wagner Gonçalves
Published: December 2021

Introduction: The early use of methylprednisolone (MP) pulse represents the only treatment suggested to stop neurological outcomes in non-operable acute spinal cord injuries (ASCI). The protocol of the drug use dates from the 1990s and results of the NASCIS 2 randomized clinical trial. However, such conduct is still an issue for discussion, due to limited evidence. Objective: To compare the results of the main studies about the use of MP in the ASCI published in the last decade. Methods: This is a narrative review of the use of MP in the ASCI. A search was carried out using the keywords “acute spinal cord injury” and “methylprednisolone” on PubMed and Cochrane, in April 2021. Indexed meta- analysis from 2011 to 2020 were used as filters. All studies (3) were selected for analysis and comparison of their results. Results: Cochrane meta-analysis, in 2012 concluded that MP administration results in an improvement of the neurological outcome and presents good safety margin. Although it agrees with the drug harmless, a Canadian study in 2017 pointed out the MP offers a poor motor function benefit in the long term. Recently, in 2019, a meta-analysis from the American Academy of Neurology, did not recommend the use of MP in the ASCI, because of the lack of benefit in neurological function and increased occurrence of complications after the adoption of the therapy. Conclusion: Data from the last ten years of analysis demonstrates a progressive decrease in the evidence in favor of the use of MP in the ASCI.