bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonic phased-array inspection of HVOF-coated internal diameters of cylindrical components
Authors: Baiotto Ricardo ,   Centre Technologique en Aérospatiale (CTA), Arѐs Olivier , Walter Julien ,   Centre Technologique en Aérospatiale (CTA),   Centre Technologique en Aérospatiale (CTA)
Published: July 2024

High-velocity oxygen Fuel (HVOF) is a coating process that produces a dense, tightly bonded layer that significantly enhances wear resistance on the coated component. Our partner, the National Research Council of Canada (NRC), develops innovative HVOF coating methods for cylindrical parts' internal surfaces used in critical applications such as landing gear components. However, to be adopted by the aerospace industry, it is necessary to demonstrate that these HVOF-coated parts can be reliably inspected using non-destructive testing (NDT) techniques. Although inspections using conventional ultrasonic of HVOF-coated parts are already well established, phased array ultrasonics (PAUT) have the potential to increase inspection productivity, defect detectability and traceability. Therefore, this study focused on the evaluation of PAUT methods performance for assessing internally coated cylindrical components in terms of defect type, size and orientation.
PENGARUH LITERASI KEUANGAN TERHADAP KEBERLANGSUNGAN USAHA MIKRO KECIL DAN MENENGAH (UMKM) DI KABUPATEN SUMBAWA
Authors: Sudiyarti Nining , Rachman Rosyidah , Rahayu Dinda Fuji
Published: July 2024

This study aims to determine the effect of financial literacy on the sustainability of micro, small and medium enterprises (MSMEs) in Sumbawa District. The type of this study was associative. This study used a quantitative data obtained directly from primary sources, namely MSME actors in Sumbawa District using research instruments in the form of questionnaires. The questionnaire was prepared based on research variable indicators, namely financial literacy and the sustainability of MSME businesses. All of data was studied using simple linear regression analysis techniques, partial parameter hypothesis testing (t test), and coefficient of determinant testing (R2). The results of this study showed that the financial literacy had a positive and significant effect on the sustainability of micro, small and medium enterprises in Sumbawa District. The ability of financial literacy to effect the sustainability of MSMEs in Sumbawa District was 35.6%, while the remaining 64.4% was effected by other variables outside this study model, such as the use of e-commerce, product innovation, and readiness to change.
ANALISIS DETERMINAN TINGKAT KEMISKINAN DI KABUPATEN SUMBAWA: TINGKAT PENGANGGURAN TERBUKA, UPAH MINIMUM DAN PDRB
Authors: Purwadinata Subhan , Tara Ulan
Published: July 2024

This study aims to analyze the determinants of poverty rate in Sumbawa District, which in this study was thought to be influenced by the open unemployment rates, minimum wages and GRDP, either partially or simultaneously. The type of this study was associative. The type of data used was quantitative obtained from secondary sources through annual reports, documents and archives collected and published by the Central Statistics Agency (BPS) of Sumbawa District regarding the open unemployment rate, minimum wage, GRDP and poverty level in Sumbawa Regency in 2010-2021. Data analysis was carried out using multiple linear regression analysis, partial hypothesis testing (t test), simultaneous hypothesis testing (F test), and determinant coefficient testing (R2). The results of this study showed that in partially the open unemployment rate had a positive and significant effect on the poverty rate in Sumbawa District, and GRDP had a negative and significant effect on the poverty rate in Sumbawa District, but the minimum wage had no significant effect on the poverty rate in Sumbawa District. Meanwhile in simultaneously, the open unemployment rate, minimum wage and GRDP had a significant effect on the poverty rate in Sumbawa District. The ability of the open unemployment rate, minimum wage and GRDP variables to influenced the poverty rate in Sumbawa District was 94.8%, while the remaining of 5.2% was influenced by other variables outside this study model, such as education and health factors, economic growth and human development index.
DAMPAK PENERAPAN TEKNOLOGI INFORMASI DALAM BIDANG E-COMMERCE TERHADAP PENDAPATAN UMKM DI KABUPATEN SUMBAWA
Authors: Hapan Fransiska Maya Kusuma Yanti , Usman U
Published: July 2024

This study aims to determine the impact of the implementation of e-commerce information technology on MSMEs income in Sumbawa District. The type of this study was comparative study used to compare the income levels of MSMEs in Sumbawa District before and after the implementation of e-commerce information technology. The type of data used in this study was quantitative data obtained directly from respondents using a questionnaire. The type of data used in this study was quantitative data collected from existing sources in the form of annual reports, documents and archives contained in MSMEs in Sumbawa District. Data analysis in this study was carried out using the two-average difference test technique. These testing techniques include the data normality test with Kolmogorov Smirnov test, paired samples statistics test, paired samples correlations test, and paired samples t-test. The results of this study showed that the implementation of e-commerce information technology had a positive impact on the income level of MSMEs in Sumbawa District. The income earned by MSMEs in Sumbawa District had increased after the implementation of e-commerce information technology compared to the income before the implementation of e-commerce information technology. Thus, it can be stated that the implementation of e-commerce information technology is a very important aspect in supporting the increase in MSME income in Sumbawa District.
EFEK REWARD TERHADAP MOTIVASI KERJA PEGAWAI DI KANTOR DINAS KESEHATAN KABUPATEN SUMBAWA
Authors: Sarita Maulinda , Pamungkas Binar Dwiyanto
Published: July 2024

This study aims to determine the effect of rewards on employee work motivation at the Health Office of Sumbawa District. The type of this study was associative study used to examine the significance effect of rewards on employee work motivation at the Health Office of Sumbawa District. The type of data used in this study was quantitative data obtained directly through questionnaires distributed to research respondents, namely all employees at the Health Office of Sumbawa District. The number of respondents in this study was 84 people who were determined using the Slovin formula and selected using probability sampling techniques with the simple random sampling method. The all of data were analyzed using simple linear regression analysis techniques, partial hypothesis testing (t test), and determinant coefficient test (R2. The results of this study showed that the rewards had a positive and significant effect on employee work motivation at the Health Office of Sumbawa District. The total effect of rewards on employee work motivation at the Health Office of Sumbawa District was 30.9%, while the remaining of 69.1% was effected by other factors not examined in this study, such as leadership style, work discipline and job satisfaction.
Scheduling Preventive Maintenance to Increase the Effectiveness of Injection Molding Machines Using the Overall Equipment Effectiveness Method at PT. Mah Sing Indonesia
Authors: Rakes David , Windyatri Hasyrani , Suhendra Suhendra
Published: July 2024

This study aims to evaluate the Overall Equipment Effectiveness (OEE) in a production environment from January to December 2023. Utilizing quantitative analysis, monthly OEE values were assessed, revealing significant variations. No month achieved the World Class OEE standard of 85%, with the highest value recorded in August (54%) and the lowest in December (35%). The average OEE for the period was approximately 44.67%, substantially below the established benchmark. The primary factor contributing to the low OEE was identified as the low Availability rate, leading to significant machine downtime. Following the implementation of a structured preventive maintenance schedule, machine downtime markedly decreased from 21,540 minutes to 1,464 minutes. Recommendations for moulding machine maintenance include weekly servicing outside production hours, during production halts, or after producing 260,000 units. For other machines, monthly, semi-annual, or annual maintenance schedules are proposed. The study concludes that proper preventive maintenance scheduling can significantly enhance OEE and reduce machine downtime, thereby improving overall production efficiency.
The relationship between Cognitive Behavior Therapy (CBT) and Depression treatment outcomes: A review of literature
Authors: Kumar Sandeep ,   School of Applied and Behavioral Sciences, NIILM University Kaithal Haryana India
Published: July 2024

Depression or depressive disorder is the common mental disorder. It affects the day-to-day life of the person and impact the outcomes at the workplace. As per WHO data, 3.8% of the world population experience depression. Suicidal attempts are also very high among depressed people. Around 75% of depression suffering population don’t receive any treatment. Due to social stigma, lack of mental health professionals and economical barriers only a few portions of the population receive psychotherapies. The current study reviews the literature related to cognitive behavior therapy outcomes analysis. No direct data collection methods are used in the study, it only reviews the literature to analyze the outcomes of CBT in depression treatment. The qualitative analysis methods were used to compare the data and draw conclusions. It concludes that CBT is efficacious in the acute treatment of depressive disorder.
The influence of the media on the recognition and promotion of the cultural heritage of the city of Novi Sad: Statistical findings and analysis
Authors: Penjišević Aleksandra , Sančanin Branislav , Stojanović Katarina
Published: July 2024

Authentic cultural and historical heritage plays a significant role in shaping the appealing image of cities and their development. Novi Sad, the second largest city in the Republic of Serbia, stands out for its concentration of unique buildings, underscoring its pivotal role as a tourist destination rooted in both tangible and intangible cultural heritage. The influence of media convergence has facilitated the dissemination of a substantial amount of data and information in the virtual realm concerning the cultural and historical heritage of Novi Sad, transcending temporal and spatial constraints. The visibility of heritage in the age of globalization, when appropriately interpreted, can be viewed as a contribution to the cultural mosaic, as realized by the authors through three media-research questions. A survey was conducted among 133 citizens of Novi Sad (n=133). The significance of understanding cultural heritage has been established, with respondents holding a "Doctor of Science" degree exhibiting the highest level of knowledge/information. Those expressing an interest in cultural heritage were identified as having the primary reasons for possessing extensive knowledge, while lack of interest and inadequate media representation were cited as reasons for limited knowledge. It has been demonstrated that social networks wield considerable influence in promoting cultural heritage, with YouTube and Instagram exerting the greatest impact. The objective of this study is to elucidate the position and function of the media in promoting the cultural heritage of Novi Sad by fostering a more comprehensive and responsible approach toward the legacy bequeathed by preceding generations, with the aspiration of captivating and motivating segments of society beyond the academic and professional spheres to engage in further creative endeavors.
The method of calculating price reductions in contracts for the international sale of goods
Authors: Popović Milica
Published: July 2024

The buyer's right to a price reduction represents an institution of Roman law that has, over time, become widely accepted in legal systems with a continental legal tradition. In the context of international sales of goods, Article 50 of the United Nations Convention on Contracts for the International Sale of Goods, which regulates this right, is of particular importance. This paper analyzes the method of calculating price reductions as one of the contentious issues regarding exercising the right to a price reduction, in terms of Article 50 of the Convention. For a comprehensive understanding of the problem, the paper presents the history of the emergence, the sources of the right to a price reduction in contracts for the international sale of goods, as well as the conditions for its application. The central part of the paper is the issue of the method of calculating price reduction, with special reference to the time and place of determining the value of conforming and non-conforming goods for the purpose of their comparison and the application of the calculation formula. These issues were controversial even at the time of the adoption of the Convention itself, and today they are still the subject of discussions in legal theory, while case law is not sufficiently harmonized. The aim of the paper is to draw a conclusion about the method of calculating price reduction, through the analysis of the Convention's provisions, and solutions given in theory, as well as in case law.
What do they know? Is climate change education necessary in primary schools in Serbia
Authors: Leščešen Igor , Basarin Biljana , Vujičić Miroslav
Published: July 2024

Climate change is a global crisis exacerbated by human activity and a matter of urgent concern. There is a significant knowledge gap among primary school students in Serbia, as the topic of climate change is barely covered in the curriculum. This study examines their awareness, knowledge and attitudes. Of the participants, 96.6% are aware of climate change, but their knowledge and attitudes vary considerably. Some 80.10% expect climate change to have a significant impact on humans through floods (90%), droughts and temperature increases (85% each). Further results show that schools are a key source of information (35.10%), followed by television (30.10%) and the internet (14.90%). In summary, this study highlights the need for comprehensive, multidisciplinary climate education to address different levels of awareness, encourage informed and proactive responses and engage young voices in discussions about climate change.
Examining the prevalence of thrombophilia in women with fetal loss
Authors: Mandić Danijela
Published: July 2024

Introduction: In addition to antiphospholipid syndrome (APS), inherited thrombophilia is one of the most important hematologic disorders that can lead to pregnancy complications such as fetal loss, intrauterine growth restriction (IUGR), preeclampsia, and fetal death. The frequency of spontaneous abortions is up to 20% of all clinically recognized pregnancies. Objective: The aim of this study was to determine the frequency of inherited thrombophilia in women with fetal loss, analyze the gestational period and age at which fetal loss occurred, and assess the frequency of successful pregnancies after prophylactic use of low molecular weight heparin (LMWH). Material and methods: The study was designed as a 30-month retrospective observational study at the Clinic for Gynecology and Obstetrics of the University Clinical Center of the Republic of Srpska, involving 69 patients with one or more fetal losses in the second and third trimesters of pregnancy, or two or more repeated fetal losses in the first trimester of pregnancy. All patients underwent tests to detect the presence of thrombophilia. Results: The average age of the patients was 30.7 years, and they had a total of 167 unsuccessful pregnancies. Thrombophilia was proven in a total of 40 patients (58%). The results showed that combined thrombophilia, including polymorphisms, occurred most frequently -47.5% (n=19). In the group of patients with inherited thrombophilia, low molecular weight heparin (LMWH) was administered to 22 patients and it resulted in a successful pregnancy outcome in 19 patients. Conclusion: Based on the conducted research, it can be concluded that COM-bined thrombophilia, including combined polymorphisms MTHFR and PAI-1, carry a significantly higher risk of pregnancy loss in patients of all age groups. Age over 35 years is a risk factor for higher frequency of spontaneous abortions irrespective of the type of inherited thrombophilia. The use of LMWH significantly improves pregnancy outcomes in patients with inherited thrombophilia and previous pregnancy losses. 154 Jun 2024. | Volumen 5 / Broj 2 | SrpSki MedicinSki čaSopiS lekarSke koMore procena učestalosti trombofilije kod ispitanica sa gubitkom ploda examining the prevalence of thrombophilia in women with fetal loss
Red blood cell adaptations induced by exercise
Authors: Stefanović Radoš , Ristić Biljana , Drvenica Ivana
Published: July 2024

Exercise significantly increases blood flow and perfusion in active muscles to enhance oxygen and nutrient delivery. These enhanced demands affect blood rheology and red blood cell (RBC) characteristics, leading to specific adaptations. These adaptations are influenced by exercise type, intensity, frequency, duration, and individual characteristics of subject population (gender, age, nutritional status etc.). This review aims to comprehensively summarize the different adaptations of erythrocytes to short-term and long-term exercise, as well as the mechanisms of their occurrence, considering the influence of various factors. The results from the previous research indicate that regular exercise enhances the metabolic, structural, and functional capabilities of RBCs. These adaptations include improved energy balance, increased cell turnover rate, improved membrane stability, as well as better antioxidative defense. Despite potential risks such as "sports anemia", exercise also affects the dynamics of hemoglobin and iron concentrations, as well as the appearance of extracellular hemoglobin. Overall , the literature highlights the critical role of exercise in maintaining optimal erythrocyte function, improving circulation, and overall health, offering potential therapeutic benefits. Through a critical review of literature data on the influence of exercise on the characteristics and functions of erythrocytes, this paper can be a useful guideline for the interpretation of clinically significant results in physically active individuals .
Chemsex related sexual behaviours and sexually transmitted infections among men who have sex with men in Belgrade
Authors: Bjekić Milan , Salemović Dubravka , Vlajinac Hristina , Marinković Jelena
Published: July 2024

Background/Aim: Chemsex is a common practice among men who have sex with men (MSM). The aim of this study was to assess the prevalence of chemsex in the MSM population in Belgrade and its association with their behaviour and sexually transmitted infections. Methods: A cross-sectional study was conducted at two institutes in Belgrade over a six-month period and it covered 469 MSM. Data on demographic characteristics, reasons of attendance, sexual history, sexual behaviour and sexualized drugs use in the previous six months were collected from all participants by the use of a questionnaire. Results: Chemsex was practiced by 123 (26.2%) participants and GHB/GBL was most commonly used (84.6%). According to the results of multivariate logistic regression analysis those practicing chemsex differed from other participants significantly, independently of other factors, in the following characteristics: they were more frequently employed (Odds Ratio -OR=2.50, 95% confidence interval -95%CI=1.19-5.26, p=0.015), had a greater number of sex partners in the last six months (OR=1.39, 95%CI =1.14-1.72, p=0.002), had condomless anal sex (OR=3.23, 95%CI=1.64-6.25, p=0.001) and group sex more frequently in the last six months (OR=4.35, 95%CI= 2.38-7.69, p<0.001), used a greater quantity of alcohol (OR=2.50, 95%CI 1.54-4.00, p<0.001), and had bacterial STIs more frequently in the last year (OR=2.70, 95%CI=1.61-4.54, p<0.001). The frequency of recreational drugs use was lower in those engaged in chemsex (OR=0.59, 95%CI=0.41-0.88, p=0.009). Conclusion: MSM engaged in chemsex practiced high risk sexual behaviour and suffered from bacterial sexually transmitted infections more frequently. The growing phenomenon of chemsex among MSM requires raising awareness about issues regarding chemsex both among the members of this vulnerable population and healthcare workers.
The effect of the decisions of the Constitutional Court of Bosnia and Herzegovina on the changes in the organization of the authorities of the entities and Bosnia and Herzegovina: Has the Constitutional Court realized the role of protector of the constitution and constitutionality in Bosnia and Herzegovina?
Authors: Pilipović Milan
Published: July 2024

The decisions of the Constitutional Court of Bosnia and Herzegovina have significantly influenced the changes in the constitutional organization of the authorities and entities of Bosnia and Herzegovina (B&H). In the decisionmaking processes, the Court judges held diametrically opposed views, and the explanations of the Court's majority decisions were disputed in terms of both theoretical and legal aspects of the matter at issue. By passing the decision on the "constituent power of the people" on the entire territory of Bosnia and Herzegovina, the Constitutional Court of Bosnia and Herzegovina influenced significant changes in the constitutional organization of the authorities in the two B&H entities: Republika Srpska and the Federation of Bosnia and Herzegovina. The manner in which this decision was implemented is contrary to the provisions of the Constitutions of these two entities and the provisions of the Constitution of B&H. In effect, the amendments were imposed by the decision of the High Representative for Bosnia and Herzegovina. The High Representative acted as a constitutional and legislative authority, enacting laws which, against the will of the entities, established new competences and new institutions of Bosnia and Herzegovina and, thus, revised the Constitution of Bosnia and Herzegovina. By accepting the competence to assess the constitutionality of the laws passed by the High Representative for Bosnia and Herzegovina (both two decades ago and today), the Constitutional Court decided that they were in accordance with the Constitution of Bosnia and Herzegovina, thus giving legality to the activities of the High Representative and the new institutions of Bosnia and Herzegovina which do not exist in the Constitution of Bosnia and Herzegovina. The decision of the Constitutional Court of B&H influenced the change in the organization of the governing powers in Bosnia and Herzegovina. Therefore, the author concludes that the Constitutional Court of Bosnia and Herzegovina has not fulfilled its role as protector of the Constitution and organization of the authorities of Bosnia and Herzegovina and the two entities.
Chemical Composition, Antioxidant, and Antifungal Characteristics of the Essential oil of Mansoa alliacea (Lam.) A.H. Gentry
Authors: PAL ARADHANA , SINGH N. N. TRIPATHI AND POOJA
Published: July 2024

The essential oil of Mansoa alliacea (Lam.) A.H. Gentry was characterized on the basis of its gas chromatography-mass spectrometry analysis, physico-chemical, antioxidant, and antifungal properties. M. alliacea essential oil (MAEO) had a complex mixture of eight major and minor components. The main constituents were disulfide, di-2-propenyl (cas) 1, 2-bis(allyl) disulfane (66.90%), trisulfide, di-2-propenyl (23.81%), and 1-Propene, 3,3'-thiobis- (cas) 4-thia-1,6-heptadiene (4.44%). The optical rotation and refractive index of oil were found to be 4.083 and 1.337, respectively. The oil showed potent antioxidant activity in 2, 2'- diphenyl-1-picrylhydazyl, ?-carotene, and ABTS assays. Oil showed fungitoxic activity against nine fungal species. The investigations confirm that MAEO has promising potential to be used as a biopesticide and as a preservative agent in food and pharmaceutical systems. . KEYWORDS :Antifungal, Antioxidant, Essential oil, Gas chromatography mass spectrometry, Mansoa alliacea
Pengaruh Peran Ganda Stres Kerja dan Beban Kerja Terhadap Kinerja Pegawai Wanita UPTD Puskesmas Ngadiluwih
Authors: Erinda Dita Ayu Putri  , Sonny Subroto  , Nuril Aulia Munawaroh
Published: July 2024

This research is motivated by a company engaged in the agency. The purpose of this study was to explain the effect of dual roles, work stress and workload on the performance of female employees. This research was conducted at UPTD Puskesmas Ngadiluwih. This research method used is a quantitative method using questionnaires as data. This research uses purposive sampling technique. The sample in this study were all female employees as many as 30 employees of UPTD Puskesmas Ngadiluwih. the technique used to analyze is with the SPSS IMB version 27 program. Data analysis techniques in this study with validity test, reliability test, classical assumption test, multiple linear regression analysis, t test, f test and R2 determination coefficient test. The results of this test concluded that the t test showed that the dual role variable partially had a significant positive effect on employee performance with a significant value of <0.001 and a tcount value of 3.874. The work stress variable partially has a non-significant positive effect on employee performance with a significant value of 0.065 and a tcount value of 1.925. The workload variable partially has a positive and insignificant effect on employee performance with a significant value of 0.932 and a tcount value of -0.086. And the results of the f test show that the dual role variable, work stress and workload have a significant effect on the performance of female employees with a significant value of <0.001 and a Fcount of 18,145 .
Big Data Analytics
Authors: Bhat Mrs. Swati ,   Assistant Professor  Dr. D. Y. Patil Institute of Management and Research Pimpri, Pune, Maharashtra, India, Chavan Dr. Rachana , Patil Mrs. Prajali , Patil Mrs. Rekha ,   Assistant Professor  Dr. D Y Patil Center for Management & Research  Pune, Maharashtra, India,   Assistant Professor  Dr. D.Y. Patil Centre for Management and Research Pimpri, Pune, Maharashtra, India,   Assistant Professor  Dr. D. Y.  Patil College of Computer and Business Studies  Pune. Maharashtra, India.
Published: July 2024

Big Data Analytics (BDA) is a dynamic and fast-developing discipline that has many applications in sectors such as healthcare, medicine, advertising, marketing, and sales. This book extensively explores all facets of Big Data Analytics and comprehensively addresses the topic matter. The content includes various examples, sample scripts, case studies, and real-life analytics of datasets such as toys, chocolates, vehicles, and student’s GPAs. This book is designed to cater to the needs of undergraduate and postgraduate students studying computer science and engineering, information technology, and other related fields. Software developers will find it beneficial as well.
A estratégia narrativa em Insubmissas lágrimas de mulheres: uma leitura interseccional
Authors: Lira Albânia Celi Morais de Brito
Published: July 2024

Personagens e escritoras negras têm sido marcadas por ausências e estereótipos dentro do sistema literário nacional. Conceição Evaristo tem, ao longo de décadas como escritora negra, feito o enfrentamento a essas marcações. A escrevivência, escrita marcada pela condição de mulher negra proposta por Evaristo (2005), para sua prática como escritora, é a estratégia narrativa de enfrentamento ao cânone, na medida em que descortina processos de violência e silenciamento de personagens femininas.  Dessa forma, este artigo tem por objetivo analisar como se estabelece esse enfrentamento na obra Insubmissas lágrimas de mulheres (2011). Como a narradora interliga as narrativas e personagens a partir de seus relatos de violência e de como subverteram tais violências para contar suas experiências. Pretende-se, portanto, a partir da perspectiva de Cândido (2011) acerca da literatura como direito humano, estabelecer diálogo com a narrativa de Evaristo, a fim de se apontar como a autora constrói uma teia de resistência de personagens femininas negras dando-lhes a voz e o lugar nas narrativas. Para fundamentar tal objetivo, o presente artigo toma por base pesquisadoras do feminismo negro, cujos debates apontam para a interseccionalidade, como Gonzalez (1984), Akotirene (2019), Collins (2016), Crenshaw (2002), a partir das quais se realiza a revisão bibliográfica. Com essa leitura da obra, resta demonstrada a intencionalidade da escrevivência, como estratégia narrativa para dar voz e visibilidade a personagens femininas tradicionalmente silenciadas e estereotipadas pelo cânone.
Flexible solid-solid phase change material with zero leakage via in-situ preparation for battery thermal management
Authors: Li Xinxi , Yang Wensheng , Li Canbing , Deng Jian , Huang Qiqiu , Jia Wei , Mao Ya , Zou Yuntao , Wu Yuhang , Tian Juxiong , Zhang Guoqing , Tang Xianwen , Shao Dan , Zhang Yanrui , Zhu Siwei , Li Xuxiong
Published: July 2024

Composite phase change material (CPCM) has great potential in addressing the challenges associated with thermal energy storage and thermal management. However, the flexibility and latent heat capacity of CPCM exist contradiction, hindering its wide application, especially in thermal management field. Herein, a novel solid-solid polyurethane structured phase change material including as chain segments PEG4000 and hexamethylene diisocyanate coupling with expanded graphite (PHE5) has been proposed and prepared via in-situ approach. Expand graphite is uniformly distributed and the carbamate group is produced by in-situ preparation, the high latent heat and anti-leakage characteristics of PHE5 are beneficial to sustain a constant mass with zero leakage even under 150�� heating condition. At a 3 C discharge rate, the battery module with PHE5 can reduce the maximum temperature to 59��, which is lower than the PE-based module. Additionally, the battery system can maintain the temperature difference below 4.5��, ensuring uniform temperature within the battery module. The flexibility and controlling temperature capabilities of PHE5 can effectively dissipate heat during charge and discharge cycles, and the mechanistic analysis of PHE5 with anti-leakage property can enhance the battery thermal safety, achieving comprehensive protection throughout normal operating and extreme conditions. Thus, this research reveals that solid-solid CPCM with polyurethane structured can improve the flexible and anti-leakage properties via in-situ preparation, which will offer an effective thermal safety solution for battery module, substantially enhancing the safety of millions of drivers and passengers.
Burden of Kala-azar on the Local Health System in Danusha and Mahottari Districts of Nepal
Authors: Adhikari Shiva Raj , Maskay Nephil Matangi , Sharma Bishnu Prasad
Published: July 2024

Health System in the Mahottari and Danusha Districts of Ne pal. The Local Health System in those districts are represented by the purposive selection of Janakpur Zonal Hospital and Mahottari District Hospital since those institutions have the sole facility in their respective districts for diagnosis and treatment of Kala -azar. The objective of the study was to determine the absolute burden of Kala -azar on the Local Health System and its burden relative to other diseases such as encephalitis, malaria andtuberculosis. The materials were obtained through both medica l records and structuredquestionnaires with key personnel in those institutions. The results indicate that there isa significant burden of Kala -azar on the Local Health System whose direct cost can beseen by the total cost to doctors and the nurse staff as well as the indirect cost throughbed occupancy. In addition, analysis of data suggest that comparison for Kala-azar, inrelation to other diseases, is tricky since its definition of the Local Health System ismuch narrower vis-à-vis other diseases.
Validation of the Nepali version of beck anxiety inventory
Authors: Kohrt B A , Koirala N R , Sharma V D , Nepal M K
Published: July 2024

This study validates a Nepali version of the Beck Anxiety Inventory (BAI). The instrument wascompared against a gold standard diagnosis of generalized anxiety. The diagnosis of GeneralizedAnxiety Disorder (GAD) was made according to the Diagnostic and Statistical Manual of MentalDisorders, Fourth Edition. GAD subjects were selected both from outpatients at Tribhuvan UniversityTeaching Hospital and a rural sample from Jumla. Healthy (non-psychiatric diagnosis) cases weretaken from a community sample in Jumla; their “healthy” status was obtained by achieving a scoreless than 2 on the Nepali General Health Questionnaire-12. This study identifies acceptable sensitivityand specificity ranges for the measure. A cut-off of 13/14 for the BAI provides sensitivity of 0.91 andspecificity of 0.89. Reliability for the BAI is comparable to most studies in Western countries (0.89). Afactor analysis of the BAI evokes four factors. A number of items reduce the validity and internalreliability of this measure. Somatic items poorly distinguish psychiatric cases; this may be due to highburden of physical illness in rural Nepal. Overall, the BAI appears to be a good instrument for clinicaland research use in Nepal.
Behavioural medicine: an integration of psychology and health
Authors: Sinha U K , Nepal M K
Published: July 2024

The process of evolution in health sciences has followed a similar path from being analytical tosynthesized or holistic. Multidisciplinary approach has taken over the specialized approach in thearea of health care delivery that follows bio-psycho-social paradigm in the understanding andmanagement of health problems in the general hospital setting. Emergene of Behavioural Medicineis the result of such evolutionary process. Behavioural Medicine is the interdisciplinary fieldconcerned with the development and integration of behavioural and biomedical sciences, knowledge,and techniques relevant to health and illness and the application of this knowledge and thesetechniques to prevention, diagnosis, treatment, and rehabilitation. The present article reviews thehistorical aspects of the emergence of Behavioural Medicine on the background of biopsychosocialmodel and impact of life-style factors on health along with the clinical application and role ofBehavioural Medicine in the primary prevention. Relevance of Behavioural Medicine in thecontext of Nepal, and the contribution of clinical psychologists in the health care system of thecountry along with the need for accepting them in the mainstream of health professionals arehighlighted.
Paediatric clinical teaching: comparison of two medical schools
Authors: Sharma P.R. , Bhattarai P. , Sharma M.
Published: July 2024

Clinical paediatric teaching in undergraduate medical education is important to impart essential skillsin communicating, diagnosing and formulating management plans for common childhood illness of the country so as to reduce existing high mortality and morbidity rates. Private medical colleges are facing challenges in paediatric teaching because of the unavailability of paediatric patients with different clinical signs; both the inpatient and outpatient paediatric attendance at their teachinghospitals is very discouraging at present. At the same time, they are plagued with inadequateinvestigative facilities. We conducted a study to evaluate some of the clinical skills in the students during their final examination. The study showed marked differences among students in some of theessential neonatal skills and other common paediatric problems. Statistically significant differences were found in the majority OSCE stations. The mean wrong answers in one medical school were 42.2% (Std D. 30.1 %) and the other school was 24.9% (Std. D 18.3 %). In one medical school the mean of signs that were rightly performed for the essential neonatal examination were 1.4% (Std. Dev. 1.1 %) and in other schools it was 10.4% (Std. Dev 6.1%). This shows that it is necessary to standardizepediatric teaching in the country’s medical schools.
How I do it: Bullet removal from head and neck regions.
Authors: Baskota D. K.
Published: July 2024

A retrospective, observational study to find out a reliable, simple and cost effective new technique (Needle guided technique) for exact localization and successful removal of bullets from head and neck regions was currently carried out in the Department of ENT- Head & Neck Surgery of Tribhuvan University Teaching Hospital Kathmandu, Nepal. Altogether two bullets of two patients were exactly localized and removed successfully without any complication in this region by applying this newtechnique. The result of this study so far indicates that “Needle guided technique” is reliable, simple and costeffective technique to localize bullets especially in head and neck regions followed by their successful removal, which is recommended to doctors working without advanced radio diagnostic support and even for those who cannot afford for the advance radio diagnosis.
Cephalosporin utilization in the inpatient wards of a teaching hospital in western Nepal
Authors: Shankar P.R. , Subish P. , Dubey A.K. , Deshpande V.Y.
Published: July 2024

Objective and rationale: Information on the utilization of cephalosporins is lacking in hospitals in western Nepal. The present study was carried out to obtain information on the demographic characteristics, cephalosporin prescribing patterns, sensitivity patterns of commonly isolated microorganisms, mean ± SD cost of drugs per patient and the cephalosporin utilization in defineddaily dose (DDD)/100 bed-days.Methods: A retrospective analysis of the case records of patients admitted to the inpatient wards of the Manipal Teaching Hospital (a tertiary care hospital in Pokhara, Nepal) and prescribed a cephalosporin during the study period (1.11.2003 to 29.02.2004) was carried out. The median length of stay and cost of the drugs prescribed during the stay was calculated. The frequency of prescribing of other antibiotics coprescribed with cephalosporins was noted.Results: 252 patients (2.56% of total patients) were prescribed cephalosporin. The median length of stay was 9 days. One hundred eighteen patients (46.8%) were prescribed cephalosporin for prophylaxis and 30 patients (11.9%) for bacteriologically proven infections. E.coli, Klebsiella spp., S.aureus, Acinetobacter spp., P.aeruginosa, P.vulgaris and Enterococcus spp. were the common organisms isolated and were generally sensitive to the prescribed cephalosporins. Mean ± SD cost of drugs per hospital admission was 34.78 ± 26.06 US$ and cephalosporins contributed to 51.56% of the total drug costs. Cephalosporin utilization was 4.6 DDDs/100 bed days. Metronidazole was the most commonly coprescribed.Conclusions: The use of cephalosporins was lower than that reported in the literature. Antibiotic use policies for postoperative prophylaxis and infection control policies for the wards are required.
Vaccination should be a priority approach for Japanese encephalitis prevention in Nepal
Authors: Joshi A.B.
Published: July 2024

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Body mass index and its relation with hypertension, diabetes mellitus and ischemic heart disease in a general health clinic in Nepal
Authors: Acharya R.P. , Prasad P.N. , Gupta M.P.
Published: July 2024

Background: Obesity is increasing rapidly in both developed and developing countries and the new generations are at increased risk. Similarly, the prevalence of non-communicable diseases are also increasing. In this context, attempt has been made to correlate the situation.
Objective: To find out the Body Mass Index (BMI) in patient suffering from three common noncommunicable diseases - hypertension, diabetes mellitus and ischemic heart disease (IHD).
Material and Methods: Aretrospective study was carried out in the clients attending General Health Check up Clinic at Tribhuvan University Teaching Hospital, Katmandu during a period of six months. Those suffering from Hypertension, Diabetes Mellitus and Ischaemic Heart Disease were included and BMI was analysed.
Results: In this study, a total of 464 records were analyzed. Analysis of BMI revealed 5.8% to be underweight (<18.5), 52.2% to be normal (18.5-25.0), 37.9% to be overweight (25.1-30.0) and 4.1% to be obese (>30.0). Out of 19 obese cases, 73.7% had hypertension, 10.5% had diabetes mellitus and 5.3% had IHD. Similarly, out of 176 overweight cases 46.0% had hypertension, 6.8% had diabetes mellitus and 3.4% had IHD. The cases with normal weight or underweight had significantly lower incidence of these diseases. Out of 242 normal cases, 21.1% had hypertension, 5.4% had diabetes mellitus and 2.9% had IHD. Out of 27 underweight cases, 3.7% had hypertension, 3.7% had diabetes mellitus and none had IHD.
Conclusion: This study showed that overweight and obesity is not uncommon in Nepali population; and is related with the higher incidence of hypertension, diabetes mellitus and IHD.
Health status of the Ex-British Nepalese army men who underwent General health check-up in TUTH
Authors: Shakya Y.M.
Published: July 2024

Background: Most Nepalese without major recognizable medical symptoms in their lives do not feel the need for a whole body checkup. If we timely evaluate their health, we can prevent ongoing major complications and even sudden unexplained death. If we do regular good health checkups every 1- 2 year generally after 35 yrs. of age,. we can detect diseases in its very early stage. This simple measure help to prevent major serious complications.
Methods: The total number of candidates between age groups of 33-46 years ,during the 1 August 2004 to 30 July 2005 was 100 Nepalese Ex-British army men. They were presenting to. IOM, TUTH General health checkup department with the detail evaluations of their clinical histories, signs and all basic investigations without meat diet 18 hours before were done. All candidates came in fasting at 9 AM to the department for investigation of, total Hb, Sugar, Urea, Creatinine, SGPT, Lipid profile, Uric Acid, VDRL, Urine R/E, Stool R/E, Blood grouping, E.C.G., X-ray chest, USG of Abdomen, HBsAg, HIV, etc.
Results: Amongst the 100 Nepalese Ex-British army men between 33 to 46 yrs. of age. They thought that they were physically and mentally fit for the work without any ongoing major problems. On routine whole body examination: 22% of the candidates were diagnosed with hypertension, which they did not know before evaluation. Similarly 74% of candidates had high BMI ranging from 25-29.9%. Most of them were unaware of increased body weight. There was a correlation between high BMI and hypertension. The higher the BMI, higher was the Blood Pressure 66.66%. Similarly lower the BMI was lesser the Blood Pressure 7.69%. 18% of them were detected with high Triglyceride level (TG). 30% had raised Uric Acid level. 19 % of them had fatty liver. A high BMI is related to rise in TG level. i.e.11.54% among normal BMI and 66.67% in high BMI cases. Fatty liver was 11.53 % among non-Alcohol and 21.62% among alcohol using groups. Raised TG level from 11.53% among non Alcohol to 17.53% among Alcohol group. Use of Alcohol was not related to raised BMI. Similarly with Uric Acid also, not much difference was detected with nonalcohol group. Among Alcohol taking group, 21.62% had fatty liver and slight rise of TG 17.53%.
Conclusion: The casual whole body checkup showed very significant and alarming findings. If they hadn't come for whole body checkup in order to work abroad as guards, they probably might have stayed at home with all the correctable problems and could have developed complications in near future. The data collection showed a clear relationship between high BMI and High Blood Pressure, high Triglyceride and Fatty liver. If we are able to maintain our standard body weight, then one might have very good robust health . A alcohol intake showed certain percentage of Fatty liver and high TG. One must not take more than standard amount of alcohol in order to maintain normal BMI & BP.
Drug sensitivity pattern of microorganisms in infected wounds at TUTH
Authors: Singh A. , Vaidya P. , Tuladhar N.R. , Maharajan S.
Published: July 2024

Introduction: The spread of antibiotic resistance and the appearance of multiple antibiotic resistant pathogens have been recognized by the WHO as a serious problem that complicates medical treatment of bacterial infections. Present study is a retrospective study from 15June to to 15th December 2004, which includes 1379 pus samples.
Methods: Culture and sensitivity testing for pus samples was done using standard Microbiological protocol in TUTH microbiology laboratory.
Results: We found that Staphylococcus aureus is the commonest isolate (57.25) followed by E. Coli (15.61) The most effective antibiotic in-vitro for Staphylococcus aureus is Cloxacillin (87.0) followed closely by Erythromycin (81.8). In E. coli, the most effective antibiotics was Amikacin (77.88). Pseudomonas was isolated in only in (5.83) cases. The most effective antibiotic in vitro was Amikacin (47.22) and Ciprofloxacin (47.22) followed by Gentamycin (32.6).
Conclusion: With rampant antibiotic use, the drugs become resistant of which the clinicians may not be aware. Similarly, the organism pattern may differ in different hospitals. So, we believe that such regular update to our clinicians will help them use appropriate antibiotics, as they will be aware of the prevalent organism and the most effective antibiotic to it.
A case of leiomyosarcoma of the kidney
Authors: Adhikari R.C. , Sayami G. , Dali S. , Shrestha H.G.
Published: July 2024

Introduction: Sarcomas of the kidney are rare.Among primary sarcomas, leiomyosarcoma is the most frequent. A case of primary renal leiomyosarcoma is presented.
Case report: This report concerns a 48-year-old woman, who presented with slowly increasing right flank mass and dull aching pain. A well-defined, gray, firm mass measuring 12.5 x 10.5 cm was histologically composed of interlacing bundles of spindle cells with cellular atypia and nuclearhyperchromasia. Mitotic figures constituted 10-12/ 10 HPF. Tumor cells showed positivity for desmin. The differentiation from sarcomatoid renal cell carcinoma is discussed.
Conclusion: The case is reported for its rarity and this is the first reported case of renal leiomyosarcomain Nepal.
Computers for Doctors
Authors: Shankar P.R. , Mishra P.
Published: July 2024

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