bluuebunny/crossref_metadata_2025 huggingface dataset:
Luigi Dallapiccola - Models to promote creation in Florence, Italy
Authors: VIERIU EMANUELA IZABELA
Published: July 2023

This study focuses on the ways in which the results of a composer's compositional and research activity are preserved, remaining current and practically building the bridge between the past and the future, connecting with past and future generations, with reference to the composer Luigi Dallapiccola, to his entire and rich activity, as well as to the Centro Studi Dallapiccola institution, in the city of Florence, Italy, where he worked for more than 40 years. The choice of the theme is due to the fact that in the same city I benefited from an Erasmus mobility, where I had the opportunity to make contact with the sounds and scores of the Istrian composer, during conferences, lessons, concerts and recitals. The introduction, as well as the second sub-chapter of the text, deals with the theme of the own Model and the Other`s Model, emphasizing as essential directions to follow: education, values, principles and traditions. I then led the content to the Model of the Other, namely the exposition of the ways in which the promotion of the composer's creation and musicological activity took place, by involving the 4 distinct and essential elements of the cultural-artistic environment: material culture, cultural infrastructure, non-material culture, technology and research; in short, the involvement of the institutions, the support of the Ministry of Culture, responsibility towards the legacy offered by the predecessors, respect towards creation. Then, in order to have a clearer picture, I detailed the attributes of each of the components of the artistic environment. I reported on the activity of Centro Studi Dallapiccola in the 4th chapter (3rd subchapter), where I highlighted the key moments, important in the expansion of events and the formation of connections with new institutions, up to the creation of a particularly well-organized infrastructure. Finally, the content is intended to be a suggestion towards taking some elements that fit Iași cultural space and applying them, with reference to the music of those Iași and/or Romanian creators.
A Study of the Improvements to the Human Organ Transplantation Law
Authors: HAN Sung-Suk , HONG Hyun-Ja , CHUN Hee-Ok
Published: July 2023

Purpose: On 18 March 2003, The Korean Ministry of Health and Welfare revised the Human Organ Transplantation Law, which was enacted to save lives and improve the quality of life of organ recipients. The present study was conducted to examine those revisions and make suggestions for further changes to the law.
Methods : First, the problematic aspects of the law, such as the determination of brain death, the obtaining of informed consent, the allocation of the organs, and the practice of living organ donations, were first identified. Secondly, these aspects of the law were then examined and criticized in light of the organ transplantation laws in foreign countries. Thirdly, efforts to improve the law were described.
Results: 1) The law should make it clear that when consent from the organ donor is impossible, consent should be obtained from the donor's guardian or the person living with the donnor. 2) In order to avoid delays in decisions concerning organ transplantation, the current organization and role of the Brain Death Determination Committee should be re-considered. 3) In the allocation of human organs and selection of organ recipients, giving priorities to the HOPO (Hospital-based Organ Procurement Organization) is not the best way to increase the number of human organ transplantations. A method is needed to increase the objectivity and justice in human organ allocation. 4) The law should be more specific in defining "living organ donations" and the role of the Hospital Ethics Committee. The law should also clearly prohibit the sale of human organs and the donation of organs from minors.
Conclusion: This study provides four recommendations for improvements to the current Human Organ Transplantation Law. First, autonomous consent must be respected in donation. Second, brain death should be determinated clearly and precisely by means of a simple process. Third, organs should be allocated fairly. Fourth, living donations should be encouraged.
Clinical Ethics, What Should Be Taught in Clinical Ethics?
Authors: KWON Ivo
Published: July 2023

Clinical ethics is an essential part of good clinical practice. The purpose of clinical ethics education is to promote competence in ethical reasoning based on relevant laws and guidelines, including professional codes of conduct.
Justifying the Use of Debate as a Teaching Tool in Medical Ethics Education: Critical Thinking Dispositions, Problem-solving Skills, and Medical Professionalism*
Authors: HWANG Hyeyoung , KIM Claire Junga
Published: July 2023

This article reports on a study that was conducted to test the validity of using debate as a teaching and learning method in ethics courses within medical education programs. The design and execution of an ethics course for second-year students at one medical college are described in detail. Additionally, the effectiveness of the teaching methodology is evaluated by measuring students’ critical thinking dispositions, problem-solving skills, and medical professionalism before and after the course. Debates, paired with exploratory group discussions and lectures to support these activities, were provided as modules. Reflection and thinking were promoted through post-debate activities, avoiding overheated competition. A statistically significant difference was found between students’ pre- and post-course critical thinking dispositions. Moreover, positive correlations were observed after the course between both students’ critical thinking dispositions and problem-solving skills as well as between their critical thinking dispositions and medical professionalism. Students' age and problem-solving skills were also identified as factors influencing pre- and post-course critical thinking dispositions, respectively. The results of this study suggest that educational programs that use debate as a teaching and learning method have a positive effect on medical students’ problem-solving skills and professionalism.
AL-‘ATHIFAH WA DAURUHA AL-FANNI FI ITSARATI AL-MAMDUHIN
Authors: Dahiru Sani  , Mukminin Amirul , Hanun Aisyatul
Published: July 2023

The art of praise is considered one of the most famous arts of Arabic poetry, through which many poets have entered since the inception of the Arab dibba. Rather, it has become one of the main purposes in Arabic poetry. It is a wide arena in which poets use their charming words and meanings to attract the attention of those praised by sultans, princes, rulers, and others. So that by praising them with the most beloved qualities and good morals, as stated by Professor Abbas Mahmoud Al-Akkad, “The praiser does not satisfy his prince unless he describes his person and elaborates on describing him with the most beloved qualities to him, as a child does when he praises you and extends his hand to the sugar in your hand, and he does not hide from you that he says the good word to take after it the sweet sugar.
THE ROLE OF THE CIVIL SERVICE IN SABAH REGARDING THE DEVELOPMENT OF ADMINISTRATION BEFORE 1963
Authors: Sharif Adam Sharifah Darmia , Mokhtar Saifulazry , Othman Irma Wani , Zaini Mohd Syafiq , Aliasah Mohammad Wazir Shafie
Published: July 2023

Civil services in Sabah have existed since the colonial era of foreign powers. At that time, the civil service was established with the aim of launching all administrative affairs of the colonialists, especially in the exploitation of natural resources for their economic interests. Before achieving independence in 1963, Sabah had experienced several shifts of administrative power which presented challenges to the administration in Sabah. However, during that period, the civil service is seen to have played an important role in ensuring that all administrative affairs can be carried out smoothly. However, there are issues such as the lack of involvement of local native who serve in the Sabah administration because most of the positions are filled by officers of British descent. Therefore, the discussion of this article will review the extent to which the role of the civil service in Sabah was related to the development of administration in the state before 1963. This study uses a qualitative analysis approach which is the analysis of documents found in the National Archives of Malaysia as well as a library study by analyzing various primary and secondary sources. such as Colonial Office Files, books and articles to obtain research data sources. This study produces an analysis that can provide a clearer understanding of the role of the civil service in Sabah before 1963. The identification of the role of the civil service will enable the planning of government strategies and policies that can further strengthen the civil service in Sabah.
IMPACT OF CORONAVIRUS DISEASE (COVID-19) ON PUBLIC RECORDS IN MALAYSIA
Authors: Mohamad Ramli Ahmad Azman , Samsudin Noor Faraliza , Zainuddin Intan Nurbaizura , Mohd Nasfi Mohd Naim , Md Yatim Norhidayu , Arshad Izzatil Husna , Othman Razifah , Baharuddin Kasmarini
Published: July 2023

The emergence of the Covid-19 epidemic has an impact on various aspects of human life in the world and Malaysia is no exception to this situation. In relation to that, the objective of this study is to conduct a survey to find out what the impact of the epidemic is on public records in Malaysia. To achieve the objectives of the study, the researcher used a literature review approach to obtain information related to the study topic. Reference materials such as newspapers, books, social media such as Facebook, websites and so on are used. The results of the study found that there are indeed certain impacts on public records in Malaysia because of the emergence of the Covid-19 epidemic. The impacts are described one by one in this article. It is hoped that the results of the study will be able to be used as a guide by public officials in Malaysia and Malaysians in general to manage public records efficiently and effectively when the country is facing an epidemic in the future. It is also hoped that the results of the study will be able to be used as a catalyst or motivator for researchers to carry out more in-depth and comprehensive research on this topic in the future.
An Intelligent System to Protect Diabetic Patients from Misinformation on Twitter
Authors:   Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Alessa Nourah , Alhawiti Maryam ,   Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Alshehri Sharifah ,   Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Majdua Amal ,   Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Aljohani Resan ,   Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Aljehane Nojood ,   Department of Computer Science, Faculty of Computers and Information Technology, University of Tabuk, Saudi Arabia., Alotaibi Mohammed ,   Department of Information Technology, Faculty of Computers & Information Technology, University of Tabuk, Saudi Arabia.
Published: July 2023

Diabetes is a chronic disease requiring careful management and accurate health information access. Diabetic patients are particularly vulnerable to misinformation on social media, as they may be more likely to seek alternative treatments and self-medicate. This can have severe consequences for their health and well-being. Also, the spread of misinformation on social media, including Twitter, can negatively impact the health and treatment of diabetic patients. In this research, we propose developing an intelligent system to detect and mitigate the spread of misinformation about diabetes on the Twitter platform. The system will utilize artificial intelligence and natural language processing technologies to identify and classify tweets containing false information about diabetes. The proposed system has the potential to protect diabetic patients from the negative consequences of misinformation and support the provision of accurate health information on social media.
Gadamer, la belleza y la improvisación musical
Authors: Babich Babette
Published: July 2023

En La actualidad de lo bello, Gadamer hace una referencia reveladora a la improvisación musical y a la importancia de la escucha musical, además de poner en primer plano la necesidad de justificación del arte. Situando este debate a través de Goethe y Platón, junto con las Lecciones de Estética de Adorno de finales de la década de 1950 y una discusión sobre Nietzsche y la Antigüedad, es posible establecer que lo que está en juego es la afinación, así como una tensión que invita a un debate ulterior tanto sobre la detención del amante en Carson como el demorarse en Heidegger. Al revisar la hermenéutica gadameriana de la programación y la interpretación musical, incluida la improvisación y el desafío de la nueva música, las reflexiones de Gadamer sobre la cultura musical en el contexto de la cultura social y su reflexión no solo pueden ser leídas a través de Platón y Goethe, sino también a partir de las concepciones de “lo bello” en Hölderlin y Rilke. Se trata de una “conversación” cultural en la que la contribución del público puede estar en tensión con la programación musical progresiva, además de la dinámica de respuesta que surge en la energeia de la improvisación tanto para el intérprete como para el oyente.
Prevalensi Tumor Payudara di RS Hermina Daan Mogot pada Tahun 2017-2021
Authors: Agatha Febrina Githa , Christina Shintia , Purnamawati Purnamawati
Published: July 2023

Kanker payudara merupakan penyebab kematian nomor satu di negara berkembang. Tujuan dari penelitian ini adalah untuk mengetahui prevalensi dan karakteristik pasien tumor payudara berdasarkan pemeriksaan histopatologi di Rumah Sakit Hermina Daan Mogot pada tahun 2017-2021. Penelitian merupakan observasional deskriptif dengan teknik cross-sectional mengenai tumor payudara dengan parameter berupa usia, diagnosis klinis dan diagnosis histopatologi. Pada penelitian ini didapatkan 716 subjek yang memenuhi kriteria inklusi dan eksklusi. Diagnosis histopatologi dengan hasil karsinoma mammae terbanyak pada usia 40-49 (40.86%) dan diagnosis histopatologi fibroadenoma mammae terbanyak pada usia 20-29 (37.35%). Diagnosis klinis terbanyak yang sejalan dengan diagnosis histopatologi adalah fibroadenoma mammae, yang merupakan bagian dari tumor fibroepitelial. Diagnosis klinis yang paling jarang ditermukan adalah papilloma (0.4%) dan diagnosis klinis terjarang adalah lesi papiler (0.3%), di mana papilloma merupakan bagian dari lesi papiler. Pemeriksaan dini payudara diperlukan untuk dapat mendeteksi lesi ganas pada tahap awal untuk segera dilakukan tatalaksana yang tepat sehingga meningkatkan angka harapan hidup pasien.
Hubungan Antara Vulva Hygiene Dan Penggunaan Alat Kontrasepsi Dalam Rahim dengan Keputihan pada Wanita Usia Subur
Authors: Anindyajati Petri Damiani , Dharmawan Ade , Layanto Nicolas , Anastasia Monica Cherlady
Published: July 2023

Keputihan patologis merupakan gangguan abnormal yang sering terjadi pada wanita usia subur dan ditandai adanya cairan berwarna putih dengan konsistensi pekat, putih-kekuningan atau putih-kehijauan, terkadang disertai bau tidak sedap dan gatal, seringkali disebabkan beberapa masalah seperti infeksi vulvovaginal. Hal ini terjadi karena komposisi mikroflora vagina berubah, yang dipengaruhi oleh  faktor internal (usia, perubahan hormonal selama menarche, menstruasi, dan kehamilan) dan faktor eksternal (praktik kebersihan, hubungan seksual, dan penggunaan kontrasepsi). Tujuan artikel ini untuk melihat hubungan vulva hygiene dan alat kontrasepsi dalam Rahim dengan kejadian keputihan pada wanita usia subur. Data dicari menggunakan google scholar dan pubmed didapatkan 8 artikel yang memenuhi kriteria. Berbagai faktor risiko yang mempengaruhi terjadinya keputihan akibat penggunaan Alat Kontrasepsi Dalam Rahim non hormonal yang terjadi pada wanita usia subur dan melalui perilaku vulva hygiene yang baik, dapat mengurangi risiko terjadinya keputihan fisiologis maupun patologis. Berdasarkan analisis yang dilakukan diperoleh kesimpulan bahwa terdapat hubungan antara vulva hygiene dan penggunaan Alat Kontrasepsi Dalam Rahim dengan keputihan pada wanita usia subur.
Situações cooperativas nas aulas de educação física nos anos iniciais do ensino fundamental
Authors: Brandl Neto Inácio
Published: July 2023

Atualmente a cooperação é uma tendência expressiva para a Educação e para a Educação Física, e está sendo vista como essencial devido aos valores e atitudes que importa e pela sua contribuição para a aprendizagem e para a convivência pacífica entre as pessoas. Com o objetivo de investigar situações cooperativas que ocorrem nas aulas de Educação Física nos anos iniciais do Ensino Fundamental, foram observadas e descritas 60 aulas de cinco regentes efetivas de três escolas da cidade de Marechal Cândido Rondon, Paraná, já que desde 2011 o município adotou a orientação da cooperação como atitude permanente que perpassa todas as ações da aula. Cada docente foi acompanhada em dois anos (séries) diferentes e em seis aulas de cada turma, totalizando 12. A pesquisa foi descritiva de natureza qualitativa e quantitativa, cujo resultado mostrou a utilização de 11 tipos de situações cooperativas e o total de 405 ocorrências.
БОРЬБА С ГЛОБАЛЬНЫМИ ЭКОНОМИЧЕСКИМИ ВЫЗОВАМИ
Authors: Аслаханова Э.А. , Бисултанова А.А.
Published: July 2023

Глобальные проблемы касаются всего человечества, затрагивая интересы и судьбы всех стран, народов и социальных слоев, они приводят к значительным экономическим и социальным потерям, а в случае обострения могут угрожать самому существованию человеческой цивилизации; они требуют для своего решения сотрудничества в общепланетарном масштабе, совместных действий всех стран и народов. Глобальные проблемы взаимодействуют друг с другом, в частности, энергетическая и сырьевая проблемы соотносятся с экологической, экологическая – с демографической, демографическая – с продовольственной.
ВНЕДРЕНИЕ ЭЛЕМЕНТОВ ЭКОЛОГИЧЕСКОГО МАРКЕТИНГА В ДЕЯТЕЛЬНОСТЬ ПРЕДПРИЯТИЯ
Authors: Дадаев Я.Э.
Published: July 2023

В статье обоснована необходимость внедрения экологического маркетинга в деятельность современных предприятий. Доказана необходимость учета экологического фактора в развитии предприятия. Обоснована необходимость экологических инноваций, проанализированы основные препятствия на пути их внедрения. Сформулированы преимущества и недостатки метода функционально-стоимостного анализа и метода оценки жизненного цикла при достижении целей экологической стратегии предприятия.
УСТОЙЧИВОЕ РАЗВИТИЕ ТЕРРИТОРИЙ И «ЗЕЛЕНАЯ» ЭКОНОМИКА КАК ЕГО ОСНОВА
Authors: Абдулхажиева М.Д. , Исаева Ж.Д. , Арсаханова З.А.
Published: July 2023

Предметом исследования данной работы явились устойчивое развитие территорий и «зеленая» экономика, как факторы, обеспечивающие благополучие общества на основе сохранения природных богатств. Цель работы – выявить наиболее точные определения понятий, представленных в наименовании статьи, а также изучить проблемы в сфере экологизации экономики и найти их решения. Метод исследования – это изучение различных источников, официальных документов и других сведений, дающих информацию по заданной теме. Результаты работы: дано определение понятия устойчивого развития, а также охарактеризована его роль в современном мире. Кроме того, рассматривается концепция так называемой «зеленой» экономики, которая направлена на поиск разумного компромисса между ростом уровня жизни населения и сохранением природных богатств. Приведены основные принципы представленной экономики, которые наиболее полно ее характеризуют. Также определены цели мировой экономики, которые достигаются на основе введения данной концепции и «зеленых» технологий. Результаты исследования имеют практическую значимость в области экономического развития и экологической безопасности общества. Так, устойчивое развитие является важнейшим критерием процветания государств, поскольку данная модель развития территорий ориентирована на обеспечение условий для обеспечения дальнейшего благосостояния общества на основе таких принципов, как экономическое развитие, социальный прогресс и ответственность за окружающую среду. В статье приводятся различные определения понятия «устойчивого развития», а также описываются проблемы, на решение которых она направлена.
The Effect of Reliability, Service Price, Guarantee, Organization Image and Responsiveness on Customer Satisfaction and Customer Loyalty on The Freight Forwarding Service Company PT Lookman
Authors: Lookman Cienthia Dewi
Published: July 2023

PT Lookman Djaja is a trucking delivery service company that has been serving Business-to-Business (B2B) consumers, especially in Java, Sumatra, Bali, Lombok to NTB. To be able to exist for more than 35 years in a highly competitive industry is certainly quite demanding, not to mention very challenging. However, it is undeniable that PT Lookman Djaja has been affected from both outside and within the industry. The economic downturn since the COVID-19 pandemic coupled with intense competition from competitors and substitute services have overwhelmed the company. Furthermore, the number of consumer contracts has also decreased in the past year. This study is conducted to examine and analyze the effect of Reliability, Service Price, Guarantee, Organization Image and Responsiveness on  Customer Satisfaction and Customer Loyalty in PT Lookman Djaja. This study is conducted for 7 months from December 2021 to June 2022. The population of this study is all B2B (Business to Business) consumers from the company, totaling 307 consumers throughout 2021. The research sample used in this study is 47 respondents determined by using purposive sampling technique. The analytical method used is Partial Least Square Structural Equation Modeling (SEM-PLS) and processed using the smartPLS 3 program. The result of this study indicates that the variables Reliability, Service Price and Guarantee have no effect on Customer Satisfaction, however Organization Image and Responsiveness have a significant effect on Customer Satisfaction in PT Lookman Djaja. In addition, this study also indicates that Customer Satisfaction has a significant effect on Customer Loyalty in PT Lookman Djaja.
Factors of Purchasing Decisions of Consumers of Blukid Residence 3 Housing in Sidoarjo
Authors: Wardani Regina Ayu Kusuma
Published: July 2023

This study aims to find out and analyze what factors consumers consider in making the decision to buy a house in Blukid Residence 3 Housing. The object studied in the study was Blukid Residence 3 Housing located in the city of Sidoarjo, East Java. In 2019 marketing experienced a decline in interest in site visits, resulting in a decline in sales in our housing. The method used in this study is a quantitative method. Researchers used Confirmatory Factor Analysis (CFA) to analyze the data. This research was conducted at Blukid Residence 3 Housing located in Sidoarjo with a sample of 97 respondents.
Analysis of Reference Group and Opinion Leader Towards Interest In Buying Yoghurt
Authors: Goncalves Manuel , Sutanto Jushua Putra
Published: July 2023

The research aims to find out analysis of reference group and opinion leader towards interest inbuying yogurt The purpose of this study was to determine the significance of reference groups and opinion leaders on the purchase interest of Yogurt. Yogurt is a start-up company managed as an entrepreneurship business project. Yogurt experienced a decline in sales which could be caused by unexpected factors, the loss of cooperation contracts with other companies, and the lack of appropriate strategies in promotion. Design. Methodology/ approach. Based on a review of the literature and the number of samples used was 124 respondents. The research approach was carried out quantitatively using processed using SPSS version 25 programs. The data collection method uses an instrument research based on variables which are expected significantly influence consumer buying interest. Originality/value – These results of research showed that the reference group and opinion leader variables significantly influenced the purchase interest of Yogurt.
Incidencia del uso de las TIC en el desarrollo de las habilidades de comprensión y expresión oral y escrita del idioma inglés en estudiantes de nivel A1 de la licenciatura en lenguas extranjeras inglés-francés de la universidad de Pamplona
Authors: Quintero William Alexander , Jaimes Guerrero Carlos Alberto
Published: July 2023

En este estudio se abordó la incidencia que tienen el uso de las TIC en el desarrollo de las habilidades de comprensión y expresión oral y escrita, del idioma inglés en estudiantes de nivel A1 de la licenciatura en Lenguas Extranjeras para dar respuesta al objetivo principal. El método de investigación utilizado fue de estudio de caso. Como lo dice Mcmillan J. Schumacher S. (2005) “Mientras que algunos clasifican el caso como un objeto de estudio (Stake, 1995) y otros lo consideran una metodología (Yin, 1994), un estudio de caso examina un sistema definido o un caso en detalle a lo largo del tiempo, empleando múltiples fuentes de datos encontradas en el entorno. El caso puede ser un programa, un acontecimiento, una actividad o un conjunto de individuos definidos en tiempo y lugar. El investigador define el caso y su límite.  Se concluyó como resultados que con el uso de los diferentes aparatos tecnológicos y plataformas encontradas en la web o proporcionadas por la universidad, se presenta un incremento importante en el desarrollo de las habilidades mencionadas, lo cual se evidencia en un mejor aprendizaje de la lengua extranjera. Al igual, el principal medio utilizado en las clases es el internet y cada uno de los equipos que facilitan su uso dentro y fuera de la clase tales como celulares, computadores, televisor del aula y plataformas que podemos encontrar en Internet tales como Edmodo, Youtube y Grammarly entre muchas otras. Finalmente, se definió el rol de las docentes, el cual es de mediadoras, facilitadoras del aprendizaje y quienes escogen las herramientas TIC adecuadas según lo que consideran más relevante en la clase. Para concluir, se resalta la incidencia positiva de las TIC sobre docentes y estudiantes, ya que trataron diversos temas de una manera más interactiva y dinámica.
Digitalization of the Financial Sector
Authors: Toumi Sayari Karima
Published: July 2023

Digital finance emerges and grows along with the environment of the unlimited integration of information technology and finance. This led to a shift from the traditional way of performing finance in different areas to another digital one. With the ongoing evolution of technology, financial innovation has made new inventions. More intelligent digital finance has emerged, which creates new opportunities and facilities. The COVID-19 pandemic has accelerated global digital transformation by altering businesses' and consumers' relationships with digital technologies in months. Digital finance becomes a necessity and offers previously unseen opportunities. The digitalization process also poses new challenges and risks which require a continuous update of regulations set by supreme committees and institutions to safeguard national security. Strict legal law is needed to strengthen trust and confidence in using e-services. Progress in three key areas will boost the prospects for broader adoption of digital finance, crypto, and decentralized finance (DeFi) markets.
The Green Revolution of Smart Contracts
Authors: Galiautdinov Rinat
Published: July 2023

The focus of this study is to examine the challenges associated with smart contracts and their overall concept. The research proposes a solution that can effectively address all the current issues related to smart contracts. Furthermore, the study recommends a new architecture for smart contracts and blockchain. The author identifies the problems, conducts an analysis, and presents a solution that will enhance the performance of smart contracts, increase their extensibility, and promote an eco-friendly environment by reducing pollution and conserving energy.
Rare Association of Aneurysm of Anterior Mitral Leaflet with Bicuspid Aortic Valve
Authors: Mohanty Vivek , Sharma Shubham Kumar , Deora Surender
Published: July 2023

Mitral valve aneurysm is defined as outpouching of the mitral valve which expands in systole and collapse in diastole. It was first reported in 1729 by Morand. Most of the cases have been described in the African population. It is rare in the Indian population. Its chief presentations are congestive heart failure, palpitations, arrhythmia, or in rare cases an embolic phenomenon. It can be diagnosed either by echocardiography or cardiac imaging (magnetic resonance imaging/computed tomography). It can either occur as an isolated defect or with other associated valvular abnormalities. Here, we present a case of a 40-year-old male who was referred for the evaluation of palpitation who on the investigation was found to have a bicuspid aortic valve with severe Aortic Regurgitation (AR) along with aneurysm in the anterior mitral leaflet causing severe mitral regurgitation. This case highlights the importance of keeping a submitral aneurysm as a differential diagnosis for mitral regurgitation and searching for other associated valvular defects which may affect the management and treatment outcomes.
Change in Prevalence and Pattern of Peptic Ulcer Disease in the Northern Savannah of Nigeria: An Endoscopic Study
Authors: Yahya Husain
Published: July 2023

Background:

Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria.

Aim:

This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world.

Methods:

Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North-West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed.

Results:

Over a 9-year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14–85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged <40 years were significantly more likely to be diagnosed with DU than GU (54.7% vs. 33.9%, P = 0.016) while those >40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU.

Conclusion:

The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed – patients were predominantly male and older, and GU predominated.
Perceived personality traits and parenting styles on addiction potentiality among nursing students
Authors: Elsisi Sabah Ali Mohammed , Mostafa Mona Hamdy , Khalil Mohamed Abd El-Fattah , Mohamed Sayeda
Published: July 2023

Background

Drug addiction among adolescents represents a public health concern that receives attention from policy experts, academics, and government officials. Many factors that may affect addiction potential among nursing students are parenting styles and personality traits. This study aims to investigate the impact of personality traits and perceived parenting styles on addiction potential among nursing students.

Setting

Faculty of Nursing, Cairo University.

Design

A cross-sectional survey and descriptive research design.

Sample

Stratified random sample included 380 nursing students.

Tools

Personal data sheet, parental styles questionnaire, potential addiction scale, and personality inventory for DSM-5 Brief from (PID-5-BF).

Results

28.8% of the studied sample had personality traits of addiction potential. They perceived their parent style as authoritative style (69.5%), Permissive style (47.7%), and authoritarian style (35.2%). About 56.8% of the nursing students experienced moderate addiction potential levels. Parenting authority and personality traits demonstrated a statistically significant positive correlation.

Conclusion

The study concluded that parenting style and personality traits are the main risk factors contributing to addiction potential among nursing students.

Recommendation

Design a counseling program for parents on the effect of various parenting styles on the risk of addiction potential among adolescents and personality.
Effect of implementing mobility protocol on selected outcomes among critically ill elderly patients
Authors: Elsalam Saadia A.A. , Morsy Warda Y.M. , Youseif Monkez M. , Mohammed Fatma A.
Published: July 2023

Background

Implementing mobility protocol for critically ill elderly patients may help prevent the sequelae of bed rest and improve patient outcomes.

Aim

To investigate the effect of implementing mobility protocol on selected outcomes among critically ill elderly patients.

Research hypothesis

Elderly critically ill patients who will be exposed to predesigned mobility protocol will have an improvement in their selected outcomes than those who will not.

Design

A quasi-experimental research design was used.

Sample

A purposive sample consisting of 60 critically ill elderly patients was included in this study within a period of 6 months.

Setting

This study was conducted at a medical ICU affiliated to a selected university hospital in Zagazig.

Tools

Two tools were developed, tested for clarity, and feasibility: (a) personal characteristics and medical data, and (b) patient outcome assessment sheet.

Results

Half (50%) of the control group and study group were males and the other half were females. The majority of study group were in the age group of 60 to less than 70 years. Concerning the past medical history, the majority of the control group and study group had a cardiac problem. The two groups were equal according to the presence of medical problems. In pretest, there were insignificant statistical differences (P>0.05) between the two groups regarding cardiovascular system outcomes. The two groups were equal, except for capillary refill (χ
2=4.32, P=0.04). Moreover, more than two-thirds (73.3%) of the control group had sluggish capillary refill compared with 93.3% of the study group, and approximately two-thirds (60%) of the control group had nonpitting edema in the right and left upper arms compared with 36.7% of the study group. In posttest, there were significant statistical differences in cardiovascular system outcomes between study group and control group in peripheral pulses (χ
2=4.32, P=0.04), edema of right upper arm (χ
2=10.13, P=0.006), edema of left upper arm (χ
2=10.13, P=0.006), edema of right lower leg (χ
2=5.96, P=0.03), and edema of left lower leg (χ
2=4.95, P=0.04).

Conclusion

Early mobilization and rehabilitation of critically ill elderly patients may help prevent the sequelae of bed rest and improve patient outcomes.

Recommendation

Integrating mobility protocol into daily nursing care has shown to be imminent. As well, studying the effect of implanting mobility protocol on selected outcomes of critically ill intubated patients. In addition replication of this study on a larger probability sample from the different geographical locations in Egypt is recommended. Replication of this study on a larger probability sample from different geographical locations in Egypt is recommended.
Effect of walking exercise on fatigue among patients with multiple sclerosis
Authors: Ragab Abeer A. , El-Naby Amel G.A. , Shalaby Nevin M.
Published: July 2023

Background

Multiple sclerosis (MS) patients frequently experience severe fatigue that can be as disabling as objective neurological deficits. Walking exercise has significant effect in reducing MS-related fatigue.

Aim

To evaluate the effect of walking exercise on fatigue among patients with MS.

Design

Nonequivalent control group time series quasi-experimental design was utilized.

Research hypotheses

H1: the fatigue mean scores of patients with MS who subjected to walking exercise would be less than the fatigue mean scores of a control group after 6 weeks. H2: the fatigue mean scores of patients with MS who subjected to walking exercise would be less than the fatigue mean scores of a control group after 12 weeks. H3: the fatigue mean scores of patients with MS who subjected to 12 weeks of walking exercise would be less than 6 weeks of walking exercise in the study group.

Sample

A convenient sample of 60 MS patients were recruited along 12 weeks.

Tools

Four tools were utilized to collect data: (a) Semi-Structured Interview Questionnaire, (b) Fatigue Severity Scale (FSS), (c) The Expanded Disability Status Scale, (d) The Beck Depression Inventory-II.

Results

supported the stated research hypotheses. As regards, the total mean scores of FSS, there were high statistically significant differences between the study and control groups after 6 and 12 weeks of implementing treadmill walking exercise (35.67 and 49.63 and 29.11 and 50.87, respectively). As well, total mean scores of FSS among the study group after 6 and 12 weeks of implementing treadmill walking exercise was 35.67±10.77 and 29.11±9.93, respectively. Moreover, 76.70% of the study group had no fatigue after 12 weeks of treadmill walking exercise compared with 50% of them after 6 weeks.

Conclusion

Treadmill walking exercise was effective in reducing fatigue severity level among patients with MS and more than three quarters of the study group had no fatigue after 12 weeks of treadmill walking exercise compared with half of the study group after 6 weeks. Recommendations: this study recommended that patients with MS should practice walking exercise regularly in order to reduce fatigue severity level. Also, further studies should be conducted to compare the effect of different types of walking exercise on MS-related fatigue.
Self-efficacy and adherence to medication and fluid restriction among patients undergoing hemodialysis
Authors: Masoud Sherine A.-E. , Abd-Elaziz Salwa H. , Mohamed Seham K. , Abdo Ola I.
Published: July 2023

Background

Self-efficacy is the confidence in one's ability to overcome barriers and perform a given task such as taking one's medications and restrict the intake of fluids to attain the desired health outcomes for patients undergoing hemodialysis (HD).

Aim

To determine the relationship between self-efficacy and adherence to medication and fluid restriction among patient undergoing HD.

Design

A descriptive correlational design was used.

Sample

A purposive sample of 116 adult male and female patients undergoing HD was recruited.

Setting

The study was conducted at the HD unit in Kom Hamada Specialized Hospital affiliated to Ministry of Health.

Tools

Four tools were used to collect data: Demographic and Medical Form, Morisky Medications Adherence Questionnaire, Self-Efficacy Scale, and Fluid Control in Hemodialysis Patients Scale.

Results

The mean age of patients under the study was 52.5±13.7 years. A positive correlation was found between fluid control and self-efficacy (r=0.23; P=0.01). Medication adherence among HD patients was low, with a mean of 7.4±2.3.

Conclusion

There was an inverse correlation between self-efficacy and medication adherence. A statistically significant positive correlation was found between fluid control and self-efficacy.

Recommendations

Periodic counseling and educational sessions among HD patients can improve confidence and adherence to medication and fluid restriction.
Is Spasticity in Acquired Brain Injury a Sensory Problem?
Authors: MacAden Ashish Stephen
Published: July 2023

There is clinical and physiological evidence that presynaptic inhibition and sensory afferent pathways have an effect on what is considered a primarily upper motor neurone problem. This could redefine spasticity and the need to refocus assessment and management of spasticity is proposed with an emphasis on functional assessment and treatments which modulate sensory afferent thresholds in order to improve the precision of skilled movements.
Rehabilitation Challenges in Orthotic Offloading with Dual Disability Involving Bilateral Lower Limbs with Right Transtibial Amputation for Charcot Joint, Left Neuropathic Foot of Hereditary Motor and Sensory Neuropathy Aetiology
Authors: Padmarani S. , Chitrarasu K. , Rajarathnam S. Jawahar , Thirunavukkarasu P.
Published: July 2023

Orthotic management of offloading neuropathic foot in hereditary motor and sensory neuropathy (HMSN) is challenging due to motor, sensory and functional deficits which may interfere with weight distribution over the foot. The challenge further becomes difficult with the involvement of the contralateral lower limb with below-knee amputation. This study is regarding challenges in offloading, weight transmission and distribution during the stance phase of gait in the case of a 35-year-old female with a left neuropathic foot due to HMSN with concomitant right transtibial amputation. The energy expenditure and cosmetic issues for the right lower limb and aiming for maximum functional conservation of the left foot, were considered by taking into account the heel pad thickness measured by musculoskeletal ultrasound, dynamic plantar pressure measured by footplate pressure measurement, the integrity of the ankle joint mobility and stability by clinical assessment, the electrophysiological status of the neuropathic foot by nerve conduction study and the weight-bearing capability of the right below-knee stump. The following management measures are planned for effective offloading with therapeutic footwear modification with silicone gel cushion heel and insole and rocker bottom outsole as an alternative to conventional weight-relieving calliper in a government tertiary care set-up, thereby conserving the foot function and morphology. This will help in planning a structured rehabilitation programme which will be beneficial in preventing future foot changes including trophic ulceration and subsequent amputation. Case follow-up after patient education and assessment of disease progression in each visit is being done. A better outcome in terms of quality of life and level of independent ambulation with concomitant bio-functionality of the left neuropathic foot was accomplished with community ambulation.
Tendoachilles Repair with Suture Anchor and Semitendinosus Autograft Augmentation
Authors: Jyothiprasanth M. , Jithin CR , Thomas Akhil K. , Pramod Sarang
Published: July 2023

Introduction:

The Achilles tendon is the strongest tendon in the human body, and it is the most common tendon susceptible for rupture also. The incidence of Tendo achilles (TA) rupture is increasing while there exist controversies on the optimal clinical outcome. Along with either conservative or surgical management protocols, early functional rehabilitation plays a pivotal role.

Technique:

The patient with tissue defect 2 cm was selected. Prone position, midline incision, and suture anchor were inserted over the anatomical footprint of TA. Semitendinosus autograft was harvested and sutured with remnant TA to cover the defect using fibers from the suture anchor.

Conclusion:

An acute rupture of a healthy tendon can be successfully treated either conservatively or operatively. The technique of Tendoachilles repair with suture anchor and semitendinosus autograft augmentation, introduced in this literature, is a novel approach that requires further research to validate its superiority over conventional surgical techniques.
A Phase II Trial of Nintedanib in Patients with Metastatic or Recurrent Head and Neck Squamous Cell Carcinoma: In-Depth Analysis of Nintedanib Arm from the KCSG HN 15-16 TRIUMPH Trial
Authors: Kim Kyoo Hyun , Lim Sun Min , Ahn Hee Kyung , Lee Yun-Gyoo , Lee Keun-Wook , Ahn Myung-Ju , Keam Bhumsuk , Kim Hye Ryun , Lee Hyun Woo , An Ho Jung , Kim Jin-Soo
Published: July 2023

Purpose Precision oncology approach for recurrent and metastatic head and neck squamous cell carcinoma (HNSCC) is necessary due to its dismal prognosis. We performed a genomic profile-based umbrella trial of patients with platinum-refractory HNSCC (KCSG-TRIUMPH). Here, we present an in-depth report of the the nintedanib arm (arm 3) of the current trial.Materials and Methods The TRIUMPH study was a multicenter, open-label, single-arm phase 2 trial, in which patients were assigned to treatment arms based on next-generation sequencing (NGS)–based, matching genomic profiles. Patients whose tumors harbor fibroblast growth factor receptor (FGFR) alteration were enrolled in the nintedanib arm (arm 3) as part of the TRIUMPH study. The primary endpoint was the overall response rate (ORR), and secondary endpoints included overall survival (OS), progression-free survival (PFS), safety, and biomarker analysis.Results Between October 2017 and August 2020, 207 were enrolled in the TRIUMPH study, and eight were enrolled in the nintedanib arm. ORR and disease control rate were 42.9% and 57.1%, respectively. The median PFS was 5.6 months and the median duration of response was 9.1 months. Median OS was 11.1 months. One patient maintained the partial response for 36 months. Overall, the toxicity profiles were manageable.Conclusion Single-agent nintedanib has demonstrated significant efficacy in FGFR-mutated, recurrent or metastatic HNSCC patients, with tolerable toxicity profiles. The results from the study have provided the basis for routine NGS screening and FGFR-targeted therapy. Because of the small number of patients due to slow accrual in this study, further studies with a larger cohort are warranted for statistical power.
Hubungan antara Literasi Numerasi terhadap Kemampuan Berpikir Kritis dan Kreatif Siswa SMP di Kecamatan Curug
Authors: Salsabila Yuke , Fatah Abdul , Jaenudin Jaenudin
Published: July 2023

Pelaksanaan ANBK merupakan salah satu bentuk asesmen literasi numerasi. Namun, hasil ANBK tidak dapat menggambarkan kemampuan tersebut secara individu. Peneliti tertarik untuk menelaah literasi numerasi siswa SMP.  Kemudian, pada pembelajaran abad-21 terdapat kebijakan berupa penerapan 4C untuk setiap pembelajaran. Berpikir kritis dan kreatif termasuk ke dalamnya, maka dari itu peneliti ingin meneliti kedua kemampuan berpikir tersebut. Tujuan penelitian ini adalah untuk mendeskripsikan hubungan antara literasi numerasi terhadap kemampuan berpikir kritis, literasi numerasi terhadap kemampuan berpikir kreatif, dan kemampuan berpikir kritis terhadap kemampuan berpikir kreatif siswa SMP di Kecamatan Curug. Penelitian ini menggunakan pendekatan kuantitatif, tepatnya paradigma ganda dengan dua variabel terikat dan satu variabel bebas. Teknik korelasi sederhana dengan koefisien korelasi Pearson Product Moment digunakan pada penelitian ini dalam mencari hubungan antara masing-masing variabel. Pada teknik tersebut diperoleh nilai korelasi sebesar 0,345; 0,207; dan 0,406 dengan sampel sebanyak 373 siswa. Ini menunjukkan bahwa ada hubungan positif antara kemampuan literasi numerasi terhadap kemampuan berpikir kritis, literasi numerasi terhadap kemampuan berpikir kreatif, dan kemampuan berpikir kritis terhadap kemampuan berpikir kreatif siswa SMP di Kecamatan Curug.