bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Ectopic Ureters with Vaginal Insertion in a Duplex Collecting System: A Case Report of a Rare Case
Authors: Chukwu Isaac , Ezomike Uchechukwu O. , Ekpemo Samuel , Okonkwo Leonard , Uchendu Chukwudi
Published: September 2024

Abstract

The usual opening of the ureters is in the trigone of the bladder. However, it may open in an infrasphincteric location causing urinary incontinence with normal voiding. This is more commonly associated with a duplex collecting system in females, albeit, a bilateral occurrence of ectopic ureters with drainage into the vagina is rare. We report a rare case of bilateral occurrence of a duplex collecting system with drainage into the vagina. She was a 3-year-old girl with a complaint of continuous dripping of urine despite normal voiding. There was no history of fever, difficulty with micturition, fecal soiling, back swelling, or pelvic surgery in the past. She had normal female external genitalia with two openings in the vestibule. A computerized tomography urography showed a bilateral duplex collecting system with prompt and symmetric excretion of contrast, and dilated ureters of the upper renal moiety draining into the vagina bilaterally. We reimplanted the ectopic ureters with a resolution of urinary incontinence.
Prevalence of Poor Quality of Sleep among the Elderly Population: A Community-based Cross-sectional Study
Authors: Kulkarni Meenal , Ghode Pranjali
Published: September 2024

Background:

The spike in cases of sleep-related issues and its ill effects among the geriatric population has been highly noted these days. The drop in sleep quality has been seen to be associated with various day-to-day factors. The study has been conducted to mark the quality of sleep and the factors associated with it in the elderly population.

Materials and Methods:

A cross-sectional study was conducted among the elderly population. A face-to-face interview of 89 individuals over 60 years of age was conducted. The study tool for assessment of the quality of sleep was Pittsburgh Sleep Quality Index (PSQI). Chi-square test was done to find out the association between various factors and quality of sleep.

Results:

The prevalence of poor sleep quality was 58.43%. About 35.95% of the population had bad subjective sleep quality, 12.36% population had sleep latency of 31–60 min, while 22.47% population had sleep duration of <5 h. Eight percent of the population reported the use of sleep medication, and 23.6% of population reported sleep disturbance of more than thrice a week. Thirty-five (67.3%) females reported poor quality of sleep which was found to be statistically significant.

Conclusion:

The prevalence of poor sleep quality was found to be high among the elderly population. Educating the population about sleep health and methods to combat the situation by health-care workers can result in significant improvement of the conditions.
Sequential Blockade with Loop Diuretics and Acetazolamide: A Novel Strategy in Acute Heart Failure
Authors: Gaikwad Nitin R. , Singh Madhusudan Prasad , Singh Alok
Published: September 2024

Acute decompensated heart failure (HF) is the most common form of acute HF (AHF) and presents with systemic congestion due to left ventricular dysfunction with sodium and water retention. Diuretics are the mainstay of treatment for AHF, with loop diuretics being the first-line therapy. However, in some studies, patients who were given high doses of loop diuretics were discharged from the hospital with residual signs of volume overload. Combining acetazolamide, a carbonic anhydrase inhibitor, with loop diuretics has been shown to be beneficial as it increases the efficacy of loop diuretics and reduces the signs and symptoms of congestion. Further, it can be used for the prevention or treatment of diuretic resistance (DR). Sequential nephron blockade with acetazolamide has emerged as a novel strategy for the treatment of AHF to enhance the efficacy of loop diuretics and prevent DR. This review highlights the combination of acetazolamide with loop diuretics as an alternative and possibly more effective decongestive strategy option in AHF patients. Nevertheless, there is limited evidence to support this combination therapy, and further research is necessary to substantiate its use in AHF patients.
Team-based Learning (TBL) in Medical Education: Fostering Collaboration and Enhancing Learning Outcomes
Authors: Dnyanesh Suma , Shirahatti Asha , Bhimalli Shilpa M. , Yadav Sanjay Kumar , Dnyanesh K
Published: September 2024

ABSTRACT

Background and Aim:

Team-based learning (TBL) is an instructional strategy that has gained popularity in various educational settings, including anatomy courses. It is an active learning approach that encourages students to work collaboratively in small teams to solve problems, discuss concepts, and apply their knowledge. Therefore, the purpose of this study was to assess how well students engaged with and learned about anatomy through the medium of TBL.

Materials and Methods:

The current study was carried out for phase I MBBS students in the Department of Anatomy at KAHER’s J N Medical College, Belagavi. TBL sessions included 65 students. One week prior, students were provided pertinent reading materials for the gross anatomy topics that were chosen. The Pre-TBL test, which was composed of five MCQs based on case scenarios, was administered before the start of the session. Students completed the Individual Readiness Assurance Test (IRAT), which had ten multiple-choice questions (MCQs) at the start of the class. The students were then put into groups where they collaborated on the same MCQs, talked about the topics, and provided identical answers. This is called the Group Readiness Assurance Test (GRAT). A post-TBL test was given after the case scenario discussion to wrap up the session. This test’s questions were the same as those on the Pre-TBL.

Results:

The effect sizes provide insights into the magnitude of change observed between pre-TBL and post-TBL test scores. In this study, significant statistical differences were found between pre and post-TBL tests across all sessions [Table 1, P < 0.001], indicating larger effect sizes associated with more significant improvements in learning outcomes attributed to TBL. This aids in interpreting the statistical significance of the results.

Conclusion:

TBL can help students achieve academic success through teamwork. Study revealed that TBL is one of the most effective ways to teach anatomy and can complement traditional didactic lectures.
Landau–Ginzburg potentials via projective representations
Authors: Labardini-Fragoso Daniel , de Laporte Bea
Published: September 2024

We interpret the Landau–Ginzburg potentials associated to Gross–Hacking–Keel–Kontsevich’s partial compactifications of cluster varieties as

F

-polynomials of projective representations of Jacobian algebras. Along the way, we show that both the finite-dimensional projective and the finite-dimensional injective representations of Jacobian algebras are well behaved under Derksen–Weyman–Zelevinsky’s mutations of representations.
Changes in Access to Alcohol-Based Hand Rub and Hand Hygiene Adherence among Healthcare Workers after a Hand Rub Production and Distribution Program in Rural Uganda before and during the COVID-19 Pandemic
Authors: Ishida Kanako , Lozier Matthew , Medley Alexandra M. , Trinies Victoria , Hug Christiana , Ripkey Carrie , Kesande Maureen , Tusabe Fred , Yapswale Sauda , Ocitti Francis , Isabirye Herbert , Nanyondo Judith , Watsisi Martin , Lamorde Mohammed , Berendes David
Published: September 2024

During the COVID-19 pandemic, the use of alcohol-based hand rubs (ABHRs) was critical for improving hand hygiene (HH) among healthcare workers (HCWs). Before and during the pandemic, we supported district-led production and district-wide distribution of ABHRs and one-time provision of portable handwashing stations to select healthcare facilities (HCFs) in five rural districts in Uganda. Comparison between baseline and follow-up assessments showed an overall increase in access to HH materials and HH adherence (HHA; handwashing with soap and water or use of ABHR) among HCWs. However, large differences in the changes in HH material coverage and HHA across districts may have been heavily influenced by the COVID-19 disease burden and its risk perception when the assessments were conducted. Using data collected at multiple time points before and during the pandemic across districts and estimating and controlling for pandemic effects in an exploratory multivariate analysis, the adjusted odds ratio of HHA in district HCFs was 4.6 (95% CI: 1.8–11.8) after (versus before) the ABHR intervention. This increase appeared to be primarily in larger HCFs, where the perceived need for ABHRs may have been greater. Additional strategies are needed to further increase HHA, especially in the smallest HCFs, among laboratory technicians and nurses and before patient contact. However, district-scale ABHR interventions seemed successful in ensuring the continued availability of HH materials.
Préface
Authors: Blinova Olga , Géry Catherine
Published: September 2024

Le volume que nous proposons ici à l'attention des universitaires et plus généralement de toutes celles et ceux qui s'intéressent à la culture russe est à la fois une collection d'études consacrées aux médiatrices — traductrices, hôtesses de salon, éditrices, rédactrices en chef, membres des comités de rédaction, critiques, journalistes, correctrices, auxquelles on peut ajouter les préceptrices ou les enseignantes — et un hommage collectif à ces « petites mains » toujours négligées, parfois anonymes, qui ont pourtant participé pleinement à la construction de la littérature classique russe du XIXe siècle et de sa future historiographie.
Preferencias ciudadanas por las penas de prisión frente a penas alternativas: alcance y factores explicativos.
Authors: Pozo Cuevas Federico , Caro Cabrera Manuel J. , Naranjo Martín Paloma
Published: September 2024

Este trabajo presenta un análisis de los datos de la 9ª ola del PACIS (Panel Ciudadano para la Investigación Social en Andalucía) centrado en dos cuestiones: conocer el grado de preferencia por la mayor dureza penal y estudiar la relación entre dicha preferencia y un conjunto de variables consideradas predictoras del punitivismo. Los resultados muestran una alta inclinación de la opinión pública andaluza por las penas de privación de libertad frente a penas alternativas ante tres escenarios delictivos diferentes. Asimismo, y recurriendo al análisis de regresión logística binaria, se muestra la influencia significativa, aunque muy moderada, de algunos rasgos personales (edad, nivel educativo, ideología y creencias religiosas) y de algunas percepciones sociales (inseguridad y problematización tanto de la delincuencia como de la regulación migratoria) a la hora de inclinarse por penas de prisión o internamiento frente a sanciones económicas, libertad vigilada o trabajos en beneficio de la comunidad.
competencias de las entidades locales para la protección de los animales de compañía a la luz de la nueva Ley de Derechos y el Bienestar de los animales
Authors: Roca Fernández-Castanys María Luisa
Published: September 2024

La entrada en vigor de la Ley 7/2023, de 28 de marzo, de protección de los derechos y el bienestar de los animales plantea numerosas cuestiones. En las líneas que siguen se trata de hacer una primera aproximación a las principales novedades que la norma implica en el ámbito local. Para ello se parte de la identificación de sus competencias para proceder a continuación a la singularización de alguno de los aspectos más importantes que los entes locales deberán atender para dar debido cumplimiento a lo previsto en la nueva Ley.
Dinamika Relasi Kuasa Antara Keluarga dengan Pecandu/Penyalahguna yang Menjalani Rehabilitasi di Balai Besar Rehabilitasi BNN
Authors: Hardi Siahaan Roy
Published: September 2024

Penggunaan Narkoba telah menjadi salah satu masalah kesehatan masyarakat yang utama dengan prevalensinya yang tersebar luas di semua kategori Masyarakat. Penyalahgunaan Narkoba tidak hanya berdampak negatif pada individu yang menggunakannya, tetapi juga bagi keluarga dan lingkungan sekitarnya  Salah satu upaya yang dapat dilakukan untuk membantu individu yang terjerat Narkoba untuk kembali ke kehidupan yang sehat dan produktif adalah melalui rehabilitasi  Salah satu faktor penting yang berperan dalam keberhasilan rehabilitasi adalah dukungan keluarga. Penelitian ini bertujuan untuk melihat bagaimana dinamika relasi kuasa antara pecandu/penyalahguna yang menjalani proses rehabilitasi di Balai Besar Rehabilitasi BNN.  Penelitian kualitatif dengan partisipan 6 orang klien usia 21-36 tahun yang sedang menjalani program rehabilitasi rawat inap di Balai Rehabilitasi BNN. Partisipan ditentukan dengan metode purposive sampling. Instrumen penelitian yang digunakan dalam pengumpulan data berupa wawancara mendalam, catatan lapangan, dan studi pustaka. Pemaknaan perasaan klien sangat beragam, misalnya: tidak percaya, tidak terima, menyatakan kecewa, merasa malu, merasa marah, merasa menyesal, merasa sedih mendalam, bahkan merasa putus asa terhadap penyalahgunaan Narkoba dan proses rehabilitasi yang harus dijalaninya. Stigma yang dirasakan oleh klien berasal dari diri sendiri, keluarga, dan diskriminasi. Ambivalensi juga dirasakan baik secara obyektif, subyektif, implisit-eksplisit, dan implisit. Beberapa mekanisme koping yang digunakan klien untuk mengatasi permasalahannya adalah berserah diri, berdoa, berbagi, menjaga kebersihan diri, mencari kegiatan dalam program rehabilitasi. Dukungan yang diterima klien selama menjalani rehabilitasi meliputi dukungan moral, dukungan finansial, dan dukungan sosial, yang berkorelasi dengan motivasi dan keberhasilan klien dalam menjalani rehabilitasi, serta harapan klien terhadap keluarga besar. Klien yang menjalani rehabilitasi mengalami proses berduka yang mendalam, dan berulang kali melalui beberapa tahapan yang terdiri dari penolakan, tawar-menawar, dan penerimaan, peningkatan spiritual, dan penerimaan kenyataan. Klien juga mengalami berbagai stigma, dan ambivalensi. Peningkatan komunikasi, kepercayaan, penerimaan dan memperbaiki hubungan keluarga harus dilakukan untuk mendukung klien dalam proses rehabilitasi yang berkelanjutan
Review of previous works on functionally graded materials (FGM)
Authors: Adda Hadj Mostefa , Slimane Merdaci , Ali Bouchafa , Elamine Dahamni Mohamed
Published: September 2024

This paper presents bibliographical research on previous works of FGM functional gradient materials. We notice that functional gradient materials represent a relatively new line of research. Since the appearance of the FGM concept, many researchers have been interested in it, and countless works have been published, but there is still much to be done.
Bargrad Nikolo-Alexander Church in Petrograd during the Period of Revolutionary Transformations of 1917–1918. (Based on materials from the archive of the temple headman A. A. Dmitrievsky)
Authors: Азарова С.Н.
Published: September 2024

Статья посвящена истории знаменитого Петроградского Николо-Александровского храма (Барградского подворья) в период революционных потрясений в стране и попыток либерально настроенной части российского общества «демократизировать» церковную жизнь. В новой политической ситуации, когда к власти пришло Временное правительство, революционные настроения особенно сильно проявлялись среди младших членов церковных причтов, возникали конфликты между ними и представителями старой формации. В качестве одного из ключевых свидетельств о сущности этих конфликтов использованы материалы из архива старосты Николо-Александровского храма профессора А. А. Дмитриевского, представителя консервативной части прихожан. Анализируя влияние политических событий на обстановку в храме, делается вывод, что важнейшей причиной противоречий революционного периода было духовное состояние общества и попытки сторонников леворадикальных реформ лишить Церковь прежнего влияния на общественное сознание.

The article is devoted to the history of the famous Petrograd Nikolo-Alexander Church (Bargrad metochion) during the period of revolutionary upheavals in the country and attempts by the liberal-minded part of Russian society to “democratize” church life. In the new political situation, when the Provisional Government came to power, revolutionary sentiments were especially strong among the younger members of church clergy, conflicts arose between them and representatives of the old formation. As one of the key evidence of the nature of these conflicts, materials from the archive of the headman of the Nikolo-Alexander Church, Professor A. A. Dmitrievsky, a representative of the conservative part of the parishioners. Analyzing the influence of political events on the situation in the temple, it is concluded that the most important reason for the contradictions of the revolutionary period was the spiritual state of society and the attempts of supporters of left-wing radical reforms to deprive the Church of its former influence on public consciousness.
Publishing and Censorship Activities of Archpriest Ioann Yakhontov (1819–1888)
Authors: Карпук Д.А.
Published: September 2024

В статье на основании архивных документов рассматривается духовно-литературная и цензорская деятельность одного из видных столичных священнослужителей второй половины XIX в. — протоиерея Иоанна Яхонтова. В 2023 г. исполнилось 135 лет со дня его кончины, а в 2024 г. исполняется 205 лет со дня его рождения. Будучи членом С.‑ Петербургского духовно-цензурного комитета в 1857–1858 гг., о. Иоанн проявил себя как выдающийся специалист в области духовной литературы, осторожно, внимательно и профессионально относящийся к литературной деятельности. В статье высказывается предположение, что именно литературный талант и образцовая цензорская деятельность о. Иоанна стали причиной назначения его редактором журнала «Духовная беседа», который был периодическим изданием С.‑ Петербургской духовной семинарии, а также по сути являлся официальным изданием Св. Синода и С.‑ Петербургской митрополии до 1875 г.

This article, based on archival documents, examines the spiritual-literary and censorship activities of one of the prominent clergy members in the second half of the 19th century — Archpriest Ivan Yakhontov. In 2023, it marked the 135th anniversary of his death, and in 2024, the 205th anniversary of his birth. As a member of the St. Petersburg spiritual-censorship committee in 1857–1858, Father Ivan demonstrated himself as an outstanding specialist in the field of spiritual literature, handling literary activities with caution, attention, and professionalism. The article suggests that it was his literary talent and exemplary censorship work that led to his appointment as the editor of the journal “Dukhovnaya Beseda” (Spiritual Conversation), a periodical publication of the St. Petersburg Theological Seminary. Essentially, it served as the official publication of the Holy Synod and the St. Petersburg Metropolis until 1875.
Desempenho do milho híbrido BRS 3046 na dosagem de cama de frango
Authors: Silvério Kleysson Silva , De Sousa João Marcos Amario , Da Silva Samuel De Deus
Published: September 2024

O cultivo de milho na região norte do Tocantins já se tornou prática comum, passando de geração em geração, seja para produção de grão, silagem ou consumo da espiga verde. No entanto, a produção de milho verde encontra alguns desafios, tais como os altos preços de insumos agropecuários. Dentre esses insumos, destacam-se os fertilizantes industriais. Diante desse contexto, surge a proposta de uma alternativa viável: a utilização de resíduos orgânicos oriundos da avicultura. Assim sendo, o objetivo deste trabalho é avaliar o potencial da cama de frango como fonte de nutrientes na produção de milho verde. O delineamento experimental foi realizado em blocos ao acaso (DBC), composto por 7 tratamentos e 4 repetições, totalizando 28 parcelas experimentais. Cada parcela foi constituída por 4 fileiras de 4 m, com espaçamento de 1 m entre linhas e 0,20 m entre plantas. Os tratamentos foram constituídos por 5 doses de cama de frango: 2,0; 4,0; 6,0; 8,0; e 10,0 Mega grama (Mg) ha-1, com duas testemunhas, uma sem adubação e outra com adubação mineral. Os dados foram submetidos a análise de variância e, posteriormente, as médias foram desdobradas usando-se uma análise de regressão. Observou-se, pela análise de variância, que existe pelo menos um contraste entre médias para as características avaliadas: AP, AIE, DE e MG. Os resultados obtidos foram animadores, provando que é possível produzir milho verde com a utilização de cama de frango e ter resultados tão bons quanto a adubação mineral.
ЖЕКЕ ТҰЛҒАНЫ ТӘРБИЕЛЕУДЕГІ ҰЛТТЫҚ ҚҰНДЫЛЫҚТАРДЫҢ РӨЛІ
Authors: Ордабекова Х.А. , Бекмұқамет А.
Published: September 2024

The article raises the problem of training and the formation of students' personal competencies by introducing national values in modern education. The problems of personality development are considered. The analysis of the Kazakh language lessons and intra-school educational activities that contribute to the formation of national values among students is given. An overview of effective methods of introducing national values that can be successfully applied in your experience of becoming a professional specialist and improving your knowledge for all educators is given.
Effects of the Macroeconomic Environment, Policy and Administrative Measures on Revenue Performance: The Case of Nigeria (2010–2021)
Authors: Mohammed Zainab Sindigawo , Oke Olakunle O , Aminu Muhammad Salisu , Hamman Aisha Mahmoud , Ojobo Joy Agbo
Published: September 2024

This study examines the impact of specific macroeconomic variables on tax revenue performance in Nigeria. Utilising quarterly time series data from 2010 to 2021, sourced from various secondary references, the study employs a variance inflation factor (VIF) test to check for multicollinearity. The analysis is conducted using a multiple regression model. The findings indicate that the gross domestic product (GDP) has an insignificant positive effect on tax revenue in Nigeria. Conversely, the inflation rate and employment negatively affect tax revenue generation, although the influence of unemployment on tax revenue is statistically insignificant. The f-statistic value of the model confirms that the combination of the variables studied significantly impacts tax revenue. Therefore, the study concludes that macroeconomic variables are crucial determinants of tax revenue generation in Nigeria. It recommends that the Nigerian Revenue Authority should take measures to strengthen the relationship between GDP and tax revenue.
Do Reforms in Automation Reduce Tax Compliance Costs in Africa? A Staggered Double-Difference Approach
Authors: Bassongui Nassibou , Honlonkou Albert N’lédji
Published: September 2024

This study evaluates the effect of e-taxation on the costs of tax compliance using a large sample of 53 African countries over the period 2004-2020. The econometric approach based on the staggered difference in difference estimator has allowed highlighting the causal effect. By controlling for heterogeneity and taking into account the dynamics of the effect of e-taxation, the results of the study show that e-taxation reduces the costs of tax compliance. Specifically, the e-taxation reform reduces the average number of tax payments per year in the long term. However, its effectiveness in reducing the time required to prepare and pay taxes is effective in the short and medium run. These results suggest the need to establish a rigorous system for monitoring e-taxation reforms in Africa. Innovations should accompany the reform in order to limit corrupt behaviour and bad governance.
Cardiomiopatía hipertrófica variante medio apical con mutación de la filamina C, una variante poco comun. Reporte de caso
Authors: Orozco Burbano Juan D. , Palacios Carlos H. , Saldarriaga Giraldo Clara I. , Durango Gutiérrez Luisa F. , Rendón Isaza Juan C.
Published: September 2024

La Cardiomiopatía hipertrófica presenta diferentes espectros de presentación, entre ellos la obstrucción al tracto de salida del Ventrículo izquierdo. El fenotipo más común es la variante septal asimétrica, siendo infrecuente encontrar la variante medio apical. Por otra parte, existen mutaciones puntuales asociadas a la Cardiomiopatía hipertrófica siendo la variante de la Filamina C una condición poco usual en estos pacientes. A continuación, se presenta el caso de un paciente sexo masculino de 23 años con diagnóstico de Cardiomiopatía hipertrófica variante medio apical, en quien se documenta variante de la Filamina C, ante la inadecuada respuesta y persistencia de sintomatología frente al manejo médico, se realizó el procedimiento de miectomía con abordaje transapical, con posterior mejoría de sintomatología clínica y obstrucción al tracto de salida. Este caso permite ilustrar una variante poco común con un abordaje quirúrgico diferente al convencional transaórtico con mejoría marcada de síntomas.
Product Demand Forecasting For Inventory Management with Freight Transportation Services Index Using Advanced Neural Networks Algorithm
Authors: Nguyen Tuan Ngoc , Hossain Md Zakir , Khan Md Munsur , Sharif Kazi Shahriar , Radha Das  , Haque Md Sabbirul
Published: September 2024

Purpose: Accurate demand forecasting is critical for optimizing inventory management, improving customer satisfaction, and maximizing profitability in the retail sector. Traditional forecasting models predominantly utilize micro-level variables, such as historical sales data and promotional activities, often neglecting the influence of macroeconomic conditions.
Materials and Methods: This study addresses this gap by integrating Freight Transportation Services Index (TSI) which is an indicator for overall economic health with time series data of retail product sales. Utilizing an advanced neural networks model, we demonstrate that incorporating macroeconomic variables significantly enhances the model's predictive accuracy and explanatory power.
Findings: The results reveal that the model with the TSI index outperforms conventional models, highlighting its potential for practical application in the industry.
Implications to Theory, Practice and Policy: This approach offers a more comprehensive understanding of demand dynamics, enabling businesses to make more informed decisions, adapt to market fluctuations, and maintain a competitive edge.
A Systematic Review of Thought Control Strategies in Obsessive Compulsive Disorder
Authors: Brahma Kumari Dr. Rupashree , Mishra Abinash
Published: September 2024

Among all the neurotic conditions obsessive compulsive disorder (OCD) considered as a debilitating one. Obsessive thoughts are categorized as unwanted, repetitive and intrusive thoughts, impulses or images that lead a sufferer to an unpleasant sate, called anxiety. In order to get relief from the unpleasant state caused by the obsessive thoughts, some repetitive behaviors or rituals performed by the sufferers which are regarded as compulsions. Basically, these rituals are performed with the intent to alleviate the anxiety stemming from obsessive thoughts. These obsessive thoughts are also common among people without having OCD (Clark & De Silva, 1985). The cognitive formulations of OCD have proposed theories regarding how “normal” Intrusive thoughts have the potential to evolve into diagnosed obsessions (Clark, 2004; Rachman, 1993, 1997, 1998, 2003; Salkovskis, 1985, 1999). The ego-dystonic thought contents, such as aggressiveness, blasphemy, and infection, in the first instance, encourages frightening interpretations of their appearance. These unhelpful interpretations lead individuals to consciously try to manage or ignore intrusive thoughts in an attempt to lessen the discomfort they feel or to avoid anticipated negative outcomes. (Rachman, 1998). Therefore, it is thought that efforts to suppress and/or control intrusive thoughts are crucial in the development and/or upkeep of clinical obsessions. However, it has been found that intrusive thoughts are less distressing in case of normal people compared to those having OCD (Rachman& De Silva, 1978; Salkoskis&Harrison 1984). If obsessive thoughts are experienced by both people having OCD and without having OCD then why do these thoughts are distressing among former than the latter?
Discourse Strategies in the ‘Membangun Negara MADANI: Visi dan Kerangka Reformasi’ by Anwar Ibrahim
Authors: Ismail Saliza , Husin Norhazlina
Published: September 2024

A leader’s discourse provides a window into his guiding principles, values, and vision for his followers and the broader community. Through this communication, the leader’s strategies, intentions, and decision-making approach become apparent, shaping his influence and impact. Malaysia MADANI was introduced by Malaysia’s 10th Prime Minister, Anwar Ibrahim, to elucidate his approach to leadership and highlight the interactions between a leader and the community. Therefore, this study aims to identify and discuss the discourse strategies used by the Prime Minister in his leadership practices. Critical Discourse Analysis (Fairclough, 1992, 1995) and Interdiscursivity of Discourse Functions (Aman, 2006) are used as the theoretical framework for this analysis. Anwar Ibrahim’s book, ‘Membangun Negara MADANI: Visi dan Kerangka Dasar Reformasi’, is used to analyse discourse strategies. Findings show that Anwar Ibrahim uses both intertextuality and interdiscursivity in his writing. Intertextuality is emphasised through metadiscourse, a crucial tool in constructing Anwar Ibrahim’s discourse. Interdiscursivity is evident in discourse functions such as informing, ensuring understanding, presenting/defending views, relaying intention, and criticising, forming the essence of the current ‘Malaysia MADANI’ discourse. It is found that the book Membangun Negara MADANI: Visi dan Kerangka Dasar Reformasi employs both discourse strategies to ensure a comprehensive understanding of Anwar Ibrahim’s leadership and the nation’s development.
The k-Bronze Fibonacci sequence
Authors: Catarino P. , Ricardo S.
Published: September 2024

In the present work, we consider the generalized k-Bronze Fibonacci sequence and we give the generalized Binet formula and its consequences, the limit of the quotient of two consecutive terms, the sum of the first terms and the generating function.
Systematic literature review on bootstrapping procedure of FHE schemes
Authors: Akleylek Sedat , Karataş Adnan
Published: September 2024

Fully homomorphic encryption is one of the ultimate goals of the cryptography. It is the utmost solution for data privacy. The first seeds of the concept were planted nearly fifty-five years ago. After the thesis of Gentry, first theoretic structure was ready for the researchers. In the following years many different FHE schemes were suggested, and they were vastly improved. FHE schemes have noise or error added to the system in order to make the schemes secure, actually post quantumly secure in some cases. But this noise should be arranged regularly, not to be preponderated over the data. The core mechanism of the FHE is bootstrapping, which regulates the noise and enables us to do homomorphic operations without losing the decryption of plaintext. In this study, we collected research articles from reputable databases and reviewed them. By doing so, we make it easier to keep up with the latest advancements in bootstrapping of FHE schemes. Our goal is to provide a valuable resource for anyone with background seeking to stay up-to-date on the latest developments in the bootstrapping procedure of FHE schemes. Also, we sought answers to our research questions. Lastly, we gave open problems for related studies.
Efficacy of a Hands-on Training OSCE Workshop on Advanced Nursing Skills at Institute of Liver and Biliary Sciences, New Delhi, India
Authors: Srivastava Sunita , George Mini
Published: September 2024

Nurses are expected to achieve a specific level of clinical competence upon completion of their nursing programme. While various methods, such as bedside practical examinations exist for assessing the competence, the Objective Structured Clinical Examination (OSCE) stands out as the gold standard. It provides a comprehensive, reliable, and valid assessment by multiple examiners across different stations, evaluating various aspects of clinical competence. This study aimed to evaluate the effectiveness of OSCE in enhancing advanced nursing skills among both nursing faculty and students. Using a one-group pre-test post-test research design with a quantitative approach, a convenient sampling method was employed. A structured questionnaire consisting of 20 multiple-choice questions was utilised to assess participants’ knowledge of OSCE on various advanced nursing skills stations. The oneday programmme encompassed theory and demonstrations of OSCE stations on selected procedures from gastroenterology, nephrology and oncology nursing. A paired sample t-test, revealed a significant increase in knowledge scores from pre-test to post-test (t=4.806, p = 0.000). To conclude, OSCE serves as an effective approach for teaching advanced nursing skills, highlighting the importance of sensitising and training nursing students, faculty, and clinical nurses in this methodology.
Fear of Childbirth among Primigravida Women: A Cross-sectional Analytical Study
Authors: Nazir Umaz , Amin Ulfat
Published: September 2024

Pregnancy is a joyful period, but some women, especially first-timers, experience anxiety and fear of childbirth, known as tokophobia. This fear can cause significant distress and increase obstetric complications. The study aimed to assess the fear of childbirth among first-time mothers in a Kashmir hospital. A quantitative approach was employed to assess primigravida mother’s fear levels. The study adopted a cross-sectional analytical design with a sample of 110 primigravida women who met inclusion criteria using a non-probability purposive sampling technique, at SKIMS MCH Bemina by using the standardised tool Tokophobia Severity Scale questionnaire. The results revealed that half of subjects (50%) belong to age group 24-29 years; majority of primigravida women (53%) had a gestational age above 36 weeks. Regarding the educational status, about a third (32%) had completed higher secondary education and majority (74%) of the subjects were unemployed. The majority of subjects (64%) belonged to joint families with about four fifth of subjects (79%) residing in rural areas. Monthly income of the 37 percent of subjects was between Rs. 18497-30830. To conclude, 22.7 percent of primigravida women had high fear of childbirth, 39.1 percent moderate fear, and 38.2 percent low fear. Age, gestational age, and education significantly influenced fear levels, unlike other demographics.
Relationship Between History/Physical Examination and Radiological Findings with Surgical Findings to Determine the Level of Obstruction
Authors: Kanwal Muhammad Hanif  , Zahid Mehmood  , Rooh Ali  , Kanwal Soomro  , Abdul Waheed
Published: September 2024

Objective: To assess the correlation between the clinical findings and radiological findings with surgical findings in patients with intestinal obstruction and the subsequent determination of the level and severity of the obstruction.
Methods: This prospective observational study was done at the general surgery department of JPMC Karachi, during 12-month from January 2022 to December 2022. Adults aged 15 years and above, clinically and radiologically suggestive of intestinal obstruction and underwent surgical intervention were included. Clinical data was collected through thorough physical examinations and detailed medical history reviews. Parameters such as abdominal pain, distension, bowel sounds, and other relevant symptoms were documented. Radiological investigations were analyzed for evidence of obstruction and its location. Patients who undergone surgical intervention, their operative findings were correlated with clinical and radiological findings. Data analysis was done by using SPSS version 26.
Results: Overall, 44 patients were studied with mean age of 38.59 ± 7.77 years, 56.8% were male and 42.3% female. Common clinical findings included inability to pass gas or stool (97.7%), constipation (95.5%), dehydration (93.2%), and tachycardia (93.2%). Radiologically, air-fluid levels with valvulae connivences were most frequent (52.3%). Intra-operatively, omental bands (22.7%) were the most common finding. There was a significant association between clinical symptoms, such as tenderness and anorexia, with specific intraoperative findings (p=0.004). Radiological findings, particularly air-fluid levels, were strongly associated with surgical diagnoses (p=0.001), highlighting their importance in guiding treatment.
Conclusion: Clinical assessments and abdominal X-rays in diagnosing intestinal obstruction, applicable in only a few instances. It emphasizes the superior diagnostic capability of abdominal CT scans, may enhance the surgeon's understanding of the underlying pathology.
Reducción no invasiva del tejido adiposo local con un láser de diodo de 630‑660 nm
Authors: Pinto Raúl , Hoogstra Ricardo
Published: September 2024

La capacidad de los láseres de diodo de baja intensidad para reducir los contenidos de los adipocitos y sus volúmenes, sin producir daño a estos ni a los tejidos vecinos, se demostró en un protocolo que integraba este tratamiento de modo complementario a la liposucción para disminuir el edema y las molestias asociadas con esta. Para este trabajo de investigación clínica se seleccionaron 15 pacientes con normopeso y adiposidades abdomino-dorsales. El análisis de la comparación de la circunferencia de las zonas tratadas, previa y posteriormente a la intervención, arrojó un resultado estadísticamente significativo en las tres zonas registradas. El objetivo de este trabajo es valorar la capacidad que tiene un láser de diodo de 630‑660 nm de emisión (I‑Lipo®) para reducir el tejido adiposo de un área determinada, sin la necesidad de recurrir a un procedimiento quirúrgico. Son necesarios nuevos estudios más amplios que confirmen estos prometedores hallazgos iniciales.
ანტიბიოტიკები: რაციონალური გამოყენების პრინციპები (ქირურგიული ანტიბიოტიკოპროფილაქტიკის საკითხები)
Authors: Jikia D. , Chkhikvadze T. , Mgaloblishvili I. , Gzobava K.
Published: September 2024

The article discusses the key issues and definitions of antibacterial therapy. The main properties and mechanisms of action of antibiotics are described. Attention is drawn to the postulates of the use of antibiotics in clinical practice and the principles of modern rational antibacterial therapy. In the form of tables, the main approaches to surgical "antibacterial therapy" in the pre- and postoperative period, in different areas of surgery, are presented separately.

ნაშრომში განხილულია ანტიბიოტიკოთერაპიის საკვანძო საკითხები და დეფინიციები. აღწერილია ანტიბიოტიკების ძირითადი თვისებები და მოქმედების მექანიზმები. ყურადღება გამახვილებულია ანტიბიოტიკების კლინიკურ პრაქტიკაში გამოყენების პოსტულატებზე და თანამედროვე რაციონალური ანტიბიოტიკოთერაპიის პრინციპებზე. ცალკე, ცხრილების სახით წარმოდგენილია ქირურგიული " ანტიბიოტიკოთერაპიის" ძირითადი მიდგომები, პრე- და პოსტოპერაციულ პერიოდში, ქირურგიის სხვადასხვა მიმართულებებში.
დიფუზური ჩირქოვანი პერიტონიტი ბავშვებში: დილემა დასკვნით დიაგნოზში
Authors: Butkhuzi D. , Chelidze A. , Gurgenadze M. , Paatishvili P. , Zambakhidze Z.
Published: September 2024

The present paper deals with the two cases of diffuse purulent peritonitis which developed almost simultaneously in two children, who were siblings. Both cases managed with urgent surgery and subsequent parenteral antibacterial therapy. Similar cases could be related to enteral disease of various infectious etiology or chronic inflammatory conditions such as Crohn’s disease. In our cases no definite infectious agent was identified in peritoneal fluid culture and final pathology proved negative for Crohn’s. In both cases treatment was directed at an emergency resolution of peritonitis, in a more severe case in accordance with the principles of damage control. In one of the patients temporary enterostomy was put in place and subsequently reconstructed. The question as to whether the simultaneous occurrence of acute peritonitis in the two siblings was a pure coincidence or familial cases of common infectious disease remain unresolved. Either way, peritonitis should be managed in accordance to the established standards of emergency surgery, which involves brief preoperative preparation, adequate surgical intervention aimed at resolution of pathological loci, which can be executed either in a single session or in a stepwise approach according to a clinical course.

სტატიაში აღწერილია გავრცელებული ჩირქოვანი პერიტონიტის ორი თანადროული შემთხვევა მცირეწლოვან ძმებში. მსგავსი შემთხვევები შეიძლება უკავშირდებოდეს სხვადასხვა სახის ინფექციურ-ენტერულ დაავადებათა გამწვავებას, ასევე, ნაწლავთა ისეთ ანთებით მდგომარეობას, როგორიცაა კრონის დაავადება. აღწერილ შემთხვევებში, პერიტონული სითხის ბაქტერიოლოგიური კვლევით ცალსახად გამომწვევის იდენტიფიცირება ვერ მოხერხდა, ხოლო მორფოლოგიურად კრონის დაავადება არ დადასტურდა. ორივე შემთხვევაში მკურნალობა მიმართული იყო პერიტონიტის ლიკვიდაციისკენ, უფრო მძიმე შემთხვევაში damage control-ის პრინციპით. ერთ პაციენტთან საჭირო გახდა ენტეროსტომის ფორმირება, რომელიც შემდგომ ლიკვიდირებული იქნა. საბოლოოდ, გამოიკვეთა საორჭოფო საკითხი - ამ ორი პაციენტის თანადროული მომართვა, მსგავსი კლინიკური მიმდინარეობა და დიაგნოზები უბრალოდ დამთხვევა იყო, თუ საქმე გვქონდა რაიმე საერთო ინფექციური გენეზის დაავადებასთან.
ღვიძლის დიდი და გიგანტური ექინოკოკური კისტის მკურნალობის შესახებ
Authors: Archvadze B. , Sabashvili G. , Chanukvadze I. , Jikia D.
Published: September 2024

The authors have proposed and adopted in clinic a method of treatment of large and giant hydatid cysts of the liver. After dissection of the cyst the method provides for filling-up of the cyst cavity with two major flaps created from the adjacent tissues. The method has been used in 20 cases with the patients diagnosed with large and giant hydatid cysts of the liv- er. In the postoperative period the dynamics of regeneration processes after the filling of the residual cyst cavity were studied according to the discharge from the drains inserted in the cyst cavity. The observations have shown that period of rehabilitation of the patients operated with the mentioned method was generally going on without complications, allowing discharge of patients from hospital within 6 days, while the process of outpatient follow-up care didn’t exceed three weeks. The method is distinguished by minimum number of complications and not a single case of lethality.

ავტორების მიერ შემოთავაზებული და კლინიკაშია დანერგილია ღვიძლის დიდი და გიგანტური ექინოკოკოზის კისტის მკურნალობის მეთოდი, რომლის არსიც მდგომარეობს ექინოკოკოზის ღვიძლიდან ამოღების შემდეგ კისტის ღრუს შევსებით, ადგილობრივი ქსოვილებისგან შექმნილი ორი ძირითადი ნაფლეთით. ოპერაცია ჩაუტარდა 20 ავადმყოფს დიდი და გიგანტული ექინოკოკოზის კისტის დიაგნოზით. ოპერაციის შემდგომ პერიოდში შესწავლილ იქნა კისტის „ნარჩენი ღრუს“ შევსების რეპარაციული პროცესების მიმდინარეობის დინამიკა კისტის ღრუში ჩაყენებული დრენაჟებიდან გამონადენის მიხედვით. დაკვირვებებმა გვიჩვენა, რომ აღნიშნული მეთოდით ნაოპერაციები ავადმყოფების რეაბილი- ტაციის პერიოდი ძირითადად მიმდინარეობს გართულების გარეშე, რაც იძლევა მათი სავადმყოფოდან გაწერის საშუალებას 6 დღის განმავლობაში, ხოლო მკურნალობის პროცესის დასრულება კი არ აღემატება სამ კვირას. მეთოდი გამოირჩევა მინიმალური გართულებებით. ლეტალური შემთხვევას ადგილი არ ჰქონია.
Legal Regulation of the Korean Labor Immigrants by the Russian Imperial Government in World War I
Authors: Сон Ж.Г.
Published: September 2024

The article analyzes the conditions of labor migration of ethnic Koreans from Manchuria and China to the Urals of the Russian Empire in 1915—1916, and their experience of interaction with the local Russian authorities. The research is based on the archival materials of the State Archive of the Sverdlovsk region (GASO). This article focuses on the legal and social status of the Korean laborers, their living conditions, habitat, and local conflicts. The study draws on theoretical insights from a range of works on immigration, and the political and economic integration of immigrants. With the onset of World War I, conscription into the Russian Imperial Army drained the manpower reserves, especially in the industries in the Urals. Some industries were under threat of permanent closure. The local tsarist administration petitioned the Foreign Ministry to employ Chinese and Korean laborers in these regions. The results of the research show that the Imperial government did not have a coherent structural plan for the accommodation of Eastern immigrant workers. The government largely improvised, regulating the migration process by issuing various decrees aimed at creating a legal basis for the immigrants. The findings also contradict the earlier Soviet historiography hypothesis about the widespread oppression of ethnic minorities in the Russian Empire. Unlike the Chinese workers who eventually left Russia for Manchuria, the Korean workers chose to stay in Russia after their contractual obligations expired and enjoyed the same rights and privileges as local Russian workers. The research reveals evidence of mistreatment of Korean workers; however, the wrongdoers were local Russian Korean merchants who acted as intermediaries between the local administration and the hired Korean immigrant workers.
The Erosion of the UN Security Council Sanctions Regime Against the DPRK
Authors: Иванов Е.Д. , Соловьев А.В.
Published: September 2024

This article seeks to examine the rationale behind the decision of the United States, China, and Russia to impose sanctions against North Korea together with the incentives to comply with the principles of the sanctions regime or not to comply with them. The convergence of their initial self-interests allowed the establishment of the UNSC Sanctions Regime. However, this institution was unable to ensure compliance with its norms and principles. Consequently, primarily due to the intensification of great-power contradictions, China and Russia appeared to lose interest in maintaining the Regime, particularly in light of their rivalry with the US. Conversely, the US demonstrated a tendency to exploit the Regime.
Interdisciplinaridade na construção da política estadual de assistência farmacêutica do Ceará: relato de experiência
Authors: Borges Karla Deisy Morais , Almeida Joyce da Silva , Silva Paulo Ricardo Merencio da , França Francisco Alisson Paula de
Published: September 2024

Objetivo: Descrever a experiência interdisciplinar para construção coletiva da Política Estadual de Assistência Farmacêutica do Ceará. Síntese dos dados: Trata-se de um relato de experiência, natureza descritiva, por meio de oficinas realizadas pela Coordenadoria de Políticas de Assistência Farmacêutica da Secretaria da Saúde do Estado do Ceará. Identificaram-se fortalezas, fragilidades, ameaças e oportunidades nos eixos: acesso universal, recursos humanos, gestão da assistência farmacêutica, financiamento e cuidado farmacêutico. Foram realizadas em três etapas, iniciadas em janeiro e finalizadas em dezembro de 2021. Na primeira etapa, foi realizada a oficina para a construção da Política Estadual de Assistência Farmacêutica do Ceará com participação dos profissionais de saúde, conselheiros de saúde, residentes e gestores a fim de discutir os processos estratégicos, processos de apoio e processos-chave da assistência farmacêutica. No segundo momento, a equipe técnica da Coordenadoria de Políticas de Assistência Farmacêutica analisou as informações coletadas durante as oficinas relacionadas às estratégias e ações frente aos problemas prioritários identificados por eixo. No terceiro momento, teve-se a construção da portaria da PEAF aprovada pela Comissão Intergestora Bipartite e publicada no diário oficial do Estado em dezembro de 2021. Conclusão: As oficinas proporcionaram o engajamento de diversos gestores na reflexão e discussão, cujo propósito foi auxiliar na tomada de decisão e desenvolvimento de novas ações relacionadas à assistência farmacêutica. Essa vivência contribuiu para a troca de saberes e práticas entre os profissionais de saúde, que resultou na elaboração de uma minuta da portaria e, posteriormente, na publicação da Política Estadual de Assistência Farmacêutica do Ceará.