bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Consumer Preference for Purchasing Ornamental Plants
Authors: Fauzia Lily , Gusmiranda Siregar Rezkika , Jufri Mohammad
Published: February 2023

Ornamental plants are an alternative business for Indonesian because of their high economic value. The ornamental plant sellers must always be alert in providing various types of ornamental plants with high demand. Sellers also must know consumer behavior and preferences in purchasing ornamental plants. With the increasing demand for ornamental plants, sellers are expected to know what attributes people like and understand consumer purchasing decisions. This research is conducted on 55 Consumers of the ornamental plant at Taman Bunga Madirsan to get consumer preferences. The study used conjoint analysis and using SPSS 16.0 analysis tool. The attribute of consumer preference is color, size, price, season, and plant care. The result shows that the most important attribute in consumer preference for ornamental plants is price followed by plant care, color, size, and season. The combination of attributes that the most preferred by the consumer is an ornamental plant which is a medium-sized green plant with rainy season plant types and prices <Rp. 100,000 and easy plant care.

Keywords: [Conjoint Analysis, Ornamental Plant, Consumer Preference]
The Influence of Career Development and Training on Work Achievement with Work Motivation as an Intervening Variable (Case Study: Labuhan Batu District)
Authors: Dalimunthe Sa’diah , Toni Nagian , Edward Yusuf Ronny
Published: February 2023

In an organization, the factor of Human Resources (HR) has an important role compared to other factors. If the organization fails to achieve its goals, then the human factor can be the cause in it. Therefore employees need to receive training and development to be able to motivate themselves to work better so as to achieve good work performance as well. This study aims to determine whether career development and training affect employee performance through work motivation as an intervening variable at the Regional Inspectorate of Labuhanbatu Regency. The study was conducted on 62 employees using a saturated sampling technique. The data collection technique used was primary data in the form of questionnaires and secondary data obtained through documentation studies. The data analysis technique used quantitative data which was processed using the SPSS version 25 program, namely the t test, Sobel test and path analysis. The results obtained in this study show 1) there is a significant influence between career development on work motivation, 2) there is a significant effect between training variables on work motivation, 3) there is a significant influence between career development variables on work performance, 4) there is a significant effect between training variables on work performance, 5) there is a significant influence between work motivation variables on work performance, 6) work motivation variables cannot influence career development variables on work performance, 7) work motivation variables cannot influence training variables on work performance.

Keywords: Career Development, Training, Work Motivation, Job Performance
The Effect of Position Promotion and Communication on Performance with Competence as a Variable Intervening on Revenue Agency Labuhan Batu
Authors: Wiryawan Hendra , . Sofiyan , . Rosita
Published: February 2023

Performance is a comparison between the work results achieved by employees with predetermined standards if the desires and goals of the organization can be realized. So that the performance of employees also increases, of course employees hope that their efforts will be rewarded with appropriate values ​​from the organization, to get competitively superior performance is through increasing human ability to be able to recognize and adapt to an ever-changing environment. This study aims to determine whether promotion and communication affect employee performance through competence as an intervening variable at the Regional Revenue Agency of Labuhanbatu Regency. The study was conducted on 52 employees using a saturated sampling technique. The data collection technique used was primary data in the form of questionnaires and secondary data obtained through documentation studies. Data analysis techniques used quantitative data processed with the SPSS version 25 program, namely t test, coefficient of determination (R2), Sobel test and path analysis. The results obtained in this study show 1) there is a significant influence between promotion on competence 2) there is a significant effect between communication variables on competence 3) there is a significant effect between promotion on performance, 4) there is a significant effect between communication variables on performance, 5) there is a significant influence between competency variables on performance, 6) competency variables can influence job promotion variables on performance, 7) competency variables cannot affect communication variables on performance.

Keywords: Promotion, Communication, Competence, Performance
The Influence of Work Environment and Work Facilities on Job Satisfaction with Motivation as an Intervening Variable in Regional Revenue Agency Labuhan Batu
Authors: Lubis Erida Hafni , Sutanto Alex Tribuana , Rostina Cut Fitri
Published: February 2023

Employees are an important resource for the company, because they have the talent, energy and creativity that is needed by the company to achieve its goals. With employees who are able to run the company well, a company will be able to develop and achieve goals effectively and efficiently. This shows that employees are the main key to the success of a company. This study aims to determine whether the work environment and work facilities influence employee job satisfaction through motivation as an intervening variable at the Labuhanbatu District Revenue Agency. The study was conducted on 52 employees using a saturated sampling technique. The data collection technique used was primary data in the form of questionnaires and secondary data obtained through documentation studies. Data analysis techniques used quantitative data processed with the SPSS version 25 program, namely t test, coefficient of determination (R2), Sobel test and path analysis. The results obtained in this study show 1) there is a significant influence between the Work Environment on motivation, 2) there is a significant effect between the Work Facilities variable on motivation, 3) there is an influence but not significant between the motivation variable on Job Satisfaction, 4) there is a significant influence between variable of Work Environment on Job Satisfaction, 5) there is a significant influence between Work Facilities variable on Job Satisfaction, 6) motivation variable cannot affect Work Environment variable on Job Satisfaction, 7) motivational variable cannot affect Work Facilities variable on Job Satisfaction.

Keywords: Work Environment, Work Facilities, Motivation, Job Satisfaction.
First Arch Syndrome: A Case Report on Crouzon Syndrome
Authors: Poudel Kalpana , R Nair Gopa Kumar , Mohan Vinay
Published: February 2023

Wide spectrum of anomalies in the first branchial arch gives rise to a variety of congenital syndromes mainly affecting the lower jaw, ear or mouth during early embryonic development. Crouzon syndrome, one of many craniosynostosis syndrome, is an autosomal dominant disorder caused by mutation in Fibroblast Growth Factor Receptor (FGFR)-2 and -3 gene. Here, we report a case of 7 years old male patient who presented to us with features of brachycephaly, exophthalmos, flat broad nasal bridge and low set ears.

Keywords: First arch syndrome, Craniofacial dysostosis, exophthalmos, copper beaten appearance
Relationship Between Protein Tyrosine Phosphatase Non-Receptor Type 22 1858>C Gene Polymorphism with Rheumatoid Arthritis Disease Activity Score-28
Authors: Iqbal Muhardani , Marpaung Blondina , Ginting Andi Raga
Published: February 2023

Background: Rheumatoid arthritis (RA) is one of the systemic inflammatory autoimmune diseases. A number of previous studies showed the potency of Protein Tyrosine Phosphatase Non-Receptor Type 22 (PTPN22) 1858c>T gene polymorphism with the incidence of rheumatoid arthritis.
Objective: To know the relationship of PTPN22 1858C>T gene polymorphism with disease activity score-28 (DAS-28) in rheumatoid arthritis patients at H. Adam Hospital Medan.
Method: 69 rheumatoid arthritis patients were conducted in this study by consecutive sampling who were treated at H. Adam Malik General Hospital, Medan from February-August 2022. The PTPN22 gene polymorphism was genotyped using polymerase chain reaction.
Results: Majority of the subject in the study was female, around 65 people (94.2%). The mean age of the subjects was 42.35 ± 12.28 years old. The most ethnic group was Batak with 34 people (49.3%). Mean DAS-28 score was 3.45 ± 0.79. All CC genotypes and C alleles were found in 69 (100%) subjects. Statistical analysis found no correlation between PTPN22 1858C>T gene polymorphism and DAS-28 score with p value <1.0
Conclusion: PTPN22 1858C>T gene polymorphism has no significant relationship DAS-28 in rheumatoid arthritis.

Keywords: PTPN22 1858C>T gene polymorphism, Disease Activity Index-28, rheumatoid arthritis
Modern Pharmaceutical Education and Its Root in India
Authors: Susan Raj Sharon , Ramaiah Balakeshav , D Saidheer.
Published: February 2023

I am not afraid of weapons but I fear pens and its action said by Napoleon the Great validates the worth of education. But the perspectives of education have undergone morphing with times and needs. Pharmacy education had also taken up the roads that no navigator took. Since human life began, nature was an open textbook for all curious ones. Though the word," pharmacy" originated in India during the British reign, Indian land always had tales of medicinal preparations to say from ancestry. But the dawn of modern pharmacy began in the late nineteenth century. Since then, the field has undergone morphological as well as technological advancements. Even mars wasn’t the limit for the growth seen in pharmacy education during the last century. From its initial step as a pharmaceutical shop in 1811 to the establishment of diploma programs in the late nineteenth century in madras medical college and its rise as a university, where the department of Pharmaceutical Engineering Institute of Technology, Banaras Hindu University, Varanasi holds its prime position being the first Pharmaceutical university to be launched in India in 1937. Now it spreads like the vascular system to different realms of a healthy society.
But, just like each cell in our body has oncogenes for growth and tumor suppressor genes for retardation, every efficient system needs to be timely regulated, which is seen through the rules brought into the table as the pharmacy act in 1948 and the amendments made later by the regulatory bodies like PCI, which was formed in 1953. A new calling was also made into pharmacy education with the starting of Pharm.D by PCI and the Government of India in 2008. Being on the shore of Pharmacy education, a boat full of opportunities waiting for the updated Pharmacy scholars.
Since its origin to this day, the pharmaceutical education system had evolved and is still evolving to reach the peak of excellence and it is a daily goal that can be achieved only if proper regulations and the use of advanced technologies go hand in hand with the growing needs of the health care. As an individual, let each pharmacy graduate make this an agenda to go forward and grow upward with the wings given by pharmacy education.

Keywords: Pharmaceutical Education, Pharmacy Colleges, B. Pharm, M. Pharm, MBA in Pharmacy, Ph.D. in Pharmacy.
Pros and Cons of Merkle Tree
Authors: Chandran Remya
Published: February 2023

The Merkle trees are a type of structure that provides for the efficient and secure authentication of vast amounts of data and is a key component of blockchain technology. This is used in distribution systems to ensure that data is authenticated effectively. This technology is used by Ethereum and Bitcoin. It is incredibly efficient because it uses hashes instead than whole files. The Merkle tree is an essential component of blockchain technology. It’s an arithmetic data structure made up of hashes of various data blocks that serves as a summary of all transactions in a block. It also enables well-organized and secure content verification in large amounts of data. It also aids in validating the data’s consistency and content. Merkle Trees are used by Bitcoin and Ethereum.
Novel Data Science Approach for Emotion Analytics: from Machine Learning to Quantum Cognition
Authors: Rika Havana , Itzhak Aviv , Bertha Aviv
Published: February 2023

In the field of People Intelligence, Emotion Analytics is one of the emerging and growing challenges. A prominent study field is analyzing an individual's emotional state from textual data, as well as recognizing emotions from audio and video recordings. Current Artificial Intelligence approaches for Emotion Analytics based on machine and deep learning and neural networks based on classic data science approaches assume rational people's decision-making process. People's decision-making is irrational. As a result of recent quantum cognition advancements, we show that emotional judgments from one modality may be incompatible with judgments from another, and they cannot be assessed together to produce a final judgment. As a result, the cognitive process exhibits "quantum-like" biases that classical AI approaches based on probability models challenged to analyze. As a result, we offer an emotion analytics approach based on the quantum data science method for predicting people's emotions by a fundamentally novel assessment method.
Hypovitaminosis D in post bariatric patients: Narrative review
Authors: Andrade Isabella Pedrotti Leme de , Angelieri Taís Donha Yarid , Cristóvão Vitória de Oliveira , Teixeira Luiza Santucci , Magalhães Giovanna Rossetto , Marum Carolina Vieira , Gentile João Kleber de Almeida
Published: February 2023

Obesity can be associated with several diseases, signs, and symptoms. Among them, there is nutrient deficiency, especially vitamin D, which regulates calcium and phosphate and helps in bone remodeling. Vitamin D deficiency is related directly to the inadequate intake of foods rich in vitamins, less exposure to the sun and, mainly, to the sequestration of fat-soluble vitamins by the adipose tissue, making it even more difficult for the body to absorb them. Among these complications is the worsening of vitamin deficiency, with a focus on vitamin D, which is already present before the patient undergoes bariatric surgery. Regarding the types of bariatric surgery, each one establishes a degree of vitamin D deficiency that the patient will have postoperatively. That is, each type of bariatric surgery, as they are performed in different ways, directly interfere with the patient's absorption of vitamins. Postoperatively, vitamin D supplementation is recommended for all patients. However, due to poor patient compliance and lack of consent among physicians on the best form of supplementation, the deficiency is maintained, further impairing the treatment, and causing a worsening of the bariatric patient's condition.
Phytol as a hepatoprotective compound in the leaves of Eichhornia crassipes
Authors: Shukla Anuradha , Tripathi Rashmi
Published: February 2023

Water hyacinth is undoubtedly an environmental problem due to its invasiveness, but it also has some promising futures. It might be preferable to consider the specific attributes of each environment where the plant grows. When there are facilities available to fully utilize this plant's potential, efforts should be focused on maximizing its growth. It has been shown that secondary metabolites, such as phenolic and anti-oxidant components, play a crucial role in the chemical defenses of plants against invaded microscopic organisms. This test was conducted to analyze whether Eichhornia crassipes leaves contained antioxidants or the hepatoprotectant. The ethyl acetate-fractionated hydroethanolic extract was used for the analysis. Using Gas Chromatography-Mass Spectrometer (GC-MS), and High-Pressure Liquid Chromatography, the bioactive components of the ethyl acetate fraction of the hydroethanolic extract of the leaves of E. crassipes (Mart.) Solms were analyzed. The GC-MS analysis of the extract revealed the presence of phytol, a constituent that is essential for hepatoprotection. The human body needs phytol for its benefits. Phytol may also be considered a potential new drug and treatment for hepatic dysfunction. The numerous substances found in plants used in traditional medicine can be used to treat several ailments. The majority of people follow traditional medicine, which contains substances derived from medicinal plants, is practiced. Therefore, research into these plants is necessary to better understand their characteristics, safety, and effectiveness. Hence, the present work aimed to evaluate the protective efficacy of the leaf extract of E. crassipes against fluoride-induced toxicity.
FAUNA ÎN LIRICA EMINESCIANĂ ANTUMĂ
Authors:   Universitatea „Ovidius” din Constanța / Institutul de Istorie și Teorie Literară „G. Călinescu” din București (România), NICOLAE Florentina
Published: February 2023

In this study, we aim to analyze the names of non-human beings that populate Mihai Eminescu’s poetic universe, as they appear in the only volume of poetry he published during his life, Poesii (1884), with a preface by Titu Maiorescu. Zoononyms have been classified according to their anatomical features, in birds and mammals, to provide an overview of Eminescu’s inner world in this regard.
ROMANIAN MEDICAL TERMS WORD FORMATION: DERIVATION
Authors:   “Victor Babeş” University of Medicine and Pharmacy Timişoara (Romania), STAICU Simona Nicoleta
Published: February 2023

Our research paper is focused on Romanian medical terminology and the analysis tries to emphasize the morpho-lexical level from a linguistic point of view, namely, word formation, especially derivation. A larger number of derived or compound medical terms have already been borrowed from different languages, a lesser part being the result of internal ways of structural terms formation. Our methodological approach exemplifies derivation and back formation as means of medical term structures.
MEDICAL TERMINOLOGY WORDS INCLUDED IN DOOM3 (THE ORTHOGRAPHIC, ORTHOEPIC AND MORPHOLOGICAL DICTIONARY OF ROMANIAN). GRAMMATICAL AND LEXICAL COMMENTS
Authors:   University of Oradea (Romania), TONȚ Anamaria-Bianca
Published: February 2023

The development of science and technology at a rapid pace and access to information through the media, which informs the public about various aspects of social and political life, have brought more and more terms into the common language. Among specialized languages that have become increasingly popular is medical language. Thus, the present article aims to trace the newly introduced elements in DOOM3 that belong to medical terminology. The selection of medical terms – out of a total of 3600 words added in the new edition of DOOM – is made by referring to medical lexicography and, where appropriate, to specialists’ articles. After the actual identification of medical terms, several statistical tables are set up on the basis of lexical-grammatical information. The last part contains comments on the means of word formation we delimited.
ENCORE UNE FOIS SUR « CHECOCURI APILPISITE » (I. L. CARAGIALE, ANTOLOGIE)
Authors:   Université « Aurel Vlaicu » d’Arad, UNGUREANU Dan , CELAC Victor ,   "Institut de linguistique « Iorgu Iordan – Alexandru Rosetti », Bucarest, Roumanie (Roumanie)"
Published: February 2023

In a study first published in 2002, Vasile Arvinte, a linguist from Iaşi, claimed that the form checocuri, from a well-known sketch by I. L. Caragiale, might mean “cocktails” and that it could be explained by a French playful compound *queue- coq (from queue “tail” and coq “cock”), invented ad-hoc by the Romanian writer (therefore, not attested as such in French), based on the English cocktail (composed of cock and tail). We have all reasons to doubt the accuracy of the analysis proposed by Vasile Arvinte. In this contribution we will try to argue that, in this case, another “connection” is required, namely with a dance name, cake-walk (in approximate phonetic transcription: keik-wok). According to the data presented and our interpretation, checocuri apilpisite means “dishevelled, unravelled dances [= cake-walks]”.
LE CHAMP LEXICO-SÉMANTIQUE DES NOMS D’ACTIONS ASSOCIÉES AU BIEN ET AU MAL
Authors:   Universitatea din Craiova, ISPAS PETCU Daniela
Published: February 2023

This study aims mainly to compare and differentiate the meanings of the lexemes included in the paradigmatic class of the names of actions or practices associated with good and evil. In the semic and contextual analysis, such lexemes as: ADULTERY, DEBAUCHERY, UNCLEANNESS, DISSOLUTENESS, ABSTENTION are discussed, all these terms being related to family life, and in a figurative sense they can refer to man's relationship with divinity. Thus, what is good and what is evil from a biblical point of view is highlighted, as well as the standard of the Scriptures in terms of morality. Starting from the lexicographical definitions, a semic analysis is made, while emphasizing at the same time the contextual compatibility of the lexemes in question.
Results of the study of the performance of implant prostheses depending on the length of the supraconstruction
Authors: Ismoilov A. A. , Ashurov G. G. , Mullodzhanov G. E.
Published: February 2023

Aim. To evaluate the performance of implant prostheses depending on the extent of supraconstruction.

Materials and methods. During implant treatment of 96 patients with occlusal defects the examined patients were divided into 3 groups: Group 1 - patients who had implant prostheses with short length of supraconstruction; Group 2 - patients who had implant prostheses with medium length; Group 3 - patients with implant prostheses with long length. The index of dental implants functioning efficiency depending on the length of implant prostheses was determined by the scoring system proposed by M.Z. Mirgazizov.

Results and discussion. In patients with short implant prostheses in the long-term period of fixed prosthetics the value of the performance index of dental implants in 87.3% of clinical situations was one, which indicates the high performance of their functioning. During the above-mentioned follow-up period, this index for the patients with medium- and high-extension implant prosthesis was 83.7% and 63.8% respectively.

Conclusion. The results obtained in patients with short, medium and long implant prostheses have shown that orthopedic constructions fixed to osteointegrated implants provide high clinical effectiveness depending on the length of supraconstruction.
Medical and social assessment of the effectiveness of the rehabilitation of people with disabilities in the Republic of Tajikistan on the example of the Sughd region
Authors: Magzumova F. P.
Published: February 2023

Aim. To conduct a medical and social assessment of the effectiveness of rehabilitating people with disabilities in the Republic of Tajikistan on the example of the Sughd region.

Materials and methods. The study materials included specially designed questionnaires comprising questions related to the social status of the respondents and the availability of various rehabilitation services in the Sughd region.

Results and discussion. The results of the study showed that out of all the respondents, there were more men than women both in cities, 578 (55.0%) men and 469 (45.0%) women, and in rural areas, 148 (60.4%) men and 97 (39.6%) women, respectively. Moreover, this difference is more significant in rural areas. According to the survey, working people made up the bulk of the disabled in urban and rural areas. Disabled children and people of working age with disabilities are among the population’s main groups that significantly impact the state’s economy, welfare and development.

Conclusion. Most families with disabilities are disadvantaged in several medical and social indicators. The existing system of rendering medical and social services in the republic has shown that the most demanded services today are social-medical and social-household services.
Immediate results of the extended modified mastectomy in patients with diffuse forms of breast cancer
Authors: Rasulov S. R. , Obidov J. S. , Rasulov K. S.
Published: February 2023

Aim. To study the immediate results of extended modified mastectomy with the closure of the soft tissue defect in the chest wall using the patient’s tissues in diffuse forms of breast cancer.

Materials and methods. Advanced modified mastectomy with soft tissue defect closure of the chest wall by the thoracodorsal and lower abdominal horizontal flap on the rectus abdominis was performed in 24 patients with diffuse forms of breast cancer.

Results and discussion. Primary healing of the wounds was observed in 21 (87,5%) patients. Marginal necrosis of the displaced flap was found in 2 cases, and necrosis of 2/3 of the displaced flap was found in 1 case, which was 12,5%.

Conclusions. The use of TD- and TRAM-flaps to close the defect of soft tissues of the chest wall after intraoperative complications did not accompany extended modified mastectomy. Local complications in the form of marginal necrosis occurred in 12.5% of cases.
Money under the mattress: economic crisis and crime
Authors: Kyrkopoulou Eleni , Louka Alexandros , Fabbe Kristin
Published: February 2023

The paper investigates the effect of a (semi-) deposit run during a debt crisis on crime rates. The study focuses on Greece’s protracted debt crisis (2009-2018) and analyzes the response of crime to deposit outflows. It shows that deposit outflows corresponded to a significant increase in property crimes (thefts and burglaries), but not other types of offenses. Our findings suggest that policy makers should also consider the potential criminogenic effects of financial destabilization.
Contributions of Advanced Practice Nursing to Primary Health Care: A Scoping Review
Authors: Neto João Cruz , Santos Paula Suene Pereira dos , Oliveira Célida Juliana de , Silva Kely Vanessa Leite Gomes da , Oliveira Joseph Dimas de , Cavalcante Tahissa Frota
Published: February 2023

Objective: To map the contributions and strategies to implement advanced practice nursing in primary health care. Materials and methods: This scoping review was carried out following the guidelines of the Joanna Briggs Institute in six databases, namely: LILACS, MEDLINE, WoS, Embase, CINAHL, and Scopus, in addition to a bibliographic repository. A total of 3,076 studies were found, from which 12 were selected. Results: The contributions mentioned by the studies regarding advanced practice nursing were divided into three subcategories, as follows: care, educational or management, and preventive practices. They concern autonomy, specialized clinical skills, therapeutic counseling, and patient-centered interaction. Some strategies to implement advanced practice are related to continuing education, practice management, self-care, and disease management. Conclusions: There is a need to improve strategies for advanced practice nursing, especially in primary care, to address gaps in specialized care, the development of indicators, and therapeutic objectives.
Función de la norma general antielusión en la interpretación tributaria
Authors: Navarro-Schiappacasse María-Pilar , Toledo-Zúñiga Patricia
Published: February 2023

Este trabajo pretende precisar la función de la norma general antielusión en la interpretación de la ley tributaria como estrategia para combatir la elusión tributaria, para su correcta aplicación y para revisar su impacto en el principio de legalidad en la materia. Con tal finalidad, se efectúa un examen de carácter dogmático en el cual se analizan los requisitos de las normas generales antielusivas de España, Perú y Chile, utilizando el instrumental conceptual de la teoría general del derecho. El estudio concluye que la aplicación de estas normas implica necesariamente las actividades de interpretación, argumentación y recalificación jurídicas, y que su uso puede ser compatible con el principio de legalidad.
Okul Öncesi Öğretmen Adaylarının Mesleği Tercih Nedenlerinin Gelecekten Beklentileri Üzerindeki Yordayıcı Etkilerinin İncelenmesi
Authors: GÜLAY OGELMAN Hülya , SARI Betül , AMCA TOKLU Dervişe , FETİHİ Leyla
Published: February 2023

Araştırmanın amacı okul öncesi öğretmen adaylarının mesleği tercih nedenlerinin gelecekten beklenti düzeyleri üzerindeki yordayıcı rolünün incelenmesidir. Çalışma grubunu bir devlet üniversitesinin Okul Öncesi Öğretmenliği Programına kayıtlı olan 215 öğretmen adayı oluşturmaktadır. Katılımcıların %77’si (n=165) kadın, %23’ü (n=50) erkektir. Araştırmada, Öğretmenlik Tercih Nedenleri Derecelendirme Ölçeği [ÖTNED] ve Geleceğe Yönelik Beklentiler Ölçeği [GYÖB] kullanılmıştır. Verilerin analizleri Pearson Momentler Çarpımı Korelasyon Katsayısı, Basit Doğrusal Regresyon Analizi ve Çoklu Doğrusal Regresyon analizi teknikleriyle gerçekleştirilmiştir. Bulgular okul öncesi öğretmen adaylarının meslek tercihinde etkili olan özgeci ve içsel nedenler ile gelecekten beklenti düzeyi arasında olumlu, dışsal nedenler ile gelecekten beklenti düzeyi arasında olumsuz yönde ilişki olduğunu ortaya koymaktadır. Meslek tercihinde etkili olan özgeci, içsel ve dışsal nedenlerin ayrı ayrı ve bir arada öğretmen adaylarının gelecekten beklenti düzeylerindeki değişimi açıkladığı belirlenmiştir. Ayrıca öğretmen adaylarının mesleği isteyerek tercih etme ve bölüme isteyerek devam etme düzeylerinin gelecekten beklentiyle ilişkili olduğu, iki değişkenin ayrı ayrı ve birlikte gelecekten beklenti düzeyini anlamlı şekilde yordadığı görülmektedir. Mesleği tercih nedenleri, mesleği isteyerek tercih etme ve bölüme isteyerek devam etme değişkenlerinin bir arada gelecekten beklenti düzeyindeki değişimi açıklayabildiği belirlenmiştir. Üniversite tercihleri sırasında tüm mesleklerde olduğu gibi öğretmenliğin de bilinçli ve idealist bir bakış açısı ile tercih edilmesi, kısa vadede öğretmen adaylarının eğitim sürecindeki motivasyonunu olumlu yönde destekleyebilecek, uzun vadede çocuk-öğretmen-anne-baba iletişimini destekleyebilecek ve eğitimin kalitesini arttırabilecektir.
發展輕度壓力性尿失禁婦女骨盆底肌強化訓練之臨床照護指引
Authors: 劉嫈茹 劉嫈茹 , Ying-Ju Liu 陳奐樺
Published: February 2023

臨床上壓力性尿失禁常使用的評估診斷工具，可能造成輕度尿失禁症狀被低估而未適當治療，使病患仍受困擾。台灣健保制度完善，利用手術治療中、重度壓力性尿失禁病患，卻沒有對骨盆底肌強化訓練如何治療輕度壓力性尿失禁進行明確規範。本文發展流程為選定主題、建構問題、系統性文獻查證，根據16篇實證文獻擬定此指引，經由德菲法共識確認，隨後以AGREE II進行外部評估，結果為強烈建議使用，發展出指引範圍包含三個構面：指引的範圍界定5項，壓力性尿失禁評估診斷2項和處置建議5項。透過會議使醫師及專科護理師間達成共識；團隊成員教育訓練；建立檢核表，標準化評估處置流程，使輕度壓力性尿失禁婦女在身心完整評估下，適切接受骨盆底肌強化訓練。由於專科護理師跨醫療護理的角色功能，更能將此指引整合落實，使輕度壓力性尿失禁病患的照護更完整與持續。

 

The commonly used evaluation and diagnostic tools for clinical stress urinary incontinence may lead to underestimation of mild symptoms. Therefore, leaving patients with long-term distress when prop-erly treatment is not provided. Taiwan has a well-established health insurance system, of which sur-gery is used to treat patients with moderate to severe stress urinary incontinence, but there is no clear regulation on the use of pelvic floor muscle training to treat mild stress urinary incontinence. Through the selection of topics, construction of issues and comprehensive literature review, this guideline was developed based on 16 empirical studies. The content of this guideline was later confirmed by the Dephi method and was strongly recommended for application after externally evaluated by AGREEII. The scope of this guideline includes three facets: 5 items for scoping, 2 items for the assessment and diagnosis of stress urinary incontinence, and 5 items for treatment. Through meetings, consensus was reached between physicians and nurse practitioners; team members were educated and trained; a checklist was established to standardize the evaluation and treatment process, so that women with mild stress urinary incontinence could appropriately receive pelvic floor muscle training after a com-plete physical and mental evaluation. Since nurse practitioner plays an important role in medical care, this guideline can be integrated and implemented to comprehensively improve the care of patients with mild stress urinary incontinence.

 
一位67歲男性以反覆發燒為表現
Authors: 邱子瑄 邱子瑄 , Tzu-Hsuan Chiu 黃妙慧 , Miao-Hui Huang 王立信 , Lih-Shinn Wang 葉惠玲
Published: February 2023

發燒是相當普遍的症狀表現，但後續評估釐清原因，並盡早確認診斷治療更是臨床一大考驗。本案是一位67歲男性，因兩週前反覆發燒合併寒顫、腹痛、全身痠痛，外院診斷泌尿道感染口服抗生素治療無效，因兩天前併發呼吸喘及頭痛就醫，本院急診初步診斷敗血性休克合併多重器官衰竭入院治療。筆者為感染科專師，照護期間為2019 年11月12日至12月10日，經詳細病史詢問及身體評估，因個案有猴子咬傷接觸史，醫療團隊初步疑似恙蟲病合併鉤端螺旋體感染，立即開立恙蟲病及鉤端螺旋體檢驗並同步給予兩種抗生素治療，於2019 年11月27日確診恙蟲病，治療後感染及敗血性休克得以控制，呼吸、腸胃、肝腎功能逐漸恢復改善，個案順利健康出院。針對反覆發燒為表現之患者，必須仔細詢問職業史、旅遊史、接觸史及群聚史，當個案屬於恙蟲病高風險感染族群時，即使未發現焦痂，在流行區仍須將恙蟲病列為鑑別診斷，以免錯失治療時機。

 

Fever is a common clinical symptom and it is crucial to assess the etiology for appropriate treatment.This article describes the nursing experience of a 67-Year-Old male patient with recurrent fever, ac-companied by chills, abdominal pain, and general soreness. Septic shock and multiple organ failure further developed. A thorough history was performed by the author as a nurse practitioner. Physical assessments, and primary care were conducted between 12th November and 10th December 2019. Ac-cording to the history, the patient was bitten by a monkey prior to the episode. Scrub typhus and/or leptospirosis co-infection were highly suspected. Immediately after the blood tests for scrub typhus and leptospirosis, empirical antibiotic treatment was applied. Scrub typhus was confirmed on 27th November, 2019. Septic shock, respiratory failure, gastrointestinal tract symptoms, hepatitis and renal failure gradually resolved after the treatments. The patient fully recovered and was discharged without sequelae. Thorough history taking including travel, occupation, contact, and cluster (TOCC) is very important to identify febrile diseases. For timely treatment, including scrub typhus into differential diagnosis for the patients with high risk is suggested, despite no eschar was found.

 
以反覆性腹痛合併癲癇表現之急性間歇性紫質症
Authors: 許瑞芸 許瑞芸 , Jui-Yun Hsu 周怡伶
Published: February 2023

急性間歇性紫質症是一種罕見的遺傳性代謝異常疾病。本案例是一位38歲女性病人，起初反覆性腹痛合併噁心、嘔吐、腹瀉之表現，後續發生癲癇大發作及急性呼吸衰竭，經實驗室檢驗及影像檢查，僅呈現低血鈉、白血球增加，其他無異常發現。由於發現尿液偏褐色，進一步檢驗發現尿液中高胺基酮戊酸、高膽色素原，以及血液中低膽色素原脫胺酶，確診急性間歇性紫質症，經血基質治療後臨床症狀逐漸改善並順利出院。針對此類以腹痛合併癲癇表現的病人，且與低血鈉之徵象並存時，必須將急性紫質症列為鑑別診斷之一，以免延誤治療時機。

 

Acute intermittent porphyria is a rare genetic metabolic disease. In this case, a 38-year-old female pa-tient who experienced recurrent abdominal pain with nausea, vomiting, and diarrhea, following with epileptic seizures and acute respiratory failure. After the laboratory and image examinations, hypona-tremia and leukocytosis were only noted without other abnormal findings. Because of brownish urine, further laboratory examinations were performed. High level of aminolevulinic acid and porphobilino-gen of urine, and low level of porphobilinogen deaminase of blood were revealed. Acute intermittent purpura was diagnosed eventually. After human hemin treatment, the clinical symptoms gradually im-proved, and the patient was then discharged. For such patient with abdominal pain, refractory epilepsy, and coexisting hyponatremia, acute intermittent purpura should be considered as differential diagnosis for punctual treatment.

 
Frequency of Contrast Induced Nephropathy in Diabetic Patients Undergoing Coronary Angioplasty
Authors: Khan Zahoor Ahmad , Khan Ahmad Ali , Ahmad Salman
Published: February 2023

Objective: To find out the frequency of contrast induced nephropathy in diabetic patients undergoing coronary angioplasty. Material and Methods: After approval from the Hospital ethical committee, the study was conducted in the department of cardiology Hayatabad medical complex Peshawar from 28th July 2020 to 28th January 2021. A total of 136 patients were followed in this study. Oral anti-glycemic agents (metformin) were stopped before and after two days of cardiac catheterization. Previous medical record was checked including renal profile. Phlebotomist was called to take blood for random blood sugar, HbA1C level and renal functions tests (RFTs). Angioplasty was performed according to the set protocol. Serum creatinine level was checked both pre and post contrast. Results: Our study included 136 individuals, with a median age of 48 (+13.36), and we found that 59% of them were men and 41% were women. Of the 136 individuals, only 7 (5%) had contrast-induced nephropathy. Conclusion: To sum up, we found that five percent of diabetic patients having coronary angioplasty in a tertiary care hospital in Peshawar had contrast-induced nephropathy. Keywords: Diabetes mellitis, Coronary angioplasty, Contrast-induced nephropathy.
Incidence, Risk Factors and Outcome of Gallbladder Perforation during Laparoscopic Cholecystectomy
Authors: Ahmed Zahoor , Khan Naveed Ullah , Ahmad Javed , Saeed Sarwat , Batool Syeda Fatima , Sami Asad , Zafar Maria , Khawar Ailiya
Published: February 2023

Background and Aim: Gallbladder perforation has been recorded in patients undergoing laparoscopic cholecystectomy and associated with the development of gallstones and bile leakage. The present study investigated the incidence, risk factors, and outcome of gallbladder perforation in patients undergoing elective laparoscopic cholecystectomy. Patients and Methods: This prospective study was conducted on 156 patients who underwent laparoscopic cholecystectomy in the department of General Surgery, Federal Government Polyclinic Hospital, Islamabad from January 2021 to July 2022. Gallbladder stone patients with chronic symptoms such as vomiting, recurrent episodes of epigastric, nausea, and hypochondrial pain on right side were included. Acute cholecystitis patients with single or multiple gallstone disease were also enrolled. All the patients were prepared for laparoscopic cholecystectomy and investigations such as blood sugar, liver function test, CBC, blood urea and creatinine, ultrasound of gallbladder, and ECG were done. SPSS version 26 was used for data analysis. Results: Of the total 156 patients, there were 126 (80.8%) females and 30 (19.2%) male. Age-wise distribution of patients were as follows: 66 (42.3%) in 20-35 years, 52 (33.3%) in 36-50 years, and 38 (24.4%) in 51-65 years. The incidence of single gall stone (SGS), multi gallstones (MGS), and acute cholecystitis was 48 (30.8%), 88 (56.4%), and 20 (12.8%) respectively. The overall mean age was 36 years. The incidence of gallbladder perforation was 26.9% (n=42) among all patients. Patients distribution based on gallbladder perforation were as follows: 17 (10.9%) in MGS, 14 (9.0%) in SGS, and 11 (7.1%) in acute cholecystitis cases. Conclusion: The present study found that the prevalence of gallbladder perforation was 26.9% among SGS, MGS, and acute cholecystitis. Majority of GB perforation occurred during gallbladder bed dissection. Acute cholecystitis patients are more prone to GB perforation. GB perforation can be reduced by utilization of harmonic scalpel in laparoscopic cholecystitis. Keywords: Elective laparoscopic cholecystectomy, Gallbladder perforation, Outcomes
Evaluation of Clinical Implications of Renal Vessel Morphology during Renal Surgeries
Authors: Billah Motasim , Raza Abbas Ali , Qureshii Ahmad Farzad , Akhtar Sabeen
Published: February 2023

Objective: Aim of this research to examine renal vessels and their morphologies as well as their clinical consequences during renal surgery. Study Design: Cross-sectional study Place and Duration: Anatomy department of Bacha Khan Medical Complex, Mardan and Multan Medical & Dental College Multan during the period from April 2022 to September 2022. Methods: There were 90 cases of both genders presented in this study. Included patients were aged between 20-80 years. With suspected abdominal diseases, patients were referred for abdominal CECT examinations. In contrast-enhanced MDCT images of the Abdomen, the renal arteries were examined for their normal structure and any abnormalities. SPSS 21.0 was used to analyze complete data. Results: Males were higher in numbers 61 (67.8%) than females. Mean age of the patients was 51.3±8.43 years and mean BMI 22.4±8.42 kg/m2. We found frequency of anatomical variations of the renal vessel in 62 (68.9%) cases. Frequency of variations of the renal artery was 47 (52.2%). Among 47 cases, supplementary renal artery was found in 41 (45.6%) cases. Early bifurcation of renal artery in 15 (16.7%). In 11 patients on the right side, 12 patients on the left side, and 3 individuals on both sides, an earlier branching of the renal artery was found. The right side was more often affected by renal vein variations, with 25 (278%) patients having late renal vein confluence and 6 (6.7%) patients having additional renal veins. Patients with late renal vein confluence (3.3%) and retroaortic vein (3.3%) were seen on the left side. Conclusion: Our findings in this research show renal artery alterations are common. Endovascular, laparoscopic, and urological procedures benefit from morphological examination of the renal vessels. Keywords: Abdominal disease, Renal Artery, Conventional Angiography, Anatomical Variations
Perinatal Outcome in Covid-19 Positive Patients at Obstetrics & Gynecological Unit
Authors: Mushtaq Saira , Shami Amber , Qarshi Waqas , Butt Maleeha Tahir , Chaudari Zarrin Khaliq , Tahir Saba
Published: February 2023

Aim: To determine the frequency of perinatal outcomes in COVID-19 positive patients at obstetric and gynecological unit. Material and methods: An observational cross sectional study was conducted at Aziz Fatimah medical college, Obstetrics and Gynecology department from January 2021 to June 2021 on 100 pregnant COVID positive patients. Perinatal outcomes such as cesarean section, postpartum hemorrhage, preterm birth and NICU admissions were assessed. Data was presented as frequencies, percentages and Mean±SD. Results: Mean maternal age was 29.71±6.05 years. The mean gestational age was 36.47±3.83 weeks. Postpartum hemorrhage was seen in 11 (11%) patients, Preterm birth rate was 37 (37%), NICU admissions rate was 44 (44%) and 54 (54%) patients had cesarean section. Conclusion: Pregnant COVID 19 positive women are at great risk of having perinatal complication. Keywords: COVID-19, Perinatal outcomes, Pregnancy
COPD Patients Had a Greater Probability of Getting GERD than the General Population. A Multi Center Study
Authors: Khan Muhammad Asif , Haq Anwar Ul , Khattak Imran Qadir , Zeb Farhan , Ullah Hameed , Awais Muhammad
Published: February 2023

Background: COPD, a kind of obstructive lung disease, is characterized by partially reversible airflow limitation as a symptom. Emphysema and chronic bronchitis are two separate histological and clinical manifestations of chronic obstructive lung disease (COPD). Both components strongly emphasize individualism. The finding of an elevated incidence of gastro esophageal reflux disease (GERD) in this patient group may assist in the decision of whether or not to routinely assess COPD patients for the potential of GERD and treat it successfully. Objective: Understanding the prevalence of GERD among people who have the illness is crucial since it is linked to a poorer outcome in COPD patients. Methodology: Pulmonology department of HMC Hospital Peshawar conducted this multi center study. Analyzed data January 2019–January 2020. This experiment included 54 participants. Patients had complete physicals and histories (aged 21 to 80). After meeting inclusion and exclusion criteria, spirometer and the Q-questionnaire were administered. The same CPSP-certified technician collected all patients' spirometer readings, and the same CPSP-fellow specialist in pulmonology rated each patient's FEV1 following bronchodilator treatment using GOLD criteria (from "01" to "04"). As a percentage of COPD cases, Q-questionnaire respondents had GERD. Results: The mean age of the people was 57.36+08.35, with a standard deviation of 11.590. Men made up only 39% of the total patients, while women accounted for 61% of them. In those with COPD, GERD was present 51% of the time. Conclusion: According to the findings of this investigation, GERD occurred in individuals with COPD 51% more often than the general population. Keywords: COPD , GERD, Population
Comparison of Conjunctival Autograft Versus Bare Sclera Technique as Treatment Modalities for Primary Pterygium
Authors: Afzal Sohaib , Qamar Farah , Khan Safeet Shahbaz , Ahmed Muhammad , Rehman Shujah Ur , Qammer Rabbia
Published: February 2023

Background: Pterygium is a fibrovascular conjunctival growth within the palpebral fissure extending onto the corneal surface. Recurrence is a common post-op complication of pterygium excision surgery, with various rates depending on the techniques used for its excision. Objective: Comparison of conjunctival autograft versus bare sclera technique as treatment modalities for primary pterygium. Material & Methods: This study was done in the Department of Ophthalmology of tertiary care hospital. In a prospective randomized controlled trial a sample size of 102 eyes with primary pterygium were allocated into two equally sized groups (51 patients in each): Group A underwent pterygium excision by bare sclera method, Group B underwent pterygium excision followed by conjuctival autograft. Both groups were analyzed and compared, for recurrence and complications with a mean follow-up time of 3 months. Result: Pterygium recurrence was detected in 16 (31.37%) patients using bare sclera technique (group A) and in 4 (7.84%) patients using conjuctival autograft technique (group B), that reveal a statistically significant difference (p = 0.003) Conclusion: Both surgical techniques are effective for pterygium excision but there is a statistically significant difference (p = 0.003) of pterygium recurrence between both techinques. Pterygium excision with conjuctival autograft should opt for better results in terms of recurrence as well as other complications. Bare sclera technique can be opted for preserving conjunctiva in case of glaucoma or scaring but at the expense of pterygium recurrences. Keywords: Pterygium, conjunctival autograft technique, bare sclera, recurrence.
Intraoperative breakage of a laparoscopic needle holder confirmed by postoperative abdominal X-ray: A case report and literature review
Authors: Hirose Rikuto , Nagase Yoshikazu , Kurahashi Hiroki , Tanaka Asuka , Masuda Kumi , Yokoi Takeshi
Published: February 2023

Introduction: Intraperitoneal retention of surgical instrument fragments may lead to severe complications. Therefore, such foreign bodies must be detected before surgery completion. We present a case with intraoperative breakage of a laparoscopic needle holder confirmed by a routine postoperative abdominal X-ray and review the literature regarding intraoperative laparoscopic instrument breakage.

Case Report: A 58-year-old woman with stage IB1 cervical adenocarcinoma underwent a laparoscopic radical hysterectomy. Surgery was completed without major complications; however, an abdominal X-ray as a routine postoperative examination revealed a radiopaque shadow of approximately 3 mm corresponding to a broken part of the tissue-pad of the laparoscopic needle holder tip. It was successfully removed using laparoscopy with fluoroscopic guidance without further complications. According to the literature review, most of the instrument breakage were noticed during surgery as they were either obvious or impaired function. In our case, since the detached foreign body was extremely small and did not significantly affect needle holder function, it remained unnoticed until the postoperative X-ray was taken.

Conclusion: Postoperative abdominal X-rays identify instrumental fragments infrequently; however, they may help detect intraperitoneal retention of foreign bodies and avoid serious complications following laparoscopic surgery.