bluuebunny/crossref_metadata_2025 huggingface dataset:
Intensive Strategy Resuscitation of Hemorrhagic Shock Patients with Ectopic Pregnancy in the Intensive Care Unit: A Case Report
Authors: Kahar Liliriawati Ananta , Wiwi Monika Sari  , Reyhan Julio
Published: July 2023

Background: Ectopic pregnancy is a health problem in women of reproductive age whose products of conception implant outside the endometrium. Fluid resuscitation and maintenance and adequate treatment in intensive care unit can reduce mortality and morbidity in patients.

Case presentation:  A 19-year-old woman came to the emergency department of Dr. M. Djamil General Hospital Padang with complaints of pain in the lower abdomen for 8 hours before entering the hospital. Physical examination results and obtained anemic conjunctiva (+)/(+). Check-up result in deep vaginal touch (VT) was obtained portion rocking pain (+). Then inspection culdosynthesis with results (+). The patient was diagnosed with acute abdominal ec suspected ruptured ectopic pregnancy at G2P1A0H1 gravid 8-9 weeks with severe anemia. After undergoing laparotomy, the patient was admitted to the ICU for 2 days.

Conclusion: Adequate resuscitation of fluids and blood products and overcoming shock causes are crucial in managing hemorrhagic shock in the intensive care unit.
Evolution of the concept of “Business Performance Management”
Authors: Povazhnyi O.S. , Moiseienko K.Ie. , Chupryna Yu.V.
Published: July 2023

The article is dedicated to the study of the evolution of the concept of Business Performance Management (BPM) – an approach to managing business processes that focuses on achieving strategic goals and maximizing efficiency. The article explores the history of the development of the BPM concept, from the initial idea of controlling financial indicators to modern innovative performance management methods, such as the Balanced Scorecard (BSC) and data analytics.
The purpose of the article is to analyze the evolution of the concept of “business performance management” (BPM) and to determine its role in ensuring successful management activities of modern companies.
The authors discuss the main trends and challenges that have influenced the evolution of BPM, such as the growth of data volume and complexity, the expansion of the global market, and the changing perceptions of the role of information in business management. Specifically, the role of business analytics technologies and their impact on the development of BPM is examined.
The article highlights that BPM is a complex approach to management that requires the integration of many factors, such as strategy, business processes, information technologies, and the human factor. The authors provide recommendations for successful BPM implementation and emphasize the need for an integrated approach to performance management.
The article provides examples of areas of application of Business Performance Management (BPM) tools that allow metallurgical enterprises to increase production efficiency and optimize costs by collecting and analyzing data.
The scientific novelty of this article is that the recommendations and conclusions provided by the authors can be useful for companies looking to improve their performance management. The recommendations contains an overview of the key trends and stages of the evolution of the Business Performance Management concept, as well as guidance on selecting and implementing a performance management system in an organization.
The authors emphasize the importance of a balanced approach to measuring performance and the need to consider the individual needs and characteristics of each company. In general, this article is useful for those who wish to gain a more detailed understanding of performance management in business.
Detection and Mitigation of (D)DoS Attacks in SDN Environment Using Entropy
Authors: Akanksha Shah  , Riddhi Ghate  , Sakshi Kalekar  , Ruchi Nitsure  , Jibi Abraham  , Ashwini Matange
Published: July 2023

Software Defined Networking (SDN) is a paradigm for the networks, where the control planes and data planes are separated. It provides centralized network control by separating the network’s control logic from the underlying hardware devices. However, like traditional networks SDN is also susceptible to Denial of Service (DoS) and Distributed Denial of Service (DDoS) attacks. This paper aims to detect and mitigate DoS and DDoS attacks in an SDN environment using an entropy-based approach. The proposed mechanism calculates the entropy of the network over the collected traffic, and derives a dynamic threshold according to the network traffic conditions to determine whether the environment is subject to DoS or DDoS attacks. In the event of the attack, the proposed mechanism installs a drop flow rule into underlying forwarding devices, discarding the traffic sent from attacking host to victim host
TÌNH TRẠNG DINH DƯỠNG TRẺ 6-23 THÁNG TUỔI TẠI PHÒNG KHÁM - TƯ VẤN DINH DƯỠNG VÀ TIÊM CHỦNG, VIỆN ĐÀO TẠO Y HỌC DỰ PHÒNG VÀ Y TẾ CÔNG CỘNG
Authors: Phan Quốc Anh , Trần Thị Phương Lan , Nguyễn Thị Hương Lan , Phạm Đức Minh , Nguyễn Minh Diệu , Nguyễn Minh Ngọc
Published: July 2023

Đặt vấn đề: Dinh dưỡng đóng vai trò quan trọng đối với sức khỏe của trẻ em không chỉ trong thời ấu thơ mà còn ảnh hướng đến sự phát triển và sức khỏe ở tuổi trưởng thành. Mục tiêu: Đánh giá tình trạng dinh dưỡng của trẻ 6-23 tháng tuổi tại phòng khám - tư vấn dinh dưỡng và tiêm chủng, Viện đào tạo Y học dự phòng và Y tế công cộng năm 2022-2023. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên 394 trẻ trong độ tuổi 6-23 tháng tuổi tại phòng khám – tư vấn dinh dưỡng và tiêm chủng, Viện Đào tạo Y học dự phòng và Y tế công cộng (YHDP&YTCC). Kết quả: Tỷ lệ suy dinh dưỡng (SDD) thấp còi 13,2%, gầy còm 9,4%, nhẹ cân 11,2%, tỷ lệ thừa cân béo phì (TCBP) 5,8%. Tỷ lệ SDD có xu hướng tăng dần trong độ tuổi 6-23 tháng tuổi. Trẻ sinh nhẹ cân có nguy cơ cao mắc SDD thấp còi hơn trẻ sinh đủ cân, tình trạng SDD gầy còm và thấp còi với tuần thai khi sinh, trẻ sinh non. Kết luận: Tỷ lệ SDD tăng lên theo các nhóm tuổi trong nghiên cứu. Tình trạng cân nặng sơ sinh có liên quan tới tình trạng SDD thấp còi và tuổi thai khi sinh có liên quan tới tình trạng SDD gầy còm và nhẹ cân.
KHẢO SÁT ĐẶC ĐIỂM SỬ DỤNG THUỐC TRONG ĐIỀU TRỊ UNG THƯ ĐẠI TRÀNG TẠI BỆNH VIỆN THỐNG NHẤT TPHCM
Authors: Nguyễn Như Hồ , Bùi Hoàng Ngọc Khánh , Nguyễn Đắc Nhân Tâm , Nguyễn Ngọc Khôi
Published: July 2023

Mục tiêu: Khảo sát tình hình sử dụng thuốc điều trị ung thư đại tràng (UTĐT) ở bệnh nhân (BN) mới có chỉ định hoá trị và đáp ứng sau 12 tháng theo dõi. Đối tượng và phương pháp: Nghiên cứu hồi cứu trên BN từ 18 tuổi trở lên, được chẩn đoán UTĐT, có sử dụng ít nhất một thuốc điều trị UTĐT trong giai đoạn 01/01/2019-01/01/2021, chưa từng điều trị bằng hóa chất trước đó. Kết quả: Nghiên cứu ghi nhận được 88 bệnh nhân với 736 đợt điều trị. Độ tuổi trung bình là 63,5±13,7 tuổi, trong đó nam giới chiếm 72,7%. Bệnh nhân UTĐT giai đoạn III chiếm tỉ lệ cao nhất (55,7%). Phác đồ XELOX được chỉ định nhiều nhất (96,6%); thuốc nhắm trúng đích duy nhất được sử dụng là bevacizumab (14,1%). Thời gian sống thêm toàn bộ trung bình là 11,3±0,2 tháng. Kết luận: Đa số BN được chỉ định hoá trị ở giai đoạn muộn và phác đồ thường được sử dụng nhất là XELOX. Nghiên cứu đã cho thấy được thời gian sống thêm toàn bộ sau 12 tháng sử dụng thuốc.
THỰC TRẠNG HOẠT ĐỘNG NGHỀ NGHIỆP CỦA DƯỢC SĨ Ở CÁC QUẦY THUỐC TRÊN ĐỊA BÀN THÀNH PHỐ BUÔN MA THUỘT NĂM 2022
Authors: Nguyễn Thị Diệu Linh , Nguyễn Ngọc Đan Anh , Trần Thị Lan Chi , Nguyễn Minh Nam , Đỗ Văn Mãi
Published: July 2023

Thành phố Buôn Ma Thuột là nơi tập trung mật độ dân cư đông đúc nhất tỉnh Đắk Lắk, số lượng các cơ sở bán lẻ thuốc trên địa bàn cũng đang gia tăng nhanh chóng. Nhưng liệu sự phát triển mạnh số lượng các cơ sở bán lẻ thuốc có song hành cùng với chất lượng hay không. Vì thế, khảo sát thực trạng hoạt động nghề nghiệp của dược sĩ ở một số quầy thuốc trên địa bàn thành phố Buôn Ma Thuột năm 2022 được thực hiện bởi phương pháp mô tả cắt ngang. Kết quả cho thấy trường hợp bán thuốc đối với bệnh đơn giản kỹ năng khai thác thông tin được tất cả các quầy thuốc thực hiện, trung bình 1 quầy thuốc hỏi 4,93 câu; 75,5% quầy thuốc không đưa ra bất cứ lời khuyên nào cho khách hàng, tất cả quầy thuốc đều thực hiện tư vấn sử dụng thuốc nhưng chủ yếu hướng dẫn về liều dùng 1 lần, 97,78% quầy thuốc bán thuốc thuộc nhóm kê đơn. Trường hợp bán thuốc kê đơn có 84,4% quầy thuốc không đưa ra bất kì câu hỏi nào, không có quầy thuốc nào hỏi về đơn thuốc và 91,11% quầy thuốc vẫn đồng ý bán khi khách hàng không có đơn, 93,3% quầy thuốc không đưa ra bất cứ lời khuyên nào cho khách hàng, 97,56% quầy thuốc không có bất kỳ hướng dẫn nào. Hoạt động ghi nhãn thuốc đúng quy định không được thực hiện ở tất cả các quầy thuốc. Bên cạnh đó chỉ có 11,1% quầy thuốc có dược sĩ mặc áo blouse và không có dược sĩ nào đeo biển hiệu ghi rõ họ tên.
ĐIỀU TRỊ PHẪU THUẬT XUẤT HUYẾT TIÊU HÓA DO UNG THƯ DẠ DÀY - DẠ DÀY ĐÔI HÌNH ỐNG
Authors: Thái Nguyên Hưng , Trần Xuân Dũng , Phan Văn Linh
Published: July 2023

Mục tiêu nghiên cứu: 1. Mô tả triệu chứng lâm sàng, cận lâm sàng ca bệnh xuất huyết tiêu hóa (XHTH)/BN ung thư dạ dày đôi hiếm gặp. Kết quả điều trị phẫu thuật (PT) BN ung thư dạ dày đôi. 2. Điểm lại Y văn. - Đối tượng và phương pháp nghiên cứu: + Mô tả hồi cứu ca lâm sàng hiếm gặp. - Bệnh án nghiên cứu (NC): Bệnh nhân Lương Thị Th, SN 1968. Địa chỉ: Lý Bôn, Bảo Lâm, Cao Bằng, Mã: 220270847. Vào: 26/9/2022. Mổ: 5/10/2022. Ra viện: 20/10/022. + Lý do vào viện: Ỉa phân đen, nôn máu, gầy sút. + Bệnh xuất hiện 2 tháng, ỉa phân đen, nôn máu, gầy sút. + Tiền sử (TS): Điều trị tăng HA. Điều trị viêm dạ dày 10 năm. + Xét nghiệm (XN): HC 3,27 G/L. Hb: 9,2g/l; hematocrit: 0,27L/L, BC: 13,4 G/L, TC: 752 G/L. ++ Đông máu: Prothrombin  86%, APTT: 27,6, tỷ lệ 0,91, IRN: 1,1. + Sinh hóa: Ure: 2,2, creatinin: 56, GOT: 61,9, GPT: 9,9, Albumin: 20,7. + CLVT: Phình vị lớn dah dày thành không đều, dày 16mm, tổn thương phá vỡ thành dạ dày tạo thành ổ dịch khí lân cận KT 73-88 mmm, thành dày ngấm thuốc mạnh sau tiêm. + NSDD (trước mổ: Thân phình vị có ổ loét đáy sâu, 3 cm, có rò KL: Phình vị bị phá vỡ, rò. Ảnh NSDD. + Chẩn đoán trước mổ: Gist phình vị lớn dạ dày thủng, XHTH, Rò dạ dày phình vị lớn. + Chản đoán sau mổ: XHTH do UTDD/Dạ dày đôi, xâm lấn cơ hoành T, lách, thân đuôi tụy đại tràng trái. + Tổn thương trong mổ: Khối lớn 10-15cm vùng tâm phình vị, thông với dạ dày, lòng có lót niêm mạc thành túi ở vùng thân vị, tâm, phình vị lớn, phá vỡ thanh mạc, xâm lấn lách, thân, đuôi tụy, cơ hoành trái, đại tràng trái thành khối, cắt. Mổ cắt TBDD, lách, thân, đuôi tụy, cơ hoành T. + Giải phẫu bệnh: U xơ cơ viêm (inflamatory myofibroblastic tumor). + XN hóa mô miễn dịch (HMMD): (+) Ki67. Kết luận: Xuất huyết têu hóa do UTDD/dạ dày đôi là bệnh lý hiếm gặp. Đây là trường hợp dạ dày đôi có sự liên thông giữa dạ dày và nang dạ dày đôi ung thư hóa (Tubular cyst), tổn thương được xác định qua chụp CLVT, nội soi dạ dày và tổn thương trong mổ nang hình ống có thành liên tục với thành dạ dày, có biểu mô lót và cơ bao phủ, tổn thương giải phẫu bệnh (hóa mô miễn dịch) là u xơ cơ viêm, 1 dạng ung thư hiếm gặp ở bệnh nhân dạ dầy đôi ung thư hóa (dạng hay gặp  là adenocarcinome).
The Role of Enterprise Risk Management in enhancing Firm Performance: does Strategic Renewal really matters?
Authors: Chandra Budi , Siagian Yolanda Masnita , Santosa Wahyuningsih , Jurnali Teddy
Published: July 2023

This study aims to measure the impact of enterprise risk management (ERM) to improve firm performance in manufacturing companies in Indonesia. This study also examines the role of strategic renewal in ERM's influence on firm performance. The AMOS application's SEM analysis technique was used to evaluate the research model used in this study. Data from 207 different firms in Indonesia's manufacturing sector were obtained. The originality of this research is adding strategic renewal as a mediating variable that has not been widely used in previous research in analysing the relationship between the ERM and firm performance. The study's results show empirical evidence that internal resources in the form of ERM significantly affect firm performance. Additionally, according to the research findings, strategic renewal is the best way for businesses to deal with environmental uncertainty and dynamic changes. Companies are expected to have adequate resources, but they also need to make changes and implement strategies to turn those resources into better performance.
ANALISIS KESULITAN SISWA DALAM MENYELESAIKAN SOAL ALJABAR DITINJAU DARI KEMAMPUAN BERPIKIR LOGIS
Authors: Rohim Abdur , Prayogi Budi Teguh
Published: July 2023

Salah satu cabang penting matematika, seringkali dianggap sulit dan abstrak adalah materi aljabar. Pengenalan konsep aljabar perlu diberikan kepada siswa, karena konsep tersebut dapat dijadikan modal siswa untuk mempelajari materi pembelajaran selanjutnya. Apabila dari awal siswa mengalami kesulitan memahami konsep aljabar, maka hal tersebut dapat berpengaruh pula pada hasil belajar siswa di masa yang akan datang. Tujuan penelitian ini adalah untuk mendeskripsikan kesulitan siswa dalam menyelesaikan masalah berkaitan dengan aljabar ditinjau dari kemampuan berpikir logis serta menganalisis faktor penyebab kesulitan siswa. Penelitian ini menggunakan metode penelitian deskriptif kualitatif. Penelitian ini menggunakan metode pengumpulan data tes dan wawancara. Untuk menganalisis data, peneliti menggunakan model reduksi data, representasi data, dan penarikan kesimpulan. Hasil penelitian menunjukan bahwa siswa berkemampuan sangat rendah tidak memenuhi semua indikator berpikir logis. Siswa berkemampuan cukup mampu memenuhi 4 indikator selain indikator menyimpulkan. Siswa berkemampuan sangat tinggi mampu memenuhi semua indikator berpikir logis. Adapun faktor yang mengakibatkan kesulitan dalam menyelesaikan soal aljabar adalah kurangnya motivasi, minimnya minat belajar aljabar, kurangnya pemahaman soal, dan ketelitian dalam penerjemahan simbol matematika.
МАТЕМАТИЧЕСКАЯ МОДЕЛЬ ДЛЯ АВТОМАТИЧЕСКОГО УПРАВЛЕНИЯ
Authors: Джулаева Жазира , Вуйцик Вальдемар , Кашаганова Гулжан , Тогжанова Күлжан , Мамбетов Сакен
Published: July 2023

Поставлено и получено решение задачи синтеза управления с учетом длины скользящего интервала оптимизации для класса непрерывных многомерных линейных объектов при квадратичном критерии качества. Получено уравнение движения замкнутой многомерной системы в общем нестационарном случае, учитывающее длину интервала оптимизации и установленные их основные свойства.
MULTIVARIATE STATISTICAL ANALYSIS OF TRANSPORT LOGISTICS IN KAZAKHSTAN
Authors: Kazbekova Kaiyrzhan , Umarov Ilkhom , Ismailovа Rauza
Published: July 2023

This article develops a fragmented approach to the study of changes in the dynamics of the main indicators of transport development on freight transportation in Kazakhstan. Its novelty and originality lies in the fact that the most pronounced indicators, such as rail, road and pipeline transport, were assessed using methods of multivariate regression analysis; a new regression equation was built; intervals of parameters of multiple regression were determined and modern mathematical software of the application software package, focused on the processing of statistical materials was used. Moreover, the results of research on transport logistics development indicators for freight transportation in Kazakhstan (billion tonnes/km) for 2016-2021, a schedule for calculating the parameters of the dynamic series, as well as econometric analysis of autocorrelation coefficients of freight turnover of the Republic of Kazakhstan are presented. The relevance of this article lies in the fact that the statistical data on the above indicators and their calculations using a mathematical apparatus have been investigated in Kazakhstan for the first time. The distribution of regional transport in terms of volume of traffic is shown in an expanded form. On the basis of the statistical data, a trend line of freight turnover corresponding to logarithmic approximation is constructed. All statistical data as well as determination coefficients by modes of transport and freight turnover are ranked in ascending order. In this paper, a detailed econometric analysis was carried out by mode of transport and freight turnover in Kazakhstan, using mathematical methods and the EXCEL application software package.
DEVELOPMENT OF A MOLECULAR DIAGNOSTIC TECHNIQUE FOR THE DETECTION OF BACULOVIRUS INFECTING OAK TASAR SILKWORM, ANTHERAEA PROYLEI
Authors: KHAJJE DIKSHA , SUBRAHMANYAM GANGAVARAPU , M. PONNUVEL KANGAYAM
Published: July 2023

Antheraea proylei, a temperate oak tasar silkworm, is one of the economically important silkworms reared for the production of oak tasar silk. A. proylei is frequently infected with A. proylei nucleopolyhedrovirus (AnprNPV), which causes tiger band disease leading to severe economic loss in oak tasar silk production. Therefore, development of an accurate diagnostic tool may facilitate early detection of pathogen, thus preventing massive economic loss. In the current study, we have developed a real-time quantitative polymerase chain reaction (RT-qPCR) for diagnosis of AnprNPV. The primers specific to p94 gene of AnprNPV were designed to investigate their sensitivity and specificity. The AnprNPV detection limit in RT-qPCR was found to be 2.5 × 101 copy number with 98.12% efficiency. The developed diagnostic technique is 100 times more sensitive than the conventional PCR for the detection of AnprNPV. Further, the technique was validated with filed samples wherein the AnprNPV viral loads in the oak tasar silkworms were ranged from 103 to 1010 copies/l.
Bilateral megalocystic ovaries in frozen-thawed embryo transfer detected during cesarean section: A rare case presentation
Authors: Sharma Sapna
Published: July 2023

In cases of in vitro fertilisation and extremely infrequently with frozen embryo transfer, hyperstimulated, enlarged ovaries and their consequences might be detected in the late stages of pregnancy, even at term.. Ovarian torsion induced by hyperstimulated ovaries can be difficult to diagnose during pregnancy, hence pregnant IVF patients should be closely monitored whether or not they have OHSS.. Although severe and critical OHSS cannot be totally prevented, early detection of high-risk variables, as well as sensible prevention and treatment techniques, can help to minimise the complications and long-term consequences of this iatrogenic illness.
Pleural Embryonal Rhabdomyosarcoma in a 2-year-old child: a rare case report
Authors: Tamhane Ankita
Published: July 2023

Rhabdomyosarcoma is a disease occurring primarily in infants and children. Most common sites involved are head and neck, urogenital tract and extremities. Other sites for rhabdomyosarcoma are quite rare. Here we present a case of a 2 year old child presenting with breathing difficulties due to a pulmonary mass which was diagnosed as Pulmonary Rhabdomyosarcoma.
Pituitary adenoma-Gonadotroph type in a 47 years old female patient: A case report
Authors: Thacker Mansi
Published: July 2023

Pituitary adenomas are tumors of the anterior pituitary. Most pituitary tumors are slow-growing and benign. They are classified based on size or cell of origin. Pituitary adenoma can be classified as microadenoma, macroadenoma, and giant tumors based on size.Pituitary adenomas are mostly found incidentally on imaging modalities obtained for other reasons. Mutations in known Oncogenes have little role in the pathogenesis of most sporadic pituitary adenomas. Case presentation : A 47 years old female patient presented with complain of diminished vision , severe headache and dizziness since 1 months.MRI was advised which showed an ill-defined low signal intensity lesion of approximate 3.4x3.2x3 cm noted in clivus, bilateral spenoid sinus and sella region. Histologically, near-signature appearance is that of elongated cells surrounding blood vessels in a pseudorosette-like ependymoma-mimicking pattern. cells with small round nuclei and there is no significant mitotic activity. Conclusion : Pitutary adenoma-gonadotroph type is benign and can cause symptoms from mass effect or by effecting the level of the hormones. Differetial diagnosis includes ependymoma, Pitutary blastoma, Pitutary nodular hyperplasia, dermoid cyst, low grade astrocytoma, meningioma, rathke cleft cyst.
Application of the software "ZHULDYZ". Adaptation and work with models
Authors: Kabdullova Laura B. , Yussubaliyev Renat A. , Urymbassarov Rustem D. , Bashev Adilbek A. , Mardanov Altynbek S.
Published: July 2023

Background: One of the conditions for the effective development of oil and gas fields is reliable forecasting of its exploitation, including using the capabilities of modern software. As a result of many years of work, the first and only Kazakhstani import-substituting software product "Zhuldyz" was developed which helps to control the implementation of process solutions at the field.

Aim: Implement a single software platform covering the complete cycle of exploration and development of the fields.

Materials and methods: This paper presents the experience of using the Zhuldyz software at the Karatobe Yuzhnoye field, as well as software modules for optimizing modeling processes.

Results: Using software accounting a set of geological and physical results and the production history of the Karatobe Yuzhnoye deposit, data were obtained for constructing development maps, assessing reservoir connectivity and distribution of injected water, analyzing field performance for wells, selecting candidate wells for well interventions, as well as software modules for optimizing modeling processes. Additional opportunities for assessing and comparing field development indicators have also been identified.

Conclusion: Based on the results of the analysis carried out in the Zhuldyz software, solutions were developed to improve the reservoir pressure maintenance system at the Karatobe Yuzhnoye deposit. The selection of wells for well interventions and the calculation of efficiency were carried out, which will reduce the number of unsuccessful well interventions by increasing the quality of selected candidate wells through a new appraisal approach from a geological and technological point of view.
Rural Education and the Challenges of Using Technological Resources in Rural High Schools in the State of Ceará
Authors: Santos Eduana Maria dos , Diniz Aldiva Sales
Published: July 2023

This article aims to analyze the progress of Rural Education as a public policy, access to technological development, and the use of its resources in teaching and learning in Rural High Schools located in agrarian reform settlements in the state of Ceará. It is based on documentary research data and theoretical foundations supported by Diniz (2019), Caldart (2004), Almeida (2005/2006), Santos (2016), Molina (2006), Freire (2015/2019), among others. In the first part of this work, we will focus on the historical context of Rural Education. Subsequently, we will present the concept of Rural Education and highlight the differences that exist between Rural Education and other forms of education. Emphasizing these differences is important for understanding the significant role that the rural movement plays in the protagonism of Rural Education for the rural population. In the second part, we will discuss how technological resources are integrated into Education as a pedagogy. In the third part, we will present the challenges of using technological resources in Rural Schools located in agrarian reform settlements. Considering this entire process, we can highlight that the teaching and learning processes, through the integration of technology, are part of the school curriculum, but there are limitations and lack of investments that go beyond the power of the Rural School.
SKEMA PENGENTASAN KEMISKINAN DITINJAU DARI PERSPEKTIF COLLABORATIVE GOVERNANCE DI KOTA MATARAM
Authors: Pratama Inka Nusamuda
Published: July 2023

Kajian dalam penelitian ini ingin mengetahui terkait dengan skema pengentasan kemiskinan ditinjau dari perspektif collaborative governance di Kota Mataram. Konsep collaborative governance muncul di era paradigma governance. Di era paradigma governance, masyarakat semakin berkembang sehingga pemerintah menghadapi masalah yang lebih kompleks. Pemerintah memiliki keterbatasan untuk mengatasi masalah tersebut seorang diri sehingga perlu berkolaborasi dengan aktor-aktor eksternal. Collaborative governance bukanlah suatu tahapan yang linear, melainkan sebuah siklus. Metode yang digunakan dalam studi ini yaitu penelitian kualitatif dengan teknik pengambilan data wawancara kepada stakeholder terkait. Hasil dalam penelitian ini Skema pengentasan kemiskinan ditinjau dari perspektif Collaborative Governance di Kota Mataram berjalan dengan baik. Kerjasama kolektif antara Pemerintah dan Swasta mampu menekan angka pengentasan kemiskinan di Kota Mataram. Kolaborasi dibutuhkan untuk terus mendorong lahirnya inovasi-inovasi dibidang pengetahuan, formulasi kebijakan yang ideal dan tepat sasaran, support bantuan dan sumbangan berbentuk logistik, serta mutual understanding dari masyarakat yang mampu memberikan dampak positif dalam menekan pengentasan kemiskinan di Kota Mataram.
THE INFLUENCE OF HEALTH EDUCATION ON THE HANDS WASHING TECHNIQUE OF STUDENTS AT THE TAFSIR BOARDING SCHOOL, SURABAYA
Authors: PAMUNGKAS PUTRI
Published: July 2023

Background: One of the best ways to prevent the spread of disease is to maintain good hand hygiene. In the Islamic boarding school environment, students often interact closely, so maintaining hand hygiene is important to prevent the spread of disease. Aim: this study was conducted to evaluate the effect of health education on the hand washing technique of students at Islamic boarding schools. Methods: This study used an experimental method with a pre-test and post-test control group design. The research sample consisted of 60 students, who were divided into two groups, namely the control group (30 people) and the intervention group (30 people). The intervention group was given health education about proper hand washing techniques, while the control group was not given health education. Data was collected by means of observation before and after the intervention using a checklist of correct hand washing techniques. The results of the study showed that after the health education intervention was carried out, there was a significant increase in students' hand washing techniques in the intervention group compared to the control group. In the intervention group, there was an increase in the percentage of correct hand washing technique from 50% before the intervention to 90% after the intervention, whereas in the control group, the percentage of correct hand washing technique only increased from 50% to 55%. Conclusion: It can be concluded that health education can influence students' hand washing techniques at Islamic boarding schools.

 

Keywords: Health Education, Hand Washing
Microreactor Testbed Automation through Digital Engineering and Digital Twins
Authors: Browning Jeren , Hansel Joshua , Wilsdon Katherine , Houck Kaleb , Pluth Adam
Published: July 2023

Digital engineering is the practice of creating repeatable frameworks to bring the power of automation and information technologies to complex systems. Model‐based systems engineering (MBSE) is an essential part of digital engineering by providing a roadmap for digitalization. Digital engineering and MBSE can be applied in a myriad of situations, one of which is for the development of digital twins for autonomous and remote control. Autonomous and remote operation of physical assets can provide numerous benefits to organizations and industries that deal with complex and distributed systems. The automation of the operation of a physical asset can be achieved through a digital twin, connected to the inputs and outputs of the asset and using machine learning (ML) and artificial intelligence (AI). Development of the digital twin requires understanding of systems interfaces and incorporating this understanding in digital systems. The effort described herein aims to determine the feasibility and benefit of such a process through the development and evaluation of a digital twin connected to a heat‐pipe test‐bed environment. Many challenges need to ultimately be addressed by a digital twin including data quality, infrastructure, privacy and security, and more. However, the focus of this paper will be on the application and use of digital engineering for the development of autonomous digital twins through a repeatable framework that can be applied across various domains and assets.
Fiscal self‐sufficiency, debt policy, and long‐term sustainability in China's emerging local bond market
Authors: Shi Yu , Li Qing , Bland Robert
Published: July 2023

Using panel data from 155 Chinese provincial‐level governments between 2015 and 2020, this study develops fiscal indicators to measure the sustainability of China's bond market given its institutional context. With these indicators, the research empirically explores the effect of fiscal institutions such as centrally‐imposed debt limits on local governments' debt sustainability. It also investigates the capacity of local governments for self‐sufficiency to meet their debt obligations and maintain long‐term sustainability. We find that debt limits have promoted local debt sustainability while local fiscal self‐sufficiency has had little effect on debt sustainability in the long‐term. The findings provide public finance and policy scholars with an understanding of the effectiveness of fiscal institutions such as debt limits imposed by China's central government.
Sources and Pathways of Glacial Meltwater in the Bellingshausen Sea, Antarctica
Authors: Sheehan Peter M. F. , Heywood Karen J. , Thompson Andrew F. , Flexas M. Mar , Schodlok Michael P.
Published: July 2023

Meltwater content and pathways determine the impact of Antarctica's melting ice shelves on ocean circulation and climate. Using ocean glider observations, we quantify meltwater distribution and transport within the Bellingshausen Sea's Belgica Trough. Meltwater is present at different densities and with different turbidities: both are indicative of a layer's ice shelf of origin. To investigate how ice‐shelf origin separates meltwater into different export pathways, we compare these observations with high‐resolution tracer‐release model simulations. Meltwater filaments branch off the Antarctic Coastal Current into the southwestern trough. Meltwater also enters the Belgica Trough in the northwest via an extended western pathway, hence the greater observed southward (0.50 mSv) than northward (0.17 mSv) meltwater transport. Together, the observations and simulations reveal meltwater retention within a cyclonic in‐trough gyre, which has the potential to promote climactically important feedbacks on circulation and future melting.
Group 2 pulmonary hypertension: from diagnosis to treatment
Authors: Frantz Robert P.
Published: July 2023

Purpose of review

Pulmonary hypertension associated with left heart disease (PHLHD) is common and associated with adverse prognosis. Proper diagnosis is critical to avoid inappropriate treatment. Practical approaches to noninvasive diagnosis are available, though invasive hemodynamics including volume loading or exercise are often necessary for definitive diagnosis. Treatment strategies and research in the field is rapidly evolving.

Recent findings

Combined pre and post capillary pulmonary hypertension is associated with remodeling of the pulmonary vasculature that is proportional to the severity of the pulmonary hypertension. Even quite mild elevation of pulmonary vascular resistance (PVR), (greater than 2.0 Wood units (WU)) is associated with adverse outcome. Guideline-directed medical therapy (GDMT) for left heart failure has rapidly evolved, including approval of SGLT2 inhibitors for treatment of heart failure with preserved ejection fraction (HFpEF). However, full implementation of GDMT is lagging. Utilization of implanted pulmonary artery pressure monitoring can facilitate patient management in selected patient phenotypes and has been utilized to demonstrate improvement in pulmonary pressures with emerging therapies in HFpEF including SGLT2 inhibitors and sacubitril/valsartan. A variety of shunt devices to create a left-to-right shunt in order to decompress the left heart are available or undergoing clinical trials. There is concern that there could be adverse response to such devices in patients who have even mild elevation of pulmonary vascular resistance. Sleep disordered breathing is common in PHLHD and should be aggressively sought out and treated.

Even mild elevation in pulmonary vascular resistance is associated with adverse outcome. A systematic approach to diagnosis of PHLHD is essential. Guideline-directed medical therapy for PHLHD prioritizes optimal management of the left heart disease. Pulmonary artery pressure sensors are useful in selected patients.
Spatio-temporal “global” neurodynamics of the human brain in continuous and discrete picture: Simple statistics meet on-manifold microstates as multi-level cortical attractors
Authors: Asai Tomohisa , Kashihara Shiho , Chiyohara Shinya , Hiromitsu Kentaro , Imamizu Hiroshi
Published: July 2023

The neural manifold in state space represents the mass neural dynamics of a biological system. A challenging modern approach treats the brain as a whole in terms of the interaction between the agent and the world. Therefore, we need to develop a method for this global neural workspace. The current study aimed to visualize spontaneous neural trajectories regardless of their measuring modalities (electroencephalography [EEG], functional magnetic resonance imaging [fMRI], and magnetoencephalography [MEG]). First, we examined the possible visualization of EEG manifolds. These results suggest that a spherical surface can be clearly observed within the spatial similarity space where canonical microstates are on-manifold. Once valid (e.g., differentiable) and useful (e.g., low-dimensional) manifolds are obtained, the nature of the sphere, such as shape and size, becomes a possible target of interest. Because these should be practically useful, we suggest advantages of the EEG manifold (essentially continuous) or the state transition matrix (coarse-grained discrete). Finally, because our basic procedure is modality-independent, MEG and fMRI manifolds were also compared. These results strongly suggest the need to update our understanding of neural mass representations to include robust “global” dynamics.
What are the outcomes in patients referred to a tertiary referral centre for Crohn's rectovaginal fistula surgery?
Authors: Sapci Ipek , Zutshi Massarat , Akeel Nouf , Hull Tracy
Published: July 2023

Aim

Rectovaginal fistulas in patients with Crohn's disease are challenging to manage, and surgical treatment remains the best option for achieving permanent closure of the fistula. Biologicals are now used routinely for patients with Crohn's disease. The aim of this study was to investigate the surgical procedures used by us to treat rectovaginal fistula in patients with Crohn's disease in the era of biologicals.

Method

Patients with Crohn's disease who underwent surgery for a rectovaginal fistula between 2010 and 2020 were included in this retrospective study and were identified from a prospectively maintained institutional database. Collected variables included demographics, perioperative and operative variables and data regarding medications used. Success of the procedure was defined as no symptoms at least 6 months after definitive repair and/or stoma closure.

Results

Twenty patients (out of 80 referred for evaluation) underwent surgery with intent to close the fistula and had at least 6 months of follow‐up. Mean age was 44 ± 12 years with a median follow‐up duration of 33 months (range 6–130 months). Forty per cent of the patients had a history of at least two surgeries to close the fistula. The overall healing rate was 70% (14/20). The most performed procedure was a transanal rectal advancement flap (7/20), with a success rate of 85%.

Conclusion

Rectovaginal fistula in Crohn's disease is difficult to cure; according to our results almost half of these patients have multiple surgeries due to recurrence. Multiple procedures may be offered for this challenging problem in motivated patients. Perioperative diversion should be strongly considered.
Insights Into the Cardiomodulatory Effects of Sex Hormones: Implications in Transgender Care
Authors: Shawky Noha M. , Reckelhoff Jane F. , Alexander Barbara T. , Yanes Cardozo Licy L.
Published: July 2023

Transgender individuals that undergo gender-affirming hormone therapy may experience discrimination in the health care setting with a lack of access to medical personnel competent in transgender medicine. Recent evidence suggests that gender-affirming hormone therapy is associated with an increased risk of cardiovascular diseases and cardiovascular risk factors. A recent statement from the American Heart Association reinforces the importance of cardiovascular-focused clinical management and the necessity for more research into the impact of gender-affirming hormone therapy. With this in mind, this review will highlight the known cardiovascular risk factors associated with gender-affirming hormone therapy and identify potential molecular mechanisms determined from the limited animal studies that explore the role of cross-sex steroids on cardiovascular risk. The lack of data in this understudied population requires future clinical and basic research studies to inform and educate clinicians and their transgender patient population to promote precision medicine for their care to improve their quality of life.
Three Policies Shape Enterprise Value: Minor Adjustments Could Enhance the Societal Benefit
Authors: Hooke William
Published: July 2023

This AMS Policy Study examines explicitly the role that public policy plays in determining the sum societal value of Earth Observations, Science, and Services (OSS) as well as the allocation of that value and the costs of OSS production across society. It examines three policy frameworks of quite different origin, purview, and standing. The first is the 2003 Fair Weather Report developed by the National Academy of Sciences. That policy focuses on collaboration. The second is the 2017 Weather Research and Forecasting Innovation Act enacted by the U.S. Congress. It focuses on innovation. The third is the current World Meteorological Organization development of Resolution 42, which seeks to make international contributions to and access to data and information more equitable, and at the same time expand the domain of data and information sharing from weather per se to Earth observations, science, and services more broadly. The study takes as its point of departure views of individual stakeholders in the so-called Weather, Water and Climate Enterprise (loosely speaking, the community of U.S. providers of weather, water, and climate information and services) with respect to these policies. Their perspectives were captured through informally solicited public and private comments from senior members of the Enterprise. Individually and in aggregate the comments hint at or suggest opportunities for extending and improving Enterprise value by broadening collaboration, fostering innovation, and making the Enterprise more equitable.
Kematian Mendadak Perspektif Hadis
Authors: Adnan Zaid
Published: July 2023

Kematian sering kali menghantui setiap orang. Tidak ada yang mengetahui kapan saatnya  kematian itu datang. Bisa saja hari ini, lusa, atau tahun depan. Tulisan ini akan membahas kematian mendadak dari sudut pandang hadis Nabi saw. Hadis yang berkaitan dengan tema ini akan dikaji dengan menggunakan kaidah-kaidah hadis yang sudah dirumuskan oleh para ulama. Diharapkan dari  hasil kajian ini dapat menjadi khazanah pustaka dalam kajian hadis. Metode penelitian yang digunakan adalah kajian kepustakaan (library research). Hadis tentang kematian mendadak terdapat dalam kitab Mu’jam as-Saghir milik Thabarani dalam susunan perawinya terdapat seorang yang tidak tsiqat walaupun sanadnya bersambung.
A formação de uma agremiação situacionista na Era Vargas: origens das carreiras políticas de dirigentes e candidatos do Partido Social Democrático do Paraná (1933-1937)
Authors: Aramis Richter Gomes Sandro
Published: July 2023

Neste artigo é desenvolvida uma investigação sobre o princípio da atividade política de dirigentes e candidatos de uma agremiação situacionista denominada Partido Social Democrático do Paraná (PSD-PR), cuja existência abrangeu os anos de 1933 a 1937. O objetivo deste estudo é avançar na compreensão acerca da organização interna e do desempenho eleitoral dos partidos estaduais que surgiram no contexto do Governo Provisório (1930-1934) de Getúlio Vargas. Há três argumentos sustentados neste artigo. Primeiro, é demonstrado que a direção do PSD-PR contou com a presença de indivíduos oriundos dos partidos governistas da Primeira República. Houve veteranos que tiveram destacada participação na estruturação desse partido. Segundo, cumpre salientar que a maioria dos candidatos eleitoralmente competitivos dessa agremiação era novata na cena política. Terceiro, é evidenciado que o PSD-PR pertenceu ao rol de partidos governistas eleitoralmente competitivos. Nessa época, foram poucos os dissidentes e oposicionistas históricos que conseguiram suplantar os candidatos situacionistas do Paraná.
Case Report of an Osteochondral Lesion of the First Metatarsal Head in an Adolescent Patient Treated by Autograft Mosaicplasty: Surgical Technique and Decision-Making Rationale
Authors: Arcângelo Joana , Silva Eduardo Ramalho , Norte Susana , Sant’anna Francisco , Thüsing Monika , Neves Manuel Cassiano
Published: July 2023

Introduction: First metatarsophalangeal (MTP) joint mobility is critical to a normal gait pattern; therefore, osteochondral defects (OCDs) of the first metatarsal head should be treated promptly to avoid functional limitation and progression to hallux rigidus. <15 cases of OCDs of the first MTP joint in the pediatric population, predominantly adolescents, have been published so far. The purpose of this article is to present a rare case of an adolescent first MTP joint OCD treated by the technique of autograft osteochondral mosaicplasty, which has been commonly used for OCDs of the knee and talus but scarcely described for the first MTP joint. Case Report: The case of a 13-year-old male futsal player with a post-traumatic 50 mm2 OCD of the first metatarsal head is presented. The Osteochondral Autograft Transfer System® (Arthrex Inc™, Naples, FL) was used to harvest a 10-mm diameter donor plug from the medial ipsilateral femoral condyle, then delivered to the first metatarsal head. At the 6-month follow-up, physical activity had been resumed with no pain or significant mobility limitation and an improvement of the American Orthopedic Foot and Ankle Society hallux score of 54–95 points. At the same time, a follow-up magnetic resonance showed complete incorporation of the osteochondral graft without bone edema or subchondral osteonecrosis. Conclusion: Treatment for osteochondral lesions, regardless of their location, aims to restore function by recreating the articular congruity reducing the potential for a progressive degenerative process. Multiple surgical treatment options exist for OCDs of the first metatarsal head. The treatment decision must take into consideration both patient factors and lesion factors. Based on this, a literature revision and treatment decision rationale are presented. This case demonstrated that an osteochondral transplant could be a reasonable treatment option for a traumatic, full-thickness OCD of the first metatarsal head in adolescent patients. Keywords: Adolescent, first metatarsal head osteochondral defect, autograft osteochondral mosaicplasty.
Tinkles
Authors: Dow Mark
Published: July 2023

Abstract: The Summer 2023 Issue. Ploughshares is an award-winning journal of new writing. Since 1971, Ploughshares has discovered and cultivated the freshest voices in contemporary American literature, and now provides readers with thoughtful and entertaining literature in a variety of formats. Find out why the New York Times named Ploughshares "the Triton among minnows." The Summer 2023 Issue, guest-edited by Tom Perrotta, features poetry and prose by Marianne Leone, Cheryl Lu-Lien Tan, Andre Dubus III, Fabio Morabito, Jen Trynin, Olufunke Grace Bankole, and Jess Walter, among others.
The elimination of trachoma as a public health problem in Togo: Successes and challenges
Authors: Bakoubayi Akila Wimima , Gadah Denis Agbenyigan Yawovi , Gnossike Piham , Zida-Compaore Wendpouiré Ida C. , Bando P’tanam P’kontème , Alaglo Kamevor , Tchalim Maweke , Patchali P’niwè , Bitty-Anderson Alexandra , Ekouevi Didier Koumavi
Published: July 2023

Background

As of May 2022, 15 countries have declared that they have reached their trachoma elimination targets, but only 13 of them, including Togo, have been validated by the World Health Organization as having eliminated the disease as a public health problem. The aim of this study was to describe the broad interventions that have supported the elimination of trachoma as a public health problem in Togo from its inception in 2006 to the validation of its elimination in 2022.

Method

A review and compilation of data and information contained in the country’s submission to World Health Organization for validation of trachoma elimination as a public health problem was conducted. Data from national and local surveillance systems and reports on actions taken after achieving the elimination target were also included.

Results

Togo has achieved the elimination of trachoma as a public health problem by 2022. The prevalence of follicular trachoma among children aged 1–9 years is <5% in all nationally defined administrative units suspected of having trachoma after stopping mass treatment for at least 2 years. The prevalence of trichiasis among persons aged 15 years and older is less than 0.2% in all administrative units previously endemic for trachoma and evidence of the ability to manage incident cases of emerging trichiasis in the community has been demonstrated. The key of the success in the elimination process was primarily the political commitment of the health authorities with financial and technical support from various international organizations.

Conclusion

The elimination of trachoma as a public health problem in Togo is a real success story that can serve as an example for the elimination of other neglected tropical diseases in Africa. But regular monitoring and surveillance is essential to avoid the re-emergence of such disease in the country.
Inhibitory effect of Greek oregano extracts, fractions and essential oil on economically important plant pathogens on soybean
Authors: Lyubenova A. , Nikolova M. , Slavov S. B.
Published: July 2023

Abstract. The inhibitory potential of Greek oregano extracts, fractions and essential oil on three economically important plant pathogens on soybean was examined. In vitro experiments were conducted to determine the effects of essential oil (EO), acetone exudate (AE), methanol extract (ME), and its polar (PF) and non-polar (NPF) fractions, originating from O. vulgare ssp. hirtum plants, on the mycelial growth of Phytophthora sojae, Pythium debarianum, and Alternaria alternata, which were isolated from diseased soybean plants. Seven variants: EO, AE, ME, PF, NPF at concentrations of 100 mg/ml, blank (with the solvent – DMSO) and control (without treatment) were performed with all isolates. The mycelial growth of P. sojae was inhibited to the greatest extent – over 95% reduction of growth under the impact of EO, ME, AE and NPF. In A. alternata variant there was also a high degree of growth inhibition – most pronounced in EO variant (97%) and least in ME variant (78%). The weakest inhibitory effect of the studied extracts was observed in P. debarianum – between 27% (NPF) and 36% (ME). In polar fraction treatments, growth enhancement was observed in P. sojae and A. alternata. Oregano essential oil, methanol extract, acetone exudate and non-polar fraction can be considered as promising candidate active compounds of potential biopesticide formulations for the control of soybean diseases.