bluuebunny/crossref_metadata_2025 huggingface dataset:
DECODING DIGITAL BUSINESS STRATEGIES: INSIGHTS FROM FIVE YEARS OF RESEARCH
Authors: Senfeng Zheng
Published: November 2024

The contemporary business environment is characterized by its dynamic nature, driven by rapid technological advancements, necessitating enterprises to adapt their operational frameworks continually to sustain competitiveness and relevance. Consequently, the formulation of a robust digital business strategy becomes imperative, serving as a strategic necessity to effectively navigate the intricacies of the digital era. Given the swift pace of digital metamorphosis and the accelerated proliferation of emerging technologies, notably artificial intelligence, a systematic examination of scholarly literature on digital business strategies is indispensable to discern current trends and inform decision-makers promptly. This investigation endeavors to delineate prominent research clusters and influential figures within the realm of digital business strategy, elucidate fundamental concepts underpinning digital business strategies, and thereby construct a comprehensive framework encapsulating the foundational principles of this domain. This study conducts a comprehensive bibliometric analysis of Web of Science publications pertaining to Digital Business Strategy within the Business and Management disciplines, focusing on works indexed over the preceding five years utilizing the Biblioshiny application. The findings underscore a burgeoning interest in this subject, a proliferation of research collaboration, and a significant internationalization of the research landscape. Noteworthy contributions emanating from countries such as China, the United Arab Emirates, Italy, Jordan, and the United Kingdom underscore the ascent of new frontrunners in the contemporary business arena and highlight the transformative influence of digital technologies in reshaping global business competitiveness. Central themes in contemporary research on digital business strategies include business implementation (performance), recognition of the innovative essence of changes and the imperative for innovation, the pivotal role of marketing, and opportunities for SMEs. Fundamentally, these inquiries are anchored in technology, innovation, impact assessment, and understanding the imperative for flexibility in management practices. The key components of a successful digital business strategy include a focus on innovation and management alongside considerations of performance and impact. Digital business strategies are intimately intertwined with digital technologies, marketing methodologies, social media platforms, business model innovations, and the optimization of supply chain operations. The insights gleaned from this research endeavor could serve to guide business decision-makers in navigating the intricacies of contemporary digital strategy formulation and offer valuable direction for future research inquiries within this domain.
РОЛЬ ШТУЧНОГО ІНТЕЛЕКТУ ДЛЯ ЗМІЦНЕННЯ БРЕНДУ РОБОТОДАВЦЯ КОМПАНІЇ
Authors: Драган Олена , Пилипенко Максим
Published: November 2024

У статті досліджується вплив штучного інтелекту на розвиток і зміцнення бренду роботодавця компанії у системі менеджменту персоналу. Досліджені складові бренда роботодавця: корпоративна культура, умови праці, професійний розвиток, система мотивації та винагород, а також загальний імідж компанії у суспільстві. Обґрунтовано, що сучасний штучний інтелект (ШІ) розвивається завдяки поєднанню різних інноваційних технологій ‒ хмарних сервісів, таких як AWS, Google Cloud та Microsoft Azure, забезпечуючи доступність необхідних обчислювальних потужностей для підприємств. Узагальнені HR-процеси для застосування штучного інтелекту з метою зміцнення бренду роботодaвця компанії ‒ підтримка корпоративної культури та мотивації; моніторинг та аналіз репутації компанії на підставі вивчення зворотного зв’язку; виявлення HR-трендів та прогнозування майбутніх змін. Обґрунтовані переваги, ризики та виклики для компанії при використанні ШI з метою зміцнення бренду роботодавця. Отже, ШI як інструмент для розвитку та зміцнення бренду роботодавця відкриває нові можливості та надає значні конкурентні переваги компанії на ринку праці.
РОЛЬ ІНФОГРАФІКИ У ВИВЧЕННІ РЕГІОНАЛЬНОЇ АРХІТЕКТУРИ: АНАЛІЗ НА МАТЕРІАЛАХ ПРОЄКТУ MAPPING GOTHIC FRANCE
Authors: Черкес Богдан Степанович , Штець Віктор Олексійович
Published: November 2024

Вивчення регіональної архітектурної спадщини є основою в усвідомленні своєї культурної ідентичності та розумінні історичного розвитку. Інфографіка та інші вдосконалені підходи до візуалізації слугують ефективними інструментами для представлення архітектурних пам’яток у привабливій зрозумілій манері. Приклади застосування інфографіки у таких проєктах, як Mapping Gothic France, продемонстрували її виражальний потенціал у візуалізації складних архітектурних об’єктів, деталізуючи як складні конструктивні елементи, так і стильові регіональні варіації. Даний підхід допомагає як професіоналам, так й аматорам отримати більше знань про нюанси готичної архітектури у вказаних місцевостях. Наочна візуалізація французьких та англійських готичних катедральних соборів допомагає дослідникам краще зрозуміти історичну та культурну специфіку кожної архітектурної спадщини. Особливо це важливо для порівняльних досліджень. Метою даного дослідження є формулювання методичних рекомендацій щодо створення вебресурсу, присвяченого візуалізації регіональної архітектурної спадщини в контексті українських реалій. Дослідження зосереджено на аналізі наявних підходів до візуалізації архітектурної спадщини, оцінці переваг та недоліків використання інфографіки та розробці інноваційних рішень для презентації архітектурної спадщини України. Методологія дослідження ґрунтується на візуальному та порівняльному аналізі, що дозволяє оцінити ефективність використання інфографіки в цьому аспекті та окреслити перспективи її подальшого розвитку. За результатами дослідження розроблено методичні рекомендації щодо створення інтерактивного вебсайту-інфографіки, який презентує архітектурну спадщину України. Перспектива подальших досліджень буде спрямована на вивченні особливостей великої кількості різноманітних географічних і культурних контекстів. Практичне значення дослідження допоможе сформувати підґрунтя для реалізації проєкту інтерактивної інфографіки, призначеної для використання в освіті та збереженні культурної спадщини.
СИМВОЛІКО-АЛЕГОРИЧНЕ ТРАКТУВАННЯ ОБРАЗІВ У ГРАФІЧНИХ ТВОРАХ ОЛЕНИ КУЛЬЧИЦЬКОЇ
Authors: Кузьменко Ольга Іванівна
Published: November 2024

В теперішній ситуації дуже гостро постає питання національної ідентичності та свідомості українського народу. Для усвідомлення власної унікальності необхідно глибинно досліджувати історичні постаті, які стануть фундаментом та прикладом для наслідування сучасних митців. Однією з таких прикладів є Олена Кульчицька – перша жінка – мисткиня, громадська діячка та викладачка з Галичини. Метою дослідження є проаналізувати графічні твори Олени Кульчицької, виявити домінуючі тематики в її творчості та описати їх символіко-алегоричне трактування. Методи дослідження. В основу дослідження покладено історичний, порівняльний та метод аналізу, які дали змогу не лише глибинно познайомити з розвитком творчості мисткині, але й позначити як її твори впливали на формування плеяди нових митців на початку ХХ ст. Результати дослідження. Олену Кульчицьку по праву можна вважати справжнім мастодонтом графічного мистецтва України. Її вклад у відродження та повернення цього виду мистецтва неможливо переоцінити. У статті увагу приділено тематиці її творів: від «геніальної простоти» та зображення буденності життя, портретів митців, князів, королів, міфологічних героїв до алегоричного зображення зрізу стану суспільства, країни, народу та світу. Завдяки працьовитості та любові до мистецтва вона залишила після себе абсолютно унікальний творчий спадок, який став фундаментом для багатьох її сучасників, особливо це стосується графіки. Висновки. Значущість нашого дослідження полягає в аналізі графічних творів Олени Кульчицької, завдяки якому сміливо можна сказати, що символізм та алегоричне зображення являється не ситуативним, а є наслідком унікального уміння художниці сублімувати чутливий досвід в твори. Результати можуть бути використані для подальшого аналізу інших видів творів Олени Кульчицької та творів її послідовників.
ВПЛИВ АБСТРАКТНИХ ІЛЮСТРАЦІЙ У КНИЖКОВОМУ ДИЗАЙНІ НА ЧИТАЧА
Authors: Пономаренко Олександра Вячеславівна , Кравченко Олег Вадимович
Published: November 2024

Метою статті є дослідження впливу абстрактних ілюстрацій у книжковому дизайні на сприйняття читача, аналіз ролі абстрактного мистецтва в формуванні емоційного досвіду. Особлива увага приділяється вивченню зв’язку між візуальною складовою книги (дизайну) та емоційною взаємодією з авдиторією. У процесі видання книжок ілюстрації грають ключову роль, а саме: доповнюють текст, створюють настрій, також додають глибину змісту. Абстрактні ілюстрації мають здатністю працювати на рівні підсвідомості читача, стимулюючи його фантазію та підвищуючи загальне сприйняття літературного твору. Ілюстрації у книжковому дизайні можуть тлумачитись кожним читачем по-різному, оскільки вони не змушують дотримуватися певних зображень чи сюжетів. Цей вид ілюстрацій звертається до прихованих емоцій, які виникають, та особистих інтерпретацій (залежно від минулого досвіду, культурного контексту та вподобань одержувача інформації). Розглядається як абстрактне мистецтво може впливати на сприйняття тексту та загальне враження від літературного твору, створюючи додаткові змісти, підсилюючи емоційність, надаючи виразності. Також досліджується вплив кольору та композиції на аудиторію та як ці елементи можуть змінити емоційний стан читача. Колір відіграє важливу роль у книжковому дизайні, оскільки він може викликати емоції та впливати на те, як читачі візуально сприймають текст і зображення. Він може підсилювати або послаблювати візуальні образи, створюючи певні асоціації та психологічні реакції, що сприяють або ж, навпаки, ускладнюють процес занурення в текст. Наукові дослідження кольору свідчать про його здатність викликати певні когнітивні процеси, зокрема покращення концентрації уваги та збереження інформації, що робить його важливим інструментом у дизайні книжок для підвищення ефективності читання та емоційного залучення. Крім цього, у статті розглядається еволюція функцій ілюстратора в сучасному дизайні книги. Нині ілюстратор активним співавтором твору, оскільки його творчість виходить за межі ілюстрацій тексту і стає невід'ємною частиною загального концепту книги. Абстрактні ілюстрації сприяють посиленню художньої концепції твору та додають нові верстви значення, дозволяючи читачеві глибше поринути у текст і розширити його сприйняття.
Quality of Life-Related to Oral Health in Post-COVID-19 Primary Care Patients
Authors:   Universidad Nacional San Luis Gonzaga Ica, Perú, Chauca Carmen , Becerra-Canales Bladimir ,   Universidad Nacional San Luis Gonzaga Ica, Perú, Arones Maritza ,   Universidad Nacional San Luis Gonzaga Ica, Perú, Phun-Pat Ynés ,   Universidad Nacional San Luis Gonzaga Ica, Perú, Curro-Urbano Olga ,   Universidad Nacional San Luis Gonzaga Ica, Perú, Quispe-Nombrera Virgilio ,   Instituto Superior Tecnológico Estatal Fernando León De Vivero. Ica, Perú
Published: November 2024

Abstract: The persistence of residual symptoms in post-COVID-19 patients has been identified as a factor that negatively affects quality of life, especially in aspects related to oral health. The purpose of the study was to determine the quality of life-related to oral health in primary care patients who had overcome the COVID-19 infection. A descriptive, non-experimental study was developed with the participation of 361 post-COVID-19 patients, to whom the survey was applied: Impact of oral health on Quality of Life (OHIP-14). The participants were mostly women (52.9%), and adults (55.4%), with occupations in the field of health (16.6%), and higher education (76.5%). Data were collected on history of COVID-19, severity of infection, hospitalization, comorbidities, risk perception, fear of the virus, presence of post-COVID-19 sequelae, and adult life stage. The analysis revealed that oral health-related quality of life in post-COVID-19 primary care patients is significantly lower. The perception of dental and oral problems during the period is correlated with a greater impact on quality of life in terms of oral health. Homogeneous distribution of the average and median values was observed in dimensions such as functional limitation, physical pain, social disability, and handicap. However, in comparison, the dimensions of physical and psychological disability stand out as the most affected. The results indicate that oral problems in this phase significantly impact the quality of life, highlighting the need for specific interventions to improve recovery and well-being. A comprehensive approach can help manage sequelae and improve the quality of life for these patients.

Keywords: Quality of life, Oral Health, COVID-19, Primary care
The History of Discipleship in Judaism
Authors: Dadon Kotel
Published: November 2024

Ovaj članak bavi se poviješću učeništva u judaizmu i njegovim prijelazom iz individualne obveze u javni obrazovni sustav. Članak je podijeljen u tri glavna dijela: prvi dio raspravlja o središnjoj ulozi obrazovanja u proučavanju Tore u judaizmu, kao i o židovskom pravnom konceptu „obrazovne obveze“ nasuprot modernom pravnom konceptu „prava na obrazovanje“. Drugi, središnji dio ispituje razvoj židovske obveze obrazovanja – prijelaz s privatnog na javno obrazovanje. Autor analizira različite talmudske propise koji su doveli do ovog prijelaza i njihov međusobni odnos. Na kraju ovog dijela, autor raspravlja o strukturi financiranja javnoga obrazovnog sustava i pravu roditelja da odaberu obrazovni okvir za svoju djecu. U trećem dijelu, autor naglašava posebnost židovskog obrazovanja kao vrhovne vrijednosti čistoga intelektualnog proučavanja Tore, što se odnosi i na financijske interese poput prava učitelja na štrajk u židovskom pravu te na predanost učenju u vremenima teških nedaća i tame poput razdoblja holokausta. U ovom istraživanju autor analizira različite židovske izvore, od pisane Tore i usmene Tore, uključujući Talmud, Mišnu, Midraš i rabinske response od srednjeg vijeka do modernih vremena. Velik dio ove literature preveden je s hebrejskog i aramejskog.
Portraits of Deficient Discipleship
Authors: Oprean Daniel G.
Published: November 2024

Cilj je ovoga članka istražiti način na koji evanđelist Matej prikazuje manjkavost učeništva skiciranjem triju portreta ljudi čije je učeništvo bilo manjkavo. Usredotočit ćemo se na Matejevo evanđelje 8,18-27. Prvi portret prikazuje nadobudnog učenika, kojega Matej opisuje kao entuzijastičnu osobu koja ipak ne razumije kakav je Isus učitelj (Mt 8,19-20). Ova je osoba prikladna ilustracija prve vrste manjkavog čovjekova pokušaja da slijedi Isusa, a možemo je nazvati besplatnim učeništvom. Drugi portret pokazuje osobu koja jest učenik, no koja ipak oklijeva slijediti Isusa zato što mu nisu jasni vlastiti egzistencijalni prioriteti i ne razumije kakav je Isus učitelj (Mt 8,21-22). Ovaj portret služi nam kao korisna ilustracija druge vrste manjkavoga čovjekova pokušaja da slijedi Isusa, koju ćemo nazvati neobvezno učeništvo. Treći portret prikazuje učenike koji su pozvani, ali su ipak opisani kao oni koji se boje jer ne razumiju kakav je Isus Gospodin (Mt 8,23-27). Ovaj je portret realistična ilustracija treće vrste manjkavoga čovjekova pokušaja da slijedi Isusa, a to je učeništvo bez nevolja. Međutim, kada se susreo s ovim trima kategorijama protagonista u biblijskom tekstu, Isus je ispravio sve tri vrste manjkavog učeništva. Štoviše, Matej spaja simptome ovih triju vrsta manjkavoga učeništva s rješenjem koje nalazimo u Isusovim odgovorima kako bi primateljima – čitateljima svoga Evanđelja – pomogao razumjeti da učeništvo ima cijenu, da iziskuje obvezu i podrazumijeva nevolje.
“Building (Not Burning) Bridges for the Gospel”
Authors: Stepp Perry L.
Published: November 2024

Ovaj članak istražuje što Pastoralne poslanice (Titu te 1 i 2 Timoteju) kažu o stvaranju učenika i bavi se ciljevima Pavlova učenja u ovim pismima i metodama koje je preporučio Timoteju i Titu te crkvama u kojima su oni služili. Ciljevi: dvadeset sedam novozavjetnih dokumenata naglašava različite vidove slijeđenja Isusa prema zrelosti (tj. ciljeve učeništva) kako već zahtijevaju situacije iz kojih su pisane i zbog kojih su napisane. U Pastoralnim poslanicama Pavlov je specifični cilj da njegovi čitatelji žive kreposnim životima, velikim dijelom definiranim poganskom kulturom koja ih okružuje. On se nada da će oni na taj način zadobiti i zadržati interes kulture za evanđelje. Time će njegovi čitatelji izbjeći ili ublažiti negativne stereotipe koji se koriste protiv kršćana i popustiti zategnute društvene odnose uobičajene u njihovu svijetu. Metode: u ovim pismima Pavao savjetuje korištenje moralnoga primjera i pozivanje na čast i sram. Osim toga, pokazuje kako koristiti vjeroispovijedi kao alat za poučavanje svojih crkava. Nakana je pokazati da Pastoralne poslanice nude jedinstvenu perspektivu u pogledu stvaranja učenika usredotočenu na važnost javnog svjedočanstva i korištenja metoda poput nasljedovanja i usklađivanja s društvenim vrijednostima. Ovo čine kako bi podigle zrele kršćane koji mogu učinkovito predstaviti poruku evanđelja u svojim zajednicama.
Thái độ về đề kháng kháng sinh của sinh viên năm cuối Đại học Y Dược Thành phố Hồ Chí Minh
Authors: Phạm Duy Thanh Trúc , Lê Thị Tú Nguyên , Phạm Ngọc Hà
Published: November 2024

Đặt vấn đề: Đề kháng kháng sinh (AMR) là mối đe dọa cấp bách đối với sức khỏe cộng đồng bởi các hậu quả như thời gian nằm viện lâu hơn, tăng tỉ lệ tử vong. Một trong những khuyến nghị để giảm thiểu gánh nặng do đề kháng kháng sinh mang lại là chú trọng đào tạo sinh viên các cơ sở giáo dục y tế nhằm nâng cao nhận thức về AMR.

Mục tiêu: Đánh giá thái độ về đề kháng kháng sinh của sinh viên năm cuối Đại học Y Dược Thành phố Hồ Chí Minh.

Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả trên 420 sinh viên năm cuối ba ngành Y, Dược và Cử nhân Điều dưỡng, năm học 2023 - 2024, Đại học Y Dược thành phố Hồ Chí Minh từ 01/2024 đến 06/2024. Thang đo đánh giá thái độ với điểm cắt 60%. Thống kê mô tả: Biến định tính: tần số, tỷ lệ phần trăm được sử dụng để mô tả giữa các biến.

Kết quả: Tỷ lệ sinh viên có thái độ về đề kháng kháng sinh ở mức chưa phù hợp là 6% và phù hợp là 94%.

Kết luận: Đa số sinh viên có thái độ phù hợp về đề kháng kháng sinh. Kết quả nghiên cứu cho thấy việc đào tạo có tác động tích cực đến thái độ của sinh viên trong việc sử dụng kháng sinh.

Từ khóa: đề kháng kháng sinh; sinh viên; thái độ
YARGITAY KARARLARI IŞIĞINDA TBK M. 138 HÜKMÜNÜN ÖNGÖRDÜĞÜ UYARLAMA İMKÂNININ TACİR BAKIMINDAN UYGULANABİLİRLİĞİ
Authors: Kaşak Esra
Published: November 2024

Sözleşmenin uyarlanması, sözleşmenin kurulması anında taraflarca öngörülmeyen ve öngörülmesi de beklenmeyen olguların meydana gelmesi sebebiyle karşılıklı edimler arasındaki dengenin bozulması hâlinde gündeme gelir. 818 sayılı Borçlar Kanunu (BK) döneminde eser sözleşmesi bakımından açıkça öngörülmüş uyarlama imkânı, 6098 sayılı Türk Borçlar Kanunu (TBK) m. 138 düzenlemesi sayesinde tüm sözleşmeler için uygulanabilir hâle gelmiştir. TBK m. 138’de kişi yönünden herhangi bir sınırlandırma yapılmamasına rağmen, tacirin basiretli davranma yükümlülüğü gerekçesiyle uyarlama taleplerinin reddedildiği veya “öngörülmezlik” bakımından kendilerinden insanüstü bir özenin beklendiği görülmektedir. Bu kapsamda çalışmada tacirin, tarafı olduğu sözleşmelerin uyarlanmasını talep edip edemeyeceği ve kendilerinden beklenen özenin ölçüsünün ne olması gerektiği sorunları ele alınmış, anılan konulardaki yargı kararları incelenmiştir.
Enhancing Efficiency and Accuracy of Optimization Techniques in Time Series Data Prediction Using Machine Learning: A Systematic Literature Review
Authors: Tu Jun , Azman B Yasin  , Nur Suhaili Binti Mansor
Published: November 2024

Undoubtedly, time series data prediction stands as a primary focus of computational intelligence among researchers in both academia and industry, owing to its wide-ranging applications and significant impact. The efficacy of prediction models heavily relies on the optimization techniques employed to enhance both efficiency and accuracy. Within the realm of Machine Learning (ML), researchers have developed numerous optimization techniques and models, leading to a plethora of studies. Consequently, there exists a considerable body of literature comprising reviews of ML-based time series prediction. Recently, Deep Learning (DL) models have emerged in this domain, demonstrating performance levels that notably surpass those of traditional ML methods. Despite the burgeoning interest in advancing time series prediction models, there remains a noticeable absence of systematic review papers dedicated solely to enhancing the efficiency and accuracy of optimization techniques. Therefore, this paper is motivated by the need to present a systematic review of the efficiency and accuracy of optimizers studies concerning time series prediction implementations. We not only classify these studies based on their targeted optimization techniques, prediction applications—such as crop yield prediction, weather forecasting for farming, and pest detection and management—but also categorize them according to the types of optimization techniques and models employed, including Convolutional Neural Networks (CNNs), Deep Belief Networks (DBNs), and Long-Short Term Memory (LSTM) networks. Additionally, this study endeavor to provide insights into the future of the field by highlighting the challenges and potential future research opportunities, thereby offering guidance to interested researchers.
Sources of Media Rights in Afghanistan: A Review
Authors: Joya Mujebburrahman , Ghlam Ahmad Susyall  , Abdul Bais Hakimi
Published: November 2024

The Media Law was established to preserve social order, unity, and continuity, to defend truth and justice to protect the rights of the disadvantaged in the media sphere. The Media Law categorizes the functions of all media and reporters within a specific framework and takes steps to maintain regularity in media works. Today, media plays a significant role in leadership and control, and therefore, its social responsibility is constantly expanding. In every country, for the stability and proper functioning of any activity, it is necessary to establish rules, and since media work is a social activity, Media Law is essential for the development and progress of media work and activities. The Afghan Public Media Law was drafted and approved taking into account both domestic and international sources. The Afghan Public Media Law was drafted and approved in light of domestic sources (law, custom, Islamic law, judicial precedent) and external sources (the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, the Declaration of Human Rights of Islamic Countries, and international agreements) to ensure the proper functioning of the media.
Low-Emission Hydrogen on the Background of “Carbon Curtain”
Authors: B. Milicevic , A. Oshchepkova , I. Mironova
Published: November 2024

In this interview, we speak with Mr Branko Milicevic, a leading expert on energy transition and hydrogen at the United Nations Economic Commission for Europe (UNECE). As a Secretary of the Group of Experts on Gas and of the UNECE Hydrogen Task Force, Mr Milicevic offers invaluable insights into the crucial role hydrogen will play in shaping the future energy system. We delve into the critical role of sustainable hydrogen in facilitating the energy transition and discuss the impactful work of the UNECE Hydrogen Task Force in promoting hydrogen as a viable and essential component of a cleaner, more sustainable energy future.

В этом интервью мы поговорили с Бранко Миличевичем, ведущим экспертом Европейской экономической комиссии ООН (ЕЭК ООН) по энергетическому переходу и водороду. Будучи секретарём Группы экспертов ООН по газу и Рабочей группы ЕЭК ООН по водороду, Бранко Миличевич поделился своим мнением о роли водорода в формировании энергетической системы будущего. Мы подробно обсудили важность водорода с низким углеродным следом для энергетического перехода, а также деятельность Рабочей группы ЕЭК ООН по водороду в контексте продвижения водорода как важного компонента устойчивого энергетического будущего.
Is There a Weekend Effect in the Management of Maxillofacial Trauma Patients?
Authors: Singh Ashutosh Kumar , Khanal Nikita
Published: November 2024

Background: Many previous studies have shown that patients admitted to the hospital at weekends have a longer delay than those on weekdays. It has been proposed that the equality of specialist services throughout the week could mitigate the ‘weekend effect.' This study aimed to determine whether or not a weekend effect is observed in Oral and Maxillofacial surgery patients at a medical college and teaching hospital.Methods: Our primary predictor variable was the day of admission. Our primary outcome of interest was the length of hospital stay from admission to operation. Descriptive analysis, correlation analysis, One way ANOVA, and post hoc comparison were performed for statistical analysis. Results: Out of 1185, 1005 (84.8%) were male and 180 (15.2%) female, with a mean age of 30.3 (SD=14.1) years. There was a significantly higher admission on weekends, Friday, and Saturday, and the weekend admissions were associated with a longer delay from admission to operation. The night shift was also associated with a longer delay from admission to operation. The diagnosis based procedure had the most significant effect on delay from admission to operation. The patient's age and gender had no association with the primary outcome. Conclusions: There is a delay in the definitive treatment of maxillofacial surgery patients admitted on weekends. These findings have implications for adequate staffing and resource allocation on the weekends based on admission volume. Keywords: Evidence-based health care; length of stay; maxillofacial injuries
Evaluation of Factors of Low Birth Weight Deliveries: A Cross Sectional Study
Authors: Karki Shrijana , Shakya Vivechana
Published: November 2024

Background: Low birth weight is the most serious challenge for infant survival, healthy growth and development. It is the major determinant of the infant morbidity, mortality and disability in childhood. Different maternal and newborn factors contribute to Low birth weight. Hence, this study aims to assess the factors of low birth weight among deliveries at a tertiary hospital.Methods: A cross sectional analytical study was conducted among 203 postnatal mothers who had delivered low birth weight babies in Patan hospital from 1st September to 30th November 2019.Purposive sampling technique was used to select the sample for the study. Interview was conducted using a self-structured questionnaire. Data were analyzed with SPSS version 20 using descriptive and independent sample t-test to identify factors of Low birth weight.Results: Increased amount of dietary intake, consumption of folic acid tablet, iron and folic acid tablet (p<0.01,CI:95%), calcium tablet(p<0.05) and hypertension during pregnancy(p<0.01) can make significant differences in the mean birth weight of the baby. Similar difference was observed with the sex of baby (p=0.05)and gestational age at birth(p<0.01).Conclusions: Less dietary intake and micronutrients supplements are largely responsible for the Low birth weight. Possible maternal factors can be eliminated in order to reduce Low birth weight deliveries. Therefore, emphasis should be given on these factors while providing antenatal care via health teaching and counseling to mothers.Keywords: Factors of low birth weight; postnatal mothers; tertiary hospital.
Tied with Hair Strands- A Case of Hair Tourniquet Syndrome involving Labia Minora in an Adult Woman from Nepal
Authors: Shrestha Deepak , Gupta Swati , Singh Kritina , Aryal Shreyashi
Published: November 2024

Hair tourniquet syndrome is the strangulation of body appendages by a thread of hair. If neglected, it results in lymphatic obliteration, venous congestion, and arterial obstruction. A 25 years lady with a history of insect bite presented with intense itching and painful swelling in the left labia minora for three days. She had tied the swollen part with a bunch of hair strands leading to painful swelling. Local inspection revealed a 2x2 cm swelling in the left labia minora. The tourniquet effect was released by cutting the hair. Hair tourniquet syndrome involving female genitalia requires immediate recognition and treatment.Keywords: Hair tourniquet syndrome; hair-thread tourniquet syndrome; labia minora
Profile of Destructive Ocular Surgery and its Indications: A Twelve-Year Review from Eastern Nepal
Authors: Chaudhary Santosh , Shah Sangeeta , Lavaju Poonam , Shrestha Bhuwan Govinda , Pant Aashish Raj , Badhu Badri Prasad
Published: November 2024

Background: Destructive ocular surgeries are performed for many conditions ranging from trauma to tumours, where the eyes cannot be salvaged. The objective of our research was to study the profile of destructive ocular surgery and their indications.Methods: This retrospective study reviewed all patients who underwent evisceration, enucleation, and exenteration at B.P. Koirala Institute of Health Sciences, a tertiary eye hospital in Eastern Nepal, between January 2008 and December 2019. Medical records on patient demographics, type of surgery performed, and an indication of surgery during the study period were reviewed.Results: One hundred thirty-four patients underwent destructive ocular surgeries. The median age of patients undergoing surgery was 14.5 (3-50) years. Children aged ten years or less accounted for 46.3% of the total patients. Fifty-two percent were male. The left eye was affected in more than half of the cases (56.7%). Enucleation was the most performed destructive ocular surgery (76 cases, 56.7%). Intraocular and ocular adnexal malignancy was the most common overall indication (62 cases, 46.3%). Ocular infection (19 cases, 41.3%) and trauma (15 cases, 32.6%) were the most common indication of evisceration. Retinoblastoma accounted for most cases of enucleation (43 cases, 56.6%). Malignancy was the only indication of exenteration (12 cases, 100%).Conclusions: Enucleation was the most common destructive ocular surgery. Malignancy accounted for most of the cases of destructive eye surgery, followed by ocular infection. Ocular infection and trauma were the most common indication of evisceration, whereas retinoblastoma and eyelid malignancy were responsible for most of the cases of enucleation and exenteration, respectively.Keywords: Eye; globe; infection; neoplasia; orbit
Trends in the Prevalence of Overweight and Obesity Among Women of Reproductive Age
Authors: Kinnunen Tarja I , Bastola Kalpana , Neupane Subas
Published: November 2024

Background: Information on trends in the prevalence of overweight and obesity and the high-risk groups helps plan health promotion programmes and health policy. This study examined trends in overweight and obesity from 2006 to 2016 and the associated socio-demographic factors in 2016 among 20 to 49-year-old women in Nepal. Methods: Nationally representative cross-sectional data were used from three Demographic and Health Surveys conducted in 2006 (n=7809), 2011 (n=4561), and 2016 (n=4904) in Nepal. Bodyweight and height were measured by trained personnel. Overweight was defined as 23.0 to 27.5 kg/m2 and obesity as >27.5 kg/m2 based on Asian-specific criteria in the main analyses. Multinomial logistic regression models were adjusted for age, parity, education, and wealth index. Results: The prevalence of overweight increased from 16.6% to 26.8% and obesity from 3.9% to 14.3% between 2006 and 2016. The adjusted odds ratios and 95% confidence intervals were 2.26 (2.06 to 2.49) for overweight and 5.26 (4.48 to 6.18) for obesity in 2016 compared with 2006. Age 30 to 49 years, higher wealth index, parity 1 to 3 and education were associated with a higher prevalence of overweight and obesity, whereas the association between the area of residence (urban/rural) and prevalence of overweight or obesity was not statistically significant. Conclusions: The prevalence of overweight and obesity increased among Nepalese women of reproductive age between 2006 and 2016. More research is needed on how to prevent overweight and obesity among women, especially women aged 30 to 49 years or with higher wealth, in Nepal.Keywords: Nepal; obesity; overweight; trend; women
Maternal Near Miss Analysis in Three Hospitals of Nepal: An Assessment Using Three Delays Model
Authors: Maharjan Nashna , Tuladhar Heera , Malla Kasturi , Kirtiman Tumbahangphe  , Budhathoki Bharat , Karkee Rajendra , Shrestha Jyoti Raj , Merriel Abi , Manandhar Dharma Sharna
Published: November 2024

Background: Maternal Near Miss cases have similarities with those dying from such complications and so present an important opportunity to improve practice. This study was conducted to assess the prevalence of Maternal Near Miss events and identify the delays experienced.Methods: This was a facility-based cross-sectional study conducted in three tertiary referral hospitals from three provinces of Nepal. All the women surviving a near miss event during six months data collection period were included in the study. Results: There were 67 near miss cases, 7 maternal deaths, and 9158 live births in the study hospitals during the data collection period. This resulted in Maternal Near Miss ratio of 7.31/1000 live births and facility-based Maternal Mortality Ratio of 76/100,000 live births. Severe obstetric haemorrhage (54%) was the most frequent clinical cause of near miss, followed by hypertensive disorders (43%). At least one type of delay was experienced by 85% women. First delay occurred in 63% (42 of 67) cases, second delay occurred in 52% (33 of 62) cases and third delay occurred in 55% (37 of 67) cases. Conclusions: This study found out that all three delays were common among women experiencing maternal near miss event. Raising awareness regarding dangers signs, improving referral system and strengthening ability of health workers can help in reducing these delays.Keywords: Maternal near miss; MNM; Nepal; three delays
Factors Affecting Psychoactive Substances Use Among Bachelor Level Students of Nepalgunj SubMetropolitan City
Authors: Basnet Puspa , Agrawal Sagtani Reshu , Bhandary Shital
Published: November 2024

Background: Psychoactive substance use among Bachelor level students have different risk and protective biological, intrapersonal, interpersonal, and sociocultural factors. This study was conducted with the aim to explore the factors affecting psychoactive substance use among Bachelor level students of Nepalgunj sub-metropolitan city.Methods: A qualitative cross-sectional study was conducted among Bachelor level students from different streams of Nepalgunj sub-metropolitan city. Pre-validated Interview Guidelines was used for 13 In-depth Interviews with Bachelor level students from different streams using psychoactive substances and 12 Key Informant Interviews with parents/guardians and teachers of some of the selected students. Deductive thematic analysis based on Domain model was done to explore the risk and protective factors for psychoactive substance use.Results: The study identified different risk and protective factors affecting psychoactive substance use within each biological, intrapersonal, interpersonal, and sociocultural domain. Major risk factors identified were adolescence and teenage, male sex, curiosity and experimentation, use for fun, to relieve or cope stress/tension, inadequate awareness, peer influence and pressure, use of psychoactive substances in family, availability, advertisements, social acceptance, and lack of strict rules and regulations. Major protective factors identified were adequate awareness, negative perception, self-motivation, lack of free time/leisure, mentality/state of mind, personal responsibilities, guidance from family, negative perception of society, and reputation.Conclusions: Increasing awareness, developing positive attitudes, reducing social acceptance, and implementation of strict rules and regulations may help minimize and/or eliminate psychoactive substance use by Bachelor level students.Keywords: Acceptance; bachelor level students; curiosity; protective factors; psychoactive substance use; risk factors
Epidemiology of Road Traffic Accidents in Nepal from 2009/10 to 2019/20: A 10 Year Study
Authors: Atreya Alok , Shrestha Dhan Bahadur , Budhathoki Pravash , Nepal Samata
Published: November 2024

Background: Road traffic accidents are the leading cause of deaths worldwide among children and young adults aged between 5 to 29 years. The risk of road traffic accident-related death is higher in low-income countries. Thus, we aim to evaluate the epidemiology of road traffic accidents in Nepal during the fiscal years from 2009/10 to 2019/20.Methods: This study is a secondary data analysis of the published police records publicly available on the official webpage of Nepal Police. A study was carried out after written permission from Nepal Police. The data obtained were analysed using Microsoft Excel-13.Results: Analysing available data about reported road traffic accidents events showed an increasing trend in road traffic accidents from the fiscal years 2011/12 till 2019/20, with a steeper increase in the number of road traffic accidents in fiscal years 2017/18 and 2019/20. In fiscal years 2009/10, 11,747 vehicles collided; which rose to 25,788 in the fiscal years 2019/20. More cases of road traffic accidents were reported to occur from 12 noon-6 pm in a day. Among reported road traffic accidents commonest predispositions behind road traffic accidents was the negligence of driver followed by over speed. Among those individuals who died due to road traffic accidents, most of them were male.Conclusions: We found an increasing trend of road traffic accidents, vehicle collisions, and injuries in Nepal over the past ten years especially among two-wheelers and four-wheelers like the car, bus, and autorickshaw.Keywords: Accidents; automobiles; Nepal; traffic
Ordinance on the Safety and Security of Health Workers and Health Institutions in Nepal: A Critical Analysis
Authors: Belbase Pradeep , Basnet Anjali , Parajuli Ayuska , Paudel Sudip , Pandey Ashok
Published: November 2024

Violence against health workers has been considered a common issue throughout the world. The protection of health workers in low and middle-income countries such as Nepal has not been considered a serious issue by the government. But due to the surge of COVID-19 pandemic and increasing violence against health workers, commendable steps have been taken by the Government of Nepal to protect the safety and security of health workers and health institutions in Nepal. However, the question mark on effective implementation of the ordinance exits suggesting for the appropriate action from concerned authorities and strong collaboration among these sectors.Keywords: Health worker; Nepal; ordinance; safety
Comparison of serum biomarkers cifra 21-1 and ca 19-9 in biliary tract cancers
Authors: Ghimire Bikal , Kansakar Prasan Bir Singh , Sngh Yogendra Prasad
Published: November 2024

Background: Biliary malignancy is common in Asia and has high fatality. CA 19-9 has been used in diagnosis of biliary malignancy but can be raised in benign obstructive jaundice as well. CYFRA 21-1 can have an important role in patients with biliary tract cancer. The objective of this study is to compare accuracy of biomarkers CYFRA 21-1 with CA 19-9 for diagnosis of biliary tract cancers and to correlate level of biomarkers with the stage of disease.Methods: Patients with histopathological diagnosis of biliary tract cancers managed at Tribhuvan University Teaching Hospital, Kathmandu, Nepal were enrolled in the study. Measurement of serum CK 19 fragments was performed and compared with CA 19-9. Demographic characteristics, physiological variables and laboratory values were analyzed.Results: Of the 61 patients included the mean age was 53.41±12.5 years. Amongst the biliary malignancies, carcinoma of the gallbladder was commonest. Most patients (64%) were in the middle age group (40 to 60 years) and presented in advanced stage (Stage III and IV). CYFRA 21-1 had sensitivity of 80.3% and CA 19-9 of 68.9 % for the detection of Biliary Tract Cancers. Comparing the means of CYFRA 21-1 and CA 19-9 for stage of the disease, progressive rise of CYFRA 21-1 with the rise in stage of the disease was observed (p< 0.03). Conclusions: CYFRA is a more reliable test than CA 19-9 in all stages of biliary malignancy and can assist in distinguishing early and advanced malignancy. In carcinoma of gallbladder, highest CYFRA 21-1 values were observed.Keywords: Biliary tract cancers; CA 19-9; cholangiocarcinoma; CYFRA 21-1
Caregiving Stress among Caregivers of Patients admitted with Suicidal Attempt
Authors: Thapa Prekshya , Lama Sami , Pradhan Nirmala , Thapa Kriti , Kumar Rajesh , Basnet Madhur
Published: November 2024

Background: Family caregivers play a key role in preventing suicide attempts. The objective of this study was to study the caregiving stress of the patients admitted with suicide attempt at a tertiary care hospital in Nepal.Methods: A mixed method study was conducted with 52 family caregivers of suicidal people who had been admitted at B. P. Koirala Institute of Health Sciences, Dharan with history of suicide attempt. Data were collected through interview using Kingston Caregiver Stress Scale and in-depth interview was conducted on five family caregivers using interview framework developed in the department for the purpose. Results: The mean caregiving stress score was 29.84(SD=5.11), with the mean score of score 22.0 (±3.9) in caregiving issues, 4.3(±1.9) in family issues and 3.5(±0.9) in financial issues respectively. Majority (65.4%) of the caregiver had perceived stress scores above the mean score. Caregiver’s stress was significantly associated with age (p= 0.023), marital status (p= 0.008) and patient’s mode of attempt (p=0.035) with stress level being higher in those with older age, married and hanging as the mode of suicide attempt. In-depth interview showed that financial difficulties, emotional and physical problems, difficulty maintaining daily activities, and stigma related problem seem to significantly increase caregiver’s stress. Conclusions: The study showed overall stress level of caregivers was high.Keywords: Caregiver; stress; suicide attempter
Factors Influencing Lymph Node Retrieval in Colorectal Adenocarcinoma
Authors: Sherpa Palzum , KC Shiva Raj
Published: November 2024

Background: Retrieval and examination of an adequate number of lymph nodes is an essential part of the correct staging of colorectal adenocarcinoma. The surgeon, pathologist, and factors inherent to patient and tumor affect lymph node yield. This study aims to evaluate the influence of patient and tumor characteristics upon lymph node retrieval by analyzing the mean number of lymph nodes and to assess whether these variables are specifically associated with adequate lymph node sampling. Methods: A retrospective study on colectomy specimens of colorectal adenocarcinoma was performed in the Department of Pathology, Patan Academy of Health Sciences, Nepal from April 2011 to October 2019. Variables including age, gender, anatomical location, tumor size, grade, lymphovascular invasion, perineural invasion, length of the surgical specimen, T stage, N stage, and AJCC stage were analyzed to determine their impact on the number of lymph nodes retrieved. The variables were also analyzed to determine their influence on adequate lymph node retrieval. Results: Gender, age, maximum tumor size, grade, lymphovascular invasion, perineural invasion, T stage, N stage, and AJCC stage showed no statistically significant association. Right-sided adenocarcinoma yielded a notably greater number of lymph nodes with a higher probability of adequate lymph node sampling. Significantly more lymph nodes were retrieved in longer surgical specimens.Conclusions: Right-sided location and longer surgical specimens were associated with higher lymph node retrieval in colorectal adenocarcinoma.Keywords: Adenocarcinoma; colorectal; lymph node retrieval; staging
Pleural Effusion: An Uncommon Manifestation of Hepatitis
Authors: Shahi Rejina , Bhatta Narendra , Mishra Deebya Raj , Acharya Achyut Bhakta , Verma Avatar
Published: November 2024

Hepatitis A virus infection is the commonest form of hepatitis in pediatric age group and common health problem in developing countries due to poor sanitation. The clinical spectrum of hepatitis A virus infection ranges from asymptomatic infection to fulminant hepatitis and the symptoms are primarily hepatobiliary or constitutional. Here, we present a case of 16 years old male who presented with complains of fever, vomiting, anorexia, right sided abdominal pain, shortness of breath and cough. On clinical examination, patient has hepatomegaly and decreased breath sounds on right sided mammary, infra- mammary and infra scapular region. Blood investigations showed aminotransferases while pleural effusion and ascites with thickened gall bladder were found in chest x-ray and abdominal ultrasonography respectively. In absence of others causes, pleural effusion can be a rare complication of hepatitis A. Thus, this complication should be kept in mind in endemic countries in clinically matching scenarios.Keywords: Acalculous cholecystitis; ascites; hepatitis A; pleural effusion
Comparison of POSSUM and SAPS II in Prediction of Postoperative Mortality in Hollow Viscus Perforation
Authors: Kansakar Prasan , Ghimire Bikal , Banjara Megha Raj , Mishra Parashuram
Published: November 2024

Background: There have been very few studies in the literature assessing various scoring systems to predict mortality in patients with hollow viscous perforation. Scoring systems like POSSUM and SAPS II are among the most widely validated risk predictors. Objective of the study was to compare POSSUM and SAPS II in prediction of mortality in patients undergoing surgery for hollow viscus perforation.Methods: Prospective observational study was conducted at Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal, over a period of 18 months. Ethical approval was obtained from the Institutional Review Board of Institute of Medicine. Informed consent was taken from all the patients. Patients aged less than 16 years, discharged on request and patients in whom no perforation found during surgery were excluded from the study.Results: Among 121 patients enrolled in the study, in-hospital mortality was seen in 19 patients (17.0%). Mean POSSUM score in survivors was 39.7 ± 7.3 and in non-survivors was 52.8 ± 5.8 (p < 0.001). Similarly mean SAPS II score was 16.4 ± 9.7 in survivors and 41.8 ± 6.4 in non-survivors ( p < 0.001). Area under ROC curve was higher for SAPS II (0.964) as compared to POSSUM (0.906) suggesting that SAPS was better.Conclusions: Both POSSUM and SAPS II provided good discrimination between survivors and non survivors in patients undergoing surgery for hollow viscus perforation. SAPS II showed better sensitivity and specificity than POSSUM in predicting mortality.Keywords: Hollow viscus; mortality; perforation; POSSUM SAPS II.