bluuebunny/crossref_metadata_2025 huggingface dataset:
Tall-forbs vegetation of the class Filipendulo-Artemisietea montanae Ohba 1973 from Kamchatka, Sakhalin and the Kuril Islands
Authors:   Botanical Garden-Institute FEB RAS, Korznikov Kirill A. ,   Institute of Botany CAS, Dzizyurova Violetta D. ,   Botanical Garden-Institute FEB RAS,   Lomonosov Moscow State University, Petrenko Tatyana Ya. ,   Botanical Garden-Institute FEB RAS
Published: October 2024

We describe three new associations and two subassociations of the previously known association of the tall-forb vegetation class Filipendulo–Artemisietea montanae Ohba 1973 from Kamchatka, Sakhalin, and the Kuril Islands. The association Cirsio kamtschaticae–Reynoutrietum sachalinensis Ohba 1973 nom. mut. was originally described on Hokkaido, and we recognised the subassociations typicum and urticietosum platyphyllae within it. Besides Hokkaido, communities of this association are also present on Sakhalin and the Kuril Islands. The association Aconito umbrosi–Koenigietum weyrichii ass. nov. is described from vegetation data collected in the mountainous regions of northern Sakhalin (the East Sakhalin Mountains), where communities form in the narrow valleys of mountain springs and streams with long-melting snow deposits. Communities of the association Symplocarpo renifolii–Petasietum gigantei ass. nov. are known from the Krillion Peninsula (southwestern Sakhalin) and nearby Moneron Island. A specific floristic and physiognomic feature of these communities is the layer of Symplocarpus renifolius under the canopy of giant forb species. The association Veratro oxysepali–Filipenduletosum camtschaticae ass. nov. unites tall-forb communities of Kamchatka. In these tall-forb thickets, common species are found in more southern territories, such as Artemisia montana and Petasites japonicus subsp. giganteus, as well as other species of the East Asian floristic region, are not present.
The Gender Gap in Mathematical Competence and School Effectiveness in the Basque Country (Spain)
Authors: Oregui-González Eider , Azkarate-Morales Ander , Lojo-Novo Amaia , Bartau-Rojas Isabel
Published: October 2024

National and international assessments consistently report gender differences in mathematics, with boys scoring higher than girls. This study aims to explore whether the gender gap has been overcome in mathematical competence; as well as to check what similarities and differences there are according to the school effectiveness, educational stage, and the Diagnostic Assessment (DA) editions in the Autonomous Community of the Basque Country (ACBC). The study follows a descriptive design with a quantitative methodology, analysing census data on the mathematical competence of 4th grade primary and 2nd grade secondary students during the most recent editions of the DA. The results confirm that mathematics achievement is determined by both the gender gap and school effectiveness. Even so, some positive trends can be observed in the latest editions of the DA and, above all, in the secondary education stage to close the gender gap. The study highlights the need to develop mechanisms for measuring equality in schools in a systematic manner, and reviews some of the strategies and action plans currently being implemented to foster gender equality in the classroom.
Aprendizaje del Concepto de Función Lineal a partir de la Implementación de una Secuencia Didáctica sobre el Movimiento de Objetos
Authors: Miranda Isaias , Vargas-Rivera Lesly Anaid , Salinas-Hernández Ulises
Published: October 2024

El concepto de función es, quizá, uno de los más importantes de las matemáticas. Su importancia radica no solo en poder relacionar variables de distinta naturaleza, sino en la vasta aplicación que de ella se hace en diversas disciplinas científicas. Sin embargo, su enseñanza y aprendizaje se han convertido en temas de interés para la investigación en didáctica de las matemáticas. Con base en los términos de objetivación, medios semióticos y labor conjunta, todos ellos acuñados en la Teoría de la Objetivación, en este artículo se analiza el proceso de aprendizaje del significado de función lineal en tres estudiantes de secundaria (14-15 años) al momento de resolver, por primera vez, una secuencia didáctica en la que se representa gráficamente, y por medio de tablas, el movimiento rectilíneo de objetos. La metodología fue cualitativa, en su modalidad de estudio de caso. Los resultados indican que, durante la secuencia, los estudiantes identifican la correspondencia entre variables y logran escribir expresiones algebraicas a partir de la información de las gráficas. El artículo concluye con una discusión sobre las implicaciones pedagógicas del diseño de esta secuencia.
DUAL RECURSIVE FORMULAS FOR THE SUMS OF POWERS OF INTEGERS
Authors: Cereceda José L.
Published: October 2024

In this note, we introduce the concept of a dual pair of recursive formulas for the sums of powers of integers Central to this concept is the symmetry property exhibited by the power sum polynomial . We illustrate the concept by some examples taken from the literature, and derive our own pair of dual recursive formulas for .
MODERNIZING CLASSICAL OPTIMAL CONTROL: HARNESSING DIRECT AND INDIRECT OPTIMIZATION
Authors: Ahmad Wan Noor Afifah Wan , Sufahani Suliadi Firdaus , Mohamad Mahmod Abd Hakim , Ramli Razamin
Published: October 2024

An introduction to optimal control, a fundamental concept in engineering and science disciplines, is a process of finding ways of controlling dynamic systems in such a way that they achieve certain goals while being subjected to given state limitations. The conventional approaches developed in the past have been integral to solving optimal control problems, including the maximum principle belonging to Pontryagin and the dynamic programming method. While relatively straightforward, these methods are not always amenable to higher-dimensional scenarios, interacting forces, or other non-trivial constraints. This paper presents a new methodology to extend classical optimal control, considering both direct and indirect optimization techniques. The direct methods, Euler and Runge-Kutta, Trapezoidal, and Hermite-Simpson, do not require the explicit derivation of the analytical control laws to execute control trajectories. Semi-analytical techniques, such as the shooting method, are based the control laws on proposed adjoint differential equations. This paper presents the basic outline of the classical optimal control problem and discusses the direct and indirect optimization methods. It is illustrated by referencing various examples, like the fixed-rate royalty payment approach. After outlining each framework, we identify the positive and negative aspects of the approach in questions of consistency and performance. Finally, the problems on the synergy of direct and indirect methods are considered further, and areas of further development of the presented methods and their integration with the more sophisticated tools, such as machine learning are identified. It can be concluded that the approach of using both direct and indirect optimization methods presents great potential in modernizing the classical optimal control, which challenges the conventional techniques and indicates potential for further development of the control system optimization.
GENERALIZED BACKWARD STOCHASTIC DIFFERENTIAL EQUATIONS DRIVEN BY TWO MUTUALLY INDEPENDENT FRACTIONAL BROWNIAN MOTIONS
Authors: SAGNA Yaya , SYLLA Lamine , AIDARA Sadibou
Published: October 2024

This paper deals with a class of generalized backward stochastic differential equations driven by two mutually independent fractional Brownian motions (FGBSDEs in short). The existence and uniqueness of solutions for FGBSDE as well as a comparison theorem are obtained.
Cost variation analysis of disease modifying anti rheumatic drugs in Indian market
Authors: Manimozhi K. , Abinish D. G. , Kalaivani S. , Aswin J. , Lokeshvaran D.
Published: October 2024

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease with systemic complications, necessitating treatment to manage inflammation and prevent joint damage. In India, significant cost discrepancies exist among branded formulations of generic drugs, posing a financial burden on patients and impacting treatment adherence. This study focuses on cost differences of disease modifying anti rheumatic drugs (DMARDs) among Indian brands and advocating strict adherence to drug price control order (DPCO) rules and suggests scheduling non-scheduled drugs under DPCO.
Methods: This observational study analysed the cost of 6 oral DMARDs across 16 tablet formulations using data from National Pharmaceutical Pricing Authority (NPPA) and DPCO ceiling prices 2024. Number of brands per formulation, cost ratios, percentage variations, and DPCO price violations was analysed. Statistical analysis was performed using Microsoft Excel Office 2021, and Zotero was utilized for managing references.
Results: This study highlights significant price variations among DMARDs in the Indian market, with methotrexate 2.5mg exhibiting the highest cost ratio (1:3.63) and percentage cost variation (263.6%). Azathioprine 50mg has the most brands available (23), while sulfasalazine 500mg, sulfasalazine 1000mg, and tofacitinib 11mg are among the formulations with the fewest brands (3 each). Notably, sulfasalazine 500mg and hydroxychloroquine 200mg showed the most frequent instances of pricing violations above DPCO recommendations.
Conclusions: Strict regulation for price control and monitoring should be implemented since the DPCO has not yet achieved its goal of enforcing price ceilings, and non-scheduled drugs should be included under DPCO regulations effectively to enhance adherence to RA therapy.
Audit of compliance to recommended antibiotics prescription guidelines in the management of community-acquired pneumonia in a children's outpatient clinic, in Portharcourt, Nigeria
Authors: Onubogu Uchenna C. , Amaewhule Obuoma U. , Amadi Ijeoma N. , Leechi-Okere Chineye C.
Published: October 2024

Background: The Paediatric Association of Nigeria produced a guideline for managing and diagnosing community-acquired pneumonia. This study aims to assess compliance with the recommended antibiotics prescriptions. 
Methods: A prospective review of the folders of children who presented with cough symptoms in the children's general outpatient clinic of Rivers State University Teaching Hospital. Their biodata, clinical examination findings, prior antibiotics exposure, and consult outcome were retrieved and analyzed.
Results: A total 253 children with a median age of 3 years were studied from June to September 2022. No pneumonia was seen in 128 (50.6%), while 93 (36.8%) had various severity of Pneumonia. Antibiotics had been taken by 55 (21.7%) of the children before presentation. Antibiotics were prescribed in 210 (83.0%) of all the consultations for symptoms of cough. The antibiotic prescription rate for children with No pneumonia was 108 (84.4%), Pneumonia was 77 (88.5%) and severe pneumonia was 5 (83.3%). Cephalosporins were the most common type of antibiotics prescribed for Pneumonia and severe pneumonia at a rate of 52.6% and 57.1% respectively. The overall compliance rate with the PAN recommendations for antibiotic treatment guidelines was 42.5%. Children with No pneumonia significantly had higher odds of being managed with prescriptions that were not in line with the recommendation (OR;25.4, 95% CI:12.2,52.7, p<0.05). The highest type of Noncompliance was prescribing antibiotics where it was not indicated 109 (85.8%).
Conclusions: Compliance with PAN recommendations for antibiotics treatment in community-acquired pneumonia is suboptimal. While the production of guidelines is excellent in standardizing health care, more work is needed to ensure these guidelines are utilized.
Study of the knowledge attitude and practice of breastfeeding among mothers admitted in post-natal ward of Dhiraj hospital, Piparia, Vadodara
Authors: Jain Amit , Pathak Sunil , Rathod Dhaval
Published: October 2024

Background: Objective of the study to assess the knowledge attitude and practice of breastfeeding (BF) among mothers admitted in postnatal ward of Dhiraj hospital, Piparia, Vodadara.
Methods: This cross-sectional study was carried out among 340 mothers who admitted in the postnatal ward of Tertiary care hospital during January 2018 to June 2019 after approval from institutional ethics committee.
Results: Total 138 mother (40.6%) had correct knowledge regarding initiation of BF within 30 min-43 (12.6%) and within 1 hour-95 (27.9%). Remaining mothers believed that BF should be started within 2 hours (169, 49.7%) or within 4 hours (33, 9.7%). In this study 214 (62.9%) mothers had adequate knowledge about positioning. Whereas 133 (39.1%) mothers had adequate knowledge about attachment. Most known sign (145, 42.6%) was “the baby’s mouth is wide open.” And least known sign (83, 24.4%) was “baby’s chin touches the breast.” The 249 (70.6%) mothers said that frequent feeding increases the quantity of breast milk secretion. 128 (37.6%) mothers said that relaxation, 138 (40.6%) mothers said that pre lacteal feed, and 24 (7.1%) mothers said that uses of bottle increase quantity of breast milk secretion. The 258 (75.8%) mothers said that exclusive breast feeding (EBF) should be continued up to 6 months.
Conclusions: Majority of mother have knowledge of early initiation of BF, colostrum, position of BF. Majority of mother have knowledge of expression of BF but less number of mother have idea about technique of expression and storage and less number of mother believe in pre lacteal feed.
Enhancing neonatal sepsis outcomes: the role of ascorbic acid and thiamine as adjuvant therapies
Authors: Mangshetty Roopa B. , Binjanwadgi Apurva A. , Gaddamanugu Gayathri S.
Published: October 2024

Background: Neonatal sepsis, a systemic infection affecting newborns under 28 days, remains a leading cause of global infant mortality and morbidity. It affects approximately 2.8% of live births and accounts for 18% of newborn deaths. Neonates are particularly vulnerable due to their immature immune systems. Current management primarily involves timely antibiotic therapy and supportive care. Emerging evidence suggests potential benefits of micronutrients like ascorbic acid (vitamin C) and thiamine in sepsis management, but research on their combined use in neonatal sepsis is limited.
Methods: This randomized controlled trial was conducted over 18 months involving 120 neonates with sepsis. The intervention group (n=60) received intravenous ascorbic acid (100 mg/day) and thiamine (4 mg/kg/day) for 5 days along with antibiotics, while the control group (n=60) received antibiotics alone. Clinical parameters, duration of hospital stay, NICU stay, antibiotic usage, ventilator support, vasopressor support, laboratory tests, and outcomes were compared between the two groups.
Results: The intervention group showed significantly shorter durations of antibiotic therapy (11.22 vs 13.06 days, p=0.035), NICU stay (7.73 vs 10.91 days, p=0.003), and total hospital stay (12.11 vs 14.55 days, p=0.013) compared to the control group. At discharge, the intervention group had lower C-reactive protein (19.04 vs 33.82, p=0.041) and serum lactate levels (2.55 vs 3.32, p=0.008).
Conclusions: Supplementation of ascorbic acid and thiamine as adjunctive therapy in neonatal sepsis appears to have potential benefits in reducing the duration of hospital stay and NICU stay, and improving certain biochemical markers, without any safety concerns.
Comparison of serum electrolytes in children with febrile seizures to febrile children without seizures: a case control study
Authors: Jayasurya K. , Singhal Pankaj Kumar , Gaba Manav , Mathur Gaurav
Published: October 2024

Background: Febrile seizures (FS) are the most common type of seizures in children aged 6 to 60 months, occurring during fever episodes without underlying CNS infections or prior afebrile seizures. Electrolyte imbalances are thought to contribute to FS, but their exact role remains unclear. This study aimed to investigate the association between serum electrolyte levels (sodium, potassium, calcium and magnesium) in children with febrile seizures and compare them to febrile children without seizures.
Methods: A case-control study was conducted at the JK Lon Children and Mothers Hospital, Government Medical College, Kota, Rajasthan, over four months. Sixty-one children with febrile seizures were identified as cases and 60 febrile children without seizures served as controls. Data on sociodemographic and clinical parameters, including serum electrolyte levels, were collected. Chi-square tests and t-tests were used to analyse categorical and continuous variables, respectively.
Results: Significant differences were found in serum calcium and potassium levels between the two groups. Hypocalcemia was more prevalent in controls (75%) compared to cases (29.51%) (p=0.000), while hypokalemia was also higher in controls (35%) than in cases (6.56%) (p=0.000). No significant differences were observed in sodium and magnesium levels between the groups.
Conclusions: Calcium and potassium levels appear to be associated with the occurrence of febrile seizures in children, while sodium and magnesium levels showed no significant differences. Further studies are needed to clarify the role of electrolytes in FS pathogenesis.
Growth and developmental pattern of early and late preterm at three months of age delivered in tertiary care hospital
Authors: Reddy M. Venkatrami , Ali Syed M. , Firdaus Uzma
Published: October 2024

Background: Preterm birth is a global health concern affecting 5-18% of births, with India experiencing around 3.5 million preterm births annually. This study aims to examine the growth, development and morbidity patterns of early and late preterm infants at 3 months of age in a tertiary care hospital.
Methods: This prospective observational study conducted at Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University, Uttar Pradesh over 2 years period included 264 preterm infants (29% early preterm, 71% late preterm). Growth and development were assessed at scheduled visits up to 3 months using Fenton's growth chart for preterm infants and the Denver 2 developmental screening test.
Results: This study investigated the growth and development of 264 preterm infants (77 early preterm, 187 late preterm) at a tertiary care hospital in India. The findings revealed statistically significant differences in weight, length, and head circumference between the two groups, with early preterm infants showing slower growth rate. Early preterm infants also experienced more developmental delays in gross motor and fine motor skills.
Conclusions: Preterm infants especially those born early, face significant growth and developmental delays and are at higher risk for health problems. Early interventions and ongoing support, including counseling at discharge and regular follow-up are critical for improving their neurodevelopmental outcomes.
Assessment of left ventricular function in patient after ventricular septal defect closure using echocardiography
Authors: Das Aditi , Dias Edwin , Ul Ayoub Touseef , Awasthy Neeraj , Sangwan Devender , Jain Vaishali
Published: October 2024

This systematic literature review assessed left ventricular function in patients after ventricular septal defect (VSD) closure, with a focus on echocardiographic evaluations. Echocardiography plays a vital role in monitoring cardiac function following VSD closure, whether performed through surgery or device catheter treatment, and is essential for guiding patient management. A thorough search was conducted across multiple databases, including PubMed, Google Scholar, and Scopus, resulting in the identification of 32 records. Of these, 7 studies met the inclusion criteria, encompassing sample sizes ranging from 7 to 188 patients. The selected studies focused on evaluating left ventricular function using echocardiographic techniques after VSD closure. The majority of patients demonstrated normal left ventricular function following VSD closure. However, a subset experienced a temporary decline in left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) immediately post-procedure. These impairments generally improved during follow-up, indicating a recovery of left ventricular function over time. Residual lesions were uncommon, with only a small number of patients exhibiting minor residual shunts. VSD closure, whether through surgery or device catheter treatment, is typically associated with significant improvements in left ventricular function. Although some patients may experience a transient decline in LVEF and GLS, recovery is common during follow-up. These findings highlight the critical role of echocardiography in ongoing assessment and monitoring, which is crucial for optimal long-term management and follow-up of patients after VSD closure.
Anisocoria - is it always sinister?
Authors: Thomas Deepa J. , Abraham Shilpa
Published: October 2024

Acute anisocoria or unequal pupil size suggests impending neurologic emergency unless proven otherwise. Anisocoria can be caused due to benign physiological, pharmacological or congenital abnormalities or sinister causes like tumor, hemorrhage or herniation causing raised intracranial tension. With detailed history, physical examination and close monitoring unnecessary investigations can be avoided. An 11-year-old boy with childhood asthma on preventers was admitted and treated in pediatric intensive care unit (PICU) for life threating exacerbation of asthma. After 72 hours of admission his pupils were found to be unequal with a normal sensorium with no evidence of papilledema or raised intracranial pressure (ICP), anisocoria was postulated to be induced by accidental exposure to nebulized ipratropium. Ipratropium was stopped and he was closely monitored with a plan for imaging in case of worsening. However, anisocoria improved and by 24 hours child’s pupils were equal in size. To confirm the diagnosis of Ipratropium induced anisocoria from trauma or nerve damage, 1% pilocarpine can be instilled into the dilated eye which fails to constrict. Though anisocoria is a medical emergency, it can also stem from benign causes which should be diligently sought to circumvent inadvertent interventions.
A rare case of an isolated mayo cysticercosis in a 5-years old child
Authors: Chaudhari Dhruvika G. , Shah Neelam R. , Chaudhari Asha S.
Published: October 2024

Human cysticercosis is caused by Cysticercus cellulose, larvae of a tapeworm, Taenia solium. The most commonly affected site is central nervous system known as neurocysticercosis is well known; but involvement of other sites such as subcutaneous tissue, eye, muscles are very rare. Here we are reporting a case of isolated involvement of muscle by cysticercus cellulose. a five-year-old child presented with complaint of painless swelling over right side of neck for two months. No other complaint was there. On examination a single palpable swelling was there on right side of the neck along the upper margin of sternocleidomastoid muscle. Diagnosis of muscular cysticercosis was made by ultrasonography and later confirmed by plain CT scan of neck. As soon as diagnosis was made patient was treated with steroids and antiparasitic therapy. Two serials follow up were made on 1st and 3rd month following discharge. On 2nd follow up patient was recovered completely. Because of rarity of muscular cysticercosis especially in children along with variable presentation it produces a diagnostic dilemma but now with ease of non-invasive imaging modality it is detectable early and timely intervention can be done.
Effect of ayurveda-based panchakarma and lifestyle modification on global longitudinal strain in cardiac disorder patients
Authors: Muramkar Priti S. , Kulthe Nilesh , Ghadigaonkar Pravin
Published: October 2024

Background: The present sought to study the change in global longitudinal strain (GLS) after 90 days in known cases of cardiac disorders with Ayurveda based Panchakarma and lifestyle modification.
Methods: A retrospective, observational, single-centre study was conducted from July 2021 to April 2022 in Maharashtra, India. Patients aged 18 years and above, diagnosed with inducible ischemia on stress test who underwent the ischemia reversal program (IRP) included in this study. Follow-up was conducted at 90 days. Day 1 and day 90 data were compared.
Results:  A total of 32 patients were assessed. Anthropometric variables such as weight (day1: 68.31±12.40 kg and day 90: 63.82±10.93 kg, p=0.00) and abdominal girth (day 1: 93.56±9.60 cm and day 90: 88.22±6.19 cm, p=0.00) improved at the 90-day follow-up. The lipid profile also improved for variables such as high-density lipoprotein (day 1: 27.66±2.69 mmol/l and day 90: 31.94±2.69 mmol/l, p=0.00), low-density lipoprotein (day 1: 146.88 ± 44.68 mmol/l and day 90: 102.00±9.10 mmol/l, p=0.00), and triglycerides (day 1: 206.03±43.41 mmol/l and day 90: 157.53±35.70 mmol/l, p=0.00). Vo2 max changed from 16.93 ± 7.87 ml/kg/min to 30.83±3.76 ml/kg/min, p=0.00). GLS improved from -14.08±3.79 to -16.35±3.26.
Conclusion: Panchakarma therapy and lifestyle modifications help in improving global longitudinal strain, reducing symptoms of chest pain, breathlessness, dyspnea on exertion, improved V02 peak and improved weight loss and ejection fraction.
Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as a marker of disease activity in patients with systemic lupus erythematosus
Authors: Saha Aritra , Pegu Ajit Kumar , Marak Rebecca R. , Ahmed Zarika , Thakuria Mayuree
Published: October 2024

Background: Systemic lupus erythematosus (SLE) is a female predominant multiple system involving autoimmune inflammatory disorder. Considering the affordability and wide availability of the recently studied marker of inflammation neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), this study was done to investigate the relationship between NLR and PLR with the disease activity in patients with SLE.
Methods: In this hospital based cross sectional study done in Assam medical college and hospital, Dibrugarh done over one year period, newly diagnosed SLE patients above the age of 13 years were included. Patients with underlying disorders or on medications that may affect cell counts, drug induced lupus and recent history of blood transfusion were excluded. The disease activity was calculated using SLE disease activity index 2000 (SLEDAI-2K) and the patients were divided in two groups, group-A (SLEDAI-2K score <9) and group-B (SLEDAI-2K score >9) and correlation was sought with NLR and PLR.
Results: In this study 49 patients were included, with a mean age of 26.33 years and a female predominance (98%). NLR was found to be higher in group-B (11.37 vs 8.05, p<0.001) and NLR positively correlated with SLEDAI-2K score (p<0.001), ESR (p<0.001) and CRP (p=0.212). PLR had a positive correlation with SLEDAI-2K score, CRP, and ESR, although it was the correlation with ESR that was statistically significant (p=0.029).
Conclusions: NLR and PLR was found to have a positive correlation with SLEDAI-2K scores, CRP and ESR and therefore can serve as an inexpensive marker of disease activity in patients with SLE.
Natural history of subclinical hypothyroidism in diabetes mellitus: a prospective observational study
Authors: Singh Shailendra Kumar , Singh Rina , Bedi Sonam , Pandey Arun Kumar , Tiwari Alankar , Rai Pradeep Kumar
Published: October 2024

Background: The natural course of subclinical hypothyroidism (SCH) is variable. Several studies have shown that not all SCH progresses to overt hypothyroidism (OH). Little data are available regarding the natural course of SCH in diabetes mellitus (DM). We aimed to investigate the natural course of SCH in DM patients.
Methods: A total of 118 patients with SCH (52 with DM and 66 without DM) were enrolled in this prospective observational study. Anthropometric, thyroid hormone and Anti-thyroid peroxidase (TPO) antibody (Ab) level were measured at baseline. Thyroid hormone levels were also estimated at 6 month and 12 months.
Result: The majority of the patients, 76(61.86%), remained with SCH, 21(17.8%) progressed to OH and 24 (20.83%) reverted to normal. The rate of progression to OH (DM: 7.69% vs non-DM: 25.76%) was significantly lower in patients with diabetes than in those without. Multivariate logistic regression analysis showed that the risk factors for progression to OH were the glycemic status and thyroid autoantibody.
Conclusion: The present study suggests that patient with SCH have variable disease courses. Glycemic status and autoimmunity are the two most powerful predictors of OH. DM protects the progression to OH whereas thyroid autoantibody increases the risk of progression to OH. We recommend a more aggressive follow up for thyroid autoantibody positive and non-diabetic patients.
A prospective randomised comparative study of intrathecal buprenorphine versus intrathecal magnesium sulphate as an adjuvant to 0.5% hyperbaric bupivacaine for lower limb surgeries under subarachnoid block
Authors: Fultambkar Gajanan , Salla Rohith , Budi Vijayanand
Published: October 2024

Background: Spinal anaesthesia can be strengthened and improved postoperative analgesia can be achieved by adding an adjuvant to a local anaesthetic. The objective of this study is to assess the onset and duration of sensory and motor block, duration of analgesia and to compare the efficacy of 0.5 percentage of hyperbaric bupivacaine with magnesium sulfate to that of 0.5 percentage of hyperbaric bupivacaine in conjunction with buprenorphine during surgeries of the lower limb.
Methods: A total of 60 ASA 1 and 2 patients undergoing lower limb surgeries under spinal anaesthesia, were randomly divided into two groups (30 each). Group B was administered a 15mg dose of a 0.5% heavy bupivacaine solution, in conjunction with 1 mcg/kg buprenorphine, as an adjuvant. Conversely, Group M received the same dosage but was additionally infused with 0.5 ml (50 mg) of magnesium sulfate (Total 3.5 ml) The subarachnoid block was performed in the interspace between the L3-L4 vertebrae following a confirmed cerebrospinal fluid (CSF) flow in the seated position. The onset of analgesic effect, degree of blockade, sedation score, duration of analgesia, occurrence of adverse effects and hemodynamic parameters were all meticulously monitored.
Results: The findings of this study revealed no significant disparities in age, sex, weight or the mean duration of surgery across the two groups. Furthermore, there was no significant difference in the time required for the onset of motor block between the study groups (p>0.05). Mean duration of sensory block (141.83 vs 90.0 mins; p<0.01) and motor block (267.8 vs 218.1; p<0.01) was significantly more in cases of magnesium sulphate group as compared to buprenorphine group. Mean duration of analgesia (294.83 vs 245.5; p<0.01) was significantly more in cases of magnesium sulphate group as compared to buprenorphine group.
Conclusions: A good analgesia is achieved by magnesium sulphate as compared to buprenorphine when added to 0.5% hyperbaric bupivacaine for lower limb surgeries. Depth of sensory block was greater with magnesium sulphate.
Thyroid isthmus agenesis coinciding with papillary thyroid carcinoma: a case report
Authors: Hamiedah Murad M. , Al-Bdour Bilal , Alshoubaki Wael I. , Al-Nawaiseh Hussien R. , Aljaafreh Hamza M.
Published: October 2024

Thyroid isthmus agenesis is a rare congenital anomaly characterized by the absence of the thyroid isthmus. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. The coexistence of thyroid isthmus agenesis and PTC is extremely rare, with limited cases reported in the literature. This case report aims to describe a rare presentation of thyroid isthmus agenesis coinciding with PTC, detailing the clinical presentation, diagnostic approach, and management. Here, we discuss a case of a 49-year-old female presented with neck pain attributed to a cervical disc issue. An MRI scan incidentally identified a left thyroid lesion measuring 5×2.5 cm. Neck ultrasound confirmed a 2.4×2.7×4.2 cm lesion in the left lobe with no suspicious lymph node enlargement. Fine-needle aspiration (FNA) biopsy indicated PTC, classified as Bethesda VI. The patient underwent total thyroidectomy. Intraoperatively, the absence of the thyroid isthmus was noted. Histopathology confirmed a unifocal, 3.9×1.8 cm PTC of the classic subtype, staged as PT2pNx, with no neurovascular invasion and a tumor-free left thyroid lobe. The patient had an uneventful recovery and was discharged two days postoperatively. The absence of the thyroid isthmus can complicate surgical procedures. Preoperative imaging and careful intraoperative management are crucial. This case report highlights the rarity of thyroid isthmus agenesis coinciding with PTC, and emphasizes the importance of recognizing anatomical variations and their implications for surgical management and prognosis. Although it is hypothesized that abnormal development may predispose to malignancy, further studies are warranted to explore the potential association between congenital thyroid anomalies and thyroid malignancy.
A novel case of rickettsial encephalitis presenting as isolated global aphasia
Authors: Wagh Tanvi Vinay , Nilajkar Gauri
Published: October 2024

This case report details a novel presentation of rickettsial encephalitis in a 25-year-old male patient who arrived with a 4-day history of fever and altered sensorium, marked by no verbal output and a loss of social inhibitions. Clinical examination revealed a 2x2 cm eschar on the right leg, moderate splenomegaly, thrombocytopenia, and leucopenia. An MRI of the brain showed focal T2/FLAIR hyperintensity involving the splenium of the corpus callosum, suggestive of cytotoxic lesions of the corpus callosum (CLOCCs). Despite the lack of structural abnormalities in primary language areas, the patient exhibited global aphasia. A positive Weil-Felix test indicated rickettsial infection. The patient was treated with ceftriaxone and doxycycline, leading to gradual neurological improvement and complete recovery within 15 days. This case highlights the importance of high clinical suspicion for rickettsial encephalitis, timely diagnosis, and appropriate antimicrobial therapy to achieve favorable outcomes.
Study of malleus as a prognostic indicator on hearing outcomes after tympanomastoid surgery: A prospective observational study
Authors: Ibji Mishal , Khairnar Poonam , Roy Kamalika Purkayastha , Mane Santosh
Published: October 2024

Tympanomastoid surgery comprises a range of surgeries (cortical, radical, modified radical). Pre-operative auditory deficit in a patient with cholesteatoma may be correlated with ossicular chain status. The incus is often expected to be eroded, which may not be true for the malleus. The presence of malleus and it’s significance on the post-operative needs to be studied further.

The purpose of our study is to determine the effect of intraoperative status of malleus on the post-operative hearing outcomes of patients undergoing canal wall-down mastoidectomy.

A prospective observational study of 24 patients was conducted, where pre-operatively pure tone audiometry (PTA) was performed. Intraoperatively, the status of malleus was noted. Canal wall down mastoidectomy was done. Post-operative PTA was recorded after 3 months and both audiograms compared.

An air bone gap (ABG) of less than 20dB post-operatively was considered significant functional improvement. In patients with a preserved malleus, mean improvement was 25.2dB (±9.8), whereas patients in whom malleus was remove had mean 16.8dB (±10.49) improvement. Similar results were found by Lu et al, Blom et al and Haberman et al. Haberman et al theorised the concentration of sound waves and preservation of middle ear volume as a contributing factor to the results.

Hence it was concluded that relatively better post-operative audiological outcomes were obtained when malleus was present/preserved intraoperatively.
Adult epiglottic abscess: A rare clinical entity with a peculiar cause
Authors: Ravindra Aditi , Dutt Sunil Narayan
Published: October 2024

Epiglottic abscess or collection of pus in the supraglottis is a rare but life threatening complication of acute epiglottitis, with a reported prevalence of 4%. It is pertinent to act fast in these cases as impending airway compromise and sepsis are a possibility. We present a peculiar case report of an adult with acute epiglottic abscess having multifactorial causation which was managed successfully by timely surgical intervention with coblation assisted Incision and Drainage.
Effect of temperature rise caused by fire on the physical and mechanical properties of concrete
Authors: Jedidi Malek
Published: October 2024

In the past few years, several concrete constructions have suffered major fires, causing very significant damage to the structure. The fire resistance of concrete depends on some of its characteristics such as the nature of the components used for its formulation, permeability, water content and mechanical resistance. In the places most exposed to fire, all the coating can be expelled, which seriously threatens the bearing capacity of the construction. In addition, the financial loss due to repair over a long period can reach several million Euros. This paper presents the physical and chemical transformations caused by the increase in the temperature of concrete in the event of a fire. These transformations mainly have an effect on the microstructure, the mechanical properties and the thermal deformation of concrete. The two phenomena of flaking and spalling of concrete were also studied in order to know their origins and found the methods of preventive. Indeed, flaking can manifest itself explosively, and have significant consequences on the resistance of concrete. It thus reduces the cross-section of the structure and also decreases its bearing capacity, which leads to an increase in the risk of structural failure. The factors influencing the flaking phenomenon were also presented.
ON THE POSSIBILITY TO ACKNOWLEDGE PUBLIC LAW STRUCTURES AND PERSONS ACTING UNDER THEIR SPECIAL INSTRUCTION AS PERSONS CONTROLLING A DEBTOR, AND BRING THEM TO SUBSIDIARY LIABILITY
Authors:   Lawyer at LiMark LLC, Litskas Mark V. , Filippova Tatyana A. ,   Professor of the Department of Civil Law of the Altai State University, PhD (Law), Kholodenko Yury V. ,   Associate Professor of the Department of Civil Law of the Altai State University, PhD (Law)
Published: October 2024

One of the central legal concepts of insolvency (bankruptcy) as a complex branch of legislation in Russia is the so-called “controlling debtor”, which appears in disputes on bringing to subsidiary liability in bankruptcy proceedings. Traditionally, legal science and judicial practice consider as such individuals and legal entities that may determine the debtor’s behavior by virtue of legal or actual affiliation with the debtor. However, public-law entities and persons acting on their special instructions in the debtor’s management bodies escape from the field of view of doctrine and practice. In this connection, the authors in this article analyze the possibility of bringing public-law entities and persons acting on their special instructions to subsidiary liability within the framework of the Federal Law “On Insolvency (Bankruptcy)”. In the course of the study, the authors come to the conclusion that it is necessary to distinguish between subsidiary liability of public legal entities and persons acting on special instructions in the debtor’s management bodies. on special assignment in the debtor’s management bodies. In addition, the authors give a negative assessment of the possibility of bringing to subsidiary liability persons acting in the management bodies of the debtor by special order and on behalf of publiclaw entities, since there is no guilt - one of the mandatory elements of the offense. The relevance of the article consists in revealing the peculiarities of bringing to subsidiary liability of persons acting on special assignment on behalf of public-law entities.
RELEVANT ASPECTS OF THE CONTRACTUAL FORM OF SHARED CONSTRUCTION OF COMMERCIAL REAL ESTATE
Authors:   Assistant Judge of the Ninth Commercial Court of Appeal, Ivanov Aleksey A.
Published: October 2024

The author has substantiated the actual aspects of shared-equity construction contracts for commercial real estate. Contractual and corporate forms of implementation of shared-equity commercial construction relations are united by common goals, risks, conditions of joint investment and construction mandatory design and safety requirements. The main participants in the contractual (non-corporate) form of shared-equity commercial construction within the framework of investment projects can be individuals with the status of sole proprietors and corporate entities — investors or contractors. The implementation of shared-equity commercial construction relations is possible with the use of named (simple partnership agreement, investment agreement, shared-equity construction agreement, etc.), as well as unnamed contracts. In order to establish the commercial nature of the shared-equity construction contract, it is advisable to supplement the norms of the relevant legislation with expanded entrepreneurial powers of its parties.
Managent of the Legal System: Legal Technologies, Design and Other Innovations
Authors:   Dean of the Law Faculty, Professor of the Department of Legal Regulation of Economic Operations of the Financial University, Ruchkina Gulnara F.
Published: October 2024

The issues of optimizing the legal function and increasing its effectiveness are raised, the possibilities and prospects of using LegalTech technology in various fields of the legal profession are revealed, the main trends in the use of innovations in the management of the legal function are highlighted. Attention is drawn to the positive experience of using artificial intelligence in managing the legal function of certain foreign countries.
The Institution of Human Rights Commissioners in Russia: Conceptual Fundamentals and Evolution
Authors:   Acting Head of the Department of Constitutional and Municipal Law of the Kutafin Moscow State Law University, Dudko Igor G.
Published: October 2024

The article examines the development of the institution of human rights commissioners in Russia. The author comes to the conclusion that Russian practice demonstrates the evolutionary development of the institution of human rights commissioners. This institution is a reflection of the federal structure of the state. The Human Rights Commissioner in the Russian Federation and the Human Rights Commissioners in the constituent entities of the Russian Federation are competently independent constitutional figures. Their interaction is carried out on the basis of coordination through various forms, which largely developed on the basis of practical activities and were subsequently enshrined in federal legislation. There is a clear tendency to expand the powers of Russian human rights defenders in all areas of their activities, and the «legal tools» of the commissioners are being strengthened. All this allows us to conclude that the institution of human rights commissioners has high authority and is in demand both at the state level and in the environment of civil relations.
The Concept of Separation of Powers (New Perspective)
Authors:   Head of the Department of Constitutional and International Law of the Gubkin Russian State University of Oil and Gas, Skuratov Yury I.
Published: October 2024

In the speech delivered at the MSU conference held on June 18, 2024 and in this article, the author addresses the nature and evolution of the concept of separation of powers, raises some problems of its implementation in the present-day Russian Federation.
Civilization State and the Russian World: Constitutional Law Issues
Authors:   Honored Lawyer of the Russian Federation, LL.D., Professor, Kolyushin Evgeny I.
Published: October 2024

Historical and philosophical views on Russia as a country-civilization and the Russian world, which do not differ in uniformity, currently do not have a theoretical and legal justification and legal mechanisms for implementation. In the combination of “I am Society — State — Law — Civilization”, the first four actors are the most mobile quantities, they can change places according to the degree of influence on each other and on Civilization as a whole, and the latter, being a composite alloy of their functioning, seems to be a kind of constant and guarantee of the existence and development of the country. The author sees the Russian world as a self-identifying non-state international cultural and linguistic state of the personality and peoples of multinational Russia, as well as citizens of other states that voluntarily recognize it. From the position of constitutional (state) law, it is assumed that the role of the state and the various structural elements of the country-civilization and the Russian world will be differentiated, giving it a new set of responsibilities to participate in their provision.
Mental Rights: The Constitutional Content and Admissibility of Limitations
Authors:   Professor of the Department of Constitutional and International Law of the Povolzhsky Institute of Management Named after P.A. Stolypin, Presnyakov Mikhail V.
Published: October 2024

Within the framework of this article, an attempt was made to comprehensively analyze the freedoms guaranteed by Article 29 of the Constitution of the Russian Federation, since, according to the author, they are not only closely related to each other, but often in inextricable unity.
Sustainable Development of the State: Constitutional Law Aspects (Results of a Scientific and Practical Conference)
Authors:   Professor of the Department of Public Law of Russia and Foreign Countries of the Mari State University, Honored Lawyer of the Russian Federation, LL.D., Mikheeva Tatyana N.
Published: October 2024

The subject of a brief scientific review was the problem presented in the title, which received a comprehensive and productive discussion at the All-Russian Scientific and Practical Conference with international participation, held on May 17, 2024 at the Faculty of Law of Mari State University within the framework of the International Legal Forum “Mari El — 2024”. During the active discussions at the conference, general theoretical and applied issues of improving the unified system of public authority, constitutional and legal architecture and digital technologies, the problems of finding an updated model of regional constitutional justice and a number of other issues were considered.
Problems of Eliminating Double Taxation during the Suspension of Russian Tax Treaties
Authors:   Chief Research Scientist of the Department of Financial, Tax and Budget Laws, Khavanova Inna A.
Published: October 2024

The novelty of the study consists in a systematic presentation of the procedure for eliminating international double taxation in the context of the suspension of certain provisions of the Russian agreements on the avoidance of double taxation of income from August 8, 2023. The author concludes that the offset of taxes paid in "unfriendly" countries is possible both in relation to corporate income tax and personal income tax, the features of the offset for specific situations are described.
Emission as an Element of Finance Legal Regulation
Authors:   Chief Research Scientist of the Institute of State and Law of the Russian Academy of Sciences, Honored Lawyer of the Russian Federation, LL.D., Professor, Zapolsky Sergey V.
Published: October 2024

The article examines the dramatic changes in the role of monetary emission that have occurred in recent decades as a result of economic reforms. A formerly attributive institution forms the entire financial system and gives substance to it. These changes have not yet been reflected in the theory of financial law, a mechanism for legal regulation of monetary issue has not been developed. The proposals put forward are designed to draw the attention of legal scholars to monetary emission as a subject of legal regulation and, above all, to intensify the scientific discussion. According to the author, all the emission control tools currently used in the manual mode need serious legal regulation and theoretical understanding.