bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Influence of Cybercrime Law Absence on Cyberbullying in Higher Institutions of Learning: A Case of the International University of Management
Authors: Iileka Albertina , Kamati Etuna , Nyalugwe Symon Fumu
Published: January 2024

Cyberbullying is a serious problem that can have a significant negative impact on victims, including depression, anxiety, low self-esteem, and even suicidal thoughts. The absence of cybercrime laws can make it difficult to prosecute cyberbullying cases, which can contribute to the problem. The purpose of this study was to understand the influence of the absence of a cybercrime law on cyberbullying in higher institutions of learning. The study focused on the International University of Management (IUM) in Namibia. The study used mixed methods research design. Data was collected through an online questionnaire comprising both quantitative and qualitative questions. The link to the questionnaire was shared with students, as well as academic and administrative staff at IUM.  The study found that the absence of a cybercrime law contributes to the problem of cyberbullying in IUM.  The study also found that that there are a number of factors that contribute to cyberbullying in IUM, such as the use of social media, the anonymity that the internet provides, and the lack of awareness of cyberbullying among students and staff. The findings of the study have implications for policymakers, educators, and parents. Policymakers need to enact cybercrime laws to help prevent and prosecute cyberbullying cases. Educators need to educate students about cyberbullying and how to deal with it. Parents need to talk to their children about cyberbullying and monitor their online activity.
Land-Use Land-Cover Change Detection Using Geospatial Techniques in Zalingei, Central Darfur, Sudan
Authors: Ahmed Hussin Omer , Kheiry Manal Awad , Yasin Emad H. E.
Published: January 2024

Using remote sensing for land use and land cover (LULC) is essential for systems that help people make decisions because it gives valuable information about space and time. A study was conducted in Zalingei, Sudan, to analyze the changes in LULC over 30 years from 1991 to 2021 using multi-temporal Landsat images. Thematic Mapper (TM) and Operational Land Imager (OLI) were classified using the supervised classification method. The pictures were divided into four groups based on how the land was used: residential areas, bodies of water, vegetation cover, and bare land. Results showed that the residential area increased by 20.74% while the water body increased by 2.32%. However, the vegetation cover decreased by 0.7%, and bare land decreased by 22.37%. The changes were caused by people, which shows how vital good land management practices and involvement from the local community are for reducing LULC change. So, to reduce LULC change in the study area, proper land management practices and active participation from the local community are needed. The study concluded that remote sensing technology is an effective tool for assessing and mapping land use and land cover changes and providing valuable information for decision support systems.
Evaluating Medical Students' Knowledge of Medical Malpractice: A Pilot Study
Authors: Nikkhahmanesh Nia , Kang Paul , VanSonnenberg Eric
Published: January 2024

Introduction: Although medical malpractice lawsuits are common and have a tremendous financial and psychological impact on physicians, education about medical malpractice is almost non-existent in most medical school curricula around the world. Nonetheless, medical students are concerned about looming legal lawsuits during their careers and have expressed desire to become educated. The objective of the present study is to evaluate and gauge baseline medico-legal knowledge of medical students.
Methods: A survey with 25 multiple-choice quiz questions regarding malpractice risks, standards of care, and malpractice premiums was prepared with information obtained from peer-reviewed articles after a thorough literature review failed to produce a validated questionnaire for medical students. The survey was distributed to medical students across 5 consecutive years at our medical school, totaling 420 students. Data from the survey was collected via Qualtrics before undergoing statistical analysis.
Results: The completion rate for the survey was 110/420 (26.2%). The results showed that no group of students scored greater than 50% correct on the survey, with an overall median score of 40% correct for all students combined. Fourth year medical students correctly answered 1.77 more questions, on average, than first year medical students. There were no statistically significant differences in survey score between students with a personal or familial medical malpractice involvement.
Discussion: The results are an indication that students are not well-educated about medical malpractice, and that medical malpractice education should be implemented in medical school to help prepare future physicians to protect their patients and hopefully avoid malpractice lawsuits.
Awareness, Coverage, and Barriers to COVID-19 Vaccination among Undergraduate Students in Nigeria
Authors: Effiong Fortune Benjamin , Hassan Ibrahim Adebayo , Olawuyi Dimeji Abdulsobur , Ogbonna Chiemela Prosper , Araoye Jeremiah Babatunde , Bassey Esther Edet , Enwerem Kenneth Emeka , Adebisi Yusuff Adebayo
Published: January 2024

Background: With the resumption of physical learning activities across Nigeria's higher education institutions, tertiary-level students, a priority group in the deployment of the COVID-19 vaccines according to the WHO SAGE, face circumstances that necessitate widespread vaccination coverage among them. This study aimed to assess Nigerian undergraduate students' knowledge, coverage, and barriers to COVID-19 vaccination.
Method: A cross-sectional survey of Nigerian undergraduates was conducted in October 2021, using an online questionnaire and a combined simple random and snowballing sampling technique. The questionnaire included sections on respondents' demographic characteristics, COVID-19 vaccine awareness, coverage, barriers, and recommendations. A total of 326 respondents electronically completed and returned the informed consent form along with the questionnaire. The data obtained were analyzed using the statistical package for the social sciences (SPSS) version 25.
Results: The overall awareness of COVID-19 vaccines among the sampled students was high; with 62.3%, 20.9%, and 16.9% having good, average, and poor levels of knowledge respectively. However, a majority of the respondents (81.3%) had not received the vaccines. The most prominent barrier to vaccination was misinformation about vaccine safety (23.6%). Opening vaccination centers on campuses (18.6%), demonstrating vaccine effectiveness and safety (18.7%), and organizing awareness campaigns (17.2%) were the most frequently recommended actions.
Conclusion: Most respondents were aware of the availability and potential benefits of COVID-19 vaccines; however, coverage remained extremely low. Our findings emphasize the importance of addressing vaccination barriers by public health stakeholders to achieve optimal COVID-19 vaccine coverage.
My Experience Building a Water System in a Small Rural Community in the Dominican Republic
Authors: Wright Rosemary
Published: January 2024

Clean water is vital for physical, social, and mental health, however, water insecurity is a public health threat for many countries. Sabana Larga is a rural community made up of approximately 230 families located in the province of Dajabon on the Northwest region of the Dominican Republic. Building a new water system has been a priority for the community for many years, however the reason for the delay in the process is the lack of funds and assistance in building such a water system. In 2016, as a Peace Corps volunteer living in the community, I asked the Saint Cloud Rotary club for financial support to build a new water system. The objective of this paper is to share my experience of building a water system in a rural community in the Dominican Republic with the Saint Cloud Rotary Club, the Dajabon Rotary Club, local engineers, and the local community. Between April 2017 and June 2017, the new water system in Sabana Larga was successfully implemented. The water system improved access to clean and safe drinking water for all families, leading to a healthier community and better quality of life. Many lessons were learned throughout the process including the importance of community involvement, understanding local customs and traditions, establishing a Water Committee, and gaining various skills.
Assessment of Traditional Herbal Remedies Use and Medical Treatment Among Hypertensive Patients attending Primary Health Care Centers in Khartoum State, Sudan 2022-2023
Authors: Mohammed Hazim H. , Jaber Mohammed H. , Alhaj Waleed M. , Abdelgadir Hiba S.
Published: January 2024

BACKGROUND: Hypertension is the leading risk factor for cardiovascular disease mortality worldwide. It affects approximately 74.7 million people in Sub-Saharan Africa, and this figure is expected to increase to 125.5 million by 2025. Although antihypertensive drugs have been used to decrease blood pressure; traditional herbal remedies have been utilized within local or regional practices, in up to 80% of African populations. The current study was carried out to assess adherence to medications and perception of Hypertensive patients regarding use of herbal treatment.
METHODS: This was a descriptive cross-sectional facility centers-based study at 3 PHC centers. A total of 100 hypertensive patients were enrolled using multi-stage sampling. The data was collected by modified open and closed ended interview questionaries. Modified Morisky score system was used to assess adherence to medical treatment.
RESULTS: The study population was 100 participants of which (57%) were females. Most of the participants (77%) were in the age group of 51 and above, (49%) had secondary and higher levels of education, (66%) were using Single type of drug and (77%) were in regular clinical checkup, (90%) were taking their medications as prescribed by their physicians, (58%) were diagnosed before ten years or more, (43%) had Diabetes as co-morbid. Fifty one percent of the participants had low adherence to medication. Forty nine percent of participants used herbal remedies with 67.3% of them had low adherence to their medications; Hibiscus was the most used herb (31%). There was significant association between lack of adherence and the medication unavailability (p =.009). There was significant association between lack of adherence and taking more than one medication (p = 0.001);and between lack of adherence and  lack of confidence  in medical treatment (p = 0.012).
CONCLUSION: A significant proportion of hypertensive patients are using herbal remedies which is negatively affects their adherence to the prescribed medications.
Clinical Presentation of Acute Kidney Injury in Pediatric; Dr Salma Dialysis Center 2022
Authors: Noorallah Mohammed Tibyan
Published: January 2024

BACKGROUND: Unlike in developed countries, where AKI typically develops in older patients with systemic diseases, multiple co-morbidities, and multiorgan failure, AKI in developing countries primarily affects young individuals, particularly children and adolescents, and is often caused by a single factor. Although early detection and management can reduce complications, there is limited data available from Africa on this disease.
AIM: This study aims to describe the sociodemographic characteristics and clinical profile of pediatric patients with AKI presenting to Salma Dialysis Center from 2017 to 2021.
METHODS: A hospital-based descriptive cross-sectional study was conducted at Salma Dialysis Center in Khartoum, Sudan. Patients' hospital records from January 2017 to December 2021 were reviewed to gather information on clinical presentation, investigations, treatment, and patient outcomes.
RESULTS: Out of the 76 patients included in the study, 60.5% were males, with a median age of 8.0 years (range 0.09-17). Approximately 39.5% of the patients were from Khartoum state. The most common presenting symptoms were fever, generalized swelling, and changes in urine colour. The mean blood urea and creatinine levels were 1.6 mg/dl (range 0.2-23.8) and 82.0 mg/dl (range 9-416), respectively. The most common causes of AKI were malaria, sepsis, and sickle cell nephropathy. The majority of patients did not require dialysis and recovered without complications (84.2%).
CONCLUSION: Malaria was found to be the most common cause of AKI in pediatric patients, with a higher prevalence among male patients. The prognosis for these patients was generally favourable.
Comparative Efficacy of Anti-Amyloid and Non-Antiamyloid Drugs for Treatment of Alzheimer’s Disease: A Network Meta-Analysis
Authors: Htet Htet Norah , Liew Yung Jiun Nathan
Published: January 2024

BACKGROUND: Alzheimer’s disease is a degenerative neurological disorder that contributes 60-80% of all dementia cases, typically occurring at the age of 65 years. Currently available therapeutics for treatment are only capable of limiting the progression of cognitive decline. The focus of many Alzheimer’s disease drug therapies involves the hypothesized cause of pathogenesis in the disease, beta protein in the brain. Based on the Preferred Reporting Items for Meta-Analysis (PRISMA) for Network Meta-Analyses (NMA) framework, the present study was conducted to compare the efficacy of such drugs that target beta-amyloid directly or indirectly, with that of other treatments studied in randomized controlled trials.
METHODS: Utilizing a network meta-analysis, direct and indirect comparisons between interventions could be done, providing a ranking of intervention in terms of efficacy in treating cognitive symptoms of Alzheimer’s disease.
RESULTS: A total of 33 studies were included in four analyses of intervention trials that reported cognitive outcomes measured by Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) or Mini-Mental State Examination (MMSE) score. Based on the findings, anti-amyloid agents did not show a marked advantage over other therapies in improving cognitive scores. Results showed that parasympathomimetic agents were consistently ranked higher in terms of Surface Under the Cumulative Ranking (SUCRA) score, with anti-tau agents providing a possible superiority over all other interventions at improving MMSE scores for treatments lasting longer than 24 weeks. High-dose anti-amyloid therapies were effective at improving MMSE score in short term treatments lasting not more than 24 weeks but fall behind other drugs in longer durations.
CONCLUSION: For better understanding on the choice of anti-amyloid and non-antiamyloid therapies, future well-designed large studies including safety outcome and cost- benefit analyses on the different interventions are recommended. Additionally, anti-tau therapies show a clearer potential over anti-amyloid therapies and should thus be given more focus in future drug research.
Clinical Audit of Electronic Health Records to Identify Prediabetic Patients and Compliance with ICGP Guidelines in their Management
Authors: Castledine Robert , Matuschka Victoria , O'Reilly Eimear
Published: January 2024

BACKGROUND: Current Irish College of General Practitioners (ICGP) Guidelines recommend that all patients with prediabetes have repeat HbA1c testing within 12 months, in addition to BMI and blood pressure measurement. It is also recommended that patients are provided with lifestyle advice. We carried out a clinical audit of electronic health records at a Dublin GP practice to evaluate adherence with guidelines.
METHODS: We searched electronic health records to identify all patients with HbA1c values between 42-48 mmol/mol dating back to 1 January 2016, excluding patients with a subsequent diagnosis of diabetes. We manually reviewed the records of 129 included patients to extract the relevant data.
RESULTS: 40.3% of patients had correct diagnosis coding. 74.4% of patients had their blood pressure checked within 2 months of a HbA1c result, whereas only 48.1% had their weight recorded. Of 81 patients with an initial HbA1c over 12 months previously, 66.6% had repeat testing within this period, and 33.3% of patients were either tested later or had no follow-up testing. A reference to lifestyle advice was made in the records of 52.7% of patients.
CONCLUSION: Management for a significant proportion of patients did not meet standards as per ICGP Guidelines. To improve this, we coded all patients with pre-diabetes and placed a reminder of their electronic chart to recheck Hba1c, BMI and BP within 12 months. We conducted an educational meeting with practice clinicians regarding ICGP guidelines. The plan is to re-audit at 6 and 12 months to evaluate the benefit of intervention.
Breathlessness in the Mississippi River Valley: Treatment Resistant Severe Pulmonary Blastomycosis in an Immunocompetent Male
Authors: Strauss Annie Catherine , Poole Aaron R.
Published: January 2024

BACKGROUND: Blastomycosis commonly presents as a respiratory infection and is endemic to the Mississippi River Valley that causes severe infections in immunocompromised individuals. Here we present a case of an immunocompetent patient with severe pulmonary blastomycosis.
THE CASE: A 20-year-old male with a history of childhood asthma with worsening cough, sputum production, shortness of breath, left sided neck mass and 40 lb weight loss over 2.5 weeks. Previously diagnosed with pneumonia 2 months prior and treated with levofloxacin and amoxicillin. Failure to improve led to hospitalization and discovery of a cavitary lung lesion. He was started on vancomycin, meropenem, azithromycin, and anidulafungin. Following discharge, outpatient CT imaging showed worsening lung lesions. At this time itraconazole was started due to high suspicion of blastomycosis. He worsened, requiring home oxygen and came to our hospital for further evaluation. On presentation, he was febrile and tachycardia to 139 with physical exam notable for decreased breath sounds and a large palpable mass under his left mandible. Pertinent labs included leukocytosis to 30.9/cmm with a left shift. Repeat imaging found severe peribronchovascular consolidations worse in the left upper lobe. Infectious disease was consulted and initiated amphotericin B due to poor response to itraconazole and possible disseminated disease. Treatment included 10-days of amphotericin B followed by 6-12 months of itraconazole.
CONCLUSION: Disseminated Blastomyces infection in immunocompetent hosts is exceedingly rare. Targeted therapy was started 6 weeks following symptom onset and we suspect that delays in diagnosis due to being in rural Mississippi contributed to disease progression.
The Role of Language Concordant Care on Increasing Parental Engagement in Shared Decision Making
Authors: Allred Caleb , Parikh Sanjay , Wang Xing , Bonilla-Velez Juliana
Published: January 2024

BACKGROUND: Shared decision making (SDM) allows patients and physicians to make decisions together by incorporating clinical expertise and patient preference. While SDM can improve patient satisfaction, preferences on the extent of involvement in SDM vary, particularly among different cultures and languages. We sought to describe preferences in decision making and degree of SDM among Spanish-speaking caregivers receiving pediatric Otolaryngology care. We hypothesized that language-concordant encounters would have higher SDM scores.
METHODS: A cross-sectional study of Spanish-speaking caregivers undergoing consultation with pediatric otolaryngology was performed (May-August 2022). Care was provided in a language-concordant (LC) setting in which the physician and caregiver communicate in Spanish, or a language–discordant (LD) setting in which the physician communicates with interpreter support. Following their appointment, caregivers were invited to complete the Spanish Control Preferences Scale (CPS, select 2 of 5 options) to determine their two most preferred roles in medical decision making, and the Shared Decision-Making Questionnaire (SDM-Q-9; scored 0-100) to assess perceived SDM. Descriptive statistics, Fisher’s exact and the Mann-Whitney U test were used for analysis.
RESULTS: Sixty-one caregivers were enrolled. CPS scores revealed the passive-collaborative medical decision making role was the most favored (59%), followed by an active-collaborative role (26%), and passive role (13%). Median SDM-Q-9 score for all caregivers was 100.00 (mean=93.70). The median SDMQ-9 score was 100 in LC visits, and 97.78 in LD visits (p = 0.428). No differences in SDM-Q-9 scores were detected for CPS categories between LC and LD visits.
CONCLUSION: High levels of SDM were observed among Spanish-speaking caregivers using both LC and LD care. Most caregivers preferred a passive-collaborative role in medical decision making. Results may be influenced by positive response bias given the high scores observed. Further studies with larger sample sizes can further our understanding of the impact of LC care in SDM.
Pediatric Liver Transplantation Secondary to Hepatoblastoma without the use of a Kehr’s T tube: A Case Report
Authors: Saldaña-Ruiz Mauricio Alejandro , Rendón-Saldivar Mauricio Linnery , Sánchez-Maldonado Héctor Fernando , Álvarez-Treviño Guillermo Alberto , Ortiz-Alonso Federico , Azpilcueta-García Jaime
Published: January 2024

BACKGROUND: Hepatoblastoma is a common primary malignant tumor in the pediatric population, it has a PRETEXT staging depending on the degree of hepatic involvement, in this stage III central and IV are indications for transplantation. At the same time, it has sought to reduce the occurrence of post-transplant complications by not using a Kehr’s T tube during the choledocho – choledochostomy, obtaining interesting results.
THE CASE A 16-month-old woman diagnosed with PRETEXT IV hepatoblastoma, who received four cycles of chemotherapy (CTX) with cisplatin plus doxorubicin, adding two cycles of ICE, before her next cycle she was informed of the availability of a cadaveric liver graft, for this reason she received a liver transplant and during surgery it was decided not to use a Kehr’s T tube. She remained stable on her first post-transplant day. On her second day, a collection in the hepatic hilum was evidenced by control Doppler ultrasound (US), placing two Blake drains. The following four days she had a favorable evolution, being discharged to transplantation floor with a downward trend of liver enzymes, where she continued with the same trend and US Doppler with adequate flows, leaving on day 19 post-transplant. One month later, she received two cycles of adjuvant CTX with CAV scheme. Currently, graft is functional and free of disease.
CONCLUSION: Liver transplantation is the treatment of choice, reaching a survival rate of over 80% at five years post-transplantation. Furthermore, even though the technique of choice is hepaticojejunostomy, it was decided to perform a choledocho – choledochostomy without a Kehr’s T tube, without the development of complications, which is consistent with results in the literature that show that the use of this technique prevents the appearance of complications in up to half of the cases, compared to when the tube is used. Also, adjuvant QT contributes to a better evolution and to obtaining a negative tumor marker, as was the case of the patient.
Learning of Intimate Area Examination Amongst Pakistani Medical Students: KAP Study
Authors: Bakhtiari Masooma , Ijaz Muhammad Tayyab , Farooq Rana Muhammad Umar , Daula Muhammad Imran Hameed , Shahab Amna
Published: January 2024

BACKGROUND: Intimate area examination (IAE) is an integral part of clinical examination skills and must be mastered by medical students before they start their careers. This study explores the experiences of Pakistani medical students regarding learning of IAE, the associated barriers and their impacts on students’ learning.
METHODS: This cross-sectional study, based on a self-designed questionnaire was conducted at two Pakistani medical colleges which included final year students, and post graduate trainees.
RESULTS: During their undergraduate training, 74.9% of the respondents had not conducted a female pelvic examination, 51.9% had not examined a female groin, 79.7% had not examined a female rectum and 72.7% had not examined a male rectum. From the 65 postgraduate doctors, 48.4% reported that they were not prepared to perform an IAE at the start of their clinical career. Regarding barriers to IAE learning more than half of the respondents felt that the opposite gender of the patient (64.7%) and patient’s refusal (63.1%) had a strong negative impact on IAE learning. A high percentage of respondents reported that they were not taught IAE during their undergraduate years. Among the currently used pedagogical techniques, 71.1% of the respondents opted for real patient-based learning, followed by clinical simulations (21.9%), and videos (7.0%). No one thought examination should be taught theoretically. A significant difference between male and female experience in IAE learning was also observed.
CONCLUSION: Learning of IAE remains unsatisfactory and poses a major challenge for the Pakistani Medical Students in the institutes included in this study.
Multilayer Perceptron Artificial Neural Networks and Tree Models as Multifactorial Binary Predictors of Heart Disease and Failure
Authors: Yasin Jehad Amer
Published: January 2024

BACKGROUND: Cardiovascular diseases (CVDs) are a significant global health concern, causing an estimated 17.9 million deaths annually, which represents 31% of worldwide deaths. A significant proportion of CVD deaths are due to heart attacks and strokes, with one-third of these deaths occurring prematurely in individuals under 70 years old. Heart failure is a notable event within CVDs and emerges when the heart cannot efficiently pump blood to fulfill the body's requirements. This complex syndrome's origins are multifactorial and often arise from conditions such as hypertension, diabetes, and hyperlipidemia. Large datasets with multiple features offer an opportunity for machine learning to aid in the early detection and prediction of heart failure.
METHODS: The study employed an unmatched case-control retrospective design. Supervised machine learning models were utilized, notably Multilayer Perceptron Artificial Neural Networks (MLP-ANNs) and decision tree-based models, to predict heart failure disease using data from 918 patients. The open licensed dataset, a combination from five independent heart datasets, comprises 11 demographic and clinical features related to patient status. The MLP-ANN, equipped with a hidden layer and a hyperbolic tangent activation function, was trained on 70% of the data and tested on the remaining 30%. Additionally, the study evaluated the decision tree model's performance through split-sample validation and 10-fold cross-validation.
RESULTS: The ANN model demonstrated an accuracy of 88.10% in predicting heart disease (AUROC = 0.942) based on six factors and five covariates. The cross-validated tree model achieved an overall predictive accuracy of 84.3%. In contrast, the split-sample validated tree model, which used a balanced 50-50 data split for training and testing, attained an accuracy of 82.0%. OldPeak (ST depression induced by exercise relative to rest) had the highest normalized importance calculated from the MLP ANN model.
CONCLUSION: Machine learning predictions have gained importance in healthcare, presenting potential benefits in early detection and intervention, leading to improved patient outcomes and reduced healthcare expenses. The study revealed that ANNs outperform decision tree models in accuracy for the dataset in use. Furthermore, the research emphasized the significance of the clinical feature "Oldpeak" in predicting heart failure through ANNs. ANNs can discern intricate relationships between variables and recognize non-linear interactions, a capability sometimes missed by decision tree models. However, the efficacy of machine learning models remains dependent on the quality and volume of the available data.
Report of Incidental Vulvar Malignant Melanoma Upon Dermatologic Evaluation for Vaginal Cyst
Authors: Shah Vrusha K. , James Alaina J. , Taylor Sarah E. , Davar Diwakar , Provost Noel
Published: January 2024

BACKGROUND: Vulvar malignant melanoma is a rare, often aggressive and recurring disease with a poorly understood prognosis. Here, we describe a patient with a longstanding vaginal cyst who was diagnosed with vulvar malignant melanoma upon a dermatologic evaluation.
THE CASE: Our patient, a 53-year-old female, with a family history of a father with malignant melanoma presented for evaluation of a vaginal cyst present for over 20 years on her right labia that had become painful and began draining over the past year. She was seen twice at urgent care and was treated with oral antibiotics (unspecified) and referred to dermatology. A comprehensive dermatologic evaluation of the epidermal inclusion cyst in the right labia majora incidentally revealed a neoplasm of uncertain behavior in the right labia minora suspected for vulvar malignant melanoma (Figure 1). Shave biopsy of her right labia minora revealed a Stage 1B malignant melanoma, superficial spreading type, with a 1.1 mm depth of invasion (Breslow thickness) and 11 per 1mm2 mitotic count. Right partial radical vulvectomy and bilateral inguinal sentinel lymph node biopsies were performed. Pathology showed malignant melanoma with negative margins and negative nodes. Treatment and excision for her vaginal cyst was not initiated as her symptoms were not bothersome at the time of visit.  She presented with a post-operative infection after 2 weeks which was suggestive of bilateral inguinal vulval acute cellulitis with no definitive abscess upon computed tomography (CT) scan. She was initially treated with vancomycin with additional piperacillin/tazobactam for a total of three days. Trimethoprim/sulfamethoxazole was later initiated for 14 days. Medical oncology referral for evaluation of metastasis revealed normal positron emission tomography-computed tomography scan. Notably, the patient had extensive confluent/atypical lentiginous basal melanocytic hyperplasia at the periphery which could not be distinguished from melanoma in situ. Upon tumor board consultation, scouting biopsies of her left labia majora were performed. Pathology showed melanocytic hyperplasia instead of residual malignant melanoma at the periphery. The patient now follows up every few months with dermatology and medical oncology.
CONCLUSION: Given the often fast, aggressive spread of vulvar malignant melanoma, timely dermatologic evaluations are necessary. Among those at higher risk due to a personal or family history of malignant melanoma, regular total body skin cancer screenings are indicated. Further, the sensitive and typically sun-protected location of a vulvar malignant melanoma might preclude a dermatologic evaluation in this area and highlights the need for more comprehensive vaginal screenings and better communication between dermatologic and gynecologic medical care teams.
The Life of an Editor: Dr. Russell Van Gelder, MD, Ph.D., Editor in Chief of Ophthalmology, the Journal of the American Academy of Ophthalmology
Authors: Cernatescu Malina , Puyana Juan C. , Bonilla-Escobar Francisco J.
Published: January 2024

In this insightful interview article, we delve into the life and role of Dr. Russell Van Gelder, MD, Ph.D., Chair of the Ophthalmology Department at the University of Washington and Editor in Chief of Ophthalmology, the Journal of the American Academy of Ophthalmology. Driven by a profound passion for literature, he emphasizes the enduring impact of scientific publications as fundamental to knowledge. He views curating this literature as a privileged responsibility, ensuring its enduring quality. Dr. Van Gelder acknowledges the complexities of predictive editing and the challenges of identifying impactful papers. He let us dig into the editorial process at Ophthalmology as we learn about its rigor, involving meticulous screening, comprehensive reviews, and constructive feedback. For aspiring editors, he underscores the importance of a genuine love for literature and the value of constructive criticism. Dr. Van Gelder addresses common misconceptions about the editor's role, highlights the ethical aspects of publishing, and advocates for a focus on content quality, especially in a world marked by predatory practices. He shares a memorable encounter with the work of Clyde Keeler, a scientist from the early 20th century, underlining the timeless nature of literature as a repository of knowledge that transcends generations. In essence, Russ, as affectionately referred to by colleagues, offers a deep understanding of the life of an editor dedicated to preserving the integrity and excellence of scientific publications in the field of ophthalmology. His perspective is distinctively important for medical students and early careers physicians, underscoring the crucial role that editors play in the advancement of scientific knowledge.
Tracing Verticality: A Critical Study of Island of a Thousand Mirrors
Authors: Ilyas Anum
Published: January 2024

This paper investigates the (de)construction of binaries vis-.-vis
the verticality of women in domestic and epistemic domains in
Nayomi Munaweera’s Island of a Thousand Mirrors. In doing so, the
study employs Greeta Gaard’s concept of naturalization of women
and feminization of nature which refer to the process of using
binaries as a means to ensure that women remain on a horizontal
position in the vertically moving structure of power. Being in a
horizontal position, both women and nature are not powerful.
Through this theoretical lens, this study explores the reasons of
horizontality by investigating the patriarchal thoughts of society
that categorize women as aquatic, domestic and wild animals
through the use of animalistic language to show their restricted
movement. The animalization reflects the subjugation of women in
the hands of capitalist man. The study also focuses on feminization
of nature which is feminized because of its caring and reproductive
attributes. These shared attributes allow patriarchal ideologies to
dominate women and nature through oppressive strategies. The
discussion on animalization and naturalization underscores the
constraints imposed on women and their mobility within
sociocultural context. Furthermore, this paper takes into
consideration the traumatic experiences, sufferings and
exploitation of rape victims and highlights how female characters
break the societal sanctions, and resurface in order to move
vertically while deconstructing the binaries of male-female,
Sinhala-Tamil, and human-nonhuman. The deconstruction of
binaries creates an inclusive society without discrimination of the
oppressed and the privileged. It also highlights that we need to
treat all living creatures equally with compassion. I use Catherine
Belsey’s method of textual analysis in order to analyze the selected
text.
The Womb of a Lesser Woman: Indian Anglophone Fiction and the Politics of Biotechnological Othering
Authors: Arshad Muqaddas , Mansoor Asma
Published: January 2024

Our paper investigates the fictional representations of ‘biotechnological othering’ and biological precarity as experienced by underprivileged Indian women with particular emphasis on the commodification of their wombs. Foregrounding the exploitation of their reproductive rights via surrogacy at the hands of the glocal capitalist elite, we rout our argument through the representational practices of The House of Hidden Mothers by Meera Syal and Origins of Love by Kishwar Desai to explore the disavowal of the reproductive rights of socio-economically vulnerable Indian women and the re-perpetuation of capitalist modes of inferiorization that target them. Contesting the egalitarian tilt of posthuman discourses, our main contention is that the biotechnological commodification of the wombs of indigent women does not merely confine them within structural inequalities, it also ensures that they remain confined within a biological precarity. Taking theoretical support from pertinent voices in the field including Deepika Bahri, Laura Harrison, Anureet Lotay, Katerina Kolarova and Eva-Sabine Zehelein, we unpick the multi-dimensional ramifications of biotechnological othering depicted in these novels to foreground the threat of biological precarity embedded within transnational surrogacy and the continuation of the dehumanization of Women of Colour in today’s world.
Commodifying Gender: A MatFem Perspective on "I Am For Sale, Who Will Buy Me?"
Authors: Syeda Zakia Resshid Ehsen
Published: January 2024

This research investigates the commodification of women in
Afghanistan through an in-depth analysis of the anonymous
Afghani-authored short story, “I Am For Sale, Who Will Buy
Me” (2010). Employing a Materialist Feminist lens and
drawing upon Silvia Federici's theoretical framework in
Caliban and the Witch (2004), the study examines the
influence of religious doctrines on women's social and
economic status, culminating in their marginalization. The
analysis dissects the exploitation of gender roles,
objectification of female bodies, and the commodification of
Afghan women, revealing the intricate interplay between
patriarchal systems, religious ideologies, and gender
disparity. Additionally, the study explores historical and
contemporary challenges faced by Afghan women,
encompassing barriers to education, economic
opportunities, and social integration. Emphasizing the
necessity for comprehensive approaches, this research
advocates transformative change and gender justice,
stressing its urgency. Positioned within the broader
discourse on women's struggles, this study aims to
contribute an understanding of women’s oppression with a
primary focus on fostering agency and societal
transformation for Afghan women.
Volcanology of the Coalstoun Lakes Volcanic Field, Southeast Queensland, Australia
Authors:   , Brown Catherine
Published: January 2024

The five hundred thousand-year-old Coalstoun Lakes Volcanic Field is an anomalously young area of basaltic volcanism in southeast Queensland. This volcanic field produced one of the longest lava flows in the world during the Quaternary. Key factors that promoted lava flow up to 165 kilometres from the vent were sustained eruption rates over many years, with magma sourced from several vents, and lavas utilising pre-existing drainage networks and the larger Burnett River that helped to confine and allow for a relatively unobstructed flow of lava.
Architectures for performance and security in IoT smart grids
Authors:   , Kane Luke
Published: January 2024

This research examined the relationship between performance and security of Internet of Things (IoT) devices and networks from the perspective of the smart grid. In addition, it presented architectures for evaluating IoT performance, and implementing appropriate security measures. This work was critical as IoT enables many commonly used devices and systems. These can range from smart appliances, all the way through to our national critical infrastructure assets. Through practical experimentation, this study demonstrated that with a balanced approach, IoT networks can be implemented securely and meet application performance requirements.
Inteligencia artificial y su uso en las campañas electorales en sistemas democráticos
Authors: Valdez Zepeda Andrés , Aréchiga Daniel , Daza Marco Tulio
Published: January 2024

El escrito describe las formas como la inteligencia artificial (IA) se está usando por partidos políticos y candidatos durante las campañas electorales, bajo sistemas de cuño democrático, con el objetivo de ganar el mayor número de votos y así acceder a un puesto de elección popular. Por ello, se examina el papel de la inteligencia artificial (IA) en las campañas electorales dentro de sistemas políticos democráticos. Utilizando una metodología descriptiva, se pudo identificar y sistematizar las diferentes maneras y acciones que se realizan durante las campañas electorales, mismas que son apoyadas o realizadas por computadoras o sistemas cibernéticos automatizados. Se concluye que la IA está modificando la forma como se realizan las campañas electorales, lo que reclama un nuevo marco normativo o regulatorio de estos procesos políticos y, sobre todo, códigos de conducta ética para evitar la vulneración de los sistemas democráticos.
La fotógrafa como productora. Técnica y dialéctica en Changing New York de Berenice Abbott y Elizabeth McCausland
Authors: Periáñez Llorente Luis
Published: January 2024

El presente artículo recompone el marco teórico desplegado por Walter Benjamin en El autor como productor y en La obra de arte en la época de su reproductibilidad técnica para interpretar desde ahí la especificidad estética y el potencial político del proyecto original de Berenice Abbott y Elizabeth McCausland, Changing New York. De igual modo, dicho marco servirá para analizar las consecuencias de la censura que sufrió el proyecto en su proceso de edición.
Pandemia, crisis sistémica y nueva normalidad neoliberal
Authors: Agulles Martos Juan Manuel
Published: January 2024

La pandemia debida a la extensión de la COVID-19 puede interpretarse como una consecuencia del proceso de acumulación de capital y la crisis sistémica que reproduce mediante su extensión geográfica. El presente trabajo tiene como objetivo abordar la relación de esa crisis permanente con el desarrollo y culminación de un modo de producción histórico. Se discuten, en primer lugar, los estudios que ligan la aparición de nuevas epidemias a los desequilibrios socioecológicos causados por la expansión del capitalismo. A continuación se analiza cómo la gestión política de la pandemia actual, sostenida en una retórica bélica, de «lucha contra el virus», enmascara la violencia intrínseca del neoliberalismo. Finalmente, se exploran las tendencias de la «nueva normalidad neoliberal» y los escenarios de polarización social, profundización de las desigualdades y control institucional que pueden ir sucediéndose en la medida en que la sociedad global capitalista adopte las lecciones aprendidas durante la pandemia como forma de gestión política de su declive histórico. Se concluye que las implicaciones de la pandemia actual exigen una mirada crítica que vaya más allá de la emergencia sanitaria y conciba la situación como un aspecto de la culminación de la ecología-mundo capitalista.
Eğitim Politikaları Konseptinde Kurumsal Değişim Yönetimi
Authors: Karakuş Deniz
Published: January 2024

The phenomenon of change is largely accepted as inevitable by today's institutions. Due to the constantly changing conditions of today's social, cultural and economic environment and the high level of competition, institutions that are considered as open systems are forced to create sustainable competitive advantages in order to realize their future goals. Undoubtedly, education is one of the most important pillars of this change. In the concept of education policies, the implementation phase of policies is evaluated as the most important and critical process in the literature. He defines the policy implementation process as the stage of converting policy objectives into action in general. Many of the researchers in public policy have focused their attention on the stage when policies turn into action and have tried to understand the deviations that occur during the implementation of policy goals. Education policies are Decriminalized by going through a certain process, and there is a possibility that there will be a gap between the goals stipulated by the laws and the outputs resulting from the implementation. Because there are many factors that affect efficiency and effectiveness during the implementation phase of policies. No matter how predictable the policy implementation is, it is always open to surprises. These give shape to policy outcomes and are sometimes very important. One way to use such surprises to improve policy outcomes is to design them at policy stages. If unpredictable problems arise at these stages and then a re-evaluation of the implementation plans is made, the policy decision probably occurs on its own. Of course, a theoretical phase should be established before the implementation of educational policies. No matter how well-intentioned the policy process in education is at the adoption stage, or whether the policy is well formulated, or no matter how much universal support it finds, public policy cannot begin to change the behavior of the target population or solve a specific public problem until someone or some institution implements the policy. Ideally, every policy involves the design of how to solve a public problem. This design will identify the changing details, the objectives of the policy, a number of instruments to be used, the institutions responsible for implementation, possible timelines and the target population. The point of policy design is to match the right set of tools with the identified problem and ultimately solve this problem. Key Words: Education Policy, Educational Concept, Corporate Change Management
Anayasa Yapım Sürecinde Muhalefet Olgusunun Meclis Tutanakları Üzerinden Değerlendirilmesi: 1921, 1924 ve 1961 Anayasaları Örneği
Authors: DUYAR Mehmet
Published: January 2024

Constitutions are texts that regulate the organs of the state, their functioning and the fundamental rights and freedoms of individuals vis-à-vis the state. Both these texts themselves and their drafting processes are of particular importance. Especially in constitution-making processes where citizens are indirectly involved in the process through their representatives, the existence and impact of the opposition phenomenon shows the democratic quality of the constitution. In this context, this study aims to examine the phenomenon of opposition in the Turkish constitution-making processes in the 1921 and later periods through parliamentary minutes. According to the results of the analysis conducted from a qualitative perspective with an interpretivist approach, it is determined that there was a functioning and qualified opposition phenomenon in the 1921 and 1924 constitution-making processes, while this determination is controversial in the 1961 constitution-making process. Key Words: Constitution making, political opposition, parliamentary debates.
2. KIẾN THỨC, THỰC HÀNH CHĂM SÓC ỐNG THÔNG TIỂU CỦA ĐIỀU DƯỠNG VIÊN TẠI MỘT SỐ KHOA NGOẠI BỆNH VIỆN ĐA KHOA TỈNH THÁI BÌNH NĂM 2022
Authors: Phúc Trần Thái , Dịu Nguyễn Thị
Published: January 2024

Mục tiêu: Nhận xét thực trạng kiến thức, thực hành chăm sóc ống thông tiểu của điều dưỡng viên một số khoa hệ Ngoại Bệnh viện đa khoa tỉnh Thái Bình năm 2022 và một số yếu tố liên quan.

Phương pháp: Nghiên cứu mô tả cắt ngang được thực hiện trên 122 điều dưỡng viên tại 5 khoa hệ Ngoại của Bệnh viện đa khoa tỉnh Thái Bình năm 2022, dựa trên 2 công cụ: “Phiếu khảo sát kiến thức về nhiễm khuẩn đường tiết niệu liên quan đến chăm sóc ống thông tiểu của điều dưỡng” và “Bảng kiểm quy trình thực hành chăm sóc ống thông tiểu”.

Kết quả: Tỷ lệ điều dưỡng có kiến thức đạt yêu cầu về chăm sóc ống thông tiểu 67,2%; Điểm trung bình chung của 6 nhóm kiến thức là 22,1 ± 3,7. Tỷ lệ thực hành quy trình chăm sóc ống thông tiểu đạt yêu cầu là 72,0%; Điểm trung bình chung thực hành là 22,5 ± 3,2. Mối liên quan có ý nghĩa thống kê giữa trình độ chuyên môn của điều dưỡng viên với kiến thức, thực hành chăm sóc ống thông tiểu; Kiến thức chăm sóc với thực hành chăm sóc ống thông tiểu.

Kết luận: Kiến thức và thực hành chăm sóc ống thông tiểu của điều dưỡng viên các khoa hệ Ngoại Bệnh viện đa khoa tỉnh Thái Bình có tỷ lệ đạt trên 67%.