bluuebunny/crossref_metadata_2025 huggingface dataset:
ƏHALININ HƏYAT SƏVIYYƏSINƏ NEFT STRATEGIYASININ TƏSIRININ
QIYMƏTLƏNDIRILMƏSI
Authors: Fəridə Əmirova, Təranə Pənahlı Fəridə Əmirova, Təranə Pənahlı
Published: June 2024

“Əsrin müqaviləsi” mühüm xarici investisiyaların cəlb edilməsi, neft sektorunun müasirləşdirilməsi və Azərbaycanı qlobal iqtisadiyyata inteqrasiya edən başlanğıc nöqtəsi oldu. Strategiya çərçivəsində həyata keçirilən Bakı-Tbilisi-Ceyhan magistral neft kəməri layihəsi neftin dünya bazarlarına nəqli üçün alternativ marşrut yaratmaqla yeni iqtisadi və geosiyasi üstünlüklər təmin etdi. Bu strateji addımlar Azərbaycanın makroiqtisadi göstəricilərinə əhəmiyyətli dərəcədə təsir göstərmişdir. 2015-2022-ci illərdə ölkənin ÜDM-i 54,4 milyard manatdan 133,8 milyard manata, dövlət büdcəsinin gəlirləri isə 17,5 milyard manatdan 30,7 milyard manata yüksəlib. Bu dəyişikliklər iqtisadiyyatın uğurlu diversifikasiyasını, qlobal neft qiymətlərinin təsirini və neft ehtiyatlarından səmərəli istifadəni nümayiş etdirir.
“Əsrin müqaviləsi”nin imzalanması Azərbaycanı ABŞ üçün daha cəlbedici etdi, münasibətlərdə yeni mərhələ açdı. Heydər Əliyev Azərbaycan-Amerika Ticarət Palatasının yaradılmasını təklif etdi ki, bu da fəal əməkdaşlığa və siyasi maneələrin aradan qaldırılmasına səbəb oldu. Azərbaycanın münaqişənin həllində dəstəyi və 907 saylı düzəlişin ləğvi hərbi və təhlükəsizlik sahələrində əməkdaşlığın genişləndirilməsi üçün əsas olub. ABŞ ilə əməkdaşlıq maliyyə yardımının əhəmiyyətli dərəcədə artmasına və Azərbaycanın Sülh Naminə Tərəfdaşlıq proqramına daxil olmasına səbəb olub. Ölkə bir çox beynəlxalq təşkilatlara üzv olub, regional təşəbbüslərdə iştirak edib və Aİ ilə fəal əməkdaşlıq edib.
Açar sözlər: neft, neft strategiyası, əhalinin həyat səviyyəsi, təsir, qiymətləndirmə
AZƏRBAYCAN RESPUBLIKASINDA IQTISADI TƏHLÜKƏSIZLIYIN TƏMIN EDILMƏSINDƏ GÖMRÜK XIDMƏTLƏRININ MÖVCUD VƏZIYYƏTININ TƏHLIL EDILMƏSI
Authors: Arif Şəkərəliyev, Xəyal Qasımov Arif Şəkərəliyev, Xəyal Qasımov
Published: June 2024

Azərbaycan Dövlət Gömrük Komitəsi dünya birliyinə inteqrasiya üçün gömrük xidmətlərini fəal şəkildə modernləşdirir. Gömrük orqanları Kioto Gömrük Konvensiyası və Avtomatlaşdırılmış İdarəetmə Sistemi kimi yeni texnologiyalar və proqramlardan istifadə edərək beynəlxalq standartlara uyğunlaşmağa çalışırlar. Azərbaycan digər MDB ölkələrinin gömrük xidmətləri ilə əməkdaşlıqda, təcrübə mübadiləsində və ümumi problemlərin həllində fəal iştirak edir. Neft-qaz sənayesinin əsas sənaye kimi seçilməsi strateji baxımdan uğurlu olsa da, davamlı inkişafı təmin etmək üçün elmi-texniki potensialın bölüşdürülməsinə və iqtisadiyyatın digər sahələrində innovasiyaların stimullaşdırılmasına da diqqət yetirilməlidir.
Son illər gömrük xidmətinin bərpası və gücləndirilməsi, qanunvericiliyin yaradılması və qaçaqmalçılığa qarşı mübarizə sahəsində mühüm işlər görülüb. Gömrük sisteminin sosial-iqtisadi sistemə inteqrasiyası onun beynəlxalq standartlara uyğun təkmilləşdirilməsini tələb edir.
İnkişaf edən Azərbaycanda gömrük orqanları iqtisadi artımın aktiv olduğu dövrlərdə mühüm vəzifələri yerinə yetirirlər. Gömrük işçilərinin peşəkar və məsuliyyətli fəaliyyət göstərməsi də vacibdir. Ölkənin iqtisadi inkişafı cəmiyyətin daimi inkişafı üçün sosial-iqtisadi münasibətlər və yeni idarəetmə formaları vasitəsilə formalaşır.
Açar sözlər: iqtisadi təhlükəsizlik, gömrük xidməti, mövcud vəziyyət, təhlil.
ИСПОЛЬЗОВАНИЕ ЦИФРОВЫХ ТЕХНОЛОГИЙ В ФАРМАЦЕВТИЧЕСКОМ
МАРКЕТИНГЕ
Authors: Камиль Шахбазов, Эльнара Ибрагимова Камиль Шахбазов, Эльнара Ибрагимова
Published: June 2024

Цифровые технологии становятся ключевым элементом современного фармацевтического маркетинга, изменяя способы взаимодействия с врачами, пациентами. В данной статье рассматриваются уникальные особенности фармацевтического маркетинга и преимущества использования цифровых технологий. Обсуждаются успешные стратегии в социальных медиа, применение цифровой рекламы, влияние мобильных приложений на взаимодействие с пациентами. Анализ данных и роль искусственного интеллекта в персонализированной медицине также будут рассмотрены. Эта статья предоставляет обзор современного состояния цифровых технологий в фармацевтическом маркетинге и исследует их роль в формировании будущего отрасли.
Ключевые слова: цифровые технологии, фармацевтический маркетинг, фармацевтические компании, персонализация, пациенты
Analisis Perencanaan Sumber Daya Manusia Dalam Meningkatkan Kualifikasi Pendidikan Dosen di Universitas Nias
Authors: Gulo John Kristian , Waruwu Sukaaro , Zega Yamolala , Telaumbanua Eliagus
Published: June 2024

Pada penelitian ini, peneliti akan melakukan penganalisaan dalam Perencanaan Sumber Daya Manusia Dalam Kualifikasi Pendidikan Dosen Di Universitas Nias, Pada observasi penelitian ditemukan peneliti adanya permasalahan yang kurang baik adalah masih tidak sesuai dengan kebutuhan universitas, misalnya tidak adanya rencana konkret untuk meningkatkan kualifikasi pendidikan dosen yang kurang berkualitas, kurangnya perencanaan sarana dan prasarana yang mendukungÂ  peningkatan kualifikasi pendidikan dosen, dan kurangnya diperhatikan rasio antara mahasiswa dan dosen menjadi satu alasan mengapa peningkatan sumber daya manusia di Universitas Nias. Tujuan penelitian ini adalah Untuk mengetahui perencanaan Sumber Daya Manusia Dalam Kualifikasi Pendidikan Dosen Di Universitas Nias, Untuk mengetahui dampak perencanaan sumber daya manusia terhadap kualifikasi pendidikan dosen di Universitas Nias.Â  Dalam penelitian ini menggunakan metode kualitatif dan teknik pengumpulan data dengan menggunakan observasi, dokumentasi serta wawancara. Hasil penelitian ini adalah Perencanaan sumber daya manusia untuk kualifikasi pendidikan dosen di Universitas Nias telah dilaksanakan berdasarkan kebutuhan secara bertahap. Langkah-langkahnya mencakup identifikasi kebutuhan pengajar, pengembangan program rekrutmen efektif, dan strategi pengembangan karir. Dosen yang direkrut diharapkan memiliki kualifikasi pendidikan yang sesuai dengan standar universitas. Melalui perencanaan ini, Universitas Nias berusaha untuk memastikan bahwa sumber daya manusia dosen yang direkrut memiliki kemampuan akademik dan profesional yang memadai. Program pengembangan karir, seperti melanjutkan pendidikan lanjutan, merupakan bagian dari upaya untuk meningkatkan kualitas sumber daya manusia dosen.
Implementasi Tanggung Jawab Sosial Dalam Meningkatkan Perekonomian Masyarakat Pada Bank Mandiri Kota Gunungsitoli
Authors: Zebua Irfan , Hulu Fatolosa , Zebua Emanuel , Batee Maria Magdalena
Published: June 2024

Institusi ataupun corporasi turut ikut melakukan proses pembangunan yang dikenal dengan konsep Corporate Social Responsibility (CSR) yang mana korporasi dituntut tidak hanya mengejar keuntungan keuangan tetapi diwajibkan memperhatikan aspek sosial dan aspek lingkungan. Tujuan dari penelitian ini yaitu Untuk mengetahui Implementasi Tanggungjawab Sosial PT. Bank Mandiri Dalam Meningkatkan Perekonomian Masyarakat. Untuk mengetahui kondisi perekonomian masyarakat setelah pelaksanaan program tanggung jawab sosial Bank Mandiri Kota Gunungsitoli. Dalam penelitian ini menggunakan jenis penelitian deskriptif kualitatif. Jumlah informan dalam penelitian ini sebanyak 5 informan. Berdasarkan data yang dikumpulkan dari penelitian yang dilakukan, maka diperoleh hasil yaitu Implementasi tanggung jawab sosial yang dilaksanakan oleh Bank Mandiri Kota Gunungsitoli yaitu ditentukan sesuai dengan kebutuhan masyarakat itu sendiri, baik berupa pembangunan gedung, dana tunai, pembinaan keterampilan, dan lain sebagainya. Bank Mandiri Kota Gunungsitoli juga mempertanggung jawabkan setiap dampak dari aktivitas usaha khususnya di bidang ekonomi, lingkungan dan sosial. Kondisi perekonomian masyarakat penerima manfaat tanggung jawab sosial (CSR) saat ini sangat berdampak pada perekonomian masyarakat warga binaan Lapas Kelas II B Gunungsitoli. Dimana warga binaan mendapatkan tambahan penghasilan di dalam lapas dengan mengandalkan keterampilan yang telah didapatkan pada pelatihan keterampilan serta bagi warga binaan yang telah selesai masa tahanannya dan kembali ke lingkungan masyarakat, warga binaan dapat membuka kegiatan usaha dan dapat meningkatkan perekonomian dengan keterampilan yang telah didapatkan pada saat berada di Lapas Kelas II B Gunungsitoli.
Phenological Diversity Trends with Remote Sensing Datacubes
Authors: Shayle Elliot Samuel , Marcantonio Matteo , Labadessa Rocco , Richiardi Chiara , Vicario Saverio
Published: June 2024

During the 2024 B-Cubed Hackathon, we extended the R package "rasterdiv" by incorporating Time-Weighted Dynamic Time Warping (TWDTW) to the package's pre-existing paRao() function for the calculation of parametric Rao's Quadratic Diversity (Rao's Q) index. This expands the user's ability to biodiversity trends when using time series of Earth Observations. Biodiversity indices like Shannon's H do not consider spatio-temporal dynamics, and others (e.g. Rao's Q) only incorporate geographic distance between observations, often leaving phenological variation overlooked.Through integrating TWDTW into the paRao() function, users can assess different facets of an ecosystem's biodiversity by incorporating phenological differences among its plant communities. This is also valuable to distinguish between natural habitats that follow a seasonal phenological trend and artificial land cover types, which may lack phenological changes. Previous studies have also found that the time weighting ability of TWDTW enables the discernment of different floral community types which could otherwise be misclassified as the same with traditional Dynamic Time Warping (DTW).To evaluate the efficacy of TWDTW within the paRao() function, we compared the ability of TWDTW Rao's Q index against other biodiversity indices at classifying the different plant communities in a disturbed grassland in Calabria, Italy. Our study used a Plant Phenological Index (PPI) time series from the Sentinel-2 satellite network. The results indicated that accounting for phenological cycles can filter out artefacts and better distinguish habitats with differing plant species diversity. This improves the ability to assess ecosystem changes through space and time, providing a more comprehensive understanding of biodiversity dynamics, and the ability to gauge the resilience of different vegetation patches.We conclude that the inclusion of plant phenology in biodiversity assessment is necessary, and that our modifications to paRao() will be valuable to facilitate the accurate detection and description of ecosystem trends in response to our changing environment.
Faire la lumière sur le biofilm en soins critiques : un compartiment mésestimé pour lutter contre les infections associées aux dispositifs médicaux invasifs ?
Authors: Maldiney Thomas , Pineau Valentin , Bregigeon Romain , Neuwirth Catherine , Perraud Florian , Podac Bianca , Blot Mathieu , Piroth Lionel , Fournel Isabelle , Clere-Jehl Raphaël , Josse Jérôme , Laurent Frédéric , Masson David , Jacquier Marine , Charles Pierre-Emmanuel , Quenot Jean-Pierre
Published: June 2024

Les biofilms sont des populations ubiquitaires de micro-organismes englobés dans une matrice extracellulaire, susceptibles de se développer sur des surfaces biotiques ou abiotiques, notamment les dispositifs médicaux invasifs, avec le risque à terme de conduire à la survenue d’infections sur matériel. En soins critiques, les cathéters intravasculaires et les sondes d’intubation sont les plus fréquemment associés au développement du biofilm. Pourtant, le rôle de ce dernier dans la survenue d’évènement cliniques infectieux, demeurent incertains. Il n’existe ainsi à ce jour aucune méthode standardisée pour la mise en évidence du biofilm. En particulier, le diagnostic d’infection liée aux dispositifs médicaux invasifs en soins critiques repose aujourd’hui sur un faisceau d’arguments cliniques et microbiologiques qui varient grandement d’une équipe à l’autre. Certaines approches innovantes, comme le recours ponctuel à l’anatomopathologie ou encore à de nouvelles modalités d’imagerie optique, pourraient améliorer la reconnaissance, le diagnostic et le traitement de ces infections. Il s’agirait notamment de mieux orienter le choix de la stratégie thérapeutique parmi le retrait du dispositif impliqué, lorsque cela est possible, ou la place du traitement anti-infectieux le plus adapté à la documentation microbiologique et au risque de germe multirésistant.
Les complications infectieuses chez le patient cirrhotique
Authors: Poli Edoardo , Sacleux Sophie-Caroline , Voican Cosmin
Published: June 2024

La cirrhose est l'une des 10 premières causes de mortalité dans le monde. Les infections représentent un des principaux facteurs déclenchant de décompensation de la cirrhose. Le lien entre cirrhose et infections est bilatéral : d’une part, la maladie représente un facteur de risque d’infection et, d’autre part, l’infection peut être un facteur de décompensation de cirrhose. Les services de soins critiques sont de plus en plus amenés à prendre en charge des patients cirrhotiques et une connaissance des outils diagnostiques et des grands principes de prise en charge de l’infection, notamment bactérienne et fongique, chez le cirrhotique est fondamentale. L’instauration rapide d’une antibiothérapie probabiliste chez un patient cirrhotique potentiellement infecté permet d’améliorer significativement la survie. Cette antibiothérapie probabiliste, à large spectre et adaptée à l’écologie locale, doit être suivie d’une réévaluation à 48-72 heures afin de procéder si possible à une désescalade thérapeutique. En effet, l’apparition de bactéries multirésistantes et hautement résistantes est un enjeu majeur qui va compliquer dans les années futures la prise en charge des patients infectés. Les indications et les limites de l'antibioprophylaxie chez les patients cirrhotiques sont aussi détaillées.
Principe de l’utilisation des tests viscoélastiques : place et interêts en réanimation
Authors: David Jean Stephane , NOUGIER Christophe , BORDES Julien
Published: June 2024

L’étude des propriétés viscoélastiques du caillot est apparue à la fin des années 40 mais ce n’est que depuis une vingtaine d’années que leur utilisation s’est développée en pratique clinique. Ces techniques vont permettre de réaliser une analyse globale de l’hémostase mais également de diagnostiquer précisément les déficits acquis. L’aspect global de cette analyse prend également en compte les phénomènes intercurrents tels que l’inflammation ou l’anémie. L’utilisation de ces techniques dans des situations variées telles que la traumatologie, les hémorragies du post partum ou digestive et la chirurgie cardiaque, va permettre un diagnostic précoce des troubles de l’hémostase. L’effet sur l’administration des produits sanguins et sur le pronostic reste à confirmer dans de futurs travaux idéalement randomisés.
Le réanimateur en dehors de la réanimation : quelle place ? quels enjeux éthiques ?
Authors: Lemiale Virginie , Biancarelli Baptiste , Cremer Robin , De Prost Nicolas , Duvivier Julien , Goulenok Cyril , Grassin Marc , Hauw-Berlemont Caroline , Joudain Mercé , Lafarge Antoine , Mercier Emmanuelle , Noizet-Yverneau Odile , Poujol Anne-Laure , Rigaud Jean-Philippe , Zuber Benjamin , Gaillard-Leroux Benedicte
Published: June 2024

Les réanimateurs sont régulièrement amenés à donner des avis en dehors de leur service. Deux circonstances distinctes sont à l’origine de ces consultations et les enjeux éthiques en sont très différents. Dans le premier cas il s’agit d’évaluer l’état clinique d’un patient avec une défaillance d’organe ou à risque de dégradation. C’est alors une expertise technique qui est demandée, comme pour tout autre spécialiste d’organe. Dans la deuxième circonstance, la demande est une discussion de limitation et/ou d’arrêt de traitement. Qu’il intervienne comme consultant extérieur afin d’assurer une collégialité ou pour son aptitude à gérer les limitations, cette activité si elle est indispensable, peut s’avérer chronophage et source de conflit éthique. Particulièrement lors des périodes de garde pendant lesquelles elle peut être répétée, cette mission peut apparaitre comme ingrate et être source de burn-out. Afin d’éviter ces difficultés différentes solutions sont possibles : la discussion des projets de soins en amont de l’urgence avec implication du patient et rédaction de directives anticipées, une gestion plus explicite des appels afin de distinguer au mieux ce qui relève de l’avis ou de l’aide à la décision de limitation ; la formation sur l’intensité des soins de réanimation auprès des plus jeunes médecins.
Place et rôle du médecin réanimateur dans le processus de réflexion relatif aux directives anticipées
Authors: Quenot Jean-Pierre , Mezher Chaouki , Lesieur Olivier , Van Der Linden Thierry , Taha Alicia , Labruyere Marie , Andreu Pascal , Jacquier Marine , Rigaud Jean-Philippe
Published: June 2024

Les directives anticipées (DA) qui faisaient partie du dispositif législatif français depuis le 22 avril 2005 s’imposent au médecin depuis la loi du 02 février 2016. Elles sont désormais l’expression de la volonté du patient et non plus celle de son souhait. Il est raisonnable d’imaginer dès lors que les DA puissent être réfléchies et rédigées à tout moment du parcours de soin du patient, mais également qu’elles puissent aborder toutes les potentialités évolutives de la maladie et, en particulier, l’éventualité d’une admission en réanimation. Dans cet article, les auteurs discutent de la place du médecin intensiviste comme interlocuteur priviligié dans le parcours de soin du patient et de son rôle potentiel dans l’élaboration anticipée d’objectifs thérapeutiques pouvant inclure la rédaction de DA. Il est abordé la question des outils et les stratégies utiles pour répondre à ces objectifs, y compris la question de la pertinence d’une admission en réanimation. Des pistes de réflexion sont également discutées, comme l’amélioration de la communication et l’anticipation des discussions qui pourraient être tracées dans l’espace internet développé par l’Assurance Maladie : « Mon Espace Santé », rubrique « Entourage et Volontés ».
Repenser la réanimation pour soigner dans un monde durable
Authors: Grimaldi David , Boissier Florence , Chabanel Valentin , Demoule Alexandre , Lecronier Marie
Published: June 2024

Le changement climatique en cours est une des conséquences de l’influence anthropique sur l’écosystème planétaire. Il est selon l’OMS “une menace fondamentale pour la santé humaine” que ce soit par ses impacts directs (canicules, inondations) ou indirects (insécurité alimentaire, migration …). Les soignants seront donc en première ligne pour faire face à ces transformations. Mais comme le système de soin est adossé à un complexe industriel et sa chaîne logistique, il est dépendant de l’utilisation d’énergie majoritairement fossile. Le système de soin est lui-même à l’origine d’émissions de gaz à effet de serre. Les soins critiques, intensifs en soins, sont intensifs en émission et doivent prendre leur part dans l’effort de décarbonation à accomplir. Cet article décrit les impacts sanitaires prévisibles du changement climatique, les principaux postes d’émissions de gaz à effet de serre et donne les outils de compréhension des leviers de la décarbonation. Il est une première étape de la formation des soignants exerçant dans les unités de soins critiques.
On the application of one modulus inequality to the mapping theory
Authors: Dovhopiatyi Oleksandr , Sevost'yanov Evgeny
Published: June 2024

The authors study mappings that satisfy some estimate of the distortion of the modulus of families of paths. Under certain conditions on the domains between which the mappings act, we established that, these mappings are Hölder logarithmic continuous at the boundary points. It is known that, the Hölder continuity is established for many classes of mappings, say quasiconformal and quasiregular mappings. In this regard, it is possible to point to the classical distortion estimates by Martio-Rickman-Väisälä type, as well as the estimates related to the modern classes of mappings with finite distortion. In particular, V.I. Ryazanov together with R.R. Salimov and E.O. Sevost'yanov established local distortion estimates for plane and spatial mappings under FMO condition, or under the Lehto-type integral condition. Recently, the second co-author have obtained Hölder logarithmic continuity for the studied class at points of the unit sphere. This article considers the situation of similar mappings of different domains, not only the unit sphere. Namely, we consider mappings between quasiextremal distance domains (QED-domains) and convex domains. Note that, quasiextremal distance domains introduced by Gehring and Martio are structures in which the modulus of families of paths is metrically related to the diameter of sets. Also, convex domains are involved in the formulation of the main result; we consider mappings that surjectively act onto them. In addition, the article contains the formulations and proofs for some other results on this topic. We consider several more cases in detail, in particular when: 1) the definition domain is a domain with a locally quasiconformal boundary, and the image domain is a bounded convex domain; 2) the definition domain is a regular domain in the sense of prime ends, and the image domain is a bounded convex domain; 3) the mapping acts between the QED-domain and the bounded convex domain and has a fixed point. In all three cases, the mapping is Hölder logarithmic continuous; moreover, in case 2), which refers to prime ends, logarithmic continuity should also be understood in terms of prime ends.
On homeomorphisms with integral constraints acting in a domain with Poincaré inequalities
Authors: Sarana Oleksandr
Published: June 2024

We study homeomorphisms with one normalization condition that transform some domain of the Euclidean space onto a domain which is Ahlfors regular and supports Poincare inequality. We assume that, the homeomorphisms satisfy the weighted modulus Poletsky condition. If the majorant in this condition satisfies some relation written in terms of singular parameters, then the specified homeomorphisms satisfy the corresponding distortion estimate at the boundary points written in their terms. In more detail, the manuscript is written in the vein of research on mappings with bounded and finite distortion, which have been actively studied recently. Observe that, for mappings with direct and inverse Poletsky inequality, the estimates of the distortion under the mappings at the inner points of a domain may be considered known, since such estimates have been obtained by various authors over the last 10-15 years. We could, in particular, point to the results of V. Ryazanov, O. Martio, U. Srebro, E. Yakubov, M. Cristea, E. Sevost'yanov, S. Skvortsov, and O. Dovhopiatyi in this regard. It should be noted that, under certain additional assumptions, mappings with a direct Poletsky inequalities are included in the class of mappings with finite distortion by Iwaniec-Martin. At the same time, the above-mentioned estimates of distance distortion at the boundary points of the domain have not been sufficiently studied. Our manuscript is dedicated to obtaining such estimates. Of course, we require that the majorant in Poletsky's inequality satisfy certain requirements for obtaining them. The conditions written in terms of singular parameters are the most convenient and cover important partial cases. In particular, functions of finite and bounded mean oscillation by John-Nirenberg, as well as functions with the Lehto integral divergence condition can be described in terms of singular parameters, and this will be taken into account in our future research. In addition to singular parameters and the use of modulus techniques, the key point of our manuscript is spaces with Poincaré inequalities. Note that one of the characteristic features of such spaces is their fulfillment of Loewner-type inequalities, i.e., metric lower bounds of the modulus of families of curves through the diameter of the sets they join. This inequality is crucial for obtaining the result of the paper.
Thrombocytopenia Following Abdominal Aortic Aneurysm (AAA) Surgery: A Case Report
Authors: Abuerjaila Ammar Khalil A
Published: June 2024

The Authors present a case report of a 69-year-old male with a known history of hypertension and previous abdominal aortic aneurysm (AAA) repair, who presented with gastrointestinal bleeding and was diagnosed with AAA and aortoenteric fistula. The patient underwent endovascular repair of intrarenal AAA and femoral-femoral bypass. However, postoperatively, he developed severe thrombocytopenia with persistent low platelet counts despite platelet transfusions. Hematology consultation was obtained, and the patient showed a positive response to intravenous methylprednisolone therapy. This case highlights the occurrence of thrombocytopenia as a complication following AAA surgery and the successful management with corticosteroids.
Basics of the Management of Chronic Kidney Disease for the General Physician
Authors: Boutrus Tamer Shalaby
Published: June 2024

Adaptive hyperfiltration is the main mechanism leading to progression of chronic kidney disease (CKD) after an insult/injury, even if this injury is cured. The kidney responds to an injury by increasing the Glomerular Filtration Rate (GFR) to the normal nephrons, this effect can keep the creatinine (Cr) at a normal level initially, but with time, the kidney function deteriorates due to the chronic high pressure in the nephrons induced by raised GFR, this deterioration is monitored by worsening proteinuria and decline in Cr level. The rationale of using medications like SGLT2/ACE inhibitors or ARB in CKD is based on this adaptive hyperfiltration mechanism, these medications help in reducing GFR and hence reducing proteinuria and intrarenal pressure and preserving the kidney function or at least minimizing the rate of decline in kidney function.
Decompensated Liver Cirrhosis for the Acute Physician
Authors: Boutrus Tamer Shalaby
Published: June 2024

Liver cirrhosis (LC) is a disease of progressive fibrosis with regenerative nodules resulting in distortion of liver architecture. Early compensated LC can be managed or even reversed by specific treatment; however, decompensated LC has multiple complications leading to increase in morbidity and mortality. Doctors and patients should be aware of the multiple risk factors which can influence compensated LC leading to decompensated LC, most common factors are infection, gastrointestinal bleeding (GIB), medications like benzodiazepines and alcohol, constipation, and dehydration with electrolyte abnormalities.
Basics of Management of Acute Pulmonary Embolism for the Acute Physician
Authors: Boutrus Tamer Shalaby
Published: June 2024

Acute pulmonary embolism (PE) is a blood clot in the pulmonary artery which can lead to increase in morbidity and mortality, management of PE is not always straight forward and can be challenging. Authors will discuss in this review the diagnosis and risk stratification of PE, the optimal management of PE, and adequate follow up plan. Asymptomatic PE is often an incidental finding in 5% of thoracic CT scans performed for another indication and underlying malignancy was the culprit in most of these cases.
Association of Gut Microbiota with the Incidence of Metabolic Syndrome among Type 2 Diabetes Mellitus Patients
Authors: Porwal Vipin
Published: June 2024

Background: Alteration of the gut microflora leads to local intestinal inflammation which produces various primary and secondary metabolites that cause chronic inflammation, leading to metabolic syndrome. Objectives: To determine the gut microbiome about biochemical and inflammatory markers in type 2 diabetes patients and to assess the clinical outcomes of metabolic syndrome for gut microbiota composition. Methods: In this hospital-based observational study, 41 type 2 diabetes mellitus patients were included and underwent clinical examination. The gut microbiome diversity was detected from stool samples through DNA extraction followed by 16s RNA gene sequencing and bioinformatical analyses. Using blood samples, the immune response analysis was also done by identifying CD4+T cells through blood immune cells analysis. Results: After gene sequencing from stool samples, the gut microbiota species of rumonicoccus, fusobacterium, and blautia were identified among 9(42.9%), 9(42.9%), and 10(47.6%) patients only in the case group. However, fecalibacterium prasunitzii, bifidobacterium, akkermansia mucinphila and bacteriodes fragilis were 1(5%), 2(10%), 10(50%) patients only in the control group. In both groups, lactobacillus, and escherichia coli were seen among 3(15%) and 20(100%) patients in the control group, followed by 4(19%) and 20(95.2%) patients in the type 2 diabetes group. The incidence of metabolic syndrome was seen in 4(20%) patients in the control group and it was in 19(90.5%) patients in the case group where the prevalence of metabolic syndrome was significantly higher in the type 2 diabetes group than the control group (Fisher’s Exact Test, P=0.001). Conclusion: Among the studied population, the gut microbiota was found to be significantly different in the diabetics when compared to non-diabetics and helped to identify the bacteria that were important in the development of diabetes. The elevation of inflammatory markers further showed the possible role of gut microbiota in creating a state of chronic inflammation in these patients, ultimately leading to insulin resistance and the development of type 2 diabetes mellitus.
Hospital Cost of Heart Failure at the Cardiology Department of the National Reference Teaching Hospital, N’Djamena (Chad)
Authors: DT Naibe
Published: June 2024

Introduction: Heart failure is a major public health problem. The aim of this study was to evaluate the cost of hospitalization for heart failure patients. Patients and method: This was a prospective descriptive and analytical study carried out in the cardiology department of the National Reference Teaching Hospital of N'Djamena from May 1st, 2022, to April 30, 2023. Patients hospitalized for heart failure were included. The financial cost was expressed in FCFA. Results: 306 patients hospitalized during the study period for heart failure, 106 (34.6%) of whom met the inclusion criteria. The average age was 51 ± 18 years old (with extremes of 17 to 86 years old) with a sex ratio of 0.79. The average direct cost of hospitalization was 227.812 ± 63.008 FCFA for an average duration of 10 days. Conclusion: Heart failure is a frequent condition in cardiology practice in Chad and diagnosis must be made early in order to implement effective therapies, at reasonable cost and accessible on a case-by-case basis.
Spontaneous Coronary Artery Dissection in a Young Female: A Complex Case of Diagnosis and Treatment Dilemma
Authors: A Mouzarou
Published: June 2024

Spontaneous coronary artery dissection (SCAD) represents a rare, yet critical condition characterized by the spontaneous tearing of coronary artery walls, predominantly affecting younger populations, particularly women. This case report elucidates the complexities of diagnosis and management of SCAD in a 34-year-old female presenting with acute chest pain and ST elevation on electrocardiogram (ECG), highlighting the challenges encountered in selecting the optimal treatment strategy. The patient underwent a comprehensive diagnostic workup, including coronary angiography, confirming the diagnosis of SCAD. Continuing management posed a therapeutic dilemma, necessitating a complex approach to address the patient's unique clinical presentation and potential complications. This case emphasizes the importance of individualized care, multidisciplinary collaboration, and long-term follow-up in optimizing patient outcomes and decision-making in managing SCAD. This case report aims to contribute to the existing literature by providing valuable insights into the diagnostic and therapeutic challenges associated with SCAD, supporting the need for further research to clarify optimal management strategies and improve patient care.
Cardiac Ultrasound-thrombolysis: Case Series
Authors: Albarrán Ángel G Nájera
Published: June 2024

Introduction and objectives: The authors present a series of 3 cases in which thoracic insonation was used during the percutaneous coronary intervention procedure in patients with acute coronary syndrome with ST-segment elevation and 100% thrombotic obstruction, showing that its application alone influences coronary thrombi recovering distal flow. Methods: The patients admitted to the emergency department with chest pain in whom ST-segment elevation acute coronary syndrome was diagnosed, the infarction code was activated, and were admitted to the hemodynamic room, diagnostic angiography was performed, followed by thoracic insonation with a 4mHz sector transducer for 15 minutes in patients with 100% thrombus obstruction and a second angiography was performed to evaluate the effect. The lesions were repaired as the case called for and a final contrast shot was made to verify results, all patients were discharged to the coronary care unit. Results: In the 3 patients presented, there was recovery of distal coronary flow after the use of conventional ultrasound waves for 15 minutes, regardless of the medical treatment used. Conclusions: This first case series suggests that the use of ultrasound-thrombolysis improves the efficacy of standard treatment in ST-segment elevation or OMI-type acute coronary syndrome, regardless of the vessel to be treated or baseline characteristics of the patients.
The Effectiveness of an Integrative Psychotherapy Program in Reducing the Symptoms of Borderline Personality Disorder
Authors: Shalaby Wafaa
Published: June 2024

This study evaluates the effectiveness of integrative psychotherapy for borderline personality disorder (BPD) in a group of 13 patients who participated in the program for 3 months. The author studied 13 patients (11 women, 2 men) with BPD as defined by DSM-IV at admission and applied for a test after 3 month and at the 3-months follow-up. For the clinical diagnoses and compared results with the 3-month follow-up. Overall, participants showed a low degree of sub-items symptoms was significantly reduced at post-treatment and at follow-up. Effect sizes for outcome measures were within the range of those of previous studies. These findings support the notion that the results of the integrative efficacy research can be generalized to patients with BPD disorder with high.
Shaving Skin at Grounding Pad Site to Avoid Skin Burns in Radiofrequency Ablation Procedures: A Case Report
Authors: Chhatre Akhil
Published: June 2024

Radiofrequency ablation is a minimally invasive procedure used to treat chronic back and neck pain. The procedure has been used for decades, yet the procedural guidelines and steps remain inconsistent. The preparation of skin by shaving hair when placing the grounding pad is a necessary step that can avoid harmful implications for the patient. This case report highlights the successful avoidance of a skin burn by thoroughly shaving the skin at the grounding pad site and the need to incorporate this step in universal perioperative guidelines for radiofrequency ablation procedures to optimize patient safety.
Analysis of the Influence of Forms of Urban Agriculture on the Socio-Economic Status of the Farmers in Kampala and Mbarara Cities, Uganda
Authors: Ninsheka Leonard , Ssemakula Edward , Tiyo Christopher , Kalibwani Rebecca , Mugizi Wilson
Published: June 2024

The study analysed the influence of the forms and drivers of urban agriculture on the socio-economic status of farmers in Kampala and Mbarara cities in Uganda. The study adopted a cross-sectional research design using multiple methods of data collection. A multistage cluster sampling technique involving simple random sampling to get both primary and secondary sampling units, snowball to get target respondents and purposive sampling for key informants and focus group members was used. Data were collected using social survey questionnaires for households, focus group discussions checklist (FGDs), key informant interview guides and observations, from a sample of 384 respondents. The study found a strong association between forms of urban agriculture and the socioeconomic status of the urban farmers in Kampala and Mbarara Cities. Subsistence forms (backyard, roadside and rooftop gardens), commercial forms (zero grazing, poultry, fish farms and crop farms), and tourist forms (demonstration sites) had a significant influence on household food and income security of urban farmers. The study established the lack of land, improved technologies and training as major obstacles and recommended the establishment of community networks, availing subsidies and credit and recruitment of extension personnel as interventions to help urban farmers
Students' Ability to Solve Story Problems on Systems of Linear Equations Using John Dewey's Approach
Authors: Suryanti Suryanti , Solikhah Bety Maratus , Suliana Riki , Pramesti Cicik , Sari Ayu Silvi Lisvian
Published: June 2024

Students can study everyday mathematics with a story problem. Through this problem, students gain critical thinking experience in solving problems. The ability of students to solve problems through John Dewey's approach is also seen to deepen students' mathematical concepts in three-variable linear equation systems. Problem solving with John Dewey's approach consists of five stages. This method of research uses a qualitative descriptive approach with three persons as the subject of the research, with good, sufficient, and less as the categories of ability. The results of the research showed the subject's ability to solve a story problem with the John Dewey approach. Four given questions showed that the subject with a category of good ability can solve two problems with clear mathematical concepts. Whereas the student with sufficient ability can only solve one problem with an obvious mathematical concept, However, the subject with less ability is only able to solve a problem until the stage of inventorying several solutions, which is the third stage of problem solving with the approach of John Dewey.
First record of Pisutiella phaeothamnos in the western Mediterranean
Authors: Aragón Gregorio , Negrón Valerie , Giménez Gil Fernando
Published: June 2024

We report the first record of Pisutiella phaeothamnos (Kalb & Poelt) S.Y. Kondr., Lőkös & Farkas in the western Mediterranean (Central Spain). The nearest previous records were from the Canary Islands and Greece. The species was discovered among mosses on volcanic rocks in the Spanish Central Volcanic Region. This finding represents a significant expansion of its distribution range.
Implementasi Manajemen Kearsipan Dalam Ketatausahaan di Madrasah Tsanawiyah Darul Ulum Kubu Raya
Authors: Abdul Pandi  , Amrozi  , Hasanuddin  , Lukman H  , Putri P  , Rosiana  , Huzaimah  , Paras Morgan  , Rizka F  , A. Ruzi  , M. Faisal
Published: June 2024

This research was conducted to find out more about the implementation of archives management in administration at Madrasah tsanawiyah Darul ulum Kubu raya by discussing several topics. First, how is the implementation of archives management in administration. Second, what obstacles are faced and efforts to overcome obstacles regarding archive management in administration at madrasah tsanawiyah Darul ulum Kubu raya. The method used in this research is a descriptive method with a qualitative approach. The main data source in this research is the head of administration and staff as an active component in the archive management implementation process obtained through interviews, observation and documentation. Based on the research results, the results of this research are: The implementation of archives management at the madrasah tsanawiyah Darul ulum Kubu raya can be classified in the good category, because it has implemented several indicators regarding archives at the madrasah tsanawiyah Darul ulum Kubu raya, such as recording, distribution, use, maintenance, and deletion of archives, however, as time goes by, it is necessary to always keep abreast of emerging technological developments in order to remain in a good position. Apart from good implementation, of course there are obstacles faced by resolving various obstacles faced in the administration section at madrasah tsanawiyah Darul ulum Kubu raya, such as experiencing difficulty in finding archives that have been stored for a long time, due to the large number of archives that have accumulated. But after being found the archive had been eaten by termites. This is due to inadequate infrastructure. Adding facilities is also hampered by limited space. Several efforts have been made to overcome obstacles in managing archives at the madrasah tsanawiyah Darul ulum Kubu raya, namely copying the archives into computers so that they are not lost and not damaged, in addition to renovating the building, especially the administration room at Madrasah tsanawiyah Darul ulum Kubu raya
Pengaruh Angin Terhadap Tata Letak dan Jumlah Sekrup Konstruksi Baja Ringan Berdasarkan SNI-7971- 2013
Authors: Syahbana Mahdi , Agustiar Agustiar , Lindawati Lindawati
Published: June 2024

Light weight steel material has experienced rapid development in the construction. However, there are still many costruction failures on light weight steel, resulting in cost loss. The failure of light steel structures often occurs at the connections. The connection tool on milld steel is usually using a self-drilling screw. The research location is at Aceh One Stop Integrated Service and Investment Service Building (DPMPTSP) Aceh. The problem in this study is the placement and number of screws on the lightweight steel roof structure in the field which is carried out for each member according to the code, and the effect of wind load on the placement and number of screws on the lightweight steel roof structure. This study aims to determine the effect of the placement and number of screws on the lightweight steel roof structure. The scope of this research of problems including the placement and number of screws on the lightweight steel roof structure. The standars used in the design of light steel structures in this study is SNI 7971 2013 and the loading planning standars using SNI 03 1727 1989. Calculation steps using the LRFD method for steel structure design regulated in SNI 03 1729 2002. Based on the results, it is obtained that the number and placement of the screws in the field are different from those obtained in the calculation. From the calculations, it is obtained from the recapitulation, dead loads with a maximum value of 123.07 kg, live loads with a maximum load of 30.1 6 kg, and for compressed air and suction loads with a maximum load of 180 kg. the maximum design force value is 1241.33 kg and the screws bearing resistance value is 256.752 kg. the number of screws is obtained where the the value of the design force is divided by the value of the bearing resistance, on each member obtained 1screw, 2 screws, 3 screws, 4 screws, and 5 screws. Whilst it is found for each member in the field using 3 screws.
PENGARUH PEMODELAN TIPE BALOK BETON BERTULANG TERHADAP RASIO TULANGAN PERLU
Authors: Wahyuni Wahyuni , Munawir Munawir , Pujianto Eko Putra
Published: June 2024

Pada perencanaan struktur bangunan gedung, balok dapat dimodelkan sebagai balok segi empat dan balok T. Balok segi empat dimodelkan dengan hanya memperhitungkan dimensi balok, tanpa memperhitungkan pengaruh plat lantai yang melekat pada bagian atas balok. Sedangkan pada perhitungan balok T, plat lantai diperhitungkan sebagai sayap pada balok yang ditinjau. Berdasarkan pemodelan balok yang diaplikasihkan pada objek kajian, yaitu gedung asrama putra berlantai 3 (tiga). Penelitian ini bertujuan untuk meninjau pengaruh tipe balok terhadap rasio tulangan perlu, karena adanya perbedaan area tekan pada balok dan peningkatan nilai inersia penampangnya. Pemodelan struktur yang ditinjau adalah sebagai portal rangka ruang (space frame), dengan pembebanan dibatasi untuk beban mati dan beban hidup. Standar yang digunakan adalah Standar Nasional Indonesia (SNI) 1727-2013 dan PPIUG 1983. Tata cara perhitungan struktur beton untuk bangunan gedung Standar Nasional Indonesia (SNI) 2847-2002. Sedangkan untuk analisis gaya-gaya dalam di lakukan dengan menggunakan bantuan software SAP2000. Input data material untuk beton, K-250 (f’c = 20,75 Mpa) dan baja (fy) = 390 Mpa. Berdasarkan hasil analisisis untuk balok induk 30/60 dengan bentang 6 m diperoleh besarnya momen (M) dan gaya geser (V) maksimum sebesar M = 188,09 kN.m dan V = 177,20 kN Untuk balok segi empat variasi 1. M = 154,19 kN.m dan V = 176,51 kN untuk balok T variasi 2. Kebutuhan tulangan perlu untuk balok variasi 1 sebesar 940,80 mm2 (ρ = 0,0056) menggunakan besi 5D16. Untuk balok variasi 2 sebesar 890,71 mm2 (ρ = 0,0047) menggunakan besi 4D16. Dengan demikian diperoleh kesimpulan bahwa pemodelan balok T menjadikan kebutuhan tulangan menjadi lebih kecil dibandingkan dengan balok segi empat.
Analisis Pemodelan Pemilihan Moda Transportasi Ke Kampus oleh Mahasiswa Universitas Muhammadiyah Aceh
Authors: Azka Cut Nawalul , Hidayat Rifki , Ramadhana Wahyu
Published: June 2024

The Study on the Selection of Mode of Transportation to Campus by Students of the University of Muhammadiyah Aceh to identify the characteristics of the choice of transportation mode and determine the factors that influence students in choosing the mode of transportation to campus. This study was conducted using the Binomial Logit modeling on the characteristics of the choice of transportation mode by students that affect the choice of transportation mode by students of the University of Muhammadiyah Aceh using the SPSS statistic V.24.0 application. Based on the most influential factor in the choice of mode to campus by students of the University of Muhammadiyah Aceh is the ownership of private vehicles, where each student prefers a private vehicle (motorcycle) obtained the equation Y = 0.311 + 0.239(X4) + 0.435(X8). This equation has a strong correlation with R which is 0.630 and the coefficient of determination (R2) is 0.397. This model can be interpreted that for every increase in the number of vehicle owners, there will be an increase in users of private transportation modes by 0.239 and every increase in ownership of private vehicles, there will be an increase in users of private transportation modes by 0.435. From the results of the modeling equation, the probability of students choosing private transportation modes reaches 72.8% Private vehicles. While the probability of students choosing public transportation mode reaches 42.3% occurs when students do not have a driver's license and private vehicle.
PENGARUH SLAB BAWAH PADA STRUKTUR BOX CULVERT TIPE SINGLE MENGGUNAKAN SOFTWARE SAP 2000
Authors: Syahbana Mahdi , Fachri Fachri
Published: June 2024

Jembatan merupakan suatu bangunan yang menghubungkan dua bagian jalan yang terputus melintasi sungai, danau, kali jalan raya, jalan kereta api dan lain-lain. Untuk menghindari terjadinya kompleksitas pada perhitungan analisis perencana menyederhanakan tipe struktur menjadi portal bidang (plane frame) pada struktur box culvert, akan tetapi pemodelan struktur box culvert tidak mengikut sertakan slab bawah pada proses analisis. Hal tersebutlah yang menjadi latar belakang dalam menganalisis pengaruh slab bawah dan tanpa slab bawah pada struktur box culvert, dengan membandingkan nilai momen dan deformasi bentuk struktur dari kedua model tersebut. Jenis Box culvert ini menggunakan tipe single, beban yang bekerja pada struktur berupa beban gravitasi. Peraturan yang digunakan adalah SNI 1725 2016. Tipe struktur yang digunakan pada analisis box culvert adalah portal bidang (plane frame), proses analisis menggunakan program komputer SAP2000 (structure Analysis Program). Hasil analisis menunjukkan momen pada box culvert dengan slab bawah terdistribusi antar elemen satu dengan elemen lainnya, perbandingan momen pada slab atas sebesar 18,58%, pada dinding 1 sebesar 6,27% dan pada dinding 2 sebesar 37,83%. sehingga berpengaruh terhadap deformasi bentuk struktur secara global. Pada box culvert tanpa slab bawah distribusi momen yang terjadi tidak menyebabkan struktur berdeformasi secara global, deformasi bentuk yang terjadi hanya pada elemen saja berupa lentur. Tidak terjadinya deformasi bentuk secara global pada box culvert tanpa slab bawah disebabkan pengaruh tumpuan jepit yang menumpu pada slab dinding, serta mengabaikan tekanan tanah dasar yang bekerja pada slab bawah.