bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjectives with spatial meaning in the Russian song genre
Authors: Чэн И.
Published: October 2024

народные песни – это уникальный источник аутентичной информации, созданный устным народным творчеством, отличающийся богатой выразительностью благодаря наличию в них ряда сложных лексических средств. Прилагательные с пространственной семантикой являются средством репрезентации пространственно-размерных характеристик художественных субъектов и явлений окружающего мира, – они способны репрезентовать предметы и явления определенной формы или объем, занимаемый их элементами, что является по настоящий момент одной из горячих точек научных когнитивно-лингвистических диспутов. Цель настоящей работы – анализ прилагательных с пространственным значением, встречаемых в текстах русских народных песен. Научная новизна заключается в выделении лингвостилистически релевантных признаков русского песенного текста как особого феномена художественной и языковой природы поэтического искусства. В результате проведенного исследования доказано, что дефиниции с пространственным значением, являясь индикатором национальной русской культуры, быта, традиций и устоев, с одной стороны, отражающим языковую ситуацию, а с другой, являющимся закономерным продуктом фольклора, позволяют определять пространственную (процессуальную) или пространственно-временную траектории зарождения и бытования песенного текста на протяжении всего его существования в русском народном музыкальном творчестве.

folk songs are a unique source of authentic information created by oral folk art, characterized by rich expressiveness due to the presence of a number of complex lexical means in them. Adjectives with spatial semantics are a means of representing the spatial and dimensional characteristics of artistic subjects and phenomena of the surrounding world - they are able to represent objects and phenomena of a certain shape or volume occupied by their elements, which is currently one of the hot spots of scientific cognitive-linguistic disputes. The purpose of this work is to analyze adjectives with spatial meaning found in the texts of Russian folk songs. The scientific novelty lies in the identification of linguistically relevant features of the Russian song text as a special phenomenon of the artistic and linguistic nature of poetic art. As a result of the conducted research, it is proved that definitions with spatial meaning, being an indicator of national Russian culture, way of life, traditions and foundations, on the one hand, reflecting the linguistic situation, and on the other, being a natural product of folklore, make it possible to determine the spatial (procedural) or spatio-temporal trajectories of the origin and existence of a song text throughout the entire his existence in Russian folk music.
Ürolojik Cerrahi Sonrası Deliryum Yönetimi
Authors: Dişbudak Büşra , Seyhan Ak Ezgi
Published: September 2024

Ürolojik cerrahi sonrası deliryum, özellikle yaşlı hastalarda sık karşılaşılan önemli bir komplikasyon olup, postoperatif iyileşme sürecini olumsuz yönde etkileyerek, hastanede kalış süresini uzatmakta ve sağlık bakım maliyetlerini artırmaktadır. İleri yaş, bilişsel fonksiyon bozuklukları, ağrı, enfeksiyonlar, anemi, elektrolit ve hormonal dengesizlikler, böbrek yetmezliği, dehidratasyon, majör ve uzun süreli cerrahi girişimler deliryum gelişim riskini artıran faktörler arasında yer almaktadır. Son yıllarda yapılan araştırmalar, ürolojik cerrahi geçiren hastalarda deliryum riskinin majör cerrahiler kadar olmasa da dikkate değer olduğunu ortaya koymuştur. Özellikle transüretral prostat rezeksiyonu veya radikal nefrektomi gibi cerrahilerin sonrasında uzun süreli kateterizasyon gereksinimi, deliryum riskini artıran faktörlerdendir. Deliryumun önlenmesi ve yönetimi, multidisipliner olarak ele alınması gereken bir süreçtir. Farmakolojik olmayan yöntemler, farmakolojik tedaviler kadar etkilidir ve hemşirelerin rolü büyük önem taşımaktadır. Erken mobilizasyon, duyusal uyaranların artırılması, bilişsel aktiviteler, yeterli sıvı ve besin alımının sağlanması gibi müdahaleler, deliryumu önlemede etkili stratejiler olarak kabul edilmektedir. Deliryum geliştiğinde ise, multidisipliner bir ekip tarafından yönetilmeli ve kanıta dayalı tedavi protokolleri hızla uygulanmalıdır. Bu makale, ürolojik cerrahi sonrası deliryum gelişiminde rol oynayan risk faktörlerini, önleyici girişimleri ve deliryumun gelişmesi durumunda uygulanabilecek farmakolojik ve non-farmakolojik tedavi yaklaşımlarını incelemektedir.
Effect of Incorporating Soursop (Annona muricata) Leaves Powder on Reproductive Performance of Japanese Quail (Coturnix coturnix japonica)
Authors: Tchoffo Herve , Margaret Mary Momo Chongsi , Forsoh Ayemle Pride , Manfouo Roussel , Kondo Nyembo Camile , Adamou Mohamadou , Kasomo Dedieu Byamungu , Baulland Nguedia Dongmo Arius , Ngoula Ferdinand
Published: September 2024

Introduction: Soursop leaves are rich in various molecules, including total phenols, terpenes, and steroids, which possess a range of pharmacological properties that can be utilized in animal production to enhance both growth and reproduction of animals. The present study aimed to evaluate the effect of incorporating soursop (Annona muricata; A. muricata) leaves powder into feed on the reproductive performance of Japanese quail.
Materials and methods: A total of 80 Japanese quails (64 females and 16 males) aged two weeks were randomly divided into four experimental groups, labeled T0, T1, T2, and T3, and received feed additives with 0 mg/kg body weight (bw), 250 mg/kg bw, 500 mg/kg bw, and 750 mg/kg bw of powdered soursop leaves, respectively. Additionally, water was provided ad libitum, and the quails' weights were measured every 7 days for a period of 75 days. At the end of the period, 12 female quails from each group were sacrificed after 24 hours fasting period. Blood was collected for hematological (Leukocyte, Erythrocyte, and Platelet indices) and serum biochemical (total serum cholesterol, total proteins, albumin, and globulin, Aspartate aminotransferase, Alanine aminotransferase, Urea, and Creatinine) analysis. The males were also sacrificed to evaluate the spermatozoa characteristics (mobility, concentration, and viability).
Results: No statistical significant changes in growth characteristics or hematological parameters were observed. However, biochemical parameters increased significantly with the inclusion of Soursop (A. muricate) in quail feed, including increased total cholesterol, total protein, and globulin levels, and decreased malondialdehyde levels. This effect was most significant at dosage of 500 mg/kg bw. Serum levels of urea, Alanine aminotransferase, and Aspartate aminotransferase were not significantly affected by A. muricata whatever the concentration considered. A significant increase in fast progressive spermatozoa, along with a decrease in immotile spermatozoa, was observed with A. muricate at dosage of 500 mg/kg bw compared to the control. Sperm viability also increased significantly, particularly in live at dosage of 500 mg/kg bw. Significant increase was observed in fertility parameters, including increased fertility rate, hatchability rate of fertile eggs, total hatchability rate, and chick weight, along with decreased embryonic mortality at 500 mg/kg bw treatment compared to the control.
Conclusion: In conclusion, the findings indicated that incorporating A. muricata leaf powder at 500 mg/kg bw into quail feed positively influences reproductive cells and boosts fertility growth promoters.
PARTISIPASI MASYARAKAT DALAM PERENCANAAN PEMBANGUNAN DAERAH DI KABUPATEN LANNY JAYA
Authors: Hattu Jacky , Poli Agustina Ivonne , Julison Bernathius
Published: October 2024

Jumlah masyarakat yang mengikuti musyawarah perencanaan pembangunan daerah pada setiap distrik di Kabupaten Lanny Jaya mengalami penurunan dari tahun ke tahun, padahal masyarakat memiliki peran penting dalam setiap program pemerintah termasuk proses penentuan kebijakan di dalamnya. Penelitian ini bertujuan  untuk mengetahui bentuk partisipasi masyarakat, tingkatan partisipasi masyarakat, serta mengetahui faktor penentu partisipasi masyarakat dalam perencanaan pembangunan melalui musyawarah perencanaan pembangunan daerah  di Kabupaten Lanny Jaya. Penelitian ini menggunakan metode deskriptif kuantitatif dengan menggambarkan keadaan yang sebenarnya dari objek penelitian dan data diperoleh melalui penyebaran kuesioner serta pengamatan di lapangan. Hasil penelitian menunjukkan bahwa bentuk partisipasi masyarakat berupa solidaritas dalam diskusi kelompok, khususnya saat dalam pengambilan keputusan. Tingkat partisipasi masyarakat di Kabupaten Lanny Jaya, khususnya pada saat mengikuti musrenbang, berada pada kategori tinggi. Dalam musrenbang daerah, lebih banyak partisipan laki-laki (99,2 %), mayoritas responden berusia 31 – 40 tahun (53,3%), dan sebagian besar memiliki pendidikan SMA sederajat (45,8%). Rendahnya tingkat partisipasi perempuan dalam musrenbang disebabkan oleh faktor budaya patriarki yang masih erat dipegang di Kabupaten Lanny Jaya.
STRATEGI PENGELOLAAN WILAYAH PESISIR KABUPATEN SARMI DALAM UPAYA MITIGASI TSUNAMI
Authors: Pamuji Danang , Setiadji Prihananto , Karapa Enos
Published: October 2024

Distrik Sarmi merupakan ibukota Kabupaten Sarmi yang mempunyai tatanan tektonik cukup kompleks. Letak geografis yang berada dekat dengan zona subduksi utara Papua di Samudera Pasifik membuat Distrik Sarmi terindikasi ancaman tinggi bencana tsunami. Kepadatan penduduk serta aktivitas perekonomian di Distrik Sarmi akan menambah tingkat kerentanan jika suatu saat terjadi bencana tsunami. Penelitian ini bertujuan untuk mengidentifikasi tingkat kerentanan bahaya tsunami dan menentukan strategi pengelolaan pesisir untuk mitigasi tsunami di Distrik Sarmi dengan menggunakan metode AHP. Perangkat lunak COMCOT (Cornell Multi-grid Coupled Tsunami Model) digunakan untuk melakukan pemodelan tsunami dengan sumber data sekunder dari historis kejadian gempa bumi dan tsunami di Papua. Dengan skenario sumber gempa bumi kekuatan maksimal M8,7, COMCOT memodelkan waktu tiba gelombang tsunami di pesisir antara 5 – 20 menit dan jarak landaan dapat mencapai maksimum 3 Km ke daratan. Dari hasil peta bahaya tsunami di Distrik Sarmi, 4 kampung/kelurahan berpotensi terkena landaan gelombang tsunami dengan run up sampai dengan 6 meter dan strategi pengelolaan pesisir dalam mitigasi tsunami di Distrik Sarmi harus berwawasan lingkungan dengan alternatif strategi berupa penanaman hutan mangrove.
PERSEPSI PENGGUNA TERHADAP PENGEMBANGAN KONSEP ECO-SHELTER TRANS SEMARANG PADA KORIDOR 7 (TERBOYO – BALAIKOTA)
Authors: Damanik Aditya , Wahjoerini Wahjoerini
Published: October 2024

Transportasi umum massal merupakan salah satu solusi dalam mengatasi masalah kemacetan, seperti misalkan transportasi umum berbasis bus BRT yang sudah diterapkan pada beberapa kota. Sistem BRT sudah beroperasi sejak lama di Kota Semarang untuk mendukung mobilitas warga setempat serta mengurai masalah kemacetan. Tetapi masih banyak terdapat beberapa sarana prasarana pendukung seperti halte/shelter yang kondisi fasilitasnya masih kurang optimal dalam memberikan pelayanan kepada para pengguna Trans Semarang. Penelitian ini dilakukan untuk mengetahui bagaimana persepsi para pengguna moda transportasi publik BRT Trans Semarang khususnya pada koridor pelayanan 7 Terboyo – Balaikota (via Genuk) terhadap fasilitas shelter sebagai lokasi titik tunggu/penjemputan (pool) apabila dikembangkan ke arah eco-shelter. Penelitian ini menggunakan metode pendekatan kuantitatif yang menganalisis data berdasarkan informasi dari sekitar 100 responden yang diambil secara acak baik dari kalangan pelajar, mahasiswa, maupun pekerja. Hasil analisis dengan menggunakan model skala likert serta Customer Satisfaction Index (CSI) menunjukkan bahwa mayoritas responden menjawab setuju dengan adanya kondisi shelter yang ada saat ini sesuai dengan pernyataan-pernyataan peneliti pada kuesioner dengan nilai CSI sebesar 67%, sedangkan kajian mengenai persepsi pengguna terhadap pengembangan dengan konsep eco-shelter juga memperoleh skor yang sangat baik yaitu sebesar 80,72% dimana para pengguna merasa setuju apabila aspek-aspek yang ada dalam konsep eco-shelter diimplementasikan dengan baik.
EMOTIONAL INTELLIGENCE: IT’S RELATIONSHIP TO MATHEMATICS ACHIEVEMENT OF SENIOR HIGH SCHOOL
Authors: PAGUYO-GUMANGAN MARY JANE
Published: September 2024

The main purpose of this study was to determine the relationship between emotional intelligence and Mathematics achievement of the senior high school students of Don Mariano Marcos National High School. Respondents were Grade 11 students with a total number of one hundred sixteen (116) students. This study applied descriptive Correlational design. The Bar-On Emotional Quotient Inventory: Short (BarOn EQ-i: S) was used to determine emotional intelligence of the respondents and Mathematics achievement was measured by their third quarter grade in Statistics and Probability. The study revealed that the emotional intelligence of the respondents was average, which indicates that they have an adequate emotional and social capacity. Furthermore, their emotional intelligence varies when grouped according to Strand. On the other hand, negligible difference was observed when they were grouped in terms of their socio-economic status, age and sex. There exist a weak relationship between emotional intelligence and Mathematics achievement of the respondents. Lastly, the study revealed that Mathematics achievement is affected by emotional intelligence of the respondents. Senior high school students should be abreast of their emotional intelligence they possess and as much as possible, so they can find ways and means to increase their emotional intelligence. In addition, curriculum developers must include emotional intelligence in the competencies to be developed in the senior high school curriculum.
THE SAFETY OF KETOPROFEN USAGE IN DIFFERENT AGE
Authors: Qahil Ibraimi  , Driton Selmani  , Arjeta Shabani
Published: September 2024

Ketoprofen, an NSAID, functions by blocking the COX 1 and 2 enzymes involved in producing prostaglandins, which are messengers responsible for inflammation. All NSAIDs inhibit this enzyme, leading to a reduction in inflammation symptoms. In Calabria, 3.69% of ADRs reported in the National Pharmacovigilance Network (RNF) relate to ketoprofen usage, with hospitalization required in only one case of a patient below the age of 12 due to severe pancreatitis. Ketoprofen is the 6th drug in Italy for ADR incidence, with 560 ADRs reported in 2012, of which 31% are severe. Although there is a high rate of spontaneous reporting, it must be noted that ketoprofen is one of the most commonly used NSAIDs. Therefore, like other frequently prescribed drugs (e.g., amoxicillin); the total number of ADRs should be considered in relation to its therapeutic use. However, the drug's safety in different ages and for vulnerable patients (such as children) remains a concern. This paper reviews the literature on the safety of ketoprofen in the elderly, children, and during pregnancy, presenting a retrospective study of ADRs reported in 2012.
ADVANCING GLOBAL HEALTHCARE THROUGH INNOVATIVE DRUG DELIVERY AND DIAGNOSTIC TECHNOLOGIES BY FUSING BIOMATERIALS AND NANOBIOTECHNOLOGY
Authors: Viola Berisha  , Adnan Duriqi
Published: September 2024

This paper focuses on the intersection between biomaterials and Nanobiotechnology, which revolutionized medical science and healthcare. Biomaterials, which are used in the development of breakthroughs such as prosthetics and drug delivery has been supported by nanobiotechnology’s ability to control manipulation on its nano scale material properties for treating pathologies. These fields have been complementary in that they result in improved drug delivery, novel tissue engineering techniques and diagnostic discoveries. In order to cover different techniques and testing approaches related with the synthesis, characterization, and biological interaction of these materials this (paper) focuses on such. It focuses on drug delivery, tissue engineering, diagnostics and smart biomaterials approaches with future directions involving machine learning computational modeling and nanorobotics. It is discussed about the challenges in biocompatibility, toxicity and opportunities of personalized medication especially emerging nations. In summary, the essay confirms that biomaterials and Nanobiotechnology play an important role in improving worldwide health care standards modern problems of medicine.
LEGISLATION ON VIOLENCE AGAINST WOMEN - INTERNATIONAL LEGAL AND POLICY INSTRUMENTS
Authors: Luljeta Xhemaili
Published: September 2024

Until recently, human rights were treated as a field-a matter of internal competence of states, therefore neither a state nor the international community had the right to raise the issue of human rights violations in a state without the risk that this should be interpreted as interference in internal affairs on that country. However, the international community, especially after the creation of international organizations-the League of Nations and the United Nations, pays more and more attention to the well-being of the individual-Man, as one of the most important conditions for maintaining peace, security, stability and democracy. Even today, in many countries of the world, human rights and basic freedoms are violated in a brutal way: ethnic, racial or religious minorities are oppressed, discrimination, genocide is practiced, and most importantly, VIOLENCE is practiced, which proves that the struggle for the full integration of this field of rights has not yet been obtained everywhere. Violence against women as a phenomenon appears everywhere. Each country with its national laws combats acts of violence in a way that ensures criminal prosecution, where they provide support to the victim and strengthen the prevention of acts of violence against women. At the core of violent behavior in the family are historically unequal relationships as a result of the views about the power of men and women-power is a function of achieving control in the family and over its members by creating violent relationships where these victims of relationships are women, children and elderly persons. States have an obligation to create various laws and policies that protect violence against women at national and international levels, but in many countries the legislation is limited and not enforced.
ANCIENT CIVILIZATIONS AND MARRIAGE: A COMPARATIVE STUDY OF CUSTOMS, TRADITIONS, AND RITUALS IN SUMERIAN, BABYLONIAN, PERSIAN, EGYPTIAN, GREEK, ROMAN, CHINESE, EUROPEAN, AFRICAN AND AMERICAN CULTURES
Authors: Murshida Khatun  , Amirul Islam
Published: September 2024

This comparative study explores the diverse customs, traditions, and rituals surrounding marriage in various ancient civilizations, including Sumerian, Babylonian, Persian, Egyptian, Greek, Roman, Chinese, European, African, and American cultures.The study examines gender roles, marriage practices, and the historical and cultural contexts that have shaped them, as well as how marriage has contributed to and upheld social order.It demonstrates that although marriage was regarded as a sacred institution by all cultures, the particular traditions and ceremonies varied widely. This research uses qualitative methodology, which is done through the analysis of secondary sources, scholarly analysis, and thematic analysis of marriage practices among the selected civilizations. While arranged weddings were widespread in Sumerian and Babylonian societies, legal considerations like dowries and divorce laws were highly regarded in Greek and Roman societies. The study also emphasizes how different gender roles and expectations are in marriage, with some cultures emphasizing the submissive role of women while others value marriages with more equal partners. This study sheds light on the nuanced and varied approaches that ancient civilizations had to the institution of marriage and highlights the significance of comprehending previous cultural practices to better understand the roots of our present society.
When Pruritus is Not Allergy: Appropriate Signs of Lymphoma and Other Malignancies for the Community Allergist
Authors: Balitsky Amaris K. , Davies Gwynivere A.
Published: October 2024

Pruritus is a common symptom that all individuals have experienced at some time. Although general malignancy is a rare cause of pruritus, there is an increased risk of hematologic malignancy in those with chronic itch. For the allergist assessing chronic itch, we have outlined an approach in the case of suspected hematologic malignancy and steps for an initial work-up.
Aeroallergen Avoidance: Updated Evidence and How to Advise Patients
Authors: Batool Tahira
Published: October 2024

Allergic rhinitis (AR) is highly prevalent in Canada, affecting approximately 20–25% of the population. Asthma is estimated to affect approximately three million Canadians, and between 12% and 25% of Canadian children. Approximately two-thirds of individuals with asthma are allergic to aeroallergens, and these allergens act as triggers for asthma exacerbations. Overall, approximately 7.7 million individuals were affected by aeroallergens in Canada in 2016. High concentrations of ambient aeroallergens, including tree pollen and fungal spores have been associated with increased risk of premature birth, myocardial infarction (MI) and asthma-related Emergency Department visits and hospitalizations in cities across Canada. This demonstrates that nation-wide aeroallergen counts are associated with severe signs and symptoms.
Children exposed to various indoor allergens are placed at an increased risk of developing asthma in later life, with sensitization in these individuals being a strong predictor of disease morbidity. Common indoor exposures for infants include house dust mite, pet, cockroach, mould, and rodent allergens. Sensitization to at least one indoor allergen has been demonstrated to be present in nine of every ten children hospitalized with asthma.
It has been noted that more than 90% of children worldwide breathe polluted air. While the impact of climate change on aeroallergen exposure is not fully understood, there is increasing evidence that it may have an impact on outdoor aeroallergens and, by extension, asthma control in children. Global warming has been projected to influence the duration and intensity of pollen seasons, and may lead to increased pollen production, prolonged pollen seasons, and increased pollen protein allergenicity.
The changing weather patterns including rainfall and wind may cause pollen species to reach environments in which they had not previously been present, contributing to a shift in geographic pollen distributions.
Adverse Reactions to Vaccines
Authors: Abdurrahman Zainab B. , Putman David M.
Published: October 2024

Vaccination is one of the most impactful and cost-effective interventions for improving global health. Routine immunization has reduced mortality and morbidity resulting from numerous types of infectious diseases.
The widespread use of any reagent is always associated with the risk of adverse reactions, including expected and common side effects, as well as those that are unexpected or idiosyncratic. Mild, local injection site reactions such as redness, tenderness, swelling, or constitutional symptoms such as fever and malaise, are common after vaccination and are not contraindications to further vaccination; they are generally manifestations of the physiologic response to vaccination. Uncommon reactions can vary; they may manifest as delayed hypersensitivity to vaccine components causing injection site nodules or severe, rare anaphylactic reactions. Anaphylaxis occurs at approximately one per million doses administered. The extremely rare Arthus reaction, a type of local Type 3 hypersensitivity reaction, resulting in local immune complex deposition due to the presence of pre-existing IgG antibodies, is typically limited in duration and is not a contraindication to further tetanus vaccination.
Allergists are often seen as stewards of information regarding many of these reactions, although most of these reactions are not allergic in nature. It can be difficult to distinguish between a true allergic reaction to a vaccine and other clinical manifestations that may occur during or acutely after vaccination, such as anxiety, vasovagal responses, and pronounced local reactions. Patients who have had adverse reactions to vaccines may be unnecessarily advised to avoid subsequent immunization, which can put them at risk of morbidity or mortality. The importance of making this clinical distinction has become particularly significant during the ongoing COVID-19 pandemic. The allergist plays an important role in investigating adverse reactions to vaccines and ensuring that patients who are eligible can be safely vaccinated following appropriate investigation. For those patients with true immediate-onset allergic reactions, allergists are able to provide safe revaccination following established protocols.
Epinephrine auto-injectors in Canada: A review of available products and clinical proposals
Authors: Kim Harold , Walter Graham
Published: October 2024

Anaphylaxis is a severe reaction with significant associated morbidity and mortality that necessitates prompt on-demand management for patients. Epinephrine administered intramuscularly at a dose of 0.01 mg/kg of body weight, up to a maximum single dose of 0.5 mg at one time, is the first-line treatment for anaphylaxis. Epinephrine auto-injectors (EAIs) are devices designed to deliver a predetermined dose of epinephrine rapidly and reliably into the vastus lateralis muscle of the mid-anterolateral thigh for treatment of anaphylaxis. All commercially available auto-injectors in Canada are fixed-dose delivery systems, therefore titration of epinephrine dose based on patient weight is not possible.
In Canada, there are several manufacturers of EAIs, providing treating physicians and patients with a variety of options to treat anaphylaxis in the community. However, as these devices all contain the same medication, physicians may not realize that specific EAIs may be of greater utility in certain clinical circumstances. This scientific review aims to describe all currently available EAIs in Canada, with detailed discussion on the differences between products and the nuances of a patient-centred approach to prescription in a market filled with seemingly “one size fits all” devices.
Surgical Management of Allergic Rhinitis
Authors: Lee Daniel J. , Chan Yvonne
Published: October 2024

The inferior turbinate is composed of a central bony structure surrounded by ciliated pseudostratified columnar epithelium. Underneath the epithelium, there are mucous glands, goblet cells and venous sinusoids in the submucosa, The inferior turbinate is supplied by the inferior turbinate branch of the posterior lateral nasal artery from the sphenopalatine artery. The inferior turbinates humidify the air, trap particles and direct airflow throughout the nasal cavity. Due to these functions, the inferior turbinates are often the first point of contact for allergens in the inspired air. With immune responses prompted by a cascade of inflammatory mediators such as immunoglobulin E, mast cells, histamine, and leukotrienes, mucous glands become stimulated and the vasculature within the inferior turbinate engorges. This results in inferior turbinate hypertrophy, leading to increased nasal discharge and nasal obstruction. For individuals refractory to medical therapy for nasal obstruction, surgical inferior turbinate reduction techniques can be employed to help alleviate the symptoms. For those with rhinorrhea refractory to medical therapy, surgical management aimed at reducing parasympathetic innervation to the nasal cavity to reduce nasal discharge production can be also option.
Adult Obstructive Sleep Apnea: A Practical Guide for the Allergist
Authors: Moolji Jalal , Adatia Adil
Published: October 2024

Obstructive sleep apnea (OSA) is a common sleep disorder, affecting 15-30% of males and 10-15% of females in North America. OSA is characterized by the recurrent obstruction of the upper airway during sleep resulting in apneas and hypopneas. OSA can be diagnosed using a home sleep apnea test (i.e., a level 3 sleep study) or a polysomnogram (PSG) (i.e., a level 1 study or PSG) in a supervised sleep laboratory which quantifies the number of apneas and hypopneas per hour using the apnea-hypopnea index (AHI). In broad terms, the diagnosis is made when an individual with symptoms or cardiac risk factors has an AHI of ≥5, or an asymptomatic individual has an AHI of ≥15. Continuous Positive Airway Pressure (CPAP) is considered the first-line treatment of OSA. Other treatment options include an oral appliance called a mandibular advancement device, or multilevel surgery of the upper airway, especially uvulopalatopharyngoplasty (UPPP). Herein we review OSA in the context of conditions commonly observed in the allergy clinic, namely asthma, chronic rhinosinusitis, rhinitis, and contact dermatitis.
Shared Decision Making in Asthma Treatment: Using Motivational Communication to Elevate Your Consultations
Authors: Dragomir Anda I. , Lavoie Kim L.
Published: October 2024

The extent to which patients are adherent to their medication regimen is critical for achieving good asthma control, preventing exacerbations, and optimizing the likelihood that patients can lead full and productive lives. Knowing this, physicians might perceive that their role is to convince their patients to comply with their prescribed medicines using educational or persuasive advice-giving strategies that focus on the health benefits of treatment compliance and the negative health consequences of non-compliance. However, evidence suggests that evoking fear of negative consequences is a poor motivator for both the adoption, and long-term maintenance, of good health behaviors such as medication adherence. In an effort to make the maladaptive behavior the ‘less desirable choice’, physicians often inadvertently become associated with the fear messages they share (through classical conditioning) and the negative emotions they elicit (through operant conditioning). This may result in physicians themselves becoming aversive to their patients, leading to patients disengaging from the therapeutic relationship and becoming resistant to treatment recommendations. In fact, treatment success depends not on the imperative to convince and control patient behavior (which defines compliance), but on the willingness to collaborate with the patient to co-construct a treatment plan that they agree with and want to follow (which defines adherence). The key takeaway is to recognize that non-collaborative communication is ineffective for behavior change and may actually be counterproductive, if not harmful.
Secondary Hypogammaglobulinemia
Authors: Kim Vy H.D.
Published: October 2024

Secondary hypogammaglobulinemia (SHG) is characterized by reduced immunoglobulin levels due to extrinsic causes, such as a medication or an acquired disease process, resulting in decreased immunoglobulin production or increased immunoglobulin loss. Most published reports of SHG refer to IgG hypogammaglobulinemia and data on isolated IgA or IgM hypogammaglobulinemia is limited. The common causes of SHG include medications, hematological malignancies, and conditions associated with protein loss. Hypogammaglobulinemia can increase the risk of infection, morbidity and mortality, particularly in patients who may already be immunocompromised due to their associated condition or use of immunosuppressive therapies. With growing use of immunosuppressive or immunomodulatory treatments that affect B-cells, it is increasingly important to assess and monitor for SHG. Treatment of the underlying condition or removal of the extrinsic factor often results in resolution of the SHG. A subset of patients presenting with autoimmune or malignant conditions can have a primary immunodeficiency (PID) or primary immune regulatory disorder. It is therefore important to consider both primary and secondary causes when assessing hypogammaglobulinemia. This article will review these common causes and discuss an approach to assessment and management of SHG.
Abstract Presentation Highlights from the 2024 EAACI Annual Meeting
Authors: Waserman Susan , Ohayon Jason , Keith Paul
Published: October 2024

Many oral abstracts, posters and case reports were presented at The European Academy of Allergy and Clinical Immunology (EAACI) Annual Meeting which was held in June 2024 in Valencia, Spain. We have selected the following 13 articles due to their relevance to Canadian allergy and immunology clinical practice and research.
Atopic March and Disease Modification
Authors: Byrne Adam
Published: October 2024

Over generations of health care providers, the approach to medicine has predominantly been reactive in nature, addressing symptoms as they arise. With advancements in medical research that explore the underlying mechanisms of disease, associated comorbidities, and improved therapeutic options, the objectives of medicine are transforming. While managing active symptoms remains crucial, there is a growing focus on altering the future trajectory of a disease which will result in new avenues to improve the quality of life of patients. In this evolving landscape, the atopic march emerges as a promising area for disease modification.
Keratinocyte Carcinoma: Canadian Landscape and an Evidence-based Approach to Follow-up
Authors: Georgakopoulos Jorge R.
Published: October 2024

Dermatologists play a vital role in the early detection, prevention and effective management of skin cancer in patients with a prior history of the disease. Regular monitoring and timely interventions greatly enhance the overall prognosis and quality of life for patients with skin cancer. Dermatologists possess the requisite expertise to accurately diagnose and oversee the management of cutaneous skin cancers. 
Skin cancer screening via total body skin exam (TBSE) is often considered one of the safest, easiest, and most cost-effective tests in medicine. Despite dermatologists’ ability to offer such invaluable care for this patient population, offering routine skin checks for all patients with a prior history of skin cancer becomes exceptionally challenging given the high demand for dermatology care across Canada. It is important for dermatologists to maximize the efficiency of care during TBSEs by adhering to evidence-based guidelines when determining the frequency and duration of follow-up. These guidelines also provide a solid foundation for discussions with patients regarding the rationale for discharge back to their primary care provider.
Dermatology Treatments and their Effects on Patch Testing
Authors: Colantonio Sophia
Published: October 2024

Patients are often sent for patch testing to rule out allergic contact dermatitis, but it is a clinical conundrum of what to do when they are on systemic agents. The clinical question is, should the systemic agents be held for 4-5 half-lives and then patch tested to ensure there is no blunting of the immune system? The reality is that in this population without systemic treatments, patients are seldom clear enough to patch test. Their backs are covered in dermatitis and testing runs the risk of eliciting an uninterpretable “angry back”. The other consideration is patients’ strong preference to remain on systemic medications that control their significant itch, rash and associated sequelae. In an ideal world, it would best to patch test patients prior to the initiation of a systemic agent but clinically this is not always feasible. 
We will explore various clinical scenarios involving patch testing and discuss the advice the dermatologist should provide patients regarding holding their medications.
Updates in Treatment of Refractory Inflammatory Myositis
Authors: Huang Kun , Pye Aidan
Published: October 2024

Idiopathic immune myopathies (IIM), also known as myositis, are a heterogeneous group of autoimmune diseases with varying phenotypes, prognoses, and treatment responses. They are primarily characterized by muscle inflammation, however, many patients have extramuscular involvement including skin rash, arthritis, interstitial lung disease (ILD), cardiomyopathy, and gastrointestinal dysmotility. The discovery of myositis-specific autoantibodies (MSAs) has been a major advancement in the field of IIMs, shaping the new landscape of the clinical, phenotypical, histological, and serological correlations. Based on this discovery, IIM can be more specifically classified into dermatomyositis (DM) (including amyopathic DM), antisynthetase syndrome (ASyS), immune-mediated necrotizing myopathy (IMNM), inclusion body myositis (IBM), polymyositis (PM), and overlap myositis (OM). An increasing number of histological studies have revealed a misdiagnosis of PM because many patients who were previously diagnosed with PM were later reclassified to other forms of IIM, including IBM, IMNM, ASyS, or DM without a rash.
Axial Spondyloarthritis Treatment Recommendations in 2024: Where Are We Now?
Authors: Rohekar Sherry
Published: October 2024

As 2024 continues to evolve, so do treatment recommendations for the management of spondyloarthritis (SpA), including ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). From a Canadian perspective, we eagerly await the publication of the Canadian Rheumatology Association (CRA)/Spondyloarthritis Research Consortium of Canada (SPARCC) Living Treatment Recommendations for the Management of Axial Spondyloarthritis (axSpA), currently in press. Until these recommendations for axSpA treatment with a Canadian perspective arrive  – where are we now?
ЭТНОМӘДЕНИ АРХЕТИПТЕРДІҢ ҚАЛЫПТАСУЫНА ӘСЕР ЕТУШІ ФАКТОРЛАР
Authors: Демесинова Л.М. , Маманова А.Ш. , Искакова Ж.М.
Published: October 2024

Шетел әдебиеттануында ХХ ғасырдың екінші жартысынан бастап көркем шығармашылықтағы архетип мәселесі, автор мен қиял, архетип әдеби сыны өзекті тақырыптардың біріне айналды. Архетип мәселесін алғашқыда К.Г. Юнг психоаналитика ғылымы негізінде қарастырса, кейіннен әдебиеттану саласында көркем шығармашылық пен қиял мәселесінде Э. Нойманн, Н. Фрай, М. Бодкин, Е. Мелетинский сияқты ғалымдар көлемді еңбектер жазып, тың тұжырымдар жасады. Алайда отандық әдебиеттануда этномәдени архетип мәселесі жекелеген мақалалар мен мифопоэтикалық зерттеулерде кездескенімен, нақты көркем шығармадағы этномәдени архетип образдар мен сюжеттер, архетип мотив пен идея мәселесі жайында көлемді ғылыми еңбектердің аздығы жұмыстың өзектілігін айқындайды. Сонымен қатар, этномәдени архетиптердің қалыптасуына әсер етуші әртүрлі тарихи факторлар, климаттық жағдайлардың ұлт санасына әсерін нақтылауда басқа да ғылым салаларымен интеграцияда қарастыру зерттеу жұмысының маңыздылығын арттырып отыр.
СӘН ДИСКУРСЫ ЖӘНЕ ТҮС ПСИХОЛОГИЯСЫ
Authors: Камзанов Д.К. , Адилова А.С.
Published: October 2024

Мақалада сән дискурсындағы түс психологиясы, оның арнайы киімдерде қолданылу ерекшеліктері когнитивтік-дискурстық тұрғыдан қарастырылады. Адамды күнделікті ресми, бейресми қарым-қатынасында қоршаған ортаға танытатын фактордың бірі – киім болғандықтан, кез келген киімнің түр-түсі маңызды қызмет атқарады. Киімнің түсі адамның көңіл күйі, әлеуметтік мәртебесі, материалдық жағдайы туралы ақпарат бере алады. Мақала түс психологиясы және қолданылу аясы негізінде заманауи сән дискурсында пайда болған  барбикор және офискор стильдерінің ерекшеліктерін ашуға арналған.
Негізгі мақсат – әр халықтың белгілі бір түсті қабылдауында ортақ тұстар мен ерекшеліктер болатынын, офискор стиліндегі киімнің бірі – форма екенін және оның түс психологиясына сәйкес әзірленетінін ағылшын және қазақ әскери киімінің эволюциясы арқылы көрсету.
Заманауи ғылымдар парадигмасындағы антропоөзектік лингвистиканың қағидаттарына сай адамның түсінуі, қабылдауы, интерпретациялауы арқылы әр саладағы іс-әрекетін, танымын, атап айтқанда, сән саласындағы түр-түстің қолданылуын  когнитивтік-дискурстық тұрғыда талдау жұмыстың өзектілігін көрсетеді.
Зерттеуде  когнитивтік-дискурстық талдау және сипаттау, салыстыру әдістері қолданылды.
Түрлі объективті және субъективті себептерге байланысты униформаның фасоны, түсі өзгеріп отырады. Ағылшын және қазақ мәдениетіндегі әскери киімнің түсін салыстыра сипаттау арқылы оларда қолданылған ортақ түстер мен ерекшеліктер көрсетілді.
Зерттеу нәтижесінде барбикор стилі, британдық және қазақстандық  әскери форманың тарихи дамуын көрсету арқылы түс психологиясы тек униформа үшін ғана емес, жалпы сән саласы үшін маңызды фактор екені нақтыланды.
Association of Vitamin D Deficiency and Diabetic Foot Ulcer Patients in Dr Mohammad Hoesin General Hospital Palembang
Authors: Dahlan Kemas , Yususf Fahmi Jaka , Irfannuddin Irfannuddin , Murti Krisna , Muradi Akhmadu , Liberty Iche Andriyani
Published: October 2024

Vitamin D plays a role in the healing process of diabetic foot ulcers (DFU); it can improve the immune system, regulate inflammation function, and regulate growth factors in diabetes mellitus (DM). The immunomodulatory effects of vitamin D include reduced production of IL-2, IL-6, and TNF-alpha and increased production of IL-10. It also increases the activity of antimicrobial peptides (AMP) such as cathelicidin, and it promotes the differentiation of monocytes into macrophages, phagocytosis, and the production of lysosomal enzymes. Furthermore, vitamin D stimulates growth factors including vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-β). In this study, the incidence of DM and DFU in DM patients at RSUP Dr. Mohammad Hoesin Palembang will be compared to serum vitamin D levels. This research uses quantitative methods with an analytical observational design. The Mean vitamin D serum level was 11,727 ng/mL, and there was a significant association between serum vitamin D deficiency and DFU (p-value; 0.036 < 0.05). There was a significant association between serum vitamin D deficiency and DFU occurrence (p-value; 0.036 < 0.05) in Mohammad Hoesin General Hospital Palembang. Based on the results of this study, we proposed that patients with diabetic foot ulcers should have their serum vitamin D levels checked, and that vitamin D should be given to them as part of their therapy.
Implementación de intranet corporativo en la empresa Porto Comercio del cantón Portoviejo
Authors: Armijo Castro Leonardo Alejandro , Suasti Alcivar Kenny Orlando
Published: October 2024

La comunicación interna en las empresas es un factor vital para su funcionamiento, dato relacionado con el amplio desarrollo de las Tecnologías de Información, dicha comunicación es vital basarla en medios y herramientas informáticas que contribuyan a un control coherente y auditable de las acciones generadas por las comunicaciones internas. Por ello este trabajo se planteó como objetivo de implementar una intranet corporativa en Porto Comercio para desarrollar transformación y optimización de la comunicación interna dentro de la empresa. La propuesta de solución fue evaluada por un grupo de trabajadores para priorizar las salidas de mayor impacto para la organización. Esta solución integral facilita la interacción entre empleados, que mejoró la colaboración y reduciendo la dependencia de métodos de comunicación tradicionales como el correo electrónico y las reuniones. La implementación también incluye capacitación para garantizar que todos los empleados puedan utilizar la intranet de manera efectiva, junto con soporte técnico para resolver cualquier inconveniente. La intranet corporativa de Porto Comercio está diseñada para optimizar la comunicación interna, aumentar la productividad y mejorar la cohesión del equipo.
Efficacy of High Tibial Osteotomy in the Treatment of Medial Compartment Osteoarthritis: A Systematic Review
Authors: Lengkong Andriessanto C. , Kambey Stefan A.G.P
Published: September 2024

Osteoarthritis of the medial compartment of the knee is one of the common degenerative diseases among the adult population, causing chronic pain, stiffness, and limited joint function. High Tibial Osteotomy (HTO) has become an important treatment option to address deformity and reduce symptoms in patients with varus osteoarthritis. Objectives: This study aimed to conduct a systematic review of the existing literature to evaluate the efficacy of High Tibial Osteotomy in the treatment of osteoarthritis of the medial compartment of the knee. A literature search was conducted through PubMed, Google Scholar, and Cochrane Library databases for studies that met the inclusion criteria. Clinical outcomes, including improvement in pain, joint function, and radiological changes, were extracted and synthesized to provide a comprehensive picture of the efficacy of HTO. The results of the systematic review showed that High Tibial Osteotomy significantly reduced pain, improved joint function, and slowed disease progression in most patients with osteoarthritis of the medial compartment of the knee. Despite variations in surgical technique and reported clinical outcomes, HTO is generally considered an effective and sustainable procedure in the management of varus osteoarthritis. High Tibial Osteotomy shows strong promise as an important treatment option for patients with medial compartment osteoarthritis of the knee. However, it is important to take into account individual patient characteristics and consider additional therapies to maximize long-term outcomes. Further research is needed to deepen our understanding of this technique and to optimize its benefits in the treatment of osteoarthritis.
Parents' experiences in dealing with the development of adolescent Autistic Sexuality in West Java Province: A Phenomenological Study
Authors: Sinaga Anni , Hufad Achmad , Rochyadi Endang , Aprilia Imas Diana
Published: September 2024

Families who have autistic children may experience a burden in their lives. Little is known about how parents deal with their autistic children who are entering adolescence and are experiencing sexual development. What parents do to deal with the development of adolescent autistic sexuality can be found in qualitative research. The participants are parents with children who are autistic. The researcher contacted the parents and explained the informed consent; if parents agreed, they would sign the informed consent and then decide to place a time to interview the participant with the researcher, interviews with participants from January 2023-March 2023. This study aims to explore family experiences in dealing with sexuality development in adolescents with autism spectrum disorders. This phenomenological study collected data through in-depth interviews with semi-structured open-ended questions of seven child participants with autism spectrum disorders. Eleven themes constructed from this study are shy children when reminded not to hold their genitals, children are distracted when holding their genitals, children going through menstruation, children showing sexual behaviour by opening their pants, children holding their genitals, children hugging their mothers and seek attention, children stimulate themselves and others, children are easily aroused, children cannot distinguish boys and girls children like to clamp their genitals, And the child likes the prone position on the floor. Parents who feel that their child is currently facing the developmental phase of adolescent sexuality independently. They recommend that Parents provide adequate support, including appropriate education and open dialogue about the changes their child is experiencing.