bluuebunny/crossref_metadata_2025 huggingface dataset:
Transforming medical education in the AI era: Balancing technological expertise with humanistic care in tomorrow’s doctors
Authors: Jong Michelle
Published: December 2024

The rapid integration of artificial intelligence (AI) into clinical practice prompts a critical re-examination of the roles of physicians and how we educate them. While AI promises unparalleled gains in accuracy and speed, and better management decisions and health outcomes, doctors must be skilled in harnessing these new AI tools effectively and wisely to improve patient outcomes. We seek to layer further upon this with a call for medical education to go further than simply improving AI literacy of doctors, but to include a comprehensive reform of medical education. This reform would aim to expand physician capabilities from the traditional cognitive knowledge of medicine to integrating AI competencies seamlessly, with a renewed focus on the humanistic aspects of medicine. We propose the Humanistic Medicine - AI-Enabled Education (HuMe-AiNE) framework, which includes the key components: (1) standardisation and individualisation of AI competencies; (2) integration of AI tools through the curriculum; (3) fostering critical thinking skills in integrating technological solutions with a humanistic approach to patient care; and (4) developing a professional identity that encompasses both technology-related and humanistic capabilities. The AI revolution provides an opportunity for developments to medical education—to train doctors to be both tech-enabled physicians and true humanists.
Sensitivity Test of Herbal Extracts of Jarem Grass (Grona triflora), Meniran (Phyllanthus niruri), and Patikan Kebo (Euphorbia hirta) Against Terrestrial Bacteria
Authors: Nufus Lale Syifaun , Ifada Andy Susbandiyah , Radiah Nur , Pahmi Khairil
Published: December 2024

Sensitivity is the ability of a medicinal substance to kill or inhibit the growth of microbes. Meanwhile, intermediate is a condition where there is a shift from a sensitive state to a completely resistant state. Method research was experimental and several procedural processes were  sterilization, making of MHA media, bacterial cultivation, and extract preparation. Result showed that the highest diameter of the inhibition zone for the extract was found in the Grona triflora extract in group 1, which was 35 mm and followed by Phyllanthus niruri extract in group 6 which was 29 mm. Furthermore, the inhibition zone diameter of positive control, ciprofloxacin and tetracyclines, were 40 mm. The active ingredients of Grona triflora are flavonoids, alkoloids, and phenolics and the components of meniran that are  flavonoid and tannin compounds are estimated as the inhibition factor that cause the inhibition zone in the media. Finally, the inhibitory zone of grass jarem herb extract (Grona triflora) (EGT) and  the inhibitory zone for extract of Phyllantus niruri  (EPN) are called to have the similar level of sensitivity when compared with several types of antibiotics ciproploxacin and tetracycline which have the sensitive level ≥ 21 mm.
Evaluation of Antagonistic Activity of Endophytic Bacteria from Dayak Onion Against Ganoderma boninense
Authors: Sinta Desiana , Norwahyunie Norwahyunie , Noraini Noraini , Zulviana Zulviana , Naibaho Frans Grovy , Wardhana Vinsen Willi , Panjaitan Desimaria , Hartanto Adrian
Published: December 2024

Basal stem rot (BSR) is one of the key contributors to the decline in palm oil production in Indonesia. BSR is caused by the pathogenic plant fungus Ganoderma boninense. Currently, the control of G. boninense growth relies on systemic fungicides. However, systemic fungicides have negative impacts as they can harm natural soil microorganisms. Biocontrol agents present an environmentally friendly alternative for G. boninense management. The objective of this research was to select and identify endophytic bacterial isolates from Dayak onion [Eleutherine bulbosa (Mill.) Urb.] with antagonistic activity against G. boninense. The investigation was initiated with the isolation of 34 endophytic bacterial isolates and G. boninense isolate. The hemolytic capabilities of endophytic bacterial isolates were evaluated on blood agar media. Antagonism assessments were conducted through the dual-culture method, and the inhibition of G. boninense was measured using the percentage inhibition of radial growth (PIRG). The endophytic bacteria exhibiting the highest PIRG values were identified through molecular analysis based on the 16S rRNA gene sequence. Results revealed that 27 isolates demonstrated no ability to hydrolyze blood agar (gamma hemolysis) indicating no pathogenicity. Isolate CED9 demonstrated the highest PIRG value at 70.26%. Genomic identification based on the 16S rRNA gene sequence confirmed that isolate CED9 was classified as Bacillus subtilis. The identification of biocontrol agents from Dayak onion represents valuable information and a potential arsenal for future strategies in mitigating (BSR) disease.
DEX Immunotherapy and Surgery: Synergy That Redefines Modern Cancer Treatment
Authors:   Department of Oncopathology, OGRD Alliance, Lewes, De, USA, Gutierrez-Sandoval Ramon , Rivadeneira Ider ,   Department of Outreach and Engagement Programs for OGRD Consortium, Charlestown, KN0802, Saint Kitts and Nevis, USA, Sobarzo Adolay ,   Department of Biological and Chemistry Sciences, Faculty of Medicine and Science, San Sebastian University, Concepción, Chile
Published: December 2024

Cancer represents one of the most complex medical challenges of
our time. Over the decades, standard approaches have included
the combination of surgery, chemotherapy, and radiotherapy.
While effective in many cases, these strategies have significant
limitations, particularly when time becomes a critical factor
[1]. One of the most controversial areas in modern oncology is
the decision to delay surgery in certain cancers, such as colon,
breast, and other solid tumors, in favor of prolonged neoadjuvant
chemotherapy [2]. This strategy, designed to reduce tumor size
and target micrometastases, can, in some cases, weaken the patient
and postpone surgical intervention, which might otherwise have
had a significant impact on early reduction of total tumor burden.
Folic acid allergy in pregnancy: a case report
Authors: Riaz Azmat , Tabbah Khaldoun
Published: December 2024

Folic acid intake prevents neural tube defects in the developing foetus. Folic acid allergy in pregnancy is very rare. Most physicians are unaware of this complication. Only 29 cases of folic acid allergy, mainly in non-pregnant women, have been reported in literature worldwide since 1949. In most reported cases, the involvement of folic acid was confirmed by the absence of symptoms after withdrawing folic acid. We present a case of folic acid allergy in a primigravida. The patient developed severe urticaria within hours of folic acid intake, followed by mild vaginal bleeding. Her symptoms improved within days of stopping folic acid. She delivered a healthy baby at term without anomalies or pregnancy complications. Allergy to folic acid was confirmed postnatally by oral intake of a lower dose of folic acid, where the patient again had urticaria that resolved when the medication was stopped.
Keywords: Pregnancy, Folic acid, Allergy.
Tear film parameters in females with thyroid eye disease and diabetes: an observational study
Authors: Alanazi Mana Alafri , Amaal Almutairi  , Al-Massaad Alanoud Abdulaziz , Baashen Mashaaer Abdulwahhab , Almutairi Meznah Saud , Alhssan Abdulaziz , El-Hiti Gamal Abdel-Rahman
Published: December 2024

Objective: To assess different tear film parameters in female patients with thyroid eye disease and diabetes using a single portable device.
Method: The observational study was conducted at the College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, from January 12 to April 28, 2022, and comprised women patients with thyroid eye disease in group A, women patients with diabetes in group B, and healthy controls in group C. The participants were subjected first to the Ocular Surface Disease Index, followed by non-invasive tear breakup time, tear meniscus height, and lipid layer pattern tests using EasyTear View+. Data was analysed using SPSS 22.
Results: Of the 120 women, 40(33.33%) with mean age 40.4±11.7 years were in group A, 40(33.33%) with mean age 39.8±12.2 years in group B, and 40(33.33%) controls with mean age 37.2±9.5 years were in group C. Significant differences were found in the median values of Ocular Surface Disease Index, non-invasive tear breakup time, tear meniscus height and lipid layer pattern in group C compared to groups A and B (p less than 0.001). The non-invasive tear breakup time score was strongly correlated in group B with the tear meniscus height score (r=0.559, p less than 0.001). The lipid layer pattern analysis indicated that grade A was predominant in groups A and B, while grade D was typical in group C.
Conclusion: Women with thyroid eye disease and diabetes had significantly thin lipid layers and lower tear meniscus height and non-invasive tear breakup time than healthy subjects.
Key Words: Dry eye syndrome, Eye abnormalities, Diabetes complications, Females, Lipids.
Academic performance and suicidal ideation in young maladaptive daydreamers, a cross-sectional descriptive study
Authors: Akhtar Aamena , Shamim Hafsa , Khokhar Muhammad Masood , Rehman Gulraiz
Published: December 2024

Objective: To find the relationship between maladaptive daydreaming with academic performance and suicidal ideation in young adults.
Method: The cross-sectional, descriptive study was conducted from August 1 to November 30, 2022, after approval from the ethics review committee of the Islamic International Medical College, Rawalpindi, Pakistan, and comprised individuals who were part of an online community of maladaptive daydreamers. Screening was done using the Maladaptive Daydreaming Scale and the Suicidal Ideation Attributes Scale. Data was analysed using SPSS 22.
Results: Of the 485 subjects, 344(71%) were females and 141(2%) were males. The overall mean age was 21.65±4.9 years. Of the total, 441(90.9%) subjects were screened as maladaptive daydreamers; 323(73.2%) females and 118(26.7%) males. Maladaptive daydreamers had a significant association with both declining academic scores and suicide ideation (p<0.001).
Conclusion: Maladaptive daydreamers were more likely to have an adverse effect on academic grades and were at a higher risk of suicide ideation than non-maladaptive daydreamers.
Key Words: Daydream, Fantasy, Suicidal ideation, Academic performance, Cognition.
Effects of core stabilization exercises with and without dry cupping on pain and disability in patients with sacroiliac joint dysfunction
Authors: Ain Noor Ul , Bashir Muhammad Salman , Noor Rabiya , Ikram Mehwish , Iftikhar Ayesha , Najm Rabiah
Published: December 2024

Objective: To determine the impact of core stabilisation exercises with and without dry cupping on aches and impairment in sacroiliac joint dysfunction.
Method: The randomised controlled trial was conducted from June 15, 2022, to November 30, 2023, at the Riphah Rehabilitation Centre, Lahore, Pakistan, and comprised subjects who were randomised into two groups. Intervention Group A received core stabilisation training in addition to dry cupping therapy, while control Group B received core stabilisation training alone. The intervention was done once a week for 6 weeks. Numeric Pain Rating Scale and Modified Oswestry Disability Index were used to assess pain and disability outcomes, respectively, at the baseline and post-intervention. Data was analysed using SPSS 25.
Results: Of the 28 patients, 12(42.9%) male and 16(57.1%) female with mean age 29.86±3.30 were in Group A, and the remaining 14(50%) with mean age 31.21±3.45 were in Group B (p>0.05). Post-intervention, both groups showed significant improvement (p<0.05) compared to baseline values, but Group A values were significantly better than Group B values (p<0.05).
Conclusion: Dry cupping therapy with core stabilisation exercise was more effective in reducing pain and improving disability in patients with sacroiliac joint dysfunction than core stabilisation exercise alone.
RCT registration Number: ClinicalTrials.govt with ID: NCT05404984.
Key Words: Dry cupping, Core strengthening exercises, Sacroiliac joint dysfunction.
Blue light cystoscopy- as an improvised diagnostic modality for bladder tumours
Authors: Mushtaq Rabeea , Saba Samad  , Areeba Raza  , Aiman Riaz  , Hamna Naseem  , Naseha Mushtaq
Published: December 2024

Bladder cancer remains a significant global health concern, being the 10th most common malignancy worldwide and the 6th most common neoplasia in males, with alarming annual incidence and mortality rates. The current narrative review was planned to delve into the multifaceted landscape of bladder cancer, exploring its epidemiology, risk factors and diagnostic modalities. While white light cystoscopy has long been considered the gold standard for bladder cancer diagnosis and surveillance, the emergence of blue light cystoscopy has ushered in a new era of early detection. Numerous studies have demonstrated BLC's superiority in reducing the risk of progression and recurrence of this lethal cancer. However, the widespread adoption of this technology remains elusive. Recent advancements in diagnostic procedures have revolutionised imaging modalities, with blue light cystoscopy and narrow-band imaging emerging as promising replacements for white light cystoscopy. Clinical trials have underscored the superior performance of blue light cystoscopy over white light cystoscopy, with reduced recurrence and progression rates. For non-muscle invasive bladder cancer, Bacillus Calmette-Guérin immunotherapy remains the gold standard adjuvant therapy, while cystectomy is considered for cases resistant to Bacillus Calmette-Guérin or with a high risk of progression. Transurethral resection of bladder tumour followed by intravesical chemotherapy is a key intervention for early-stage bladder cancer. Blue light cystoscopy is poised to overcome the limitations of white light cystoscopy by providing comprehensive visualisation of neoplastic boundaries, particularly benefiting late-detected squamous-type non-muscle invasive urothelial carcinomas associated with lower survival rates. The current findings highlighted the transformative potential of blue light cystoscopy and other emerging diagnostic techniques, offering a ray of hope in the battle against bladder cancer, while emphasising the need for wider adoption and integration into clinical practice.
Key Words: Bladder carcinoma, Blue light cystoscopy, White light cystoscopy, Urothelial carcinoma, Non-muscle invasive carcinoma, Narrow-band imaging.
Addressing the rising fear of nomophobia among medical students
Authors: Desouza Gabrielle Vivian Rhonda , Saqlain Esha , Shabbir Ahsan , Ahmed Hassan
Published: December 2024

Dear Editor, I am writing to draw your attention to an escalating fear of nomophobia in the medical student community. Nomophobia or no mobile phobia is a self-build fear of missing out on mobile phones, which is becoming prevalent in the younger generation. It’s a psychological condition where people show signs of anxiety and stress upon losing their smartphones 1. Nomophobia's impact on medical students is far more alarming due to the demanding nature of their educational pattern and the simultaneous role of technology in their educational and professional development.
According to a study conducted in Egypt, nomphobia affected almost all the medical resident and many had poor communication skills with their patients2. These days medical students are very dependent on their smartphones for accessing important information and communicating with their colleagues and professors amidst their extensive and rigorous study schedules, However, detrimental dependency leads to distress when separated from their phones, which results in sleep deprivation and poor academic performance3.
The prevalence of nomophobia varies between  6% to 73% in various populations and is expected to rise further. 4 It is imperative that medical institutions and public health professionals take immediate action to raise awareness about the deleterious effects of mobile phone addiction and its potential long-term complications. A concerted effort must be made to educate students and the broader community about the risks associated with nomophobia, with a focus on promoting responsible cell phone use and mitigating the likelihood of a burgeoning public health crisis.
As a future healthcare professional, medical students must prioritize their mental health to provide optimal care and satisfy their patient's needs. Through proper guidance and acknowledging the rising fear of nomophobia, we can build a stronger generation of physicians. Thanks for your consideration of this manuscript.
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Etiological spectrum and short-term outcomes of acute kidney injury in hospitalised patients of uncertain aetiology who underwent percutaneous renal biopsy
Authors: Qazi Muhammad Huzaifa  , Tabassum Elahi  , Sunbal Jahangir  , Kalimullah Khan  , Irum Memon
Published: December 2024

Objective: To analyse the aetiological spectrum, clinical presentation and short-term renal outcomes of patients withacute kidney injury of uncertain aetiology subjected to percutaneous renal biopsy.
Method: The prospective, cohort study was conducted at the Sindh Institute of Urology and Transplantation, Karachi,from March 1 to October 30, 2024, and comprised hospitalised acute kidney injury patients of either gender aged 18-75 years who had been subjected to percutaneous renal biopsy. The patients were followed up for at least threemonths from the time of the biopsy. Data was analysed using SPSS 26.
Results: Of the 115 patients with mean age 32.61±10.20 years, 60(52.2%) were females and 55(47.8%) were males.The mean estimated glomerular filtration rate was 23.05±18.62ml/min/1.73m². Over half 62 (53.9%) required kidneyreplacement therapy at presentation. Most patients 104(90.4%) had renal involvement due to glomerulopathy, whilethe rest exhibited non-glomerular renal disease. The most common primary glomerular diseases were focal segmentalglomerulosclerosis 26(22.6%), membranoproliferative glomerulonephritis 16(13.9%) and membranousnephropathy 4(3.5%). The leading secondary glomerular diseases were pauci-immune necrotising glomerulonephritis18(15.7%), thrombotic microangiopathy 16(13.9%) and lupus nephritis 8(7.0%). At 3-month follow-up, 43(37.4%)achieved complete recovery, 34(29.6%) achieved partial recovery and 38(33%) showed no recovery, while 4(3.4%)patients from the no recovery group expired at the time of the last follow-up. Patients who required kidneyreplacement therapy on admission had lower rates of complete recovery (p <0.001), with more patients progressingto end-stage kidney disease (p=0.02) and increased mortality (p=0.08).
Conclusion: Most biopsied acute kidney injury patients had coexisting glomerular disease with worse renal recovery,while acute tubular necrosis alone was less frequent.
Keywords: Acute kidney injury, End-stage kidney disease, Glomerular diseases, Kidney replacement therapy,Percutaneous renal biopsy.
Emerging role of ultrasound guided interventional management in cervicogenic headache
Authors: Sarah Razaq  , Sajjad Ali Akbar  , Zahid Rustam  , Farooq Azam Rathore
Published: December 2024

The objective of this mini review is to discuss the role ofmusculoskeletal ultrasound (MSK US) in identification andtreatment of pain generators in cervical spine in patientspresenting with cervicogenic headache (CEH). CEH is asecondary headache arising from cervical nociceptivestructures emerging from facet joints, intervertebral discs,nerves, muscles, fascia and ligaments. It presents acomplex challenge in clinical management.Traditional treatments often provide limited relief,prompting the exploration of innovative interventionslike US guided techniques. MSK US is gaining momentumsince last 2 decades and it has transformed theinterventional management options for diverseconditions including CEH with improved accuracy andefficacy. The management of CEH needs to bemultidisciplinary keeping biopsychosocial model of painin mind. In countries like Pakistan, there is a hugepotential to apply US guided procedures in its population,as it reduces the number of visits by the patient andreduces the overall healthcare cost. By targetting specificpain generators and minimizing collateral damage, theseinterventions hold immense promise in improving themanagement. Herein, we briefly discuss the diagnosis ofCEH and evidence based US guided interventions oncervical pain generators.
Tele-Dermatology during crisis, comparison of patients’ perspective between tele and onsite clinics
Authors: Masood Sadia , Unzela Ghulam  , Awan Safia , Fazal Zoha , Naveed Shaheen
Published: December 2024

Objective: To assess patients’ satisfaction with tele-dermatology versus face-to-face visits, and to identify their attitude toward the new modality.
Method: The cross-sectional study was conducted from January to December 2021 at the Department of Dermatology, Aga Khan University Hospital, Karachi, and comprised patients of either gender. Those who opted to personally visit the outpatient department were placed in group A, while those opting for tele-dermatology were placed in group B. A self-designed questionnaire was used to evaluate the experiences in both the groups. Scoring was done using a Likert scale. The responses were recorded as dichotomised, and a cut-off score of 14 was identified as an expression of satisfaction. Data was analysed using SPSS 20.
Results: Of the 202 patients, 100(49.5%) were in group A; 65(65%) females and 35(35%) males, with 44(44%) aged 20-30 years. There were 102(50.5%) patients in group B, with 71(69.6%) females and 31(30.4%) males, and 42(41.2%) aged 20-30 years (p>0.05). Satisfaction was expressed by 94(46.2%) patients in group B compared to 108(53.8%) in group A. More females 48(57.1%) were satisfied than males 36(42.8%) in group A, while more males 50(69.4%) expressed satisfaction in group B females 22(30.5%).
Conclusion: Tele-dermatology was found to be a valuable method to deliver healthcare which could be adopted in future practices.
Key Words: Tele-dermatology, Onsite visits, Pandemic, Patients’ satisfaction.
Pengaturan Perjanjian Kerja Waktu Tertentu (PKWT) Berdasarkan Peraturan Pemerintah Nomor 35 Tahun 2021 Tentang Perjanjian Kerja Waktu Tertentu, Alih Daya, Waktu Kerja dan Waktu Istirahat, dan Pemutusan Hubungan Kerja
Authors: Ria Sintha Devi
Published: December 2024

This research discusses how to implement fixed-term work agreements (PKWT) based on Government Regulation (PP) Number 35 of 2021 concerning Fixed-Time Work Agreements, Outsourcing, Working Time and Rest Time, and Termination of Employment Relations. This type of research is normative law and the nature of this research is descriptive analysis. The data collection technique was carried out by means of library research, the data used is secondary data obtained from primary legal materials, secondary legal materials and tertiary legal materials. Research results This method uses qualitative analysis which will later be arranged systematically to answer the problems that have been formulated. Regulations regarding PKWT itself have been specifically regulated in Law no. 13 of 2003 (Employment Law), but along with the enactment of Law no. 10 of 2020 (Job Creation Law) which was later amended by Law no. 06 of 2023, several provisions in the Employment Law have undergone changes. However, the rules regarding the validity of a work agreement have not changed as regulated in article 52 of the Manpower Law. The Specific Time Work Agreement (PKWT) underwent several significant changes after the enactment of Law no. 6 of 2023 which is a stipulation from Perppu no. 2 of 2022 concerning Job Creation, as well as Government Regulation (PP) no. 35 of 2021. In PKWT, contract workers have a working period specified in the agreement, and the Job Creation Law introduces new provisions regarding compensation for contract workers when the work period ends, different from the previous Employment Law. Job Creation Law no. 6 of 2023 also extends the duration of PKWT, clarifies the types of work that can be tied to PKWT, and adds rules regarding non-permanent work. The PKWT extension provisions, which were previously limited to three years, can now be extended to five years or until the work is completed. One other important difference is that PKWT must be in writing, and if not, it automatically changes to PKWTT.
Assessment of risk of health from violations of mandatory sanitary and epidemiological requirements in the provision of medical services based on the results of the control and supervision activities of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor)
Authors: Shur Pavel Z. , Redko Svetlana V. , Lir Darja N. , Fokin Vladimir A. , Tsinker Mikhail Yu.
Published: December 2024

Introduction. One of the main provisions of the reform of the state supervision system is the concept of a risk-oriented approach. The process of making changes to sanitary legislation goes on. However, not all changes take into account the risk criteria for health. In this regard, there are advisable amendments to the sanitary and epidemiological requirements using criteria based on risk assessment, including at objects with a high risk of harm to health.
The purpose of the study is to evaluate the risk of the health for the sanitary and epidemiological requirements when providing services to the population based on the results of the control and supervision activities of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor).
Materials and methods. A systemic analysis of the domestic and foreign experience of the substantiation of sanitary and epidemiological requirements was carried out. More than six hundred fifty units of departmental documentation of the Rospotrebnadzor, carried out during control and supervision events in medical institutions of the Perm Territory, were studied. To establish causal relationships between the frequency of disorders of sanitary and epidemiological requirements and the adverse responses from the health side, the logistics regression method has been applied.
Results. In case of violation of the sanitary and epidemiological requirements for the provision of medical services, the level of acceptable risk was shown to be formed from 2.1 ∙ 10–6 to 8.3 ∙ 10–5. Thus, with the proper execution of requirements for the provision of services in medical institutions, health safety is ensured by risk criteria.
Research limitations. The application of risk criteria for health in the sanitary and epidemiological requirements is based on Art. 1 of the Federal Law of 31.07.2020 No. 248-ФЗ «On State Control (Supervision) and Municipal Control in the Russian Federation».
Conclusion. The resulting risk levels show the exercise of the powers of Rospotrebnadzor, in the context of a risk-oriented model of supervision to provide a stable sanitary and epidemiological situation in institutions providing medical services in a specific territory.
Assessment of bone metabolism in children in conditions of the strontium biogeochemical province
Authors: Maklakova Olga A. , Shtina Irina E. , Valina Svetlana L.
Published: December 2024

Introduction. Excessive strontium entry into the body in a specific biochemical province creates elevated risks of diseases of the musculoskeletal system.
The purpose of the study. To assess the state of bone metabolism in children living in the strontium biogeochemical province.
Materials and methods. We examined by performing clinical examination of one hundred fifty six 5–10 years children (45.5% boys and 54.5% girls) (the observation group). They were exposed to strontium in drinking water in doses reaching 1.2 maximum permissible concentration. The reference group was made of 192 children (45.8% boys and 54.2% girls) who drank water conforming to hygienic requirements fixed in the sanitary legislation. We assessed strontium levels in biological media (blood and urine). Bone metabolism was examined relying on such indicators as phosphor and calcium metabolism, synthesis and resorption of bone tissues, regulation of osteoclastogenesis in blood serum, levels of hormones and vitamin D responsible for regulation of calcium metabolism.
Results. Children resided in a strontium biogeochemical province had elevated strontium levels in blood and urine. We established 2.2 times higher likelihood of deforming dorsopathy and constitutional changes for the exposed children. Also, children with strontium contamination in biological media were established to have slower formation of bone tissues that became obvious through lower N-osteocalcin levels and less active bone isozyme of alkaline phosphatase in 37.9% of cases. Resorptive processes in bones tended to be activated in the exposed children and it involved lower levels of tartrate-resistant acid phosphatase in 84.2 of cases, lower osteoprotegerin levels in 37.2%, and elevated levels of C-terminal telopeptides and Ampli-sRANKL in 40.4–43.4% of the exposed children. Likelihood of elevated bone tissue resorption was established to be 2.9 times higher for the children with strontium contamination in biological media.
Research limitations. The study included children aged 5–10 years.
Conclusion. Changes in bone metabolism in children living in a strontium biogeochemical province can facilitate early development of osteopenia and diseases of the musculoskeletal system.
Hygienic approach to the formation of corporate programs for the preservation of the health of the able-bodied population
Authors: Sukhova Anna V. , Preobrazhenskaya Elena A. , Lapko Inna V.
Published: December 2024

Protecting the health of the working population is a priority area of state policy in the field of labour relations, ensuring safe working conditions, and preventing chronic noncommunicable diseases (CVD), which is implemented, among other things, through corporate programs to preserve and strengthen health.
The purpose of the study is to substantiate a hygienic approach to the formation of corporate programs for the preservation of the health of the able-bodied population.
Materials and methods. In carrying out this work there was used the analytical method, regulatory and legal documentation on health protection and ensuring sanitary and epidemiological well-being of the population, as well as literary sources on the subject of research of information resources such as eLIBRARY.RU, CyberLeninka over the past 5–10 years.
Results. The developed hygienic approach to the formation of corporate programs makes it possible to form risk-oriented corporate programs to minimize occupational risk to the health of employees, preserve and strengthen health by ensuring safe working conditions, raising awareness of employees on the prevention of CVD and a healthy lifestyle, creating conditions for the formation of healthy lifestyle skills, correcting behavioural risk factors for diseases, medical and preventive measures for the management of medical support for employees. The development and implementation of corporate health preservation programs should be based on clear algorithms for the interaction of all stakeholders: employers, employees, regulatory authorities.
Research limitations. The study is limited by the results of the analysis of regulatory and legal documentation on health protection and ensuring sanitary and epidemiological well-being of the population and literary sources on the subject of research of information resources such as eLIBRARY.RU, CyberLeninka.
Conclusion. A hygienic approach to the formation of corporate programs will ensure the sanitary and epidemiological well-being of the able-bodied population, monitoring of working conditions, assessment and management of occupational risks to the health of employees, raising awareness of employees on the prevention of CVD and a healthy lifestyle, prevention and reduction of morbidity, disability, and premature mortality, increasing the duration of work activity.
Analysis of the trend in obesity incidence among the working-age population
Authors: Dolich Vladimir N. , Komleva Nataliia E. , Lyapina Elena P. , Mazilov Svyatoslav I. , Pozdnyakov Michail V. , Zaikina Inna V. , Chekhonatsky Andrei A.
Published: December 2024

Introduction. Obesity is one of the socially significant chronic non-communicable diseases and, according to numerous forecasts, the incidence of obesity may increase several times by 2030.
Purpose of study. To analyze the primary and general morbidity of obesity and assess its relationship with the coefficient of availability of medical staff and the incidence of coronary heart disease among the working-age population over ten years on the example of the Saratov region.
Materials and methods. Based on the data from the State Health Institution “Medical Information and Analytical Center” of Saratov, the trend indices of general and primary morbidity of obesity among the working-age population in the Saratov region over 10 years (2013–2022) were analyzed.
Results. The overall obesity incidence in Saratov increased by 6.8%, in the Saratov region — by 22.2%; the primary morbidity increased by 53.3% and 81.4%, respectively. A correlation was established between the primary and general morbidity of obesity in Saratov: r = 0.63,
p = 0.04; between the general morbidity in Saratov and the Saratov region: r = 0.68, p = 0.03. In all districts of the region, no correlation was found between the indices of general and primary morbidity of obesity and coronary heart disease: r = –0.13; p = 0.45 and r = 0.3; p = 0.07, respectively. The relationship between the coefficient of availability of medical staff and the incidence of obesity has not been established.
Research limitations. The study has regional (Saratov region) and age (adult population) restrictions.
Conclusion. To find out additional reasons for the insufficient detectability of obesity, it is advisable to conduct additional studies aimed at studying the level of awareness of primary care physicians, as well as the working-age population living in the Saratov region, about the role of obesity in the development and course of other diseases. An important area of research may be the search for external objective factors that cause different levels of obesity prevalence within the same group of districts formed taking into account the coefficients of availability of medical staff.
Simferopol God-pleasing institutions during the Crimean War over 1853–1856
Authors: Zvereva Ekaterina E. , Kutia Sergey A.
Published: December 2024

This article for the first time covers previously unknown pages of the history of the Simferopol God-pleasing institutions related to the period of the Crimean War. Thanks to the search among the unique materials of the State Archive of the Republic of Crimea, memoirs of contemporaries, funds of Crimean libraries and museums of Simferopol, it was possible to restore the chronicle of the terrible war days in the fate of the hospital and revive the names of forgotten doctors. The God-pleasing institutions, the largest civilian medical institution of the Taurida province, immediately after the beginning of the war accepted wounded soldiers.
Civilian doctors of Simferopol stood alongside military doctors to accept their “battle”: with a huge number of wounded, high mortality, epidemics, shortages of medicine and food. Senior doctor Fyodor Fyodorovich Bruns, in addition to medical work, carried out special care for the sisters of mercy of the Krestovozdvizhenskaya community. Junior doctor Nikolai Vladimirovich Pleshkov worked in several hospitals, carried out special assignments of the governor on sanitary and epidemiological matters. Under the vaults of the God-pleasing institutions, the great surgeon Nikolai Ivanovich Pirogov himself worked, assisted by the first Sisters of Charity.
New technologies in project management within the framework of process management
Authors:   Moscow State Institute of International Relations (University) of the Ministry of Foreign Affairs of the Russian Federation, Krivtsov Artem I. , Barkova Polina K. ,   Moscow State Institute of International Relations (University) of the Ministry of Foreign Affairs of the Russian Federation
Published: December 2024

Process management in this article is considered as a key approach to business management.
To improve efficiency, as well as meet the needs of the end consumer, the approach is aimed at analyzing, optimizing, and regularly improving all processes in the business environment. The relevance of this work is due to the fact that the text highlights such modern technologies as BPMS, ERP, blockchain, virtual and augmented reality to adapt all processes to avoid customer dissatisfaction. These technologies contribute to the improvement of project management due to the automation of processes at all levels. The main goal of this article is to introduce modern technologies and improve processes using process management in an already formed business to increase efficiency and improve quality to meet customer needs. The scientific novelty of the work lies in improving business processes through the introduction of modern technologies. The article reveals how artificial intelligence technologies help speed up the execution of tasks by reducing
the need to manually perform work in order to increase the organizational level in the market. The practical value of this article lies in providing up-to-date information on process management in the context of using modern technologies to optimize processes. The article also describes the difficulties of implementing new technologies, which makes it relevant for practitioners.
Method of reducing the dimension of matrices of systems of linear equations and transformation to tridiagonal form in solving economic problems
Authors:   Bashkir Institute of Social Technologies (branch) of the Academy of Labor and Social Relations, Bystrov Alexander I. , Gilmutdinov Rif Z. ,   Bashkir Institute of Social Technologies (branch) of the Academy of Labor and Social Relations
Published: December 2024

A method of reducing the dimensionality of matrices is proposed for solving systems of linear
equations in problems with high dimensionality. An algorithm is given for the method of reducing sparse matrices of systems of linear equations to a tridiagonal form in order to apply the sweep method to solve systems, which speeds up the calculation process. The application of these methods will allow more efficient use of computing system resources when solving high-dimensional problems in economics and other scientific fields.
Reflections on political activity and possibilities of raising its level in modern realities
Authors:   Kuban State University, Gusev Konstantin D. , Kerimli Rufat N.-ogly ,   Nizhny Novgorod Institute of the International Innovation University, Rybkina Olga S. ,   Nizhny Novgorod Institute of Management — branch of the Russian Presidential Academy of National Economy and Public Administration, Fomenkov Artyom A. ,   N. I. Lobachevsky State University of Nizhny Novgorod
Published: December 2024

This article analyzes some features of the attitude of the population to representative government,
as well as to political activity in general. Conclusions are drawn regarding the correspondence between living standards and political activity. Separate measures have been proposed to increase the awareness of deputies, primarily at the regional and local levels.
Features of using information and legal technologies in agriculture
Authors:   Institute of Law, Ufa University of Science and Technology, Vladimirov Igor A. ,   Bashkir Institute of Social Technologies (branch) of the Academy of Labor and Social Relations, Iksanov Radmir A. ,   Institute of Law, Ufa University of Science and Technology,   Bashkir Institute of Social Technologies (branch) of the Academy of Labor and Social Relations
Published: December 2024

This article provides a detailed analysis of digital technologies that facilitate the development and integration of digital tools in the agricultural sector, thereby increasing the level of food and environmental security in agriculture. Particular attention is paid to the importance of digital skills and professional competencies for agricultural specialists. The final thoughts of the article highlight the prospects for the application of digital technologies in the agro-industrial complex, which can lead to the improvement of production processes, an increase in the quality of agricultural products and the maintenance of environmental friendliness in agricultural production. The analysis showed that the legislation in the field of digitalization of agriculture needs to be revised and expanded, taking into account the specific characteristics and requirements of the agricultural sector, which differ from industrial production and the service sector.
Impact of Patient Flow on Satisfaction of Care at the Outpatient Department at University Teaching Hospital of Butare (CHUB): A Cross-Sectional Study
Authors: Shema Sam , Ukwizagira Baptiste , Twagirumugabe Théogène , Ndayiragije Cyriaque
Published: December 2024

Purpose: Patient satisfaction is important for assessing the efficiency of healthcare services provided to clients. When people visit healthcare institutions, they strongly desire high-quality care. Unsatisfying anticipated requirements and expectations may result in dissatisfaction. This study aimed to determine the impact of patient flow on satisfaction of care at outpatient departments of the University Teaching Hospital of Butare (CHUB).
Methodology: A cross-sectional study was conducted at CHUB, with 779 outpatients. Surveys were used to obtain information regarding patient characteristics, waiting time, and level of satisfaction.
Findings: The overall patient satisfaction rate was 81%. Satisfaction levels varied significantly across different outpatient departments, with the Maternity department having the highest satisfaction rate at 90% and the Surgery department t with the lowest at 78%. There was a significant association between the total time spent on services and patient satisfaction (p = 0.001). Specifically, an increase in the time spent in services by 1% was associated with a decrease in patient satisfaction (B = -0.002, 95% CI [-0.003, -0.001]).
Unique Contribution to Theory, Practice and Policy: The analysis found that Overall, client satisfaction was high. Addressing patient flow issues, such as high wait times, lack of medecine in pharmacy and lack of orientation, to greatly increase patient satisfaction in CHUB outpatient departments, to improve care quality, targeted interventions, such as appointment systems, additional personnel, and improved customer service should be implemented.
Fixed Point Results in Hilbert Space via Altering Distance Functions
Authors: Patel P. , Saxena B. , Bhardwaj R. , Sonam
Published: December 2024

Drawing on the principles of functional analysis within the framework of Hilbert space, this research aims to establish fixed point results for distinct mappings under newly proposed rational contractions employing altering distance functions. The study employs specific mathematical techniques, including Banach Contraction Principle, iterative methods, and relational mappings that incorporate partial orders and metric spaces. In particular, we construct appropriate complete metric spaces and apply rational expressions to define contraction conditions. The methods also involve proving convergence through iterative sequences and leveraging the properties of partial orders to manage relational structures. Additionally, the findings are illustrated with examples to enhance understanding. The paper further explores the derivation of corollaries, which serve as specialized instances of the main results. Through iterative processes and methodological rigor, this work advances understanding in the field, providing valuable insights into the properties of fixed points under the specified rational contractions.
JIM-Index-Vol-27-2024
Authors: X X
Published: December 2024

X
Numerical Simulation of a Single-tank Molten Salt Cell with Multifunctional Coupling
Authors: Yang Ying , Jin Yingai , Sun Yanwei
Published: December 2024

Molten salt tanks are crucial in photovoltaic power plants, serving as the core of new energy-storage systems. Although suitable for small-area domestic heating, they are complex in structure and prone to significant heat loss. To address these issues, this study proposes a novel single-tank molten salt system that combines monitoring, preheating, heat exchange, and storage functionalities. By incorporating a U-tube heat exchanger within the molten salt accumulator, the system achieves cost-effective heat storage and release. The effectiveness of the heat extraction method used with the U-tube profoundly affects the overall system performance. Through numerical simulations, this study examines the impact of different heat extraction techniques on the performance of the single-tank heat storage system, focusing on changes in the flow field within the molten salt during heat release. By modifying operational conditions, improvements in outlet temperature, heat release power, and heat utilization efficiency of the U-tube heat exchanger are demonstrated. This study explores the heat release process in a single tank of molten salt using 3D unsteady Computational Fluid Dynamics (CFD) simulations. Operation behaviour estimate results show that varied initial temperatures of the molten salt have distinct impacts on the thermal behavior of the system. Higher initial temperatures lead to a smaller temperature differential between the highest and lowest points in the tank during the same exothermic periods. And under conditions of constant inlet velocity, the exothermic power decreases as the duration of heat release increases. In scenarios with a constant inlet mass flow rate, the time required to reach the limit of exothermic power decreases as the mass flow rate increases. Throughout the exothermic process, the average heat flow density gradually declines. This decline is particularly notable in the first 10 minutes of the exothermic activity. As the process progresses, the average temperature through the heat transfer oil within the heat exchanger increases, which reduces the temperature differential between the hot and cold fluids, further decreasing the average heat flow density.
Divriği Kalesi’nde Memlûk Sultanı Çakmak Dönemine Ait Bir Kitabe
Authors: Boşdurmaz Nurcan , Avcı Oğulcan
Published: December 2024

Orta Çağ Anadolusu hakkında temel kaynaklardan biri olarak değerlendirilen kitabeler, içerik açısından çeşitli konular hakkında yazılabilmektedir. Bu çağın önemli kalelerinden biri olan Divriği Kalesi’nin surları üzerinde farklı tarihlerde yazılmış dört kitabe bulunmaktadır. İlk kitabe giriş kapısının üzerinde bulunmaktadır. Hicri 634 [1236/1237] tarihli kitabeye göre kale kapısı Mengücekoğlu Ahmed Şah tarafından yaptırılmıştır. İkinci kitabe ise yine Ahmed Şah’a ait olup hicri 640 [1242/1243] tarihlidir. Bu kitabede sadece Ahmed Şah’ın adı yazılıdır. Üçüncü kitabe ise Ahmed Şah’ın oğlu Melik Salih’in yaptırdığı aslanlı burca ait hicri 1 Şaban 650 [7 Ekim 1252] tarihli inşa kitabesidir. 1236-1252 yılları arasına ait olan bu kitabeler kalenin Mengücekoğlu hakimiyetinde iki kere onarım/yapım aşamasından geçtiğini göstermektedir. Günümüze ulaşamayan dördüncü kitabenin varlığı, Türk-İslâm epigrafisi hakkında XX. yüzyılda yapılan çalışmalardan öğrenilmektedir. Memlûk Dönemi’ne ait olan bu kitabe, farklı araştırmacılar tarafından ele alınmıştır. Bu çalışmada, kitabe Divriği Kalesi ve çevresinin hem coğrafi açıdan hem de tarihteki önemi dikkate alınarak, siyasi ve toplumsal olaylarla birlikte yorumlanmıştır. Bu yorumlamayı yaparken daha önceki yapılan çalışmalar temel alınmış ve yeni bir okuma önerisi getirilmiştir. Yapılan araştırmalara göre kitabe, Memlûk Sultanı el-Melikü’z- Zâhir Ebû Sâid Seyfüddin Çakmak el-Alâî dönemine aittir ve hicri 14 Safer 854 [29 Mart 1450] tarihlidir. Kitabe, Divriği’nin tarihî süreç içindeki önemini göstermesi açısından önemlidir. Tarihî ve coğrafî bağlam göz önüne alındığında kitabenin vergi kaldırma amaçlı bir ferman olduğu anlaşılmıştır.