bluuebunny/crossref_metadata_2025 huggingface dataset:
Super Refractory Status Epilepticus: A Case Report from Livingstone Central Hospital
Authors: Sheikh Waqas Ahmed , Chinyathi A D , Kapembwa K C
Published: January 2023

Background: Status Epilepticus (SE) is defined as more than five minutes of persistent seizure activity without full recovery of consciousness in between the seizures. If SE fails to respond to two antiepileptic drugs, it is called refractory status epilepticus (RSE) and if it continues or recurs 24 hours after anesthesia, it is called super refractory status epilepticus (SRSE). We present a case of 22 years old Zambian nursing student who presented with first episode of generalized tonic clonic seizures which later turned out to be SRSE. This case has been presented due to the rarity of this condition.  To the best of our knowledge this is the first documented case of SRSE in Zambia.

Objective: To familiarize the clinicians through this case about SRSE and challenges in its diagnosis and the management in resource poor Zambian health settings.

Case History: A 22 years old male nursing student with first episode of generalized tonic clonic seizures brought into the medical emergency of Livingstone Central Hospital. He was treated with 60mg of diazepam but fits continued and patient was transferred to ICU, where he was treated with phenobarbitone infusion with no effect until he was intubated and given general anesthesia with thiopental infusion. After 36 hours, he was extubated, and fits returned soon. His fits finally came under control after treatment with sodium valproate, levitracetam and lorazepam His FBC, LFTs, RBS, electrolytes, CT scan of brain and MRI of brain did not show any abnormality.

Conclusion: Though SRSE is a rare condition but once it presents, it becomes difficult to manage. All cases of SE should be treated with urgency to prevent them from becoming RSE and SRSE.
The Prevalence of Kidney Dysfunction and Associated Risk Factors among ART-Naïve HIV-1 infected Adults at the University Teaching Hospital in Lusaka, Zambia
Authors: Tembo S , Chirwa L , Mulenga L B , Mweemba A , Musonda P
Published: January 2023

Background: Chronic HIV infection is associated with renal complications including renal dysfunction. Risk factors found in literature for kidney disease in the HIV population include hypertension, diabetes mellitus, cardiovascular disease, low CD4 count, high viral load, hepatitis C virus co-infection, hypoalbuminemia, and a family history of CKD, black race, nephrotoxic drugs including antiretroviral medication. Other factors implicated being underweight, obesity, herbal medication use, chronic NSAID use.

No local studies have been done to validate these risk factors in our ART naïve HIV infected adult population.

General objective: To determine the prevalence of renal dysfunction and associated risk factors in ART naïve HIV infected adults at the University Teaching Hospital, Lusaka.

Methods: This was a cross sectional analytical study with 360 participants enrolled. A structured questionnaire was used to collect data. Blood and urine samples were collected for creatinine, CD4 count, HIV-1 viral load, serum albumin, hepatitis B surface antigen, Hepatitis C antibody, Random blood sugar, urinalysis. Data was entered onto a Microsoft office excel spread sheet, and analysed using STATA version 13. We investigated the association between the dependent variable and each independent variable.

Results: The prevalence of renal dysfunction was 24.76%. The overall mean age for the sample population was 36.62 (renal=37.53 and non-renal 35.47). The study population comprised more females (54.63%) than males. Hypertension OR=2.63, (95% CI 1.11, 6.12) was the only factor found to be predictive of renal dysfunction.

Conclusion: The prevalence of renal dysfunction among ART naïve HIV infected adults was high. However, no significant predictors of renal dysfunction were found in our study other than hypertension.
Narcolepsy in a Pre-teen Girl: A Case Report
Authors: Sheikh W A , Fubisha R C
Published: January 2023

Background: Narcolepsy is a neurological disorder, the main classic feature of which is excessive day time sleepiness (EDS), with recurrent episodes of irresistible sleep (sleep attacks). It is thought to result from genetic predisposition, abnormal neurotransmitter functioning and sensitivity, and abnormal immune modulation. The onset of narcolepsy symptoms usually starts in late 2nd or 3rd decade of life. Rare cases of narcolepsy have been reported to occur in the first decade of life, even in infants. We are presenting a case of narcolepsy in a 10 years old girl, who presented at Livingstone Central Hospital. This case has been presented due to rarity of this condition in this age group. To the best of our knowledge, this is the first documented case of narcolepsy in a pre-teenaged child in Zambia.

Objective: To familiarize the health workers about narcolepsy and diagnostic challenges it pose in resource poor Zambian health settings.

Case History: A 10 years old girl was brought to the pediatrics department of Livingstone Central Hospital by her mother with complaints of having episodes of EDS for the past three years. The onset was insidious and episodes had increased in frequency in past 3 years. She used to sleep while in the class, during talking and sometimes during eating. There was no history of having cataplexy, hallucinations or sleep paralysis. Clinical diagnosis of narcolepsy without cataplexy was made and she was treated with oral fluoxetine and modafanil. She was discharged after staying in the hospital for 6 days. At her follow up after 3weeks, the patient had responded well to treatment and was free of those episodes of day time sleepiness. Currently the patient is doing fine and still on the same treatment. Her FBC, DLC, ESR, LFTs, Urine routine & microscopy, HIV test, all came out normal. She was weighing 43 Kg and was 1.43m tall. Her CT scan of brain didn’t show any abnormality. Her physical & neurological examinations were unremarkable.

Conclusion: Narcolepsy in children is a rare condition but once it presents, it poses diagnostic challenges in Zambia due to unavailability of sleep laboratories and lack of knowledge among health workers about this disorder.
Cervical Meningomyelocoele: A Case Report and Review of the Literature
Authors: Musa G , Gots A
Published: January 2023

Cervical meningomyelocoele is a rare neural tube defect accounting for 1-5% of all neural tube defects. Very few cases have been reported in literature. We present a 4day old female patient who presented with a cervical cystic lesion. There was no CSF leakage or sign of infection at presentation. On further evaluation, other congenital abnormalities were excluded by thorough clinical and radiological examination. The patient had normal movement in all four limbs pre-operatively. Intra-operatively, the CSF filled cystic lesion had a hollow fibro-neurovascular stalk extending through the vertebral defect at the level C2-C3. This stalk is thought to be non-functional in most cases in literature but because we could not establish functional status, the hollow stalk was repaired and buried in the surrounding tissue after dura repair. Intra-dural exploration was done to remove adhesions up to the level of the defect to reduce the risk of tethered spinal cord syndrome. Post-operatively, the patient had full power in all limbs with no CSF leak or surgical site infection.
Knowledge and Perception of Laparoscopic Surgery among Surgical Outpatients in a Nigerian Teaching Hospital
Authors: Afuwape O O , Ayandipo O O
Published: January 2023

Background: Laparoscopic surgery is the gold standard in developed countries. Challenges in developing countries apart from the cost of instrumentation include a low acceptance level among patients. The consequent low volume of surgical cases debars cost reduction for surgery.

Objective: The aim of this study is to determine the knowledge level and perception of laparoscopic surgery in patients attending the surgical outpatient for the first time in a teaching hospital in Nigeria. We also determined probable factors which affect this.

Design of the study: This was a prospective study carried out on consenting new patients at the surgical out-patient clinic of the surgical out-patient clinic of a Nigerian Teaching Hospital. The questionnaire was administered to consenting patients through a face-to-face interview by non-medical personnel who had been instructed by the investigators. Data collection was on clinic days within the period.

Results: A total of 370 persons were recruited in this study with a male: female ratio of 1:1.79. The age distribution was between 14years and 81 years with a mean age of 44.19. 62.6% had no knowledge of laparoscopic surgery. 108(29.3%) and 260(70.7%) had positive and negative perception respectively. Only 44% of the patients with positive perception acquired information from appropriate hospital personnel. The longer the duration of perceived knowledge by the patients the higher the tendency to have the wrong perception. The level of education was a significant contributory factor to appropriate perception of laparoscopic surgery.

Conclusion: There is a need for public health education in the region to drive this relatively new frontier of surgery to improve our practice and encourage indigenous innovations.
The Lunar Effect on Delivery and Other Birth Outcomes in Rural Zambia
Authors: Vwalika Bellington , Sindano N , Stringer J M
Published: January 2023

Objective: It is a widely held belief that the period of a full moon is associated with higher birth rates compared to periods when the moon is not full. We investigated whether more births occurred during a full moon in a rural African population. 

Design: Data collected from 42 clinical sites in rural Zambia associated with the Better Health Outcomes through Mentoring and Assessment (BHOMA) Study were evaluated. We compared the proportion of pregnancies born during a full moon to the proportion that would be expected if there were no association.

Main outcomes: Proportion of births during the full moon.

Measures: Demographics and birth outcomes.

Results: A total of 10,127 women delivered at a participating site between 8 December 2010 and 19 August 2015. Mean maternal age was 25.1 years (standard deviation [SD] 6.4 years), mean maternal weight 62.7 kg (SD 13.9 kg), 14.4% were HIV seropositive, and 3.7% were syphilis positive. The mean birthweight was 3032 g (SD 0.5 g); 49.6% newborns were female, and 1.48% were stillborn. There was a full moon during 70 of the 1715 days under observation. In the absence of an association, we would expect 70 / 1715 (4.08%) of births to occur on these days. We observed a total of 434 deliveries (4.29%; 95% Confidence Interval [CI]: 3.89%, 4.68%) during these 24-hour periods. Thus, an association between the full moon and higher delivery rates was not observed (p=0.87). An additional analysis, where the entire lunar cycle was divided into 8 equal bins, also yielded no association. Finally, we did not identify any other birth outcomes that were associated with lunar cycle (birthweight, stillbirth, gender, or congenital malformation).

Conclusions: In this large, rural population, we found no evidence of a lunar effect on delivery or adverse birth outcomes. These results refute a common belief and should provide assurance to managers who opt to ignore lunar cycle when scheduling midwife staffing of rural clinics.
Serum Selenium levels in Essential hypertension among adults at the University Teaching Hospital, Lusaka, Zambia
Authors: Mukosha Moses , Sijumbila G , Lambwe N , Chisulo A C
Published: January 2023

In Zambia, essential hypertension is one of the commonest and prevalent non-communicable diseases. In the current medical literature it is not clear on the serum selenium levels among essential hypertensive patients in Zambia despite evidence in literature of its role in development of hypertension.

The present study investigated serum selenium levels in essential hypertensive adults. We hypothesized that serum selenium levels were significantly lower in this population and was a risk factor for developing hypertension. An analytical cross-sectional design was applied to a total of 245 participants. Blood was collected for serum levels of Selenium, glucose, urea, creatinine and electrolytes. Student t-test was used to compare the serum selenium levels between hypertensive and normotensive participants. Significant (p<0.0001) lower levels of serum Selenium were observed in essential hypertensive adults (0.093mg/L ± 0.048) than in healthy normotensive adults (0.109mg/L ± 0.047). Regression results showed no significant relationship off Selenium levels with age (p=0.255), BMI (p-0.232), systolic blood pressure (p=0.175) and diastolic blood pressure (p=0.195). From these findings serum selenium levels may not be a risk factor for essential hypertension in this population.  Nevertheless, more studies in the same geographical area are needed to confirm this.
Pancreatic Cancer: Patterns in a Low- to Middle-Income Population, Zambia
Authors: Asombang Akwi W , Madsen R , Simuyandi M , Phiri G , Bechtold M , Ibdah J A , Lishimpi K , Banda L
Published: January 2023

Introduction In 2007, the Cancer Disease Hospital (CDH) was opened as the national referral center for patients diagnosed with cancer in Zambia.   Since inception of the CDH, there has been no systematic analysis of the disease burden and implication on healthcare delivery with regards to pancreatic cancer.   There are limited studies describing patterns of pancreatic cancer in a native African population. Data suggest African-Americans have a higher incidence and poorer prognosis of pancreatic cancer than non-African Americans. 

Objective:

Our aim is to describe the demographic features (age, gender) of pancreatic cancer using the Cancer Disease Hospital (CDH) data base in a native African population and compare with the African-American cohort using the Surveillance, Epidemiology End Results (SEER) Program database.

 

Methods This was a retrospective study of patients diagnosed with pancreatic cancer at the CDH in Zambia, Southern Africa between 2007 and 2014.  We entered the term “pancreatic cancer” into the CDH database, extracted patient medical records numbers, and manually located the records for review.  From each chart we extracted: age, gender, geographic origin, ethnicity, clinical features at presentations, location of tumor, stage at diagnosis and treatment. Data collection tool and master code sheet created a priori were used. Data was analyzed using statistical analysis software (SAS).  Descriptive statistics including means, medians as well as frequency distributions and cross-tabulations were used.    SEER database was used to compare subjects between Zambia and USA. Groups were compared using Chi-square tests and Wilcoxon Signed Rank test.  A p-value less than 0.05 was used as the level of significance.

Results Thirty-eight charts were identified in the CDH dataset, of which 27 were included in final analysis and 11 excluded (5 non-pancreatic cancer diagnosis, 6 not manually located). The mean age of diagnosis was 55.7 years in the native African population, compared to 66.7 years for the African-Americans in the SEER database, p < 0.0001.  There were 63.0% males (CDH) compared to 48.1% (SEER), p=0.121.  Further review of the CDH database revealed that the most common presenting symptom was abdominal pain (52.6%), mode of diagnosis surgical (83%, missing 3), histopathology adenocarcinoma (86%, missing 6), location head of pancreas (83%, missing 9) and stage 4 at diagnosis (100%, missing 3). ConclusionPancreatic cancer occurs at a younger age in Zambians when compared to the African American, USA population. There is no statistically significant difference in sex presentation between Zambian and USA black population.
Objectives and Related Requirements of College English Teaching: A Comparative Textual Analysis of College English Curriculum Requirements and College English Teaching Guidelines (2020 Version)
Authors: Rao Qianmei
Published: January 2023

In order to explore the longitudinal development of the objectives and their related requirements of college English teaching in the last nearly two decades in China, the author adopting the methods of literature reading and textual analysis, draws a diachronic comparison between the College English Curriculum Requirements and the College English Teaching Guidelines(2020 version). Through careful reading and analyzing, the key findings are that at least three-aspect similarities and differences respectively exist in the two documents. For the similarities, the teaching objectives and their related requirements in the two documents both reflect the value orientation of instrumentality, the attention to students’ autonomous learning as well as their comprehensive cultural literacy and the classification of three-level teaching requirements. However, as to the differences, firstly, special attention has been paid to the cultivation of students’ listening and speaking skills in the teaching objectives of the Curriculum Requirements, while humanity in the teaching objectives of the Guidelines(2020 version) has increasingly become a major value orientation; additionally, an overall description of three-level teaching requirements has been made in the Guidelines(2020 version) apart from the individual description of each language skill; lastly, the numbers have been taken full advantage of to quantify English proficiency(five basic language skills) of three levels in teaching requirements of the Curriculum Requirements. Drawing on these findings, some corresponding suggestions are provided with in this paper.
TRADITIONAL CONCEPTS AND APPROACHES IN PSYCHIATRY AS PRECONDITIONS FOR PSYCHOSOMATIC CONCEPT: THE NEUROBIOLOGICAL ASPECT
Authors: Sukiasyan S. H.
Published: January 2023

In the current article, conceptual approaches in psychiatry (considered as backgrounds in revising of psychosomatic conception) are discussed. The increasing development of neuroscience demonstrated the limitation of psychopathological methods. Significant differences and discrepancies in assessing the type, degree, course of psychopathological disorders at the nozological level are revealed. The widespread use of the new classification systems led to dissolving boundaries between mental and behavioral norms and pathology led to rejection of the classical approaches. It made transition from monothetic to polythetic categorization. Nozological psychiatry transformed into syndromological one. The phenomenological approach in psychiatry is considered as an alternative to the nozological principle. However, despite some advantages, they are not without disadvantages, which cover diagnostic, terminological, theoretical, pedagogical and other aspects. The phenomenological approach still leads to a disagreement among psychiatrists regarding the terminological definitions, the theoretical basis. The current classifications of mental and behavioral disorders lead to a blurring of the boundaries between the mental and behavioral norm and pathology and enormously expand the boundaries of mental abnormality, narrowing the boundaries of norm and health. Analysis of pathogenetic mechanisms of mental disorders demonstrated the failure of all the concepts, and approaches (primarily neurobiological) due to the lack of specificity for certain pathology. It is indicated that both endogenous disorders and psychosomatic ones are based on neurotransmitter processes. In this case the discrepancy in the diagnosis of mental disorders by different specialists is observed. There is no specific etiology, pathogenetic mechanisms, and environmental factors for a particular mental disorder.
Investigation of DNA affinity levels of pesticides: docking analysis results
Authors: ARAS Merve , YAYINTAŞ Özlem , OYMAK YALÇIN Sibel
Published: January 2023

Objective: According to studies conducted in recent years, pesticides can lead to the development of cancer, Parkinson's disease, Alzheimer's disease, reproductive system disorders, and birth defects. The aim of this study is to examine the DNA affinity levels of Alpha-cypermethrin, Malathion, Quinclorac, and Roundup (Glyphosate) plant protection products and to discuss them in the light of the literature. Methods: Docking results between ligand and receptor were detected using Hex 8.0.0 software. Preparation of the receptor and ligand for docking was done with UCSF Chimera 1.15 software. Docking visualizations were made with BIOVIA Discovery Studio and PyMol software. While the interaction images of pesticides with DNA were detected with BIOVIA Discovery Studio software, DNA binding images were detected with PyMol software. Results: In our study, the affinity levels of the plant protection products frequently used in the Çanakkale region were determined as Alpha Cypermethrin>Malathion>Quinclorac>Roundup /Glyphosate, respectively, according to the results of the docking analysis. The pesticide with the highest interaction with DNA was Alpha Cypermethrin (-248.24 KJ mol-1) and the lowest binding energy was Roundup (-161.54 KJ mol-1). Conclusion: In line with the literature, alpha-cypermethrin is the molecule with the highest toxicity and gene damage potential. Considering the variety of products, it is necessary to pay attention to the use of both single and multiple plant protection products. During the use of this molecule, plant protection products with lower DNA affinity and toxicity can be preferred as an alternative.
Municípios brasileiros e o orçamento público para o esporte (2002-2018)
Authors: Barboza Eiras de Castro Suélen , Rocha de Camargo Philipe , Marinho Mezzadri Fernando
Published: January 2023

Objetivo do estudo: Investigar o financiamento orçamentário dos municípios brasileiros para o esporte e lazer de 2002 a 2018.Metodologia/abordagem: Estudo descritivo e de natureza quantitativa que coletou dados orçamentários e sociodemográficos dos municípios brasileiros dos portais Secretaria do Tesouro Nacional e Instituto Brasileiro de Geografia e Estatística (IBGE). Originalidade/Relevância: A pesquisa colabora com a compreensão do comportamento dos municípios no financiamento de esporte e lazer ampliando os recortes temporais de estudos anteriores e propiciando um panorama nacional.Principais resultados: Os municípios brasileiros têm, em sua grande maioria, financiado ações para esporte e lazer em suas localidades. Os valores variaram entre R$ 3,67 (Maraial/PE – 2010) e R$ 714 milhões (Rio de Janeiro/RJ – 2015), e entre 0,000019% (Betânia/PE - 2013) e 57,3% (Ribeirão do Largo/BA - 2016) dos orçamentos municipais. O investimento per capita médio foi de R$ 21,46, tendo variado entre R$ 0,00003 (Maraial/PE – 2010) e R$ 4.716,47 (Manoel Urbano/AC – 2011). A subfunção “Desporto Comunitário” foi priorizada em todos os anos analisados, somando R$ 24,9 bilhões (58,1%), seguida da subfunção “Lazer” (R$ 6,2 bilhões - 14,5%), demais subfunções (R$ 5,3 bilhões - 12,4%), “Desporto de Rendimento (R$ 4,7 bilhões – 11,1%) e “Administração Geral” (R$ 1,6 bilhão - 3,9%). Contribuições teóricas/metodológicas: A compreensão do papel que tem sido desempenhado pelos municípios pode colaborar com a discussão das competências dos demais entes federativos, bem como com a proposição do Sistema Nacional de Esporte e Lazer.
Gestão nos clubes de futebol: um olhar sobre a produção científica mundial em uma base de excelência
Authors: Ingles da Luz Thiago Savio , Pedroso Bruno , Santos Lise Natasha , Archanjo de Freitas Júnior Miguel
Published: January 2023

Objetivo do estudo: Compreender quais são os principais temas que emergem dos estudos sobre gestão esportiva nos clubes de futebol em nível mundial, tendo como lócus de pesquisa a base de dados SCOPUS (2016-2020). Metodologia/abordagem: Delineou-se um estudo exploratório por meio do Estado do Conhecimento, utilizando-se dos preceitos da Análise de Conteúdo e análise das características bibliométricas para exploração do material selecionado. Originalidade/relevância: Este estudo permite compreender o que tem sido pesquisado sobre gestão nos clubes de futebol na base SCOPUS. Como se trata de uma pesquisa feita em uma das principais bases de dados, observou-se a carência de estudos neste formato, sumarizando características das publicações. Principais resultados: Este estudo identificou um crescente número de publicações sobre gestão esportiva nos clubes de futebol durante a baliza temporal de 2016-2020. Os principais temas abordados em estudos sobre gestão do futebol foram: economia, governança e relacionamento. O periódico com mais publicações foi o European Sport Management Quarterly. Os autores mais produtivos foram Daniel Plumley e Robert Wilson. Na análise dos países, constatou-se a proeminência da Inglaterra, principais interrelações no continente europeu e a escassez de trabalhos brasileiros.Contribuições teóricas/metodológicas: O estado do conhecimento e análise das características bibliométricas permitem perceber o nível que se encontram os estudos da temática, as lacunas a ser abordadas, as redes de relacionamento de pesquisadores, os subtemas que emergem nas análises. Desta forma contribui metodologicamente para que outros estudos possam aprofundar a partir das macro categorias emergidas.
Homebirth Meta-Analyses Across two Reviews: Hutton et al., 2019 and Reitsma et al., 2020
Authors: Regan Maeve
Published: January 2023

Research unwrapped is a popular series to help readers make sense of published research by undertaking a detailed appraisal of an article in a careful and considered manner. In doing so we can advance our knowledge and understanding of a research topic and apply it to our practice. This process is designed to assess the usefulness of the evidence in terms of decision-making and application to practice. Here, this meta-analysis combined the results of observational studies of more than 500,000 homebirths. It found no difference in the risk of perinatal morbidity or mortality, and a significant reduction in birth interventions and maternal morbidity. This article will break down the methods used and statistical findings.
Effective Communication During a Homebirth Transfer to Hospital
Authors: Brown Sarah , Robinson Stacey , Mansfield Amanda
Published: January 2023

Although the likelihood of a women requiring transfer is low, all midwives should be familiar with the process of requesting an emergency transfer, the time they can expect to wait before an ambulance arrival and any additional interventions required with the ambulance crew.1 Communication and teamwork are key skills to support a safe and reassuring transfer and minimise a traumatic experience for the birthing woman, partner, midwives and ambulance clinicians.1,2 Midwifery transfers fall into two categories: those that are not immediately life threatening to the woman and her baby and those in which interventions may be necessary and ongoing while emergency assistance is requested.3
Supporting a Home Vaginal Birth After Caesarean (VBAC)
Authors: Westbury Becky
Published: January 2023

I was privileged to be present for a beautiful homebirth that happened to be a VBAC waterbirth – and I share this story with permission. This was the first homebirth I had attended since starting my new role in a new area. My passion for midwifery lies in both supporting women’s informed choices, as well as normality and homebirth. Therefore this was an experience that I truly loved. I had met the woman a few times as she had attended the pregnancy yoga sessions that I run at the hospital, so there was an element of continuity.
Development and application of a simple physiologically based pharmacokinetic model that quantitatively describes the distribution and elimination of the commonly measured proteins
Authors: Levitt David  G. , Levitt Michael D.
Published: January 2023

Increased plasma concentrations of a variety of cellular enzymes (alanine transaminase, aspartate aminotransferase, alkaline phosphatase, amylase, etc.) are commonly used as routine screening tests for a range of conditions. An increased concentration usually is assumed to result from an increased rate of delivery to the plasma. Factors such as decreased metabolism or excretion or altered extravascular distribution usually are ignored. As a prelude to a detailed analysis of all the factors producing altered plasma enzyme levels, we have reviewed the relevant literature describing the pharmacokinetics (PK) of 13 of the commonly measured plasma proteins and developed a PK model that provides a simple physiological description of all the data. Our model starts with the general 3-compartment, 6-parameter system previously developed for albumin and interprets the fluxes in terms of unidirectional sieved protein convectional volume flows from the plasma to the two tissue compartments and equal lymph flows returning to the plasma. This greatly constrains the model such that each protein is characterized by only two adjustable parameters (plasma clearance and sieving factor). In addition to accurately fitting the plasma kinetics, the model can accurately describe the tissue and lymph protein PK. For example, it can describe the thoracic duct lymph protein concentration following an intravenous infusion or the plasma concentration following a subcutaneous tissue injection. This simple model provides a satisfactory framework for the PK of 12 of the 13 proteins investigated. The glycoprotein intestinal alkaline phosphatase is the exception, requiring the addition of a liver recycling compartment involving the asialoglycoprotein receptor.
Anal stenosis. Recommendations of the Polish Coloproctology Club Research Association
Authors: Kościński Tomasz
Published: January 2023

Anal stenosis is a rare complication in proctology. The recommendations discuss indications for treatment as well as both medical and surgical management. The surgical technique depends on the severity of stenosis, its size, and location. The most common techniques include excision of scar tissue and repair with a V-Y advancement flap or rotation flap. Critical stenosis refractory to surgical reconstruction may require diversion colostomy
Functional disorders of the pelvic floor. Recommendations of the Polish Club of Coloproctology Scientific Society
Authors: Kościński Tomasz
Published: January 2023

Functional disorders of the pelvic floor are complex phenomena due to anatomical losses within the musculofascial systemand are dependent on innervation and the qualities of connective tissue. Functional disorders of the pelvic floor vary inform and location. Configuration of these disorders determines the clinical presentation including the lowering of pelvicfloor, genital prolapse, rectal prolapse, rectoceles, enteroceles, and cystoceles. The presented recommendations concernthe principles of diagnostics and comprehensive therapeutic management. The objective of surgical treatment consists inrestoration of proper architecture of supportive tissues within the pelvic floor using tension-free procedures and appropriateprosthetic materials. This allows for effective fixation of lowered structures and prolapsing organs.
Surgical management of gastroschisis with the use of primary and staged closure on the basis of the department’s 20 years of experience
Authors: Sosnowska-Sienkiewicz Patrycja , Bućko Ewa , Skinder Dominika , Mańkowski Przemysław
Published: January 2023

Introduction: Gastroschisis is a common developmental anomaly of the abdominal front wall. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique.

Aim: The aim of this paper is to analyze our 20 years of experience surgically treating gastroschisis with primary and staged closure, to compare the postoperative course for these techniques, and to identify factors that influence the course and early results of treatment.

Methods: The research material consists of a retrospective analysis of the medical history of patients treated at the Pediatric Surgery Clinic in Poznań over a 20-year period from 2000 to 2019. A total of 59 patients were operated on (30 girls and 29 boys). Surgical treatment was performed in all cases. Primary closure was performed in 32% of the cases, whereas staged silo closure was performed in 68% of the cases.

Results: Postoperative analgosedation was used for 6 days on average after primary closures and for 13 days on average after staged closures. Generalized bacterial infection was present in 21% of patients treated with primary closures and in 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later than those treated with primary closure (day 22 vs. day 12).

Conclusions: It is not possible to clearly indicate which surgical technique is superior based on the results. When choosing the treatment method, the patient’s clinical condition, associated anomalies, and the medical team’s experience must be taken into consideratio
Infección por Helicobacter pylori y su relación con patologías gástricas en pacientes de Latinoamérica.
Authors: Mero Veliz Genesis Yelene , Tuárez Sosa Genesis Katherine , Murillo Zavala Anita María
Published: January 2023

La infección por Helicobacter pylori es una de las infecciones humanas más comunes dado que afecta a más del 50% de la población mundial. Adicionalmente, este patógeno es responsable de afecciones gastrointestinales alrededor del mundo. Bajo este contexto, el objetivo general del presente trabajo fue analizar la infección por Helicobacter pylori y su relación con patologías gástricas en pacientes de Latinoamérica. El diseño del estudio documental es de tipo descriptivo, puesto que se realizó una revisión bibliográfica en bases de datos científicas como PubMed, SciELO, Elsevier, Google Scholar, Redalyc y Springer, además, se emplearon ecuaciones de búsqueda con los términos “H. pylori”, “afecciones gastrointestinales”, “prevalencia”, “Latinoamérica” y los operadores booleanos ‘AND’ y ‘OR’.. En la búsqueda preliminar se encontraron 113 documentos o artículos, con los criterios de inclusión y exclusión, fueron evaluados de forma independiente mediante lectura crítica los resúmenes para eliminar los documentos o artículos duplicados, quedando como resultados 45 artículos para la realización de la investigación. Se obtuvieron los resultados que Colombia tiene una de las tasas de infección más altas que otros países, puesto que los estudios reportan un 86% de prevalencia de Helicobacter pylori en adultos y un 80% en niños, en la patología gástrica en los estudios reportan el 83,3% gastritis crónica, el 12,5% úlcera gástrica y el 4,2% cáncer gástrico. Se concluye que la infección mencionada está asociada a distintas patologías gástricas entre las cuales se destaca la gastritis con mayor prevalencia seguida de las úlceras pépticas, duodenales y neoplasias gástricas.
What is a Risk of Increased Traffic in Boka Bay?
Authors:   University of Montenegro, Faculty of Maritime Studies Kotor, Petrović Igor , Ivošević Špiro ,   University of Montenegro, Faculty of Maritime Studies Kotor, Vukičević Miroslav ,   University of Montenegro, Faculty of Maritime Studies Kotor
Published: January 2023

Boka is undeniably one of the most beautiful destinations in the world. This may be a subjective opinion, however being included in UNESCO’s world heritage list may be an objective proof of such a statement. This is recognized by the Government, and nautical tourism has been set as one of the main development strategies for this area. The economic growth, on the other side brings problems that our limited sources can hardly cope with. Increased traffic i.e. number and size of vessels (boats/yachts/ships) that are visiting Boka Bay, enormous fuel quantities burnt by giant engines on mega cruisers, by-products of every day processes such as garbage and sewage cause many side effects that could be hidden. These are all risks that could create catastrophic consequences if not handled properly, and in long term, may turn one of the finest destinations into a place to be avoided. Navigation is a skill. Years of experience are required to become professional navigator. It is not a sport and it is risky to treat it like that. Risk management concept will be utilized for assessing mentioned risks and for establishing controls that will definitely reduce them. After short introduction of the concept, priority will be given to analysis of all factors that must be taken into account for successful risk assessment. Special attention will be paid for database that must be established for Boka Bay area. Next step in the process is identification of all hazards related to visits of different types of vessels. Setting the criteria and matrixes that are relevant for this special area is essential before final part of the research focused on risk assessment.
Some Considerations Regarding the Safety of Touristic Vessels Operating in the Albanian Bays
Authors:   University Ismail Qemali Vlora, Faculty of Technical Sciences, Vidhaj Miranda , Lapa Kristofor ,   University Ismail Qemali Vlora, Faculty of Technical Sciences
Published: January 2023

Ship’s stability is one among the foremost important and complicated concept regarding ship and navigation’s safety and it's governed by maritime law as well as maritime codes. In Albanian bays, there has been considerable maritime tourism development in recent years, which has consequently brought about an increasing demand for passenger ships offering mainly one day cruises. The ships intended for this type of service are of different typologies: tourist vessels built especially for this destination, but there are many vessels which have changed the destination mainly from fishing vessel to tourist vessel. From the field observations along with contacts with the port authorities and Albanian maritime administration, it is revealed that these ships bare problems related to meeting service and security standards that they offer. Considering existence of such problems and the absence of technical data related to the safety of ships, it is required that geometric and stability calculations are performed with the view meeting the norms of stability. In this paper we will be presenting the causes that lead to ship stability failure and their impact on navigation safety. A case study of the calculation of the ship stability is going to be presented, the causes are going to be analysed and the possible ways of stability failures are going to be assessed. Vessel’s intact stability is a fundamental component of seaworthiness so it's in the interest of all owners/operators to be aware of this subject and make sure that their vessel has a satisfactory level of stability in order to ensure its safety as well as that of people on board.
Chemical-physical criticality and toxicological potential of lipid nanomaterials contained in a COVID-19 mRNA vaccine
Authors: Segalla Gabriele
Published: January 2023

The medicinal preparation called Comirnaty by Pfizer-BioNTech is an aqueous dispersion of lipid nanomaterials, intended to constitute, after thawing and dilution, the finished product for intramuscular injection. In the present study, we examine some evident chemical-physical criticalities of the preparation, regarding the manifest instability of its qualitative-quantitative composition, as well as its consequent toxicological potential, in this case related to the possible formation of ROS (reactive oxygen species), after intramuscular inoculation, in different biological sites, such as, potentially, kidneys, liver, heart, brain, etc., causing dysfunctions and alterations thereof.
Of particular concern is the presence in the formulation of the two functional excipients, ALC-0315 and ALC-0159, never used before in a medicinal product, nor registered in the European Pharmacopoeia, nor in the European C&L inventory. The current Safety Data Sheets of the manufacturer are omissive and non-compliant, especially with regard to the provisions of current European regulations on the registration, evaluation, authorization and restriction of nanomaterials.
The presence of electrolytes in the preparation and the subsequent dilution phase after thawing and before inoculation raise well-founded concerns about the precarious stability of the resulting suspension and the Polydispersity index of the nanomaterials contained in it, factors that can be hypothesized as the root causes of numerous post-vaccination adverse effects recorded at statistical-epidemiological level. Further immediate studies and verifications are recommended, taking into consideration, if necessary and for purely precautionary purposes, the immediate suspension of vaccinations with the Pfizer-BioNTech Comirnaty preparation.
Makna Ketaatan Abraham dalam Mempersembahkan Ishak
Authors: Halawa Solingkari , Putrawan Bobby Kurnia
Published: January 2023

Abstract: In Abraham's life, obedience was the principle that motivated his life. He willingly obeyed God, not out of law, but out of love. In the course of his life, Abraham was an obedient and God-fearing man. In addition, the story in Genesis chapter 22 becomes a severe test in Abraham's life, where God commanded Abraham to sacrifice his only son as a burnt offering (Gen 22:2a). This article aims to find the meaning of Abraham's obedience in offering Isaac in Genesis 22:1-19. The method used is narrative analysis. The result is in this case explaining how the life of Abraham who always feared God as evidence of faith in God. Abraham's life can be a guide for the Christian life today. In this context, Abraham is an example of faith, how people live in obedience to God by giving the best, namely the most beloved son in Abraham's life.Abstrak: Dalam kehidupan Abraham, ketaatan merupakan prinsip yang memotivasi kehidupannya. Ia dengan rela menaati Allah, bukan karena hukum, melainkan karena kasih. Di dalam perjalanan hidupnya, Abraham adalah seorang yang taat dan takut kepada Tuhan. Selain itu, kisah di Kejadian pasal 22 menjadi ujian yang berat dalam hidup Abraham, dimana Allah memerintahkan Abraham untuk mengorbankan anaknya yang tunggal menjadi kurban bakaran (Kej 22:2a). Artikel ini bertujuan menemukan makna ketaatan abraham dalam mempersembahkan ishak di Kejadian 22:1-19. Metode penelitian yang digunakan adalah kualitatif dekriptif dengan pendekatan hermeneutik analisa naratif. Hasilnya adalah dalam hal ini ini menjelaskan bagaimana ketaatan Abraham dalam mempersembahkan Ishak si Kejadian 22:1-19. Kehidupan Abraham yang taat akan Allah sebagai bukti iman kepada Allah. Kehidupan Abraham dapat menjadi pedoman bagi kehidupan orang Kristen pada zaman sekarang ini. Dalam konteks ini, Abraham menjadi contoh teladan iman, bagaimana umat hidup dalam ketaatan kepada Tuhan dengan memberikan yang terbaik, yaitu anaknya yang paling dikasihi dalam hidup Abraham.
JUDGES’ ASSOCIATIONS AND TRADE UNIONS – INTERNATIONAL STANDARDS AND SELECTED NATIONAL PRACTICES
Authors: Knežević Bojović Ana S. , Misailović Jovana M.
Published: January 2023

The aim of the paper is to present international standards and their implementation in the national legislations in European countries regarding judges’ right to association with special regard to judges’ right to unionise.

Authors hypothesise that although not strictly envisaged in any of the hard law sources, there is a plethora of soft-law instruments to assert this right. Consequently, the authors conclude that there is nothing in the relevant international standards that a priori prevents judges from unionising. Additionally, they posit that judges benefit from collective workers’ rights generally linked to the trade unions through activities of judges’ association, even in cases where judges are explicitly prohibited from joining and forming trade unions. The latter assertion is supported by a comparative overview of practices in selected European countries.
CROSS-BORDER SURROGACY AND THE RIGHT TO RESPECT FOR FAMILY LIFE
Authors: Ćorac Sanda S.
Published: January 2023

Surrogacy is indisputably connected with the right to respect for family life guaranteed by Article 8 of the European Convention on Human Rights and Fundamental Freedoms. In the practice of the European Court of Human Rights (ECHR), many issues are open as disputable, among other things also in the context of the connection between cross-border surrogacy and the right to respect for family life. Taking into account the circumstances of each specific case, ECHR considered, first of all, the question of the (non)existence of a genetic link between the intended parents and the child born by the surrogate mother, the duration of cohabitation between them and the legal uncertainty that surrogacy creates, i.e., their possible impact on the violation of the right to respect for family life.
Consultas Médicas Tomo 6
Authors: Macias Nuñez Allison Richelle , Cuadra Cabrera Ana Belén , Solórzano Suriaga Juana Jessenia , Mena Acosta Byron Hernán , Moncayo Tigre Luis Ernesto , Armijos Dutan Amy Andrea , Moncayo Tigre Kevin Julio , Rosas Echegaray Fressia Ibeth
Published: January 2023

La presente obra es el resultado del esfuerzo académico de un grupo de profesionales de la salud, quienes han recopilado la información disponible con la evidencia científica más actualizada sobre temas que esperamos ayuden a los profesionales de la salud y a médicos en formación interesados en profundizar sus conocimientos sobre patologías frecuentes que pueden presentarse dentro de su ámbito profesional.
Planning and Capacity Building for High-Speed Rail Development in India: Five Key Lessons
Authors: Wong Ka Ying , Pandey Sakshi , Wee Veronica Ern Hui , Seetha Ram KE
Published: January 2023

India’s urbanization rate has increased from 26% in 1991 to 35% in 2021, and it is expected to reach 41% by 2030 (World Bank 2022). In response to this, as the backbone of its growing economy, the country’s infrastructure development, particularly transportation development, has been heavily emphasized. The railway sector will see an investment of $715.41 billion by 2030. Along with a series of supporting government policies, an opportunity to expand the high-speed rail (HSR) network has been presented in India. From the viewpoint of the government, HSR is an effective tool to address the surge in travel demand because of its mass transportation, high speed, and high energy efficiency (Suzuki et al. 2022). Besides, HSR projects bring about a ripple effect on the Indian economy by generating local employment opportunities, catalyzing the steel and cement sector and galvanizing AatmaNirbhar Bharat (an initiative by the Government of India to make the country self-reliant) through the indigenization of technology (National High Speed Rail Corporation Limited 2022). From the perspective of communities and individuals, HSR improves their quality of life by offering a faster and safer transportation option for work and travel.