bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Community Health Volunteers Practices on Advancing Social Accountability in Nairobi County, Kenya
* Corresponding Author: Malkia Moraa Abuga, Email: malmoraa815@gmail.com
Department of Health System Management Kenya Methodist University, Nairobi, Kenya
Authors: ABUGA MALKIA MORAA , Tenambergen Wanja Mwaura , Njoroge Kezia Muthoni
Published: June 2022

Abstract
Background: Community Health Volunteers position in the health system allow them to act as community mouthpieces, fighting inequities and advocating for community rights and needs to government structures. However, questions about how they carry out this role, specifically how they present community concerns to the health system and vice versa, remain unanswered. The purpose of this study was to evaluate the practices of community health volunteers that promote social accountability.
Methods: The study used a cross-sectional research design across two sub-counties that were purposefully chosen due to their health indicators status. The quantitative data sample size was 180 Community Health Volunteers (Embakasi North 90, Embakasi Central 90) who were sampled using stratified sampling. Focus group discussions, key informant interviews and document review were used to collect qualitative data.
Results: In Embakasi North and Embakasi Central, respectively, the study found that 66 (73.3 %) and 64 (71.1 %) of Community Health Volunteers rarely recorded complaints, 68 (75.6 %) and 53 (58.9 %) of Community Health Volunteers always reported complaints to the Community Health Assistant, and 67 (74.4 %) and 47 (52.2 %) of Community Health Volunteers always provided feedback to clients on the complaints raised.
Conclusion: There was sub-optimal and inconsistent implementation of social accountability practices by the Community Health Volunteers in the two sub-counties. This was influenced by inadequate information on their mandate in social accountability, a lack of reporting indicators targeting social accountability and a lack of awareness about formal channels of complaint handling mechanisms at community health systems.
Keywords: Social Accountability, Community Health Volunteers, Community Health Systems
Targeted mRNA demethylation in Arabidopsis using the human ALKBH5 catalytic domain
Authors: Fang Ruiqiu , Chen Xiaolong , Ying Duo , Shen Jie , Wang Bin
Published: June 2022

N6-methyladenosine (m6A) is an important epigenetic modification involved in RNA stability and translation regulation. Manipulating the expression of RNA m6A methyltransferases or demethylases makes it difficult to study the effect of specific RNA methylation. Recently, m6A editor was reported to manipulate RNA methylation in a locus-specific manner in human cells, but it remains unclear whether this tool can be used in plants. Here, we report the development of a plant m6A editors (PMEs) using dLwaCas13a (from L. wadei) and human m6A demethylase ALKBH5 catalytic domain. PMEs specifically demethylates m6A of targeted mRNAs (WUS, STM, FT, SPL3 and SPL9) to increase mRNAs stability. In addition, we discovered that a double ribozyme system can significantly improve the efficiency of RNA editing. Together, these findings demonstrated that PMEs for targeted transcript editing will be useful in plant functional genomics research.
Aryl hydrocarbon receptor involved in Th17/Treg imbalance in chronic hepatitis B via the AhR–RORγt–FoxP3 axis
Authors: Zhang Ruyi , Liu Huaie , Lin Jie , Ding Jie , Zhao Yinzhou , You Jing , Geng Jiawei
Published: June 2022

Objectives: To investigate the involvement of aryl hydrocarbon receptor (AhR) in the Th17/Treg imbalance of chronic hepatitis B (CHB) via the AhR–RORγt–FoxP3 axis.Methods: The proportions of Th17 and Treg cells in peripheral venous blood collected from 18 healthy controls (HCs) and 30 patients with CHB were determined by flow cytometry. AhR, retinoic acid-related orphan receptor gamma t (RORγt), and forkhead box protein 3 (FoxP3) mRNA levels were tested by RT-qPCR. Moreover, AhR, RORγt and FoxP3 protein levels were detected by western blot. Results: The proportions of Th17 and Treg cells were significantly higher in the CHB group than those in the HC group (p < 0.005). The Th17/Treg ratio was remarkably higher in the CHB group than that in the HC group (p < 0.001). Furthermore, AhR, RORγt, and FoxP3 mRNA levels were higher in the CHB group than those in the HC group (p ≤ 0.001). The expression levels of AhR, RORγt and FoxP3 protein were higher in the CHB group than those in the HC group. Moreover, there were positive correlations between AhR and RORγt mRNA (p < 0.001, r = 0.632) and between AhR and FoxP3 mRNA (p < 0.001, r = 0.798).Conclusion: The AhR–RORγt–FoxP3 axis may mediate Th17/Treg balance in CHB to influence disease development.
MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience
Authors: Yu Liang , Chen Guangliang , Wang Hua , Wang Xiaojie , Huang Ying , Chi Pan , Chen Zhifen
Published: June 2022

Background: Anastomotic leakage (AL) was one of the most serious postoperative complications after colorectal anastomosis. This study aims to evaluate the feasibility and diagnostic accuracy of Magnetic resonance imaging (MRI) in the early detection of AL in patients with clinically suspected AL after rectal anterior resection.Methods: This was a prospective study including patients who underwent anterior resections and post-operative MRI examination. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of diagnosing AL of MRI were calculated.Results: Total of 23 patients received MRI after surgery and the median time interval from surgery to MRI was 10 days (3-21 days). The median distance from anastomosis to anal verge was 4.0cm (2.0-10cm), and 11 patients underwent diverted ileostomy. Eighteen patients were found to had an anastomotic leak, including one patient who had a pelvic abscess, and five patients who had no evidence of AL in the MRI examination. the overall sensitivity and specificity were 94.4% (17/18) and 80% (4/5), respectively. The PPV was 0.94 and the NPV was 0.80. For patients who had anastomosis lower than 5cm, the diagnostic accuracy of MRI was 93.7% (15/16). T2-weighted with fat-suppression can show the leak track well.Conclusions: The accuracy of plain MRI examination in diagnosing AL was favorable for patients who were suspected of AL. T2-weighted with fat-suppression was the best imaging to estimate the AL.The multi-center prospective study with more samples is needed to further estimate the safety and feasibility of MR in diagnosing the AL.
The influence of RGO gain on Co 0.5 Mn 0.3 Cu 0.2 Fe 2 O 4 nano-composites' construction, morphology, and magnetic characteristics
Authors: Moradi Seyed Ali Hosseini , Ghobadi Nader
Published: June 2022

One-pot simplified co-precipitation procedure was used to produce non-stoichiometric ferrite (Co0.5Mn0.3Cu0.2Fe2O4) and diminish graphene oxide (rGO) nano-composites in this investigation. Powders such as XRD, FT-IR, and SEM were used to study the structural and surface analysis of the composites. An investigation of the magnetic characteristics of Co0.5Mn0.3Cu0.2Fe2O4 nanocomposites (NCs) was also conducted using VSM. A vector network analysis tool was used to conduct microwave adsorption investigations on Co0.5Mn0.3Cu0.2Fe2O4 NCs in the 2–18 GHz frequency spectrum. By adjusting the amount of rGO added to Co0.5Mn0.3Cu0.2Fe2O4, the electromagnetic (EM) wave absorbing characteristics of Co0.5Mn0.3Cu0.2Fe2O4 nanocomposites may be remarkably adaptable due to their customizable microstructure and synergistic effects. The addition of rGO can significantly improve EM wave absorption characteristics compared to the unadulterated Co0.5Mn0.3Cu0.2Fe2O4 ferrites. The generated Co0.5Mn0.3Cu0.2Fe2O4 NCs' minor reflection loss (RL) was 39.7 dB in the 11.9 GHz frequency spectrum. The effective absorption bandwidth is a maximum of 6.5 GHz (RL under 10 dB) with a thickness of two millimeters. The Co0.5Mn0.3Cu0.2Fe2O4 NCs that haven't been changed since synthesis (: as-synthesized) might be considered a novel alternative for the slight EM wave absorber due to their proper impedance matching and synergistic effect among dielectric and magnetic loss.
Interference effects in GaN high electron mobility transistor power amplifier induced by microwave pulses
Authors: Zhao Jingtao , Chen Quanyou , Chen Chaoyang , Chen Zhidong , Liu Zhong , Zhao Gang
Published: June 2022

Owing to the rapid development of wireless communication, radar and pulse power technology, the electromagnetic environment faced by electronic systems is increasingly complex and the intensity of electromagnetic field can be significant. In this study, a new interference phenomenon was observed when the microwave pulses were injected into the gallium nitride (GaN) high electron mobility transistor (HEMT) power amplifier through the output port. We investigated the relationship between the peak power of reverse injection microwave pulses and the duration or the amplitude of the interference by effect experiments. The interference duration could reach the magnitude of millisecond. Deep traps in GaN HEMT power amplifiers are proved to be the cause of this interference effects.
Validation of a Rapid Remote Digital Test for Impaired Cognition using Clinical Dementia Rating and Mini-Mental State Examination: An Observational Research Study
Authors: Alim-Marvasti Ali , Kuleindiren Narayan , Harvey Kirsten , Ciocca Matteo , Lin Aaron , Selim Hamzah , Mahmud Mohammad
Published: June 2022

BackgroundThe Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) are useful screening tools for mild cognitive impairment (MCI). However, these tests require qualified in-person supervision and take up to 60 or 15 minutes to complete respectively. We have developed a digital cognitive screening test (M-CogScore) that can be completed remotely in under 5 minutes without supervision. We set out to validate M-CogScore in head-to-head comparisons with CDR and MMSE. MethodsTo ascertain the validity of the M-CogScore, we enrolled participants as healthy controls or impaired cognition matched for age, sex, and education. Participants completed the 30-item paper MMSE Second Edition Standard Version (MMSE-2-SV), paper CDR, and smartphone-based M-CogScore. The digital M-CogScore test is based on time-normalised scores from smartphone adapted stroop (M-Stroop), digit-symbols (M-Symbols), and delayed recall tests (M-Memory). We used Pearson’s correlation coefficient to determine the convergent validity between M-CogScore and the 30-item MMSE-2, and non-parametric tests to compare M-CogScore with a CDR diagnosis of impaired cognition (CDR 0.5 or 1). M-CogScore was compared to MMSE-2-SV using area under the receiver operating characteristic curves (AUC) with corresponding optimal cut-offs. Results72 participants completed all three tests. The M-CogScore correlated with both MMSE-2 (r=0.66, p<0.0001) and impaired cognition on CDR (Mann Whitney U 187, p<0.001). M-CogScore achieved an AUC of 0.85 (95% bootstrapped CI [0.80, 0.91]) when differentiating between normal and impaired cognition, compared to an AUC of 0.78 [0.72, 0.84] for the MMSE-2-SV (p=0.21) ConclusionM-CogScore was significantly correlated with established cognitive tests including CDR and MMSE-2-SV. M-CogScore can be taken remotely without supervision, is automatically scored, has less of a ceiling effect than the MMSE, and takes significantly less time to complete. Digital screening tests such as M-CogScore are desirable to aid in rapid and remote clinical cognitive evaluations.
Phenotyping diverse cowpea genotypes reveals shoot traits contributions to drought recovery
Authors: Sakariyahu Solihu Kayode , Aliyu Ramatu Enehezeyi , Indabo Sadam Sulaiman , Muhammad Hadiza Usman , Aminu Aliyu , Ahmed Hauwa Oziohu , Mohammed Saba Baba , Adamu Abu-Kasim
Published: June 2022

The success of a breeding program largely depends on the presence of sufficient genetic diversity in crops to provide an avenue for selection of desirable genotypes for utilization in crop improvement. However, the primary gene pools of many crop plants are so depleted in genetic variability which is a consequence of continuous selections imposed by plant breeders. This necessitates exploring the potentials of landraces for sources of resistance to biotic and abiotic stresses. Thus, the “Wooden box techniques” was adopted to screen cowpea genotypes for their response to seedling drought stress, owing to its rapid and high throughput nature. Here, 420 cowpea genotypes were evaluated for their tolerance to seedling drought. Time course analysis of growth and agronomic traits revealed gradual cessation of growth as drought stress intensified as evidenced by reduction in trifoliate number, increase in leaf senescence and stem wilting. Multivariate analysis using principal component (PC) analysis and k-mean clustering identified 3 major clusters where PC1 and PC2 explained 46.7% of the variability in response to drought stress. The biplot analysis showed that plant height, stem greenness and trifoliate number contributed positively to PC1 while leaf senescence score was negatively related to the clustering on this axis. The comprehensive data analysis pipeline allows us to identify the relationship between the agronomic and stay-green parameters, which provides us with the understanding of traits that could be useful during the selection of lines under drought stress at the seedling stage. Our method provides an aid-to-selection for rapid screening of a large collection of cowpea lines for their response to seedling drought stress. Additionally, our results identified potential tolerant genotypes for use as parents for genetic analysis of drought tolerant traits and incorporation into breeding programs targeting the development and deployment of drought tolerant varieties.
Survey on public awareness, attitudes and self-protective behavior adoption in different periods of COVID-19
Authors: Fang Fang , Chen Sijie , Geng Xianhui , Kiprop Emmanuel
Published: June 2022

Background: The outbreak and spread of the pandemics have been an issue of critical concern globally, posing a significant threat to the health sector globally. This study aimed to examine the basic knowledge and attitudes toward the recommended protective measures at different times, respond to the COVID-19 pandemic, and provide recommendations for developing targeted strategies and measures for preventing and controlling public health emergencies. Methods: The study used self-filled questionnaires to examine the public's knowledge, attitudes, and practices on COVID-19 at two different period, from 20 - 31 March 2020 (the beginning period) and 22 - 27 April 2022 (the regular epidemic prevention and control period) . Descriptive and quantitative analyses were used for statistical analysis. Results: The survey collected 2375 valid questionnaires. A comparison of the two periods reveals that as the epidemic continued over a long period, the level of knowledge, attitudes towards preventive measures, risk perceptions, and adoption behavior of the respondents at the beginning of the epidemic were significantly higher than during the regular epidemic prevention and control period. Conclusion: With the upsurge in the spread of the epidemic, the public needs a multi-channel, targeted, and all-round guidance and information on prevention and control of the COVID-19, and internalizes knowledge into individual's behavior of actively responding to diseases.When the epidemic lasts for a long time, the relevant agencies should strengthen their monitoring role to promote public compliance with the recommended measures.
Bioinformatics and integrated pharmacology network to identify the therapeutic targets and potential molecular mechanism of alpha-lipoic acid on primary ovarian insufficiency
Authors: Kong Deqi , Cho Heeryun , Lee Jaeeun , Choi Eunsaem , Lee Ahyoung , Choi Ehnkyoung , Kim Yunbae , Kim Haijoong , Hong Sooncheol
Published: June 2022

Women experiencing primary ovarian insufficiency (POI) are more likely to experience infertility, and its incidence is increasing worldwide annually. Recently, the role of alpha-lipoic acid (ALA) in the treatment of POI has been reported. However, details of the potential pharmacological targets and related molecular pathways of ALA remain unclear and need to be elucidated. Thus, this study aims to elucidate the potential therapeutic target and related molecular mechanism of ALA on POI. First, the potential targets of POI and ALA related targets were downloaded from online public databases. Subsequently, the overlapped target genes between POI and ALA were acquired, and Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, Protein-Protein interaction (PPI) networks were performed and constructed. Finally, molecular docking was performed to verify protein-to-protein effect. A total of 152 potential therapeutic targets were identified. The biological processes of the intersecting targets were mainly involved in the cellular response to peptides, response to xenobiotic stimuli, and response to peptide hormones. The highly enriched pathways were the cAMP, PI3K/AKT, estrogen, progesterone mediated oocyte maturation, and apoptosis signaling pathways. The top ten hub targets for ALA in the treatment of POI were STAT3, STAT1, CASP3, MTOR, PTGS2, CASP8, HSP90AA1, PIK3CA, MAPK1, and ESR1. The binding between ALA and all top hub targets were verified using the molecular docking analysis. In summary, using the systematic integrated pharmacology network and bioinformatics analysis, this study illustrated that ALA participates in the treatment of POI via multiple-targets and multiple-pathways mechanisms.
Impact of COVID-19 pandemic era 2020 on Rashtriya Bal Swasthya Karyakram (RBSK) - National Child Health program in India – A cross-sectional comparative research study
Authors: Kumar Piyush , Anupama Advocate
Published: June 2022

In India because of the elevated birth rate and Brobdingnagian population (globally next to china) Rashtriya Bal Swasthya Karyakram (RBSK) (National Child Health program) is a significant measure by the Government of India, quite vital for public health care provision systems for reducing mortality in children (to achieve SDG goal), particularly within the current COVID-19 pandemic era throughout which most of the essential maternal- kid RCH (Reproductive and Child Health) health services were disrupted globally as well as in India. One of the researchers is a medical doctor who felt that the performance of RBSK during COVID-19 must be investigated to know the status of implementation of services during the pandemic crisis to alert policymakers if there is a disruption of these vital health services due to ongoing pandemic so that proper and timely action should be taken to rectify disruption if any during as well as after pandemic. This analysis study was done to supply significant information to the scientific community and decision-makers with concrete information analysis from authorized HMIS (Health Management data system) of Government - MoHFW (Ministry of Health and Family Welfare)) to provide the COVID-19 impact on RBSK services by public health care facilities across thirty-six states and UTs of India. This novel cross sectional research study revealed that COVID-19 period 2020 had a less number of Male/Female children identified with Disease (6 month to 18 years) screened by RBSK services mobile health teams at Govt and Govt aided schools and Anganwadi centre under RBSK services in India on an all India cumulative basis. This is clearly due to less number of screenings done during the COVID-19 era. The prevalence of Male/Female children identified with Disease (6 month to 18 years) / 1000 screened were 23.49, 31.18 and 29.72 for males and 22.37, 30.27 and 29.31 for females during 2018-2019-2020 respectively, is reduced during COVID-19 era is a good sign.
Measuring crater volumes from bullet impacts: implications for field methods and cratering mechanics
Authors: Campbell Oliver , Blenkinsop Tom , Gilbert Oscar , Mol Lisa
Published: June 2022

Bullet impacts are a ubiquitous form of damage to the built environment resulting from armed conflicts. Bullet impacts into stone buildings result in surficial cratering, fracturing, and changes to material properties, such as permeability and surface hardness. Controlled experiments into two different sedimentary stones were conducted to characterise surface damage and to investigate the relationship between the impact energy (a function of engagement distance) and crater volumes. Simplified geometries of crater volume using only depth and diameter measurements showed that the volume of a simple cone provides the best approximation (within 5%) to crater volume measured from photogrammetry models. This result suggests a quick and efficient method of estimating crater volumes during field assessments of damage. Over the engagement distances studied (100 – 400 m), there is little consistent effect on crater volume, but different target materials result in an order of magnitude variation in measured crater volumes. Bullet impacts in the experiments are similar in appearance to damage caused by hypervelocity experiments, but crater excavation is driven by momentum transfer to the target rather than a hemispherical shock wave. Target material plays the dominant role in controlling damage, not projectile energy as predicted by some impact scaling relationships.
Hyperbilirubinemia and associated factors among neonates admitted to neonatal care unit in Jimma Medical Center
Authors: Asaye Sintayehu , Bekele Misgana , Getachew Aklilu , Fufa Diriba , Adugna Tesfaye , Tadese Edosa
Published: June 2022

Background: Neonatal hyperbilirubinemia is a widespread and significant clinical problem among neonates worldwide. Globally, every year about 1.1 million babies develop it and the vast majority reside in South Asia and sub-Saharan Africa. Studies on magnitude and factors associated with neonatal hyperbilirubinemia are limited in Ethiopia. So this study was aimed at assessing the prevalence and associated factors of neonatal hyperbilirubinemia among hospitalized neonates in the neonatal intensive care unit of Jimma Medical Center (JMC), Jimma, South West Ethiopia. Methods: Hospital-based cross-sectional study was conducted at JMC from July 24 to October 19, 2020. A total of two hundred twenty-two neonates with their mothers were included and conveniently selected. Data was collected by interviewing mothers through structured questionnaires and reviewing neonates' medical records using a checklist. Multivariable binary logistic regression analyses were employed to identify factors associated with neonatal hyperbilirubinemia. Results: from a total of neo-maternal pairs included in the studies; the proportion of Neonatal hyperbilirubinemia was found to be 94(42.3%). Neo-maternal ABO incompatibility 33 (35.1%), prematurity41 (43.6%), sepsis 35 (37.2%), Neonatal birth asphyxia 20 (21.2%), and Rh isoimmunization 10 (10.6%) was significantly associated with neonatal hyperbilirubinemia.Conclusion and Recommendations: The prevalence of neonatal hyperbilirubinemia in the study setting was high. Antenatal care (including both mother and fetus detail examination and follow-ups) as well cautions during labor need to focus since Neonatal hyperbilirubinemia-associated factors were maternal and neonatal. Hence, further assessment, early intervention, and timely treatment are important to mitigate the burdens in neonates due to hyperbilirubinemia.
A stochastic Schumacher diffusion process: Probability characteristics computation and statistical analysis
Authors: Nafidi Ahmed , AZRI Abdenbi EL , Gutiérrez-Sánchez Ramón
Published: June 2022

The principal goal of this article is to establish a methodological approach to computational statistical analysis for a new inhomogeneous stochastic diffusion process with mean function corresponds to the Schumacher curve. Firstly, we analyse the principal probabilistic characteristics like the functions of the mean and the transition probability density of the process. So, the parameters estimation appearing in the current process are determined by the maximum likelihood approach with discrete sampling. Finally, so as to provide the performance of the proposed process, we will apply these computational statistical results to simulated data based on a discretization of the analytical expression of the processus by justifying the fit and prediction possibilities.
Prof. V.i. chernov was elected a corresponding member of the Russian academy of sciences
Authors: Editorial Article
Published: June 2022

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Teoria da Agência: Uma Avaliação e Revisão
Authors: M. Eisenhardt Kathleen
Published: June 2022

A teoria da agência é uma importante teoria, ainda que seja controversa. Este artigo traz uma revisão sobre a teoria da agencia, suas contribuições para a teoria das organizações e do trabalho empírico existente bem como desenvolve proposições testáveis. As conclusões são de que a teoria da agência oferece uma visão única sobre sistemas de informação, incerteza dos resultados, incentivos risco e é uma perspectiva empírica válida, principalmente quando combinada com perspectivas complementares. A recomendação principal é incorporar uma perspectiva agência em estudos sobre os muitos problemas que têm uma estrutura cooperativa.
Government communication management during the pandemic
Authors: Minaeva L. V.
Published: June 2022

The types of crises that the State witnesses are so complex and multidimensional that anyone who has tried to pigeonhole the functions and activities of crisis communication managers inevitably has noticed that this is no easy job. The Covid-19 pandemic is a very special crisis in the sense that it is a new mass phenomenon which, nevertheless, has specific national features. The article encompasses the various governments’ communication with the general public in seven European countries during the initial stage of the pandemic and the communicative role played by political leaders and state structures within each nation. The paper considers the government crisis communication drawing on the principles of crisis communication theory and shows the extent to which government communication at this period followed the key indicators of effective communication. This study proposes a number of crisis communication models which contribute to the generalization of functions and characteristics of State communication affected by their specific political and cultural contexts.
Digitalization of museums as a socio-cultural phenomenon
Authors: Chaikovskaya A. M.
Published: June 2022

The paper considers the process of digitalization of Russian museums as an important project of state. The author reviews and analyses the approaches to the definition of the term digitalization in Russian sociology and studies the measure of influence of the COVID-19 pandemic on the rate of digitalization of museums based on the interim results of the national project “Culture” dedicated to digitalization of the infrastructure of the cultural sphere. Within this study the author shows the experience of the digitalization process on the example of domestic museums and as successfully implemented examples that contributed to the improvement of the digital communication process, analyzes the processes of digitizing museum expositions, introducing virtual reality mechanisms, audio guides (their analogues in the form of QR codes), and online events. Based on these technologies, the author comes to conclusion (1) about the multifaceted activities of museums, which cease to be just a place to store exhibits of historical and cultural value, and (2) that modern social demands make the issue of digitalization of museums relevant in the context of communication interaction in society. Russia has successful examples of implemented cases of digital museums, but a further continuation of this work is required, since many museums have partially implemented digitalization.
A LARGE HEPATIC HEMANGIOMA REVEALED BY EPIGASTRIC PAIN
Authors: Azzouz Lotfi , Dahbi-Skali Laila , Zohra Benmoula Fatima , Baiss Marouane , Jalil Mdaghri , Said Benamar , Rahal Mssrouri , Settaf Abdellatif
Published: June 2022

Hepatic hemangiomas are the most common benign tumors of the liver and are often asymptomatic, diagnosed incidentally. They are considered giant when they exceed 5 cm at their largest diameter. Giant hepatic hemangiomas are rare. Diagnosis is essentially based on imaging (CT, MRI). Spontaneous or traumatic rupture, intratumor hemorrhage, rapid growth, diagnostic uncertainty and coagulopathy are the main indications for surgery. We present the case of a 53-year-old woman with two hepatic hemangiomas, the largest of which occupies the entire left lobe and measures 17 cm in diameter. It is not known how long the tumor had been growing. She underwent surgical management due to obvious mass effect.
CUSTOMER RETENTION STRATEGIES AND PROFITABILITY AMONGST INSURANCE COMPANIES IN KENYA: A CASE OF LIBERTY LIFE ASSURANCE CO. LTD
Authors: Bach Peter , Gichuhi Kimani
Published: June 2022

This study sought to investigate the influence of customer retention on profitability of insurance companies in Kenya using Liberty Life Assurance Company Ltd as a proxy. The Specific objectives of the study were to examine the effect of product quality assess the effect of quality customer service, and to establish the influence of firms service/product pricing on profitability. The theories of Assimilation, Contrast, and Assimilation-Contrast guided this current study. Descriptive and correlational design were used on a target population of 2, 653 customers who have held life policies since 2010 with Liberty Life Assurance Co. The sample of the study consisted of 347 respondents. A questionnaire was used to collect primary data from customers while a structured interview schedule was used to collect qualitative data from 10 managers. Validity of instruments was ensured by consulting experts from Business Administration Department, Africa Nazarene University. Reliability of instruments was achieved through test-retest method on randomly selected 39 customers, whereby Cronbachs Alpha of 0.849 was calculated from the obtained data. Qualitative data was analyzed through thematic analysis while correlation and regression analysis were used to analyze the relationship between customer retention strategies and profitability in Liberty Life Ltd, Kenya. The study findings showed that 40.4% changes in profitability at Liberty Life Assurance is attributed to the customer retention strategies investigated by the study (R2 =0.4042). Findings also showed that product quality (Î²=0.428) quality of services (Î²=1.188) and product pricing (Î²=0.601) all are significant predictors {F (1, 338) =88.495, P<0.05} of profitability at Liberty Life. It is concluded that product quality, quality of services, and product pricing are critical customer retention strategies for enhancing firm profitability. The study therefore recommends insurance should adopt corporate social responsibility practices as well as flexibility mode of premium payment to improve and stabilize their customer base. Further research should be done on the influence of expanded benefits in insurance product packages on customer retention and profitability.
AN EVALUATION OF STREET CHARACTER AS A FACTOR FOR LIVELINESSA CASE FROM ISTANBUL
Authors:   Research Scholar, Okan University, Faculty of Art, Design and Architecture, Istanbul / Turkey., Abu Esleih E. , Akbalik E. ,   Assistant Professor, Dogus University, Faculty of Art and Design, Istanbul / Turkey.
Published: June 2022

Streets, being vital elements of public spaces, provide mobility and social contact. Beyond their transportation character, streets are the locations where people may interact with each other, satisfy their needs, and express themselves. These functions contribute to the liveliness of streets and have a significant influence on social life in public spaces. This research examines street characteristics as factors of liveliness that help us to identify the street as a public space. Taking physical features, visual identity, functions, and activities as parameters of street character; the research examines Istanbuls Bagdat Avenue by emphasizing these parameters on the liveliest sections of the avenue. The two-stage organized research outputs have shown that the liveliest sections of the avenue include variety of businesses, individual retailers, segments with a unique identity, and buildings with permeable and articulated facades. It can be asserted that the streets characteristics encourage individuals to behave in a way that enhances publicity and that the streets characteristics help in creating a more attractive place and a lively atmosphere for people to behave in a comfortable way that strengthens the publicity. This research aims to contribute to academic literature to develop a framework for rethinking design and planning for revitalizing urban life and explaining the human aspect of environmental design.
A STUDY ON THE EFFECT OF COVID-19 ON EYE CARE AND ACADEMICS IN A TERTIARY CARE TEACHING HOSPITAL
Authors:   Assistant Professor of Ophthalmology, Andhra Medical College/ Government Regional Eye Hospital, Visakhapatnam, Andhra Pradesh., Rajiv Krishna M.S K.S
Published: June 2022

Objective: Covid-19 has severely affected both clinical and medical education work in all teachinghospitalincluding eye care hospitals. The objective is to study the effect of covid-19 in a regional eye hospital. Material and Methods: This study is a descriptive cross-sectional study. Datafrom April 2016 to March 2021 -regarding census, effect of pandemic on patients from different backgrounds, patient care services like OP, IP, Refraction and Surgeries were collected from the hospital records before and during Pandemic period and is tabulated and analysed. Results: In this study Data from April 2016-March 2021 at our centre is analysed. OPD census reduced to almost 1/3rd in the pandemic year 2020-21. In patient census reduced to one-seventhwhen compared to admissions in non-Pandemic years. Similarly, refractions were reduced to half to one-third in comparison with previous years data, refraction being one of the most common OPD procedure. On the surgical side, Cataract surgeries and minor surgeriesperformed were also reduced significantly to one-seventh & one-sixth respectively when compared with previous years performances. On the medical education front both Undergraduate and postgraduate teaching could not take place for about (50%) half of the academic year2020-21 on any platform. Conclusions: Unforeseen Pandemic Covid-19 has severely affected eye care services, including basic services at our tertiary eye care centre. Pandemics like covid-19 emphasize on improving eye care at all levels and also the need of developing infrastructure for Teleophthalmology to cater the need of patients.
USEFULNESS OF THERMO LABILE ALKALINE PHOSPHATASE AS A BIOMARKER IN DIAGNOSIS OF POST-MENOPAUSAL OSTEOPOROSIS
Authors: S. Narayana , Babu S.V Suresh
Published: June 2022

Background: Osteoporosis is characterized by demineralization of bones and it is a complication of women in post-menopausal life. Bone alkaline phosphatase is an isoenzyme of alkaline phosphatase which helps in the mineralization of bones and it is heat labile in nature. Its measurement facilitates the clinical diagnosis of Osteoporosis. Objectives: To assess the status of total alkaline phosphatase and heat-labile isoenzyme fraction (bone fraction) in serum of pre and post-menopausal women and to relate the findings to the clinical condition /final diagnosis to make out the correlation between the pre and postmenopausal women. Methodology:A total of 70 subjects, consisting of 35 pre-menopausal women (38.11 Ã‚Â± 4.3 years of age) and 35 post-menopausal women (54.40 Ã‚Â± 4.6 years) were constituted for the study. Their total alkaline phosphatase was measured directly and the heat stable alkaline phosphatase was measured after heating the serum at 56â„ƒ for 10 minutes. Spectrophotometric P- Nitro-Phenyl Phosphate method was followed for the estimation. Heat labile alkaline phosphatase levels were obtained by subtracting the heat stable fraction from total Alkaline phosphatase. Result: The measured serum total alkaline phosphatase level was slightly increased in post menopause compared to premenopausal women but it was not statistically significant. The levels of heat-labile Alkaline phosphatase showed significant difference between pre and post-menopausal women by ***: p < 0.01: ***: p < 0.001 respectively. Conclusion: Heat labile alkaline phosphatase can be used as a biomarker to diagnose Osteoporosis in post-menopausal women.
RELIABLE ROUTING OF EMERGENCY DATA IN WIRELESS BODY AREA NETWORKS UNDER STATIC AND MOBILE SCENARIOS
Authors:   Research Scholar, Department of Computer Science and Engineering, VidyaVikas Institute of Engineering & Technology Research Center., S.R Hemanth , Pande M.B Sanjay ,   Professor, Department of Computer Science and Engineering, GM Institute of Technology.
Published: June 2022

Timely intervention can help save precious lives of people who are at risk from chronic diseases or fatal diseases such as cardiac arrest, heart diseases to mention a few. These are the major causes of disability and death across the globe. Continuous monitoring of vital body parameters can be useful in timely intervention which can save the lives of the patients suffering from chronic diseases which can be life threatening, also improve the quality of life. This can be done using Wireless Body Area Networks (WBAN) with sensors placed on human body. This network uses routing protocol to transmit the sensed data packets to the destination node. if the detected information falls into the category of emergency data, It is critical for sensor nodes to transmit data in a reliable and timely manner while consuming as little energy as possible. Existing protocols propose routing methods that classify traffic and prioritize emergency data transmission. However, apart from traffic classification, robust measures to reduce the loss of emergency packets at various levels during transmission have not been adequately addressed. This can reduce the reliability of emergency data, also increasing the traffic load and energy consumption in forwarder nodes. This shortcoming drives us to propose a routing protocol EER-QR (Energy Efficient Routing with QoS and Reliability) which uses specialized modules with measures for a specific task. Experimental results have demonstrated that EER-QR is Capable of reliably transmitting emergency data, minimizing network load and therefore extending network lifetime. This can help with proper diagnosis in such critical situations resulting in timely intervention and treatment saving the lives of patients.
PERCIEVED METHODS OF ENHANCING UTILIZATION OF SKILLED DELIVERY CARE SERVICES IN MUKUYUNI LOCATION, BUNGOMA COUNTY, KENYA
Authors:   Department Of Environmental and Occupational Health, Kenyatta University., W. Innocent Wapukha
Published: June 2022

The study sought to establish perceived methods of enhancing utilization of skilled delivery care services in Mukuyuni location of Bungoma County in Kenya. A community-based cross-sectional study design was employed in the study. The target population for the study were women of reproductive age residing in Mukuyuni location who had delivered within a five-year time frame and willing to respond unconditionally. The researcher used systematic random sampling to select the women to be interviewed from each of the sampled villages of the study area which had a study population of 2300. 300 respondents provided the information while 2 women refused to cooperate with the researcher and 25 of the sampled women were not available during the time of study. The collected data was coded and entered into SPSS software package for processing and analysis using descriptive and inferential statistics. The data was presented using tables, charts and graphs where appropriate. 148 (49.3%) of the respondents had skilled delivery in a health facility while 152(50.7%) had unskilled delivery. Among those women who had unskilled delivery, 45 (15%) were assisted by TBAs, 94 (31.3%) by relatives and 13 (4.3%) gave birth by the roadside after intensified contractions. Suggestions that were given by respondents on how to enhance utilization of skilled delivery care services among expectant women comprised of building more health facilities increasing essential equipment in health facilities training health professionals to provide holistic and friendly services educating the community on importance of skilled delivery services giving incentives to the mothers when they deliver in the health facility providing emergency vehicles to ferry expectant women to health facilities for delivery and improvement of road infrastructure for better and faster access to health facilities. The study concluded thatthe current acceptance of utilization of skilled delivery care services in the area of study is still below average and therefore the researcher recommends that more health facilities should be constructed within the study area to reduce the distance from peoples homes to the health facility, health professionals should change their attitude and handle pregnant mothers in a friendly manner and lastly public health department should organize more community outreaches to mobilize and sensitize communities on importance of skilled attendance at delivery.
Propuesta de protocolo para la detección, atención y seguimiento de niñas, niños y adolescentes en situación de trabajo infantil en el estado de México
Authors: Alemán Martínez Sandra , Peralta Bravo Samantha
Published: June 2022

La infancia, por su condición de vulnerabilidad puede estar expuesta a situaciones de violencia, negligencia, explotación infantil, trabajo infantil, entre otras, por parte de sus madres, padres, tutores, cuidadores, su entorno social y el Estado. El trabajo infantil, es una realidad para miles de niñas, niños y adolescentes en México, responde a la necesidad de sobrevivir, bajo condiciones de pobreza y marginación. Esta investigación realiza un análisis de la legislación en materia de protección de la infancia en situación de trabajo infantil, el presupuesto asignado y las condiciones jurídicas para la atención de la problemática; considerando la necesidad de especialización en la materia, propone un Protocolo estatal para la detección, atención y seguimiento de NNA en situación de trabajo infantil, apegado a los principios rectores y legislación vigente en materia de derechos de NNA, que proporcione seguridad jurídica a los sujetos de detección, atención y seguimiento, a su madre, padre o tutor legal y a las diversas instituciones públicas a las que se pudieran canalizar, al tiempo de delimitar las atribuciones y facultades para el actuar paso por paso de las y los servidores públicos municipales que realizan la detección, atención y seguimiento de casos de trabajo infantil, evaluación de indicadores de riesgo, coordinación interinstitucional, así como medidas para la protección y restitución de derechos de la infancia.
Evolución en la aplicación de la cláusula rebus en tiempos de la Covid-19
Authors: Cintora Egea María Cristina
Published: June 2022

En el presente trabajo se realizará una aproximación a la figura de la cláusula rebus sic stantibus y el cambio jurisprudencial en su aplicación derivado de los cambios producidos por la crisis por la pandemia mundial de la covid-19.
Procedimiento judicial de consumo en la ciudad autónoma de Buenos Aires
Authors: Tambussi Carlos Eduardo
Published: June 2022

Este artículo investigativo se genera en base a la interpretación del articulado 637 del cuerpo normativo Código Procesal Civil (CPC) Perú, en relación a la competencia que corresponde, en cuanto a la resolución de la oposición en contra de una medida cautelar concedida en vía de apelación, disputando si es el órgano jurisdiccional de primera instancia o de segunda instancia quien debe hacer conocimiento y resolución de dicha oposición, y correlacionado a lo expuesto, se busca a su vez dilucidar si la naturaleza de la oposición es contradictoria respondiendo al derecho a la defensa o si posee carácter de recurso en uso del derecho impugnatorio de quien lo ejerce.
Análisis de la oposición a medida cautelar por Ad Quem
Authors: Mendizabal Anticona Walter
Published: June 2022

Este artículo investigativo se genera en base a la interpretación del articulado 637 del cuerpo normativo Código Procesal Civil (CPC) Perú, en relación a la competencia que corresponde, en cuanto a la resolución de la oposición en contra de una medida cautelar concedida en vía de apelación, disputando si es el órgano jurisdiccional de primera instancia o de segunda instancia quien debe hacer conocimiento y resolución de dicha oposición, y correlacionado a lo expuesto, se busca a su vez dilucidar si la naturaleza de la oposición es contradictoria respondiendo al derecho a la defensa o si posee carácter de recurso en uso del derecho impugnatorio de quien lo ejerce.
Despenalización de la eutanasia en Cuba. Vivir y morir con dignidad
Authors: Momblanc Liuver Camilo , Mendoza Pérez Juan Carlos , Jarrosay Veranes Aymara
Published: June 2022

La penalización de la eutanasia en Cuba que limita el derecho de los pacientes terminales a una muerte digna, ha sido una de las complicaciones que trasciende el sistema jurídico cubano. Cimentar lo dicho, es permisible a través del estudio doctrinal, exegético, histórico y comparado, en aras de normar esta institución en el ordenamiento jurídico cubano como garantía y vital derecho de los pacientes terminales. Como principal resultado de la investigación se obtiene un conjunto de pautas que han de servir de base y orientación para la elaboración de la normativa sobre la legalización de la eutanasia en Cuba.
Leyes de las evidencias, nuevas teorías
Authors: Velásquez Alemán Orlando Vladimir
Published: June 2022

Alex Stein es parte de la facultad del “Brooklyn Law School” y en este artículo revisa y define algunos principios de la teoría de la evidencia para el “Common Law”. En este artículo se explica y justifica algunos de los principales principios de la teoría de las evidencias. Stein explica que la teoría general de la evidencia está relacionada directamente con la búsqueda de la verdad y sus principios se aplican para cada caso en particular, basado en la credibilidad de la historia descrita por las partes participantes de la disputa. Entre los principios más importantes tenemos al “principio económico”, el cual demanda el mínimo error posible al momento de valorar los hechos, el “principio de igualdad” que provee la protección máxima posible contra el riesgo de error en forma igualitaria para cada una de las partes. El autor critica con fundamentos validos estas nuevaspropuestas doctrinarias, llamadas por el autor “anti doctrinas” enfocadas en cambiar o reemplazar los principios básicos de las leyes de la evidencia dentro del sistema judicial norteamericano. Estas nuevas propuestas se basan en los siguientes principios: “economía (mínimo error), probabilidad (estadística) y moral”. El articulo hace referencia a los siguientes autores y sus teorías: Luis Kaplow y su teoría de la “carga de la prueba”, Daniel Kaheman y Amos Tversky “las probabilidades matemáticas son irracionales” y Ronald Dworking con su teoría: “diferencias entre riesgos de errores impuestos de forma accidental y deliberada”.