bluuebunny/crossref_metadata_2025 huggingface dataset:
A cross-sectional study to evaluate the safety and efficacy of post-placental and intra-cesarean insertion of intrauterine contraceptive device
Authors: Medhi Robin , Pandey Shruti
Published: January 2025

Background: India’s growing population necessitates effective postpartum contraceptive methods to reduce unintended pregnancies and to improve reproductive health outcomes. Postpartum intrauterine contraceptive devices (PPIUCDs) offer a reversible, long-term solution, but insertion timing- post-placental or intra-cesarean may affect their safety and efficacy. Objective was to compare the safety and efficacy of post-placental versus intra-cesarean insertion of IUCDs among postpartum women in a tertiary care hospital in Assam, India.
Methods: This prospective observational study enrolled 210 postpartum women from June 2023 to May 2024 at the Fakhruddin Ali Ahmed Medical College and Hospital, Assam. Eligible participants underwent either post-placental or intra-caesarean insertion of CuT 380A IUCDs. Data on demographics, complications, and continuation status were collected at six months post-insertion. Statistical analysis was done using appropriate statistical tests.
Results: Participants’ mean age was 28±4.1 years; 79.5% were primipara. Continuation rates of PPIUCD was 77.6%, with 26.4% and 19.3% discontinuing in the post-placental and intra-caesarean groups, respectively. Expulsion rates were higher in the post-placental group (15.4%) compared to intra-caesarean (1.7%) (p<0.001). Complications included excessive bleeding, pain, missing thread and expulsion. Factors such as age, parity, and insertion type influenced continuation, with multiparous women and intra-caesarean insertions demonstrating higher retention rates.
Conclusions: Intra-caesarean IUCD insertion is associated with lower expulsion rates and comparable continuation rates compared to post-placental insertion. Addressing social barriers and managing complications can further enhance PPIUCD utilization. These findings can help to design strategies for improving family planning interventions in similar settings.
A rare case of Lesch-Nyhan syndrome in adulthood
Authors: Zafar Sharjeel , Shafique Hira
Published: January 2025

Lesch-Nyhan syndrome (LNS) is a rare X-linked recessive disorder characterized by hyperuricemia, neurodevelopmental delay, self-mutilation, and gouty arthritis. We present a unique case of a 19-year-old male with a delayed diagnosis of LNS, highlighting the diagnostic challenges associated with adult presentations of this syndrome. The patient exhibited classic symptoms, including severe hyperuricemia, bilateral renal stones, gouty tophi on palms, polyarthralgia, self-injurious behavior, low IQ, delayed motor development, and ataxia. The diagnosis was confirmed through clinical evaluation and biochemical testing, revealing significantly elevated serum uric acid levels. Management included dietary modifications, aggressive hydration, and uricosuric medications, leading to symptomatic improvement. This case underscores the importance of considering LNS in patients with unexplained hyperuricemia and neurobehavioral symptoms. Early diagnosis and appropriate management can improve the quality of life and reduce complications.
Treatment of well-differentiated invasive squamous cell carcinoma of the skull and reconstruction by ultrathin anterolateral thigh flap
Authors: Ramírez Eduardo D. , Mendoza Jose B. , Ugalde Juan A. , Ríos Rodolfo L. , Canepa Patricio , Perrusquia Daniela
Published: January 2025

Invasive squamous cell carcinoma is an aggressive form of skin cancer that requires radical surgical treatment and reconstruction. This article presents a clinical case of a 74-year-old patient with well-differentiated invasive squamous cell carcinoma of the skull, treated with surgical resection and reconstruction using an ultrathin anterolateral thigh flap. Reconstruction with an ultrathin anterolateral thigh flap is an effective therapeutic option that can offer numerous benefits and advantages for patients, improving their quality of life and their ability to carry out daily activities. This reconstructive technique allows for the restoration of the shape and function of the skull and face, minimizes morbidity and complications, and enhances facial aesthetics. Timely and effective treatment of invasive squamous cell carcinoma through reconstruction with an ultrathin anterolateral thigh flap can significantly improve the patient's survival and quality of life. In conclusion, the ultrathin anterolateral thigh flap is an excellent reconstructive option for patients with scalp defects secondary to extensive oncological resections.
Reconstruction of a large check and nose defect following excision of a basal cell carcinoma with squamous differentiation with cheek rotation flap and paramedian forehead flap in a patient with albinism
Authors: Boro Sumanjit S. , Kakati Kaveri
Published: January 2025

Squamous differentiation of basal cell carcinomas are very aggressive tumors. The albino population on the other hand very much susceptible to radiation-induced skin changes and malignancies. Here we have presented a case of 34-year-old lady with large basal cell carcinoma of the cheek and lateral nose wall presented to us at a very late stage due to COVID-19-induced lockdown in this part of India. She was referred to the plastic surgery outpatient department (OPD) from the head and neck surgery for the reconstruction-related opinion. We excised the tumor with adequate margins and reconstructed the right cheek defect with the cheek rotation flap of size 15×14 cm and the right nose defect with a left paramedian forehead flap. The postoperative period was uneventful. After three weeks of the surgery, the flap division was done and one more week later, radiation therapy started. The patient was followed up at three monthly intervals at the OPD and she was doing fine till now and is also happy with the aesthetic appearance. For the large defects of the nose and cheek, a combination of cheek rotation flap and paramedian forehead flap can be done. Both are very reliable flaps and good color match and proximity to the defect made them an attractive option.
Dual diagnosis: unravelling the complexity of mitochondrial respiratory chain disorder and familial hypercholesterolemia in early childhood
Authors: Phadke Abhishek K. , Kumble Ali , Khan Shuhadamol Arif , Raikar Poonam S.
Published: January 2025

Complex I deficiency is the most frequently encountered single mitochondrial enzyme deficiency in patients with a mitochondrial disorder. Most of patients present with symptoms similar to leukodystrophy. Pathogenic mutations identified in the majority of the 44 genes encoding the structural subunits of complex I. No cure for complex I deficiency and the treatment options restricted to symptomatic treatment. Here we report a case of mitochondrial complex I deficiency in an 11-month-old infant presented with failure to thrive, regression of milestones, and metabolic acidosis with a high anion gap and high lactate. MRI brain showed extensive white matter involvement. Before starting treatment with IEM cocktails, genetic testing was sent. Whole exome sequencing revealed homozygous variants in NDUFAF5 (Exon 6) associated with mitochondrial complex-I deficiency and heterozygous mutation in LDLR (+) familial hypercholesterolemia (FH) type 1. After starting treatment metabolic abnormalities got corrected. This rare co-occurrence highlights the importance of considering mitochondrial disorders in infants with unexplained metabolic acidosis and regression of milestones. The case emphasizes the need for early recognition and diagnosis to initiate appropriate management and genetic counselling. This unique combination of disorders expands our understanding of the genetic and phenotypic spectrum of mitochondrial diseases.
Hemophagocytic lymphohistiocytosis: a clinical overview and case study
Authors: Fatima S. Zohra , Bhaganagare Vivek V. , Mohammed Owaise , Amjad Mariyah , Siddiqua Syeda A.
Published: January 2025

Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially life-threatening hyperinflammatory syndrome resulting from excessive immune activation. It is broadly classified into primary (genetic) and secondary (acquired) forms, with secondary HLH often triggered by infections, malignancies, or autoimmune diseases. The condition presents significant diagnostic challenges due to overlapping features with other systemic inflammatory disorders and sepsis. This report describes a pediatric case of HLH associated with a bacterial infection, highlighting the importance of timely diagnosis and treatment to improve outcomes. A 9-year-old female presented with persistent fever, abdominal pain, distension, facial edema, hepatosplenomegaly, and pancytopenia. Laboratory investigations revealed hyperferritinemia (18,500 ng/ml), hypertriglyceridemia (450 mg/dl), and hypofibrinogenemia (1.2 g/l). Bone marrow aspirate demonstrated hemophagocytosis. Blood cultures identified Klebsiella pneumoniae as the infectious trigger. The patient met six of the eight HLH-2009 diagnostic criteria, confirming the diagnosis of secondary HLH. Treatment included intravenous dexamethasone and immunoglobulin (IVIG), along with supportive care. The patient responded well, with clinical improvement and normalization of laboratory parameters. Genetic evaluation was done to exclude primary HLH and it turned out to be PRF1 gene. This case underscores the critical need for early recognition of HLH in patients presenting with fever, cytopenias, and elevated inflammatory markers. Adherence to established diagnostic criteria and prompt initiation of treatment are essential to improving survival in this severe condition. The case also highlights the role of multidisciplinary care and genetic testing in ensuring optimal long-term management.
Understanding the recurrence of amoebic liver abscess in South Bihar: a clinical case report
Authors: Mahto Binay Kumar , Kumar Sanjay , Kumar Sant , Kumari Rashmi , Shreya  , Kushwah Hotam Singh , Kumar Ashish , Tumram Akshay Shamrao , Shekhar Shashank
Published: January 2025

Amoebic liver abscess is a common disease condition in some parts of India, including Bihar, due to the higher prevalence of amoebiasis and habitual consumption of toddy (tari). Recurrence of amoebic liver abscess is not uncommon; although it is underreported with only a few previous reports. In this study, a patient from South Bihar presented with three subsequent episodes of amoebic liver abscess over a period of six years. Possible considerations for these recurrences have been explored, which revealed the fact that recommended full-dose treatment with metronidazole followed by a luminal amebicide agent to eradicate intestinal amoebic colonization is necessary for effective treatment of an amoebic liver abscess.
Probiotics to prevent acute respiratory infections in pediatric and adult populations
Authors: Espinosa Alisson Camila Valladares , Balanzategui Camila Brito , Velasco Albert Isaac Grijalva , Márquez Pierina Inés Cantos , Cadena Marilyn Paola León , Jácome Dario David Chicaiza , Rodríguez Carlos A. Chango , Pineda Galo D. Moreno
Published: January 2025

Respiratory tract diseases are among the most common infections of childhood and adolescence. Probiotics in recent years have been presented as a promise and prophylactic and curative alternative for various digestive, mental and respiratory pathologies. This is attributed to the great influence that the intestinal microbiota exerts on the immune system. Multiple studies indicate that an impact on the microbiota due to external or internal factors generates an alteration of the immune system. Among the uses that currently exist, they are used for the prevention and treatment of respiratory diseases in children, adolescents and adults. From the studies analysed, it is observed that Lactobacillus casei shows better results in the prevention of upper respiratory diseases than the rest of the probiotics in combination or alone, however the necessary administration time is unknown.
DIFUSI INOVASI CABAI JAWA: TRANSFORMASI SOSIAL KAMPUNG MODERASI BERAGAMA LINGGOASRI
Authors: Bakhri Syamsul , Subhi Muhammad Rifa’i
Published: January 2025

Pemberdayaan ekonomi di Desa Linggoasri, Kecamatan Kajen, Kabupaten Pekalongan, bertujuan untuk memperkuat kampung moderasi beragama dengan mengadopsi budidaya cabai jawa. Menggunakan teori tindakan komunikatif Habermas dan teori difusi inovasi Rogers, pemberdayaan ini menyoroti peran kritis dalam memahami validitas klaim komunikatif dan mengatasi ketidakadilan jual beli rempah-rempah. Melalui analisis teori hegemoni Antonio Gramci, penelitian menunjukkan bahwa optimalisasi budidaya cabai jawa dapat menghadirkan keadilan ekonomi dan memperkuat kerukunan beragama. Metode partisipatif action research dan teknik analisis CIPP digunakan untuk mengevaluasi konteks, input, proses, dan produk pemberdayaan. Penelitian menemukan kesadaran masyarakat Linggoasri terhadap kebenaran klaim komunikatif, adopsi budidaya cabai jawa sebagai inovasi ekonomi, dan pengaruh positif terhadap kesejahteraan. Kesimpulan menunjukkan bahwa strategi pemberdayaan ini berhasil meningkatkan kerukunan beragama dan kesejahteraan masyarakat. Kontribusinya meliputi konsep inovatif budidaya cabai jawa, penghapusan ketidakadilan dalam perdagangan, dan model pemberdayaan masyarakat yang berkelanjutan.
Escalas simples, cuerpos complejos ¿Cómo las medidas de una casa impactan los roles de género?
Authors: Noguerón Maldonado Lesly Yanely
Published: January 2025

A house is more than just a collection of spaces, objects, and people; it is also shaped by hierarchies, roles, and tensions influenced by the broader context that permeates its boundaries and manifests in human relationships within it. Whether it is a room, an apartment, an anti-refuge, or a domain, these dynamics are ever-present. This research presents a quantitative analysis of the representation of gender roles in anthropometry and ergonomics manuals commonly used in design and architecture. In the manuals by Neufert, Fonseca, and Panero & Zenik, over 90% of service spaces in homes are depicted using graphic scales of women, while recreational and rest spaces predominantly feature men. This study critically examines how these representations reinforce structures of domination and highlights the need for more inclusive design alternatives.
50th anniversary of the discovery of Feigenbaum's patterns
Authors:   Saratov Branch of Kotelnikov Institute of Radioengineering and Electronics of the RAS, Russia, Kuznetsov Aleksandr , Sedova Yuliya ,   Saratov Branch of Kotelnikov Institute of Radioengineering and Electronics of the RAS, Russia
Published: January 2025

In 1975, while experimenting with a pocket programmable calculator, American physicist Mitchell Feigenbaum discovered the universal patterns of transition to chaos through period doubling bifurcations, which now bear his name.
Economic Burden of COVID-19 in West Azerbaijan, Iran: A Societal Perspective
Authors: Norouzi Soheila , Aghlmand Siamak , Faramarzi Ahmad
Published: January 2025

Background: The COVID-19 pandemic has resulted in massive loss of life and an unprecedented economic crisis, with far-reaching social impacts. This study aimed to estimate the economic burden of Coronavirus from a societal perspective in Iran.
Methods: This cross-sectional study was conducted between March 20, 2020 to March 19, 2021. To calculate the direct cost associated with COVID-19, a bottom-up approach was used with a record of 264 on the prevalence-based method and using the human capital approach. All the costs hospitalized patients. Indirect costs related to COVID-19 patients were estimated based were reported as US Dollars, using the exchange rate ($US 1=172,430 Rials) in 2020 and a 3% discount rate.
Results: From March 20, 2020 to March 19, 2021, this study included 467,883 patients with COVID-19 and 5,806 deaths in West Azerbaijan. Due to the economic burden, COVID-19 was approximately estimated at $647.37 million ($1,384 per patient), of which $425.32 million was caused by lost productivity and $222.05 million by direct costs. The results show that the mean cost of direct medical services was $1415 in the ICU ward and $426 in the general ward.
Conclusion: The findings of this study underscore the substantial economic impact of the COVID-19 pandemic, particularly in developing countries. Notably, the economic burden primarily arises from indirect costs, such as lost productivity due to premature mortality and morbidity. This investigation revealed that medicine and consumables account for 50% of the direct medical costs associated with COVID-19.
Association between Serum Bilirubin Levels and Acute Exacerbation in Patients with Chronic Obstructive Pulmonary Disease
Authors: Najafpour Maryam , Mozdourian Mahnaz , Nabavi Shima , Ebrahimzadeh Farnoosh , Mehrad-Majd Hassan
Published: January 2025

Background: The literature on the potential protective role of serum bilirubin levels in the development of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) has produced conflicting findings. This study aimed to investigate the potential relationship between serum total and direct bilirubin levels and the risk of acute exacerbation in COPD.
Methods: Over a period of 18 months, a total of 99 patients were recruited from two major hospitals in Mashhad, Iran, comprising 49 individuals with stable COPD and 50 with AECOPD. After obtaining informed consent and conducting a comprehensive medical history and physical examination, both groups underwent an assessment of various laboratory indices, such as total and direct bilirubin levels. Appropriate statistical analysis was applied to assess the potential associations between bilirubin concentrations and the risk of AECOPD.
Results: The study population had a mean age of 64.97±10.12 years, and there was no significant difference in gender distribution (p=0.546). The majority of subjects (55.6%) were male. The serum levels of AST and ALT were significantly higher in the AECOPD group (p<0.001). Additionally, although there were no significant differences in total bilirubin levels between the two groups (p=0.323), there was a significantly higher level of direct bilirubin in the AECOP group (p<0.001).
Conclusion: Serum direct bilirubin levels were higher in COPD patients with acute exacerbation. It may be an independent biomarker for screening the COPD patients with and without acute exacerbation. Further studies are required to validate the findings.
The Optimism Effect: How Core Self-Evaluation Shapes Well-Being in Punjab’s Nursing Students
Authors: Saleem Mohammad , Salhotra Ashima
Published: January 2025

Background: The current study investigates the intricate relationship between dispositional optimism, core self-evaluation, and mental well-being among nursing students. The present research aims to understand the mediating role of core self-evaluation on nursing students’ well-being and dispositional optimism.
Methods: The present study was cross-sectional in nature and included a purposively selected sample of 286 (112 females, 172 males) nursing students from Punjab (India). Students completed a measure of a short version of the Warwick–Edinburgh Mental Well-being Scale, The Revised Life Orientation Test (LOT-R), and the Core Self-evaluations Scale. The collected data was analyzed using correlational and multiple regression analysis. Moreover, the mediational analysis was analyzed using the Hayes PROCESS macro.
Results: The results indicated that core self-evaluation (β=0.606, p<0.01) and dispositional optimism (β=0.394, p<0.01) are significant predictors of nursing students’ mental well-being. Mediation analysis showed that core self-evaluation completely mediated the relationship between dispositional optimism and mental well-being. Furthermore, it was found that the measures of t-value of dispositional optimism (t=-1.536), and mental well-being (t=-1.594) were non-significant at the 0.05 level, while significant differences were found in core self-evaluation (t=-2.223).
Conclusion: The results of the present study demonstrated the predictive role of dispositional optimism and core self-evaluation in the mental well-being of nursing students. Moreover, the current study highlighted the underlying mechanism through which dispositional optimism influences nursing students’ mental well-being.
Investigating and Comparing the Relationship between the SYNTAX Score and Short-Term and Long-Term Consequences of Patients with STEMI under Thrombolytic Treatment and then Angiography in the Years 2018-2020
Authors: Jodi Saeid , Separham Ahmad , Jabbaripour Sarmadian Amirreza , Rakhsha Naeem
Published: January 2025

Background: The SYNTAX score is a strong predictor of adverse cardiovascular events such as cardiac death, myocardial infarction, and lesions with revascularization. This rating was also confirmed for patients with left ventricular problems and all the patients referred for percutaneous coronary interventions Percutaneous Coronary Interventions (PCI).
Methods: This study was conducted on 107 patients with ST-Elevation Myocardial Infarction (STEMI) who underwent thrombolytic treatment and then angiography. SYNTAX score was calculated in all the patients. Finally, the short-term and long-term prognoses were examined. Finally, the STR values were compared in two groups of people with high syntax and low syntax.
Results: Eighteen patients (16.8%) suffered Congestive Heart Failure (CHF), one (0.9%) experienced GI bleeding, and one (0.9%) suffered ReMI. The patients’ mean±standard deviation, maximum, and minimum SYNTAX scores were 12.82±7.19, 35, and 3, respectively. Twelve patients (11.2%) had SYNTAX scores higher than 22 (high risk), and 95 (88.8%) had scores lower than 22 (low risk).
Conclusion: Results of the present study indicated that patients with SYNTEX scores >22 had STR lower than 50. CHF incidence rate in patients with SYNTAX scores higher than 22 (high risk) was higher. There was also a significant relationship between the patients’ prognosis and SYNTAX scores.
The Impact of Social Media Platforms on Art Marketing
Authors: Nguyen Thi Van Anh , Ha Ngoc Son , Dinh Huy Hai Duong , Nguyen Minh Huyen
Published: January 2025

Research paper on the impact of social media on art marketing. Using qualitative research methods based on previous studies, data on the impact of social media and current art marketing trends on reputable websites and social networks, the study shows that social media is an important and effective tool in art promotion and marketing activities. Some popular social networking sites currently used in art marketing activities such as Instagram, Tiktok, Youtube, Facebook reach customers through specific tools including videos, live streams, posts, stories or reels. Art marketing on social media platforms increases audience reach, builds loyal fan communities, enhances the art experience for audiences, expands relationships between artists and influencers, and is cost-effective. Besides the positive impacts that social networks bring, there are some limitations and challenges that need to be mentioned in art marketing activities such as saturation, intellectual property issues, and frequently changing algorithms of social networking platforms that require marketers to constantly innovate their strategies. Thereby, the research team proposes some effective strategies for art marketing through social media and solutions for marketers to deal with the above challenges.
Governance assessment in post-earthquake urban regeneration: historic and commercial center of Portoviejo
Authors: Moreira Torres Kelvin Elian , Moretta Macías Betsy
Published: January 2025

The main objective of this article is to evaluate the quality of territorial governance in the post-earthquake recovery of Portoviejo following the April 16, 2016 earthquake analyzes the articulation between the public and private sectors, as well as citizen participation in all urban regeneration programs, with the purpose of identifying the main urban changes in the sector. For this purpose, an exhaustive documentary review was carried out, and information was collected in situ, including the elaboration of thematic maps and focus groups. It is concluded that, despite addressing social, economic and environmental aspects, urban regeneration in Portoviejo is still exposed to vulnerabilities and threats. Problems in urban structure, infrastructure and governance are highlighted, suggesting comprehensive regeneration to improve the quality of life and promote sustainable development.
Digital transformation in the construction industry: Analysing the impact of technological changes on construction processes
Authors: Emelianova Olena , Tytok Viktoriya , Lavrukhina Kateryna , Shatrova Inna , Demydova Olena
Published: January 2025

The relevance of the problem under study lies in the rapid development of digital technologies, which provide unique opportunities for optimising and improving the efficiency of construction production. The purpose of the study is to analyse the impact of digital changes on the technology and organisation of construction activities in Ukraine. The methods of literature review, experimentation, and abduction were used. The study determined which digital technologies, such as BIM, IoT, and AI, are most important to construction organisations. A framework of efficiency-boosting tactics, including personnel training, process optimisation, and technology integration, was created. To visualise data on digital priorities and initiatives, an application was developed. The study emphasised the significance of all-encompassing digital transformation plans and the demand for ongoing innovation in the building sector.
Ecuadorian and world research on architecture transcends in Estoa
Authors: Jiménez-Pacheco Pedro
Published: January 2025

We are proud that during this time, we have achieved indexing in Scopus, as well as several national and international awards and recognitions, which also means an enormous commitment to the Research Center of the Faculty of Architecture and Urbanism of the University of Cuenca, where the journal is edited. Our editorial team today consists of six editors, 18 members of the new Editorial Advisory Board, and five professionals in charge of editorial management and production. This edition, the first of the quarter-century, contains 16 scientific articles, all of which can be read in English. The research results are located in seven countries on three continents: Spain, China, Argentina, Turkey, Mexico, Ecuador and Ukraine.
O Movimento Docente na Universidade Federal do Pará: contra-poder frente à razão do Estado?
Authors: Jacob Chaves Vera Lúcia
Published: January 2025

Este estudo tem por objetivo analisar a atuação do Movimento Docente (MD) organizado na UFPA  no período de 1979 a 1994, no que tange às reivindicações e às conquistas locais. Ao resgatar o processo de organização e luta dos intelectuais universitários, constata-se que o Movimento se constitui em resistência (contra-poder) à razão do Estado e definiu políticas educacionais para a Universidade em âmbito local e nacional.
Paulo Freire e as cosmovisões dos povos originários
Authors: Fleuri Reinaldo Matias
Published: January 2025

Many peoples from the continent of Abya Yala (Americas), as well as of Africa and Oceania, have been decimated or subordinated by the violent colonization and enslavement processes, imposed throughout history. However, their worldviews resist and re-exist in multiple ways. Through intense and sensitive listening, we can learn from these peoples to reestablish our ways of life and production according to ancestral principles, which we indicate here with the concept of Well Living, which can be summarized in its principles of relationality, integrality, complementarity and reciprocity. The epistemological and pedagogical principles formulated by Paulo Freire show an intimate relationship with the educational principles inherent to the original peoples’ cultures. Paulo Freire developed his pedagogical conception using cultural references from Western critical theories. But his engagement with popular social movements most likely allowed him to learn from epistemological perspectives of the original peoples’ cultures relived by popular communities in Latin America.
Medical Blogging in Russia: Crime Prevention and Problems of Practical Implementation of Applicable Criminal Liability Mechanisms
Authors:   Attorney, Founder of Medical Law Faculty, LLC, Associate Professor of the Department of Innovative Medical Management and Public Health, Gabay Polina G.
Published: January 2025

The article presents a legal research of the problems of medical blogging in Russia and considers issues related
to crime prevention in this area. Among other things, the legal aspects of distinguishing blogging from medical
activities, including those carried out within the framework of telemedicine consultations, as well as the problem
of high latency of crimes committed by medical bloggers, have been investigated.
Zbieg sankcji w unijnym prawie podatkowym – uwagi na tle wyroku TSUE z dnia 4 maja 2023 r. (C-97/21), MV-98
Authors: Majka Paweł
Published: January 2025

Przedmiotem artykułu jest analiza problematyki zbiegu sankcji stosowanych w prawie podatkowym za naruszenie obowiązków o charakterze instrumentalnym, przy wykorzystaniu metody dogmatycznoprawnej, której tło stanowi wyrok TSUE z dnia 4 maja 2023 r. (C-97/21), MV-98. Celem analizy jest wskazanie na granice, jakie regulacje prawa unijnego wytyczają w sytuacji zbiegu dwóch sankcji podatkowych, oraz ustalenie, czy odnoszą się do sankcji podatkowych wykorzystywanych w prawie polskim. Z wyroku TSUE wynika, że sankcja polegająca na zamknięciu lokalu przedsiębiorcy naruszającego obowiązki formalne w zakresie podatku VAT jest sankcją karną oraz nie może być kumulowana z karą pieniężną. W ocenie autora, odnosząc ustalenia TSUE do polskiego prawa, należy stwierdzić, że charakter sankcji karnych niepodlegających kumulacji mają kary pieniężne oraz sankcje dodatkowego zobowiązania podatkowego. Jako postulat de lege ferenda wskazano, by wprowadzane sankcje w celu dostosowania ich do wymogów Karty praw podstawowych Unii Europejskiej opierały się na procentowym wymiarze oraz zawierały regulacje umożliwiające ich miarkowanie, co zagwarantuje ich proporcjonalność.
How do age and sex influence pain threshold and tolerance among Santal tribal people living in West Bengal, India?
Authors: Santra Arpita , Roy Subrata Kumar , Goswami Monali , Chatterjee Diptendu
Published: January 2025

The perception of pain, encompassing pain threshold and tolerance levels, is a complex phenomenon influenced by biological, psychological, and sociocultural factors. Notably, age and sex have consistently emerged as pivotal determinants in modulating pain perception. The study aimed to examine age and sex differences in pain threshold and tolerance levels. Furthermore, it delved into exploring whether age-related differences in pain threshold and tolerance levels vary between males and females. This study incorporated 484 healthy Santal tribal individuals aged 18–88 years (male 203 and female 281) living in Howrah and Purba Bardhaman Districts of West Bengal State, India, who reported no chronic or significant pain at the time of data collection. Pain threshold and tolerance levels were assessed using a digital algometer. Results of two-way ANOVA revealed significant main effects of age and sex on every pain threshold and tolerance level assessed in this study, indicating that older individuals had lower pain threshold and tolerance levels than younger ones. Males demonstrated greater levels of pain threshold and tolerance relative to females. Age and sex showed a significant interaction effect on pain tolerance levels, but not on pain threshold levels demonstrating the age-associated declining trend in pain threshold levels was consistent for either sex; however, such a tendency in pain tolerance levels was more pronounced in men. These findings highlight the importance of considering age and sex factors when assessing pain perception.
Investigation of prospective mathematics teachers’ noticing of student thinking related to probability
Authors: Girit Yıldız Dilek , Müftüoğlu Esila
Published: January 2025

The aim of this study is to reveal and evaluate the attending and interpreting skills of student thinking of prospective teachers, as well as their instructional suggestions as responding skills. The current study was conducted with 29 prospective mathematics teachers (PMTs) within a qualitative design in the context of probability. First, three probability problems were asked to sixty-two 8th graders (13-14 years old) in a middle school, and their solutions were used to create tasks for PMTs. PMTs answered the tasks in a written report. Then, a class discussion was held, and PMTs were given the opportunity to revise the initial reports. Content analysis was used for data analysis. PMTs demonstrated partial or robust evidence for attending to and interpreting students' thinking. However, they struggled to respond to students' reasoning. In the revised reports, the PMTs' evidence for noticing skills was better with the support of the class discussion. This study provides an example of an approach that can be used for teaching in method courses, allowing PMTs' noticing skills for student thinking to be revealed and improved.
Analisis Bauran Informasi Sebagai Strategi Pemasaran Informasi Di Perpustakaan Universitas Islam Riau
Authors: Ulfa Hurriya
Published: January 2025

Nowadays, libraries face many problems. Due to the development of information technology that is growing rapidly, so that this phenomenon not only makes it easier for humans to get information but also becomes a threat to the extinction of libraries. Therefore, every library must have a strategy to maintain the function of the library as an information provider institution by the public. One way is to apply the 4P marketing mix (Price, Product, Place and Promotion) such as the Riau Islamic University library which has implemented the concept.The purpose of this study was to analyze the information mix as an information marketing strategy at the Riau Islamic University library. The method used in this research is a qualitative method with a case study approach.Data was collected through interviews, observations, and document analysis.The participants of this research consisted of librarians and users who were selected purposively.The results showed that the information mix at the Riau Islamic University library included four main components, namely information promotion, information distribution, information content, and user interaction.Information promotion involves the use of social media, websites, and electronic newsletters to disseminate information about library services and resources.
Cerebral Oxygenation Monitoring During Coronary Artery Bypass Grafting and Its Correlation with Hematocrit, Mean arterial pressure, and Partial pressure of Oxygen in Arterial Blood
Authors: Sharma Jai , Verma Indu , Agarwal Swati , Dagar Nivedita
Published: January 2025

Introduction: Optimal cerebral oxygenation is vital during coronary artery bypass grafting (CABG) to prevent neurological complications like cognitive decline and stroke. Non-invasive monitoring methods include near-infrared spectroscopy (NIRS), electroencephalography (EEG), and transcranial doppler (TCD). It offers real-time rSO2 assessment, detecting critical thresholds and reducing risks during cardiopulmonary bypass (CPB). Objective: This observational study aims to investigates cerebral oxygenation changes during CABG and correlations with hematocrit, mean arterial pressure (MAP), blood oxygen levels, CPB flows, and temperature. Methods: Seventy-two elective CABG patients underwent CPB with parameters including rSO2, hematocrit, MAP, PaO2, temperature, and pump flows assessed at specific time points: T1: Baseline pre-anesthesia; T2: Post-anesthesia induction (FiO2 100%); T3: Post-anesthesia induction (FiO2 50%); T4: CPB initiation; T5: CPB at 35°C; T6: CPB at 32°C; T7: CPB rewarming (36°C); T8: Post-CPB weaning (FiO2 100%); T9: Post-CPB weaning (FiO2 50%). Results: The mean baseline values for rSO2 were 72.14 for the right side and 71.90 for the left side. Upon initiating CPB at 35°C, a significant maximum reduction in rSO2 of 10.5% was observed, which remained below baseline during the hypothermia phase. The rSO2 values began to increase during the rewarming phase, nearly reaching baseline levels after CPB. A post hoc analysis indicated that changes in rSO2 were correlated with variations in hematocrit (correlation coefficient = 0.518), MAP (correlation coefficient = 0.399), and PaO2 (correlation coefficient = 0.001). Conclusion: This study explored the fluctuations in rSO2 during CABG with CPB and examined its correlations with hematocrit, MAP, PaO2, CPB flows, and temperature. The findings highlight significant correlations among these variables, providing insights into factors influencing cerebral oxygenation during cardiac surgery.
Differentiating of Sepsis-Associated and Sepsis-Induced Acute Kidney Injury in Intensive Care Unit Patients
Authors: Hotabilardus Nusi , Anggraeni Novita
Published: January 2025

Introduction: Acute kidney injury (AKI) is a severe and common complication in Intensive Care Unit (ICU) patients, commonly resulting from sepsis. It is associated with elevated mortality, chronic renal failure, and other long-term consequences. Sepsis-associated AKI (SA-AKI) and Sepsis-induced AKI (SI-AKI), a specific sub-phenotype, differ in their underlying pathophysiology. Objective: To examine the distinctions between SA-AKI and SI-AKI, focusing on their pathophysiology, biomarkers for detection, and associated prognoses in critically ill patients. This literature review examines the findings of randomized control trials (RCTs) or meta-analysis studies that learn about biochemical mediators and biomarkers for SA-AKI and SI-AKI, including NGAL, Kim-1, and others, as well as the prognostic impact of these conditions. The literature was gathered from Google Scholar and PubMed using the keywords Sepsis-Associated Acute Kidney Injury, Sepsis-Induced Acute Kidney Injury, Intensive Care Unit, and Sepsis and published within the last ten years (2018–2023). Articles unavailable in the full text were excluded. Review: SA-AKI and SI-AKI are distinct entities within the broader spectrum of sepsis and AKI. SI-AKI involves sepsis-induced direct kidney damage, which differentiates it from other forms of SA-AKI. Various biomarkers such as NGAL, Kim-1, and others are crucial for early detection and differentiation between these conditions. Patients with SA-AKI and SI-AKI usually have a bad outlook. They are more likely to die, be disabled for a long time, and need longer stays in the ICU and hospital than patients with sepsis or AKI alone. Figuring out the underlying pathophysiology and using the right biomarkers can help with early diagnosis and could lead to better outcomes for patients through targeted therapies. Summary: SA-AKI and SI-AKI represent critical complications in ICU patients with sepsis, leading to high mortality and long-term adverse outcomes. Differentiating between these conditions using biomarkers is essential for early detection and management. These patients have a worse prognosis than those with sepsis or AKI alone. This shows how important it is to keep researching and finding better ways to treat these serious complications in critically ill patients.
Alterações hematimétricas em pacientes hospitalizados por COVID-19 em uma instituição pública universitária do Ceará
Authors: Bringel Marília de Oliveira , Verde Ana Teresa Sobreira Lima , Chaves Ana Vitória Magalhães , Lima Yara Ceres e Silva Ferreira , Nassar Yuri Lopes , Duarte Fernando Barroso
Published: January 2025

Objetivos: identificação das principais alterações hematimétricas e sua associação com desfechos de óbito, cuidados em Unidade de Terapia Intensiva (UTI), uso de ventilação mecânica (VM) e tempo de internação hospitalar, em pacientes internados por COVID-19 no Hospital Universitário Walter Cantídio, no Ceará. Metodologia: foram selecionados 457 pacientes internados com teste confirmatório para SARS-CoV-2 entre janeiro de 2020 a dezembro de 2021. Dados hematimétricos, sociodemográficos e de desfechos foram obtidos através de prontuário eletrônico e analisados de forma descritiva, a partir de testes estatísticos apropriados. Resultados: A maioria dos pacientes encontravam-se em enfermaria (73,96%), eram do sexo masculino (57,33%), com idade média de 57 anos e tempo de internação de 10 dias. A mortalidade foi de 17,94%. Hemograma admissional sem alterações foi visto na maioria dos pacientes, porém desfechos de mortalidade, necessidade de cuidados em UTI, uso de VM e maior tempo de internação hospitalar foram associados a alterações nos parâmetros hematimétricas, principalmente anemia (hemoglobina ≤ 12mg/dL) aumento de leucócitos > 10.000/mm3 e neutrófilos > 7000/mm3 e redução de linfócitos < 1500/mm3 e plaquetas <150.000/dL, com significância estatística. Conclusão: A infecção por SARS-CoV-2 apresenta manifestações importantes no sistema hematopoiético. Anemia, leucocitose, neutrofilia, linfopenia e plaquetopenia foram associados a aumento no número de óbitos, necessidade de UTI, uso de ventilação mecânica e aumento do tempo de internação hospitalar.
Fungi That Live Within Animals: Application of Cell Cytometry to Examine Fungal Colonization of Ambrosia Beetle (Xyleborus sp.) Mycangia
Authors: Joseph Ross A , Bansal Kamaldeep , Nguyen Jane , Bielanski Michael , Tirmizi Esther , Masoudi Abolfazl , Keyhani Nemat O.
Published: January 2025

Ambrosia beetles bore into trees, excavating galleries where they farm fungi as their sole source of nutrition. These mutualistic fungi typically do not cause significant damage to host trees; however, since their invasion into the U.S., the beetle Xyleborus glabratus has vectored its fungal partner, Harringtonia lauricola, which has acted as a devastating plant pathogen resulting in the deaths of over 500 million trees. Here, we show differences in mycangial colonization of the indigenous X. affinis ambrosia beetle by H. lauricola, and the native fungal species, H. aguacate and Raffaelea arxii. While X. affinis was a good host for H. lauricola, the related ambrosia beetle, X. ferrugineus, was only marginally colonized by H. lauricola. X. affinis beetles neither fed on, nor were colonized by, the distantly related fungus, Magnaporthe oryzae. Mycangial colonization was affected by the nutritional state of the fungus. A novel method for direct quantification of mycangial contents based on cell cytometry was developed and validated. The method was used to confirm mycangial colonization and to demonstrate alternating fungal partner switching, which showed significant variation and dynamic turnover. X. affinis pre-oral mycangial pouches were visualized using fluorescent and light microscopy, revealing that newly emerged pupae displayed uncolonized mycangia prior to feeding, whereas beetles fed H. lauricola contained single-celled fungi within 6 h post-feeding. Mixed populations of fungal cells were seen in the mycangia of beetles following alternating colonization. Nuclear counter-staining revealed insect cells surrounding the mycangia. These data highlight variation and specificity in ambrosia beetle-fungal pairings and provide a facile method for direct quantification of mycangial contents.
Induction of DNA Single Strand Breaks and Base Damages by Ultra-High Dose Rate Irradiation
Authors: Wang Yu-Cheng , Zhang Yan , Huang Chen-Yang , Fu Qi-Bin , Huang Tu-Chen
Published: January 2025

Background: The study of different types of DNA damage after ultra-high dose rate irradiation (UHDR) is of great significance for further understanding the mechanism of FLASH effect. Methods: pBR322 plasmid DNA was irradiated by electron FLASH beam. The content of each subtype of plasmid DNA was measured by gel electrophoresis, and the extent of DNA double strand break (DSBs) and single strand break (SSBs) under UHDR and conventional dose rate irradiation (CONV) was quantitatively compared. Further, by adding the endonuclease Nth and Fpg, the extent of base damage in UHDR and CONV group was quantitatively analyzed. In addition, the effects of different plasmid concentrations on the damage degree were also studied. Results: The induction rates of SSBs (×10−3 SSB/Gy/molecule) of UHDR and CONV were 21.7±0.4 and 25.8±0.3, respectively. When treated with Fpg and Nth enzyme, base damage induction rates (×10−3 SSB/Gy/molecule) of UHDR and CONV were 43.3±2.0 and 58.4±4.5, respectively. Additionally, it was found that plasmid concentration also affected the degree of damage, with lower SSB induction at higher plasmid concentration for both FLASH and CONV. For high-concentration plasmids, the induction rates of SSBs of UHDR was still 14% lower than that of CONV. Conclusions: UHDR has significant effect on reducing SSB and base damage compared to CONV regardless of plasmid concentration.
The Comprehensive Evolution of ERP Systems: Classification, Financial Integration, and Future AI Integration
Authors: Chen Bing
Published: January 2025

The evolution of ERP systems from rigid on-premise solutions to agile, cloud-native platforms has revolutionized organizational management. Today, ERP systems span diverse industries and functionalities, from financial management to supply chain optimization. This paper synthesizes the capabilities of prominent ERP systems—SAP, Oracle, MRI, iScala, PeopleSoft, JDE, Salesforce, and QuickBooks—highlighting their roles in financial operations and their readiness for AI-driven transformation. Additionally, this paper explores the application of ERP systems in emerging industries such as fintech and biopharma, where the integration of AI and ERP is becoming increasingly crucial for competitive advantage. Recent advancements in AI, such as the development of more sophisticated machine learning algorithms and natural language processing capabilities, are further enhancing the potential of ERP systems to drive business innovation and efficiency.
The Effect of Mold Flux Wetting Conditions with Varying Crucible Materials on Crystallization
Authors: Nazim Muhammad Anwarul , Emdadi Arezoo , Sander Todd , O'Malley Ronald
Published: January 2025

Understanding mold flux crystallization is essential for evaluating heat transfer during steel casting. In casting, the mold gap's complexity raises questions about the ideal testing method and nucleation type—heterogeneous or homogeneous. This study examines how crucible materials influence mold flux crystallization, focusing on the wetting behaviors of platinum and graphite with mold flux. Confocal laser scanning microscopy (CLSM) was employed to observe in-situ nucleation, and differential scanning calorimetry (DSC) was used under non-isothermal conditions across cooling rates (5–30°C/min) for the flux sample to determine the crystallization temperatures. Results showed significantly lower crystallization temperatures in graphite crucibles versus platinum, with similar trends for synthetic slag and Li2SO4, validated through experimental DSC data and Factsage® simulations. X-ray diffraction (XRD) and scanning electron microscopy- energy dispersive X-ray spectroscopy (SEM-EDS) were utilized to identify crystal phases and interactions between the flux and graphite wall. Graphite’s non-wetting characteristics hindered nucleation, requiring greater undercooling, while platinum’s superior wetting properties facilitated nucleation by lowering surface energy and the free energy barriers. These findings highlight the influence of crucible materials on nucleation behavior, providing valuable insights for refining mold flux testing methodologies and, ultimately, advancing the understanding of nucleation mechanisms during solidification in the casting process.