Mandatory Use Research Articles

Preserving renal function: gliflozins, GLP1 agonists, and antialdosterones.

For a long time, a prognostic and therapeutic fatalism accompanied even the most motivated clinicians when they had to deal with a progressive decline in renal function; the modest successes were nullified by an increasingly aggressive syndrome whose therapy had remained the same for more than 30 years. In the meantime, the increased understanding of the physiopathological mechanisms connected to it had not been accompanied by an equal development of drugs capable of counteracting it, and this, also due to the progressive aging of the population, had rapidly made 'chronic kidney disease' (CKD) a problem of World Public Health due to its incidence, prevalence, and exponentially increasing costs in every part of the world. The progressive reduction of glomerular filtration rate, as has been known for some time, is accompanied by an increase in cardiovascular risk, understood as fatal and non-fatal heart attack, stroke, heart failure, and mortality. Therefore, every effort must be aimed at preventing or slowing the decline of renal function to reduce not only critical renal events (the need for dialysis or transplant among the most feared) but also the incidence of cardiovascular events. Since the disease is asymptomatic for a long time (it is often detected occasionally and with culpable delay), it is essential to make a correct and early assessment of renal function with appropriate methods. Once CKD was identified, clinicians, to slow its progression, could rely for a long time only on strict control of those risk factors most responsible for worsening it, such as diabetes and its complications, on the optimization of high blood pressure values and the mandatory use of drugs blocking the renin-angiotensin-aldosterone system, particularly in the presence of albuminuria. This strategy has proven to be only partially effective over time, and most patients still showed a progressive worsening of renal function. Only in the last few years have we had access to two classes of innovative drugs, such as gliflozins and incretins, that have imposed themselves on the therapeutic scene because they have shown that they can slow the progression of CKD, first in patients with Type 2 diabetes and subsequently in patients with CKD regardless of the presence or absence of diabetes. Unexpectedly and convincingly, they have also shown a significant impact on cardiovascular prognosis. Initially antidiabetic drugs, their efficacy has forced the reviewers of both cardiology and nephrology guidelines to indicate them among the drugs to use. Lately, the class of mineralocorticoid receptor antagonist drugs has been enriched by finerenone. This molecule has favourable pharmacokinetic characteristics compared with previous medications of the same class and tested in Phase 3, randomized, placebo-controlled trials (FIDELIO-DKD and FIGARO-DKD) which has been shown to significantly reduce the risk of cardiovascular and renal disease in diabetic patients compared with placebo.

Trends in Road Traffic Crash Fatalities in Belgrade: A Twelve-Year Retrospective Analysis (2010-2021).

The road traffic crashes (RTCs) are one of the significant public health challenges. According to the latest WHO data, about 1.2million people die as a result of RTCs, making RTCs the main cause of death in many countries. This study assesses road traffic crash (RTC) fatalities in Belgrade, Serbia from 2010 to 2021, utilizing data from the Belgrade Police Department and employing joinpoint regression analysis. Over the period, 1,264 fatalities were recorded with a peak in 2011 (136 deaths) and a reduction to 76 by 2021, indicating a significant annual decrease of -4.4% in mortality rates. Men made up 72.7% of the deaths, with pedestrians being the most affected group (41.0%). There was a notable decline in fatalities among most demographic groups, particularly pedestrians and young adults aged 26-35. The findings highlight a downward trend in RTC mortality, yet the numbers remain concerning. Enhanced enforcement of existing road safety regulations, such as mandatory seat belt use, and targeted measures for vulnerable groups like pedestrians and seniors are recommended to further reduce fatalities.

Prevention and counteraction to corruption in the judicial system of Ukraine: international standards and regulatory regulation

The article clarifies international standards and regulatory regulation of preventing and countering corruption in the judicial system. The system of international acts in the field of preventing and countering corruption is determined; the features of regulatory regulation of preventing and countering corruption in the judicial system of Ukraine are clarified and some ways of its improvement are identified. As a result of the study, it was established that the basis of international legal regulation and legislation of Ukraine on the prevention of corruption and corruption-related offenses in the judicial system are the provisions of such international regulatory documents as – the Civil Convention on Combating Corruption, the UN Convention against Corruption, the Criminal Convention on Combating Corruption (and the Additional Protocol thereto); laws of Ukraine - the Laws of Ukraine «On Prevention of Corruption», «On the Principles of State Anti-Corruption Policy for 2021-2025», «On the National Anti-Corruption Bureau of Ukraine», «On the Judiciary and the Status of a Judge», the Criminal Code of Ukraine and the Code of Ukraine on Administrative Offenses; subordinate legislation - decisions of the Cabinet of Ministers of Ukraine, orders and explanations of the National Agency for the Prevention of Corruption, on the features of the application of anti-corruption legislation; acts of doctrinal interpretation of legislation - decisions of higher judicial instances (the Constitutional Court of Ukraine and the Supreme Court) on the application of anti-corruption legislation in the process of considering cases of administrative or criminal corruption offenses. It has been established that the main shortcomings of national legislation on the prevention of corruption and corruption-related offenses in the activities of a judge (court) are the following: a large number of anti-corruption regulatory acts that use the same concepts but with a slightly different interpretation; hasty and inconsistent adoption of amendments and additions to them; ineffectiveness of Anti-Corruption Programs, most of the provisions of which remain unimplemented due to the lack of either financial support or effective implementation mechanisms; lack of systematization of recommendations on the application of anti-corruption norms; lack of mandatory use of case law of higher courts on the application of anti-corruption legislation in the activities of courts.

Влияние цифровых договоров на регулирование подрядных отношенийв Республике Казахстан

In the article is examinedthe impact of digital contracts on the legal regulation of construction contracts in the Republic of Kazakhstan. An analysis of the current legislation was carried out in the context of its adaptation to modern digital realities, including the possibilities of using digital contracts and electronic digital signatures, as well as electronic document management platforms such as “Documentolog”. The experience of Singapore in the field of digitalization of the construction industry is considered on the example of theCORENET system and the mandatory use of BIM. The author emphasizes the prospects of implementing digital technologies, such as digital construction project management platforms, to increase transparency, optimize processes, reduce costs and minimize risksin contractual relationships. It is noted that digital contracts contribute to increasing the effi-ciency of cooperation between the customer and the contractor, providing an unprecedented level of control. As a key solution, it is proposed to create a state integrated digital platform covering all stages of the construction life cycle, from design to operation, and to consolidate the conceptual apparatus of digital construction, including the “digital contract”, at the legislative level. The introduction of this platform, along with the development of the legal framework, the adaptation of building standards to digital technologies and increasing the digital litera-cy of industry participants, will ensure the sustainable development of the construction industry in Kazakhstan in the context of digital transformation of the economy and increase its competitiveness

Ferry Electrification Energy Demand and Particle Swarm Optimization Charging Scheduling Model Parameters Analysis

Maritime transportation significantly contributes to air pollution, especially in coastal cities. Air pollution represents the greatest health risk related to the environment in the European Union. Therefore, the European Commission published the European Green Deal, which introduces the rule of zero-emission requirements for ships at berths with the mandatory use of power supply from shore or alternative technologies without emissions. The electrification of ferries has proven to be a key approach in reducing the negative impact on the environment; hence, it is necessary to provide adequate infrastructure for charging electric ferries. To determine the energy needs of the shore connection, a daily energy profile of the ferry fleet was created. Due to the sailing schedule, daily energy needs may be non-periodic. By optimizing the charging process, a reduction in peak charging power can be achieved. The charging process was optimized using particle swarm optimization. To improve the function goal, the parameters of the model were analyzed and optimized. It was found that the correct selection of population size and inertia weight factor can significantly enhance the optimization effect. The proposed model can be applied to other ports of interest, considering the specifics of the exploitation of the fleet of ships.

Sex and Gender Identity: Data Collection and Language Considerations for Human Research Ethics Committees and Researchers

Abstract Including women in research and collecting and disaggregating data on sex is an ethical imperative. However, increasingly gender identity is being prioritised over sex in data collection and language which has ethical implications. In this paper, the authors share their experiences as study participants; a health consumer advocate, patient research advisor, and lay researcher; and academic researchers of engaging with researchers, Human Research Ethics Committees (HRECs), university ethics offices, and editors and reviewers of journals regarding data collection and communication on sex and gender identity. We argue that HRECs, researchers, and publishers must carefully consider the implications of omitting data collection on sex, mandatory and universalising gender identity questions and use of desexed language. We also propose that reduced data collection and disaggregation by sex, universal imposition of gender identity, and use of desexed language in research is decreasing data quality, reducing the willingness of some to participate in research and is culturally imperialistic. Recommendations for HRECs are made and research needs in relation to sex and gender identity are outlined. Respect for women in the conduct of research requires their sex-related experiences and needs are considered and therefore that data on sex is appropriately collected and reported upon.

Can we slow down the decline in renal function?

Can we slow down the decline in renal function?

Analysis of prodromal symptoms and need for short-term prophylaxis in angioedema patients under long-term prophylaxis

BackgroundPatients with hereditary angioedema (HAE) experience recurrent, unpredictable episodes of edema. These swellings are often preceded by prodromal symptoms. HAE management includes acute treatment, long-term prophylaxis (LTP), and short-term prophylaxis (STP) before procedures with a risk of swelling. The effects of LTP on prodromal symptoms and the necessity for STP in patients on LTP remain unclear.MethodsA questionnaire-based study involving HAE and AAE patients receiving LTP was conducted. Changes in prodromal symptoms and the incidence of procedures with an increased risk of swelling, including surgeries, dental procedures, and endoscopies were assessed.ResultsA total of 26 patients were included in the study. Among them, 18 experienced zero to three attacks since starting LTP. Abdominal attacks constituted 60% of all attacks, followed by swellings of the extremities and head and neck. The most frequently reported trigger factors were stress and mechanical stimuli, followed by infections. 9 patients reported surgical procedures, with 8 using STP. Of these, 4 experienced breakthrough attacks, including one laryngeal attack. 105 dental procedures were reported, with STP used for only one. Only one angioedema attack occurred after an intervention without STP. For endoscopies, 7 procedures were reported, 3 of which were performed under STP. Two abdominal attacks were reported by the same patient, both without prior STP. Prodromal symptoms remained consistent in type but varied in intensity and frequency under LTP.ConclusionsFor dental procedures, the mandatory use of STP in HAE patients on effective LTP should be reconsidered, provided acute treatment is available and other trigger factors are absent.

The association of state policies and opioid analgesic amount dispensed from retail pharmacies.

The association of state policies and opioid analgesic amount dispensed from retail pharmacies.

The use of ICT in classrooms: The effect of the pandemic

Abstract Although various studies advocate for the integration of information and communication technologies in education, the forced digitization caused by the pandemic has yielded contradictory results on student learning. Conversely, research has shown that when students manage ICT, they achieve better learning outcomes but when teacher-centered approaches are employed, their effects on learning tend to be negative. Has the pandemic crisis served to promote or hinder the integration of ICT in classrooms? Have the uses of ICT changed? This article focuses on whether changes after the mandatory use of ICT in classrooms during the pandemic have favored the integration of digital technologies in classrooms. The analysis of these results has not only practical implications but also theoretical, since they allow us to test the influence of different variables on the change in teaching conceptions and practices. 731 primary and secondary Spanish teachers responded to a questionnaire investigating the frequency with which they used ICT in their classrooms, the type of use they made, and the learning outcomes they promoted. The results showed that teachers reported a higher use of ICT than in previous periods. Also, similar to studies before and during the pandemic, these results indicated a higher frequency of teacher-centered activities, mainly oriented towards the transmission of verbal content. However, this effect seems to have been moderated after the pandemic. There were, however, different teacher profiles reflecting different styles in the educational use of ICT. A critical variable for making student-centered use of ICT seems to be the frequency of use. Those teachers more familiar with ICT tended to make more complex and varied uses, suggesting that their inclusion in teacher training should be an essential step to promote the integration of ICT in classrooms.

AS MÁSCARAS ENTRE A PROIBIÇÃO E A OBRIGATORIEDADE: DIREITO, VIOLÊNCIA E SUBJETIVIDADE

This article outlines considerations on the exercise of democracy and citizenship in Brazil based on bans on the use of masks and other means of covering one's identity during public demonstrations. These bans, a response of the State to the acts that occurred from the "June days" of 2013, associate the use of masks in the midst of such protests with the actions of "vandalism" through anonymity. We seek to address the limits to the effectiveness of law and justice focusing on the effects of the ban on civil rights and citizens' behavior, analyzing the subversive positions of the protesters and the consequences of the curtailment of freedoms on the eve of the 2014 and 2016 "mega-events" in the city of Rio de Janeiro. We contrast this ban to the subsequent mandatory use of masks for personal protection during the Coronavirus pandemic. Attentive both to the violence of the protests and to the violence that occurs against citizens on a daily basis, through public institutions such as the police and the ineffectiveness of laws in the face of justice, we conclude by outlining criticism of how the management of the right produces effects of subjectivity production, highlighting elements that help in the (re)construction of discourses that enable other modes of insertion in the plots of current society.

Implementation of open API technology in the Russian banking sector

The relevance of the research topic is due to the fact that Open APIs have been successfully distributed in the financial sector of Russia, from 2026 their mandatory use by the largest banks is planned, and from 2027 – by other financial organizations. The purpose of the study is to analyze the formation and development of Open APIs in the Russian banking sector based on scientific papers, the results of a survey of respondents, and the experience of foreign countries and to determine the prospects for their further development. The result of the study are systemic proposals for the implementation of a phased implementation of Open APIs in the banking sector; the establishment of uniform software requirements; the adoption of a separate standard dedicated to a unified technology for ensuring information security of Open APIs; to amend the Roadmap "Basic principles and stages of the introduction of Open APIs in the financial market" with mandatory indication of persons responsible for execution of events, deadlines for the implementation of events (with monthly clarification), etc.

Developing a decarbonization policy model of container terminal clusters

PurposeThe purpose of this research is to develop a set of policies to solve the decarbonization issues of container terminal clusters.Design/methodology/approachThis research used the system dynamics approach to develop an integrated multi-issue policy model.FindingsWe found that the mandatory use of low-sulfur fuel can decrease GRDP and container throughput and hinder the growth of companies and workers due to high fuel prices. However, it can contribute to a significant reduction in SOx emissions.Research limitations/implicationsThis research used the Tanjung Priok container terminal cluster in Jakarta, Indonesia, as its case study. Hence, some findings are attached to the characters of this container terminal cluster.Practical implicationsWe found that an integrated policy approach that can tackle technical and social issues can be used to develop a novel approach to solving the complexity that arises in a complex socio-technical system such as container terminal clusters.Social implicationsAs this research used the socio-technical systemic point of view, we found that solutions for major environmental issues should be coupled with significant social programs to (at least) maintain the welfare of society.Originality/valueThis research used the integrated complexity model approach, system dynamics, which can significantly increase society’s ability to tackle multi-issue problems such as decarbonizing container terminal clusters.

INDONESIA’S ELECTRONIC MONEY LANDSCAPE: BETWEEN EFFECTIVITY AND INCLUSIVITY

Technology has transformed payment systems. Regulated digital money transactions are replacing traditional cash transactions. However, policy frameworks on payment systems often neglect to consider the diverse needs of society despite the critical role that payment systems play in society. This can be seen by the increasingly mandatory use of electronic money, which may exclude groups who have relied on traditional cash transactions but have unequal technological access. This paper explores the importance of electronic money accessibility from the perspective of Indonesian court decisions. This study reveals that current implementations, policies, and court decisions regarding electronic money have mainly focused on effectiveness rather than inclusivity. Electronic money was created to help unbaked people access financial services. However, ensuring people have technological access to these services must include everyone. This study recommends that policymakers ensure that electronic money services are accessible to the unbanked and those with limited technology access when promoting their use. On top of that, the government must also reinforce that using rupiah, in any form, remains a legal means of payment and must be respected in all transactions.

In-human Nanofluidic Air Transport through Respirators and Masks

In-human Nanofluidic Air Transport through Respirators and Masks

Iodine deficiency in pregnant women through neonatal tsh assessment study retrospective of neonatal screening in Romania

Iodine is an essential micro-nutrient for the human being taking in account its role in the synthesis of thyroid hormone. In pregnancy it is an increased iodine requirement according to the high metabolic rate and if the iodine requirement is not covered by an adequate intake the pregnant women and the fetus are at risk of iodine deficiency consequences This paper work aims to evaluate neonatal TSH as a marker of iodine status of women in pregnancy, which in pregnant women include, abortion, premature birth, low birth weight, increased perinatal mortality and in newborn impaired brain development and low IQ. Currently, iodine deficiency prevention in Romania is implemented by law 586 /2002 and 1904/2004 which indicate the mandatory iodization of table salt and the mandatory use of iodized salt in the bakery. The neonatal TSH was retrospectively analyzed from MEDILOG neonatal screening registry Romania. The individual TSH values were rated against a threshold of 5 mIU/L from 317449 children enrolled in the screening program for congenital hypothyroidism in 2017, 2018, 2019, 2020 and 2023. In Romania 23.5% of neonates have TSH values above the previous mentioned threshold, fact which enrolls the population as moderate iodide deficient (according to UNICEF, WHO norms). There are differences at different couny level with a iodide deficiency ranking from mild to moderate. There are no differences between endemic and non-endemic areas. The results of this study are discussed in the context of similar works at the national and international level.

AUXILIARY DO IN PERIPHRASTIC CONSTRUCTIONS IN EARLY MODERN ENGLISH

The paper delves into the syntactic changes that occurred during the Early Modern English period, focusing specifically on the mandatory use of the auxiliary verb do in various sentence types, including interrogative, negative, and imperative constructions when no other auxiliary is present. This study is directed towards the process of grammaticalization across various sentence types in Early Modern English, wherein do gradually transitioned from a lexical verb to a crucial auxiliary verb integral to the sentence structure. The analysis highlights both internal linguistic factors and the social factors that played a crucial role in this transformation. The study assumes that the emergence of do as an obligatory auxiliary was not solely a result of gradual linguistic evolution; rather, it was intricately tied to the social context of the time. The sociolinguistic research discusses how social variables like age and gender influence the language variation and change. The grammaticalization is explored within the broader context of the language change, where internal pressures interacted with external social influences to propel the shift toward the Present-Day English syntactic system. The paper provides insights into how both linguistic structure and social forces can interact in shaping the development of grammatical norms in a language over time.

Зоологічні експозиції природничих музеїв: класичне виконання та сучасний підхід

Traditional natural history museums display elaborate stuffed animals in showcases or as part of dioramas. Classic diorama displays are three-dimensional images, with a combination of natural objects and artworks depicting a natural setting. The basis of a zoological diorama is a realistic image of the landscape (a photograph or painting depicting a certain landscape), which serves as a background for the main objects of the exhibition. To create a realistic atmosphere, natural materials such as soil, stones, plants, and trees are used, and stuffed animals in dioramas are made in dynamic poses typical of the species. This means of recreating a part of the natural environment helps to demonstrate the peculiarities of the ecosystem and the atmosphere itself in which the represented animal species live. The author, who has been visiting zoological museums in different cities and countries for many years, has had the opportunity to observe the emergence of fundamentally new approaches to exhibition activities in modern museums, and the impetus was his acquaintance with the Grande Galerie de l’Évolution in Paris, which is part of the Muséum National d’Histoire Naturelle. The Evolution Gallery exhibition is a vivid example of a new approach that skilfully combines the display of stuffed animals and modern technologies to convey information about the principles of evolution, biodiversity, and the role of animals in ecosystems. The Gallery widely uses such technologies as multimedia displays, interactive panels, mobile applications, etc. In fact, the further development of zoological exhibitions is determined by scientific and technological progress, and the development of digital technologies (high-quality cameras, drone technology, and smartphones) has made the process of nature photography more accessible. This provides endless possibilities for involving such materials in exhibition activities, which is facilitated by the variety of social networks and various aggregators of visual and audio information available for exchange and use. Therefore, the production and display of new biogroups and dioramas requires the mandatory use of modern technologies, which increases the attractiveness of the exposition for the modern museum visitor. The most successful examples of the use of new approaches in the design of the exposition are presented and analysed.

Towards Equitable Healthcare: Redesigning Informed Consent Regulations

Informed consent is a fundamental element of ethical and legal healthcare practices, serving as a cornerstone for patient autonomy and equitable care. In Indonesia, informed consent is regulated under frameworks such as Law No. 17 of 2023 on Health, Government Regulation No. 28 of 2024, and Ministerial Regulation No. 290 of 2008. While these regulations establish foundational guidelines, they are limited in addressing contemporary challenges, particularly in the communication of medical information tailored to diverse patient needs. This article examines the gaps in the current regulatory framework, particularly regarding the inadequacies in ensuring patient understanding and participation in medical decision-making. The analysis highlights key shortcomings, including the lack of detailed technical provisions for adapting information delivery to various patient conditions, such as those with disabilities, language barriers, or limited literacy. It argues that these gaps undermine the principles of equity and justice, potentially resulting in consent that does not reflect informed patient choice. To address these challenges, the article proposes regulatory reconstructions emphasizing justice, transparency, and inclusivity. Suggested reforms include the mandatory use of digital documentation, enhanced communication technologies, and support systems such as translators or visual aids for vulnerable populations. By integrating these reforms into the legal framework, the healthcare system can foster a more inclusive informed consent process, enhancing patient trust, autonomy, and equity in medical decision-making. These changes are crucial for bridging the gap between ethical theory and practical application in Indonesia’s evolving healthcare landscape.

Mandatory use of only Persian in Iranian schools

This paper explores teachers’ experiences of using only Persian language in Iranian schools and its consequences. To do this qualitative method and phenomenological approach was employed. Participants included all teachers of K-12 across Sanandaj and fifteen experienced teachers (8 male and 7 female) were selected via purposive sampling. A semi-structured interview was conducted to gather data. Using the Braun & Clarke (Braun and Clarke in Cooper et al.Camic et al.Long et al.Panter et al.Rindskopf et al.Sher (eds), APA handbook of research methods in psychology, American Psychological Association, Washington DC, 2012) framework, thematic analysis was applied for analyzing the data. Despite teachers emphasizing the significance of the mother tongue in various aspects such as Cultural Identity, Sense of Belonging and Communication Knowledge and Skills, they perceive that the educational system enforces a monolingual policy (Persian) through Educational Centralization, Cultural Assimilation, and A Policy of Denying or Neglecting Linguistic Rights. They also highlighted potential consequences of this policy, including Students’ Identity and Cultural Crisis, Intensifying Cultural Duality and Hindered Learning. These findings prompt policymakers to consider language minorities in educational planning.