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Cluster headache (CH) is a common primary headache that severely impacts patients’ quality of life, characterized by recurrent, severe, unilateral headaches often centered around the eyes, temples, or forehead. Distinguishing CH from other headache disorders is challenging, and its pathogenesis remains unclear. Notably, patients with CH often experience high levels of depression and suicidal tendencies, necessitating increased clinical attention. This comprehensive assessment combines various reports and the latest scientific literature to evaluate the current state of CH research. It covers epidemiology, population characteristics, predisposing factors, and treatment strategies. Additionally, we provide strategic insights into the holistic management of CH, which involves continuous, individualized care throughout the prevention, treatment, and rehabilitation stages. Recent advances in the field have revealed new insights into the pathophysiology of CH. While these findings are still evolving, they offer a more detailed understanding of the neurobiological mechanisms underlying this disorder. This growing body of knowledge, alongside ongoing research efforts, promises to lead to the development of more targeted and effective treatments in the future.

Hepatic hydrothorax is a pleural effusion (typically ≥500 mL) that develops in patients with cirrhosis and/or portal hypertension in the absence of other causes. In most cases, hepatic hydrothorax is seen in patients with ascites. However, ascites is not always found at diagnosis and is not clinically detected in 20% of patients with hepatic hydrothorax. Some patients have no symptoms and incidental findings on radiologic examination lead to the diagnosis of the condition. In the majority of cases, the patients present with symptoms such as dyspnea at rest, cough, nausea, and pleuritic chest pain. The diagnosis of hepatic hydrothorax is based on clinical manifestations, radiological features, and thoracocentesis to exclude other etiologies such as infection (parapneumonic effusion, tuberculosis), malignancy (lymphoma, adenocarcinoma) and chylothorax. The management strategy involves a stepwise approach of one or more of the following: Reducing ascitic fluid production, preventing fluid transfer to the pleural space, fluid drainage from the pleural cavity, pleurodesis (obliteration of the pleural cavity), and liver transplantation. The complications of hepatic hydrothorax are associated with significant morbidity and mortality. The complication that causes the highest morbidity and mortality is spontaneous bacterial empyema (also called spontaneous bacterial pleuritis).

BackgroundThe rich tapestry of student politics and movements in Bangladesh is marked by a history of significant contributions to the country's sociopolitical landscape. This study was prompted by a keen interest in exploring the dynamics of contemporary student movements at Bangabandhu Sheikh Mujibur Rahman Science and Technology University (BSMRSTU), Gopalganj, and their interplay with the broader sociopolitical climate of Bangladesh. A critical examination of these movements reveals a complex web of motivations, strategies, and outcomes that both mirror and influence national sociopolitical dialogues.MethodsEmploying qualitative research methods, including in-depth interviews (IDI) with 26 individuals directly affected by the culture and mechanics of these movements, this study uncovers the nuanced ways in which student activism at BSMRSTU mobilizes cultural ideologies toward societal change. Purposive and snowball sampling techniques were utilized to select participants, revealing that the rhetoric of movements—framed around justice, rights, equality, and reform—plays a crucial role in recruiting and energizing participants.ResultsHowever, this investigation also highlights a darker facet of these movements: the destructive consequences of specific actions, such as property damage, which not only impact the immediate community but also fuel further unrest. The prevalence of movements centered on themes of injustice underscores the urgent need for both governmental and academic institutions to engage more constructively with student concerns. Addressing this gap requires a nuanced understanding of the motivations behind student movements and a commitment to implementing policies that nurture a culture of dialogue and reform.ConclusionThis study, therefore, problematizes the contemporary student movements at BSMRSTU by questioning the balance between activism and the potential for unintended consequences, urging a reevaluation of how such movements are perceived and managed in the context of Bangladesh's evolving sociopolitical milieu. For harmful movement culture in academia to be prevented, government and university authorities must take student movements seriously and implement policies and strong norms.

Sebagai penghafal Al-Qur’an memiliki sifat istiqomah adalah sebagai sebuah keharusan. Dan pada prosesnya ada beberapa kendala yang di alami dalam perwujudan sikap istiqomah dalam menghafal. Tujuan dari penelitian ini adalah untuk Mengetahui bagaimana perilaku istiqomah pada proses menghafal al-Qur’an, serta faktor penghambat dan pendukung, dan bagaimana manifestasi QS: 46 (13-14) pada upaya membangun perilaku istiqomah pada proses menghafal al-Qur’an di SD Takhassus Al-Qur’an Wonosobo. Penelitian ini adalah studi tentang latar belakang situasi yang dirinci secara intensif dan interaksi individu, sosial, dan kelompoknya.. Hasil penelitian ini menunjukan Manifestasi ayat dalam QS: 46 (13-14) dapat meningkatkan semangat anak agar tetap istiqomah dalam menghafal al-Qur’an dengan didasari dan didukung oleh peraturan sekolah dan asrama serta asatidz dan pembina kamar yang selalu mendampingi dan menjadi juru kunci kesuksesan dalam pengamalan ayat ayat al-Qur’an agar bisa di amalkan kepada anak dalam proses menghafal al-Qur’an.

Jun Liu,1,* Yi Zhang,2,* Jianpeng Cai,2,* Lingyun Shao,2 Xiufeng Jiang,3 Xiaohong Yin,4 Xinguo Zhao,4 Sen Wang2,5 1Department of Laboratory medicine, Wuxi Fifth People’s Hospital Affiliated to Nanjing Medical University, Wuxi, People’s Republic of China; 2Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital Affiliated to Nanjing Medical University, Wuxi, People’s Republic of China; 4Department of Tuberculosis, Wuxi Fifth People’s Hospital Affiliated to Nanjing Medical University, Wuxi, People’s Republic of China; 5Huashen Institute of Microbes and Infections, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sen Wang; Xinguo Zhao, Email wangsen329@126.com; zhaoxg0469@sina.comBackground: Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens leading to pulmonary tuberculosis (PTB) co-infection, but the data of co-infections is scarce. This research aimed to study the clinical and microbiological characteristics of K. pneumoniae co-infections in pulmonary tuberculosis cases.Methods: Clinical manifestations and examination results of PTB cases co-infected by K. pneumoniae were retrospectively collected from the medical record database of a tertiary teaching hospital in China between November 2019 and October 2021. The K. pneumoniae strains isolated from the patients were sent for whole-genome sequencing. Statistical analyses were conducted using Stata v.14.0.Results: A total of 80 strains were collected from 76 PTB patients with K. pneumoniae co-infections (two strains were isolated from each of the four patients at different time points), including 37 primary and 39 retreated TB cases. Among these, 29 (36.3%) of the K. pneumoniae isolates were extended-spectrum β-lactamase (ESBL)-producing strains, and seven (8.8%) were determined as carbapenem-resistant Enterobacteriaceae (CRE) strains. We found that patients in the multidrug resistance (MDR)-group received more respiratory support than the non-MDR group (40.6% vs 18.2%, P= 0.031) and possessed higher elevated C-reactive protein (62.6% vs 41.8%, P=0.008) and lower haemoglobin (87.5% vs 47.7%, P=0.001). We found that 80.3% (61/76) patients had lung lesions and 57.8% (44/76) patients were immunocompromised within one month. The most common K. pneumoniae strain sequence type was ST23 (15%), followed by ST15 (12.5%) and ST273 (7.5%). Among the strains, 26.25% were classically hypervirulent K1/K2 K. pneumoniae, and all carried salmochelin and rmpA.Conclusion: This study demonstrated the important clinical features, phenotypic and genomic characteristics of isolated strains of PTB patients with K. pneumoniae co-infection. These data suggested a special attention for multidrug resistant K. pneumoniae infections with more obvious inflammatory responses which calls for more respiratory support and timely clinical management.Keywords: Klebsiella pneumoniae, tuberculosis, co-infection, manifestation, multidrug resistant

Humans and the environment are inseparable partners. The environment is our home, where we live and interact with everything around us, both living and non-living. Allah SWT has created this environment to meet our needs, as we depend on it for our survival. This shows how crucial it is for us to treat our environment wisely, ensuring it can continue supporting us. However, not everyone treats the environment wisely. Sometimes people prioritize their own interests without considering the long-term health of nature. This can lead to resources running out or becoming damaged. This article explores how the teachings of Prophet Muhammad SAW guide us in preserving the environment, both through what he said and what he did. Prophet Muhammad SAW’s guidance encourages us to act responsibly when using the environment. These teachings also highlight that we are responsible for taking care of the environment, as Allah SWT has chosen us to look after it. Allah SWT knows that humans can be greedy and harm nature. So, Allah SWT has rewards and consequences based on how we treat the environment. When we follow Islamic teachings, we are rewarded, and when we disregard them, there are consequences. Following these teachings means thinking about the environment’s long-term well-being. It means taking positive care of nature so that all of Allah SWT’s creations—living things and the environment—can thrive. Ultimately, this approach benefits us, leading to a complete, beautiful, peaceful, healthy, and refreshing environment

A proposition or logical proposition is the smallest unit of knowledge defined as “justified true belief”. Some Qur'anic verses are a single proposition and some contain several propositions. Quranic propositions are sometimes religious laws. Sometimes they are moral and sometimes they are philosophical. In the same way, sometimes Quranic propositions are mystical. What are the criteria and indicators of the mystical nature of Quranic propositions? This question is the main question of this article. According to the findings of this study, being related to the unity of existence in the true and defensible sense, being related to the unity of divine acts, denoting multiple mystical worlds, denoting a descent arc and an ascent arc, denoting the stream of consciousness and knowledge in the whole existence, etc.,… are some of the criteria for being mystical propositions in the Qur'an. It should be noted that in this article theoretical mysticism is the basis of the discussion and practical mysticism requires its own independent writing.

Land disputes have significantly disrupted legal order, production, and social harmony, and has been regarded as a quintessential challenge in public governance, attracting worldwide attentions from scholars. As an emblematic feature of China’s latest reform and opening-up strategy, the Yangtze River Economic Belt (YREB) in China has experienced rapid development after entering the new era (2012–2021) alongside substantial risks and challenges, particularly regarding land disputes. Better understanding of the manifestation and formation mechanism of new characteristics of land disputes is beneficial for contemporary public governance and for achieving a high-quality development of the YREB, whose Gross Domestic Product (GDP) accounted for 46.3% of the national GDP in 2023. A total of 325,105 land dispute cases in 11 provinces or municipalities of the YREB from 2012 to 2021 were collected and analyzed. On this basis, an evaluation index system of the new characteristics of land disputes, named the overall land dispute (OLD) index, was constructed according to measurement theory by coupling the interactions of quantity, claim amounts, duration periods, and the appeal rate of land dispute. Then, the OLD index was evaluated by descriptive statistical methods, a geographic information system (GIS) spatial analysis, a center of gravity model, kernel density estimation, and Theil index methods, to reveal the new characteristics and formation mechanisms of land disputes in the YREB from 2012 to 2021. The results indicated that: (1) The OLD index exhibited a trend of an initial increase followed by a decline, indicating that land disputes in the YREB showed signs of alleviation. (2) The government’s capacity for resolving land disputes was significantly improved, as evidenced by the decline in the OLD index from 0.59 in 2018 to 0.51 in 2021. This improvement could be attributed to the effectiveness of enhanced governmental working mechanisms, regulatory standards, and the integration of digital technologies. (3) The analysis of the center of gravity model indicated that the focus of land disputes shifted westward, propelled by national policy support for upstream regions of the YREB and the need for land ecological protection. (4) The analysis of kernel density estimation indicated that regional disparities in land disputes within the YREB had declined, driven by a positive trend toward balanced regional development and rural governance. This study provides scientific insights into the new characteristics of land disputes in the YREB and guidance for policy decision making on effective land dispute management.

BACKGROUND: Type 1 diabetes mellitus (T1D) is an autoimmune disorder that leads to pancreatic β-cells destruction and progressive decrease of insulin secretion. Specific islet autoantibodies (AAbs) are the main diagnostic marker of T1D. Residual β-cell function, as measured by C-peptide, has repeatedly been demonstrated to be clinically important.AIM: To study the frequency and levels of residual C-peptide secretion and persistence of pancreatic AAbs in children with T1D with different duration and age of manifestation of the disease.MATERIALS AND METHODS: The levels of C-peptide and AAbs to ZnT8 (zinc transporter 8), AAbs to IA-2 (Insulinoma Antigen 2), AAbs to GAD (Glutamate Decarboxylase), IAA (insulin autoantibodies) were measured. Patients were divided into 3 groups depending on the duration of T1D (1st — 5 years) and age of manifestation (A — prepubertal and B — puberty).RESULTS: The median duration of T1D was 1.8 [0,8;3,9], 76.3% out of 1333 patients were seropositive, 40% had residual levels of C-peptide. With disease duration there were a decrease in AAbs+: 1st group 74%, 2nd group 69%, and 3rd group 48%. In all groups, percentage of patients with positive levels of one or more AAbs was significantly higher in children with T1D manifestation at puberty. GADA and ZnT8A were more common in the first year of the disease. IA-2A were observed with the same frequency in the group of adolescents. IAA were more common in patients at prepubertal age. An undetectable level of C-peptide was observed significantly higher in children with T1D manifestation in prepubertal age (p

17. yüzyıl Türk edebiyatının önde gelen mutasavvıf şairlerinden olan Niyâzî-i Mısrî, Halvetiyye tarikatının Mısriyye kolunun kurucusudur. Yaşadığı dönemden günümüze değin tasavvuf ehlinin öncülerinden olmuş, Dîvân’ı başta olmak üzere kaleme almış olduğu tüm eserleriyle Türk İslam Edebiyatı alanına büyük katkı sağlamıştır. Tasavvuf Edebiyatı çizgisinden ayrılmayan şair, başta Dîvân-ı İlâhiyât olmak üzere eserlerinin neredeyse tümünde tasavvuf düşüncelerine yer vermiştir. Çalışmamızın amacı, Niyâzî- Mısrî’nin şiirlerinde mündemiç olan insan tasavvurunu ortaya koymaktır. Tasavvufta insan, ahsen-i takvîm olması ve yeryüzü halifesi sırrına mazhar olarak Yüce Allah’ın tecellîlerini taşıması hasebiyle mükemmel bir varlıktır. İnsana atfedilen bu özellik geçmişte ve günümüzde tetkik konusu olmakla birlikte, birçok esere de konu olmuştur. O, âlemin tüm hakîkatlerini kendinde toplamıştır ve bu nedenle “küçük âlem” olarak anılmıştır. Niyâzî-i Mısrî, İbnü’l-Arabî’nin tasavvuf görüşlerinden ziyadesiyle etkilenmiş, başta insan ve vahdet-i vücûd görüşleri olmak üzere birçok görüşünü onun görüşleri üzerine temellendirmiştir. Mamafih vahdet-i vücûd düşüncesinin en önemli figürü olan insanın âlemdeki yeri ve önemi üzerinde sıklıkla durmuş, tasavvufta insan ile birlikte tecellî, vahdet-kesret, seyr u sülûk, insân-ı kâmil, varlık mertebeleri, irfan, nefs, hayret gibi kavramlar da eserlerinin ana temalarından olmuştur. Onun benimsediği bu vahdet-i vücûd düşüncesine göre Allah’ın vücûdundan gayrı bir vücûd yoktur. Yüce Allah dışındaki tüm varlıkların varlığı mecazidir. O nedenle bu görüşü benimseyen her sûfi, manevi bir yolculuk olan seyr u sülûk ile kendi benliklerinden sıyrılarak tek vücûd sahibinin Allah olduğu hakîkatine erişmelidir. Bu yolculuk sayesinde Niyâzî-i Mısrî, insanın kendi nefsinde gizli olan ledün bilgisine de ulaşabileceğini savunur. Kâinatta vuku bulan bütün olaylar, Yüce Allah’ın ism-i şeriflerinin tezahürü neticesinde gerçekleşmiştir. Niyâzî-i Mısrî, Allah’ın isim ve sıfatlarının insanda tecellî etmesini ayna metaforu kullanarak açıklamıştır. Allah, isimlerini kainattaki varlıklar içerisinden insanda aksettirmiştir. Bundan ötürü tasavvufta insan, Yüce Allah’ın cemal sıfatını taşıyabilen yegâne varlık konumundadır. Bir tarikat piri olan şair, tasavvufun gerekli kıldığı halleri hayat düsturu edinmiş, ona göre yaşamış ve bu yaşantı neticesinde dünyanın ruhun zindanı olduğu kanısına varmıştır. Hakîki mutluluğa ise nefsini fena ederek maddi âlemden uzaklaşmak sûretiyle kavuşabileceğini savunmuştur. Ve bunun için nefsin mertebelerinin, manevi yolculuğa çıkılarak geçilmesi gerektiğini ifade etmiştir. Niyâzî-i Mısri, insanı akıllı ve kâmil dereceye ulaşabilme kuvvetine sahip olmasından dolayı yaratılmış varlıklardan daha üstün kabul etmiştir. O, Yüce Allah’ın kendisine atfettiği değer neticesinde varlığın ve varlığının hakîkatini idrak edebilen insanı, bu dünyadaki amacını gerçekleştirmiş olarak nitelendirmiştir. Niyâzî-i Mısrî’nin insan telakkisini idrak edebilme açısından hazırlanan ve eserlerinin ana temasını oluşturan vahdet-i vücûda ve binâenaleyh sıklıkla yer verdiği insan ve âdem kavramına yaklaşımı çözümlenmeye çalışılmış olan bu çalışma, aynı zamanda âlem-insan ilişkisi ve insân-ı kâmili anlama hususunda alana katkı sunmayı hedeflemektedir.

Relevance. In recent years, there has been an increase in the prevalence of allergic rhinitis (AR) in children, which varies depending on the child's age, region of residence, the presence of comorbid allergic diseases and other risk factors.Purpose of the study. To study the nature of comorbid allergic diseases, their manifestation in children of 7–8 years of age with allergic rhinitis on the basis of the data of parental questionnaires.Materials and methods. A survey of parents of first-graders in 3 schools in Smolensk, located in different districts of the city, was carried out. In total, 400 questionnaires were handed out, 379 (94,75%) were returned filled. The average age of children was 7.7±0.02 y.o. The questions in the questionnaire included physically verified diagnoses of allergic diseases, risk factors, heredity, age of children at the time of manifestation of an allergic disease, the presence of comorbid allergic diseases in children with AR. The questionnaire was approved at a meeting of the «Pediatrics» section of the Ethics Committee of the State Budgetary Educational Institution of Higher Professional Education of the SSMU of the Ministry of Health of the Russian Federation dated 25.03.2017. Statistical processing was performed using the Microsoft Excel software package and 95% confidence intervals.Results. It was found that in a cohort of 7–8 year old children in Smolensk, the incidence of AR is 18.2%, atopic dermatitis — 11.9%, bronchial asthma — 2.9%, food allergy — 12.2%, insect allergy — 12.4%, allergic conjunctivitis — 3.97%, drug allergy — 15.6%, allergic contact dermatitis — 4.5%. Analysis of the data obtained in children with AR showed that the manifestation of year-round AR is mainly observed at the age of 2 to 5 years, and seasonal AR — from 3 to 5 years and older than 5 years. It has also been shown that multimorbidity is present, i.e. combination of AR with other allergic diseases; in particular, with atopic dermatitis in 47.8% of cases, bronchial asthma in 10.1%, food allergy in 30.4%, allergic conjunctivitis in 15.9%. One third of children with AR have comorbid diseases of a non-IgE-dependent or mixed mechanism, such as drug allergy, insect allergy, and every tenth child has allergic contact dermatitis. The manifestation of comorbid allergic diseases took place at different age periods, which indicates multimorbidity in children with allergic rhinitis.Conclusion. The results of our study show that AR is the most common allergic disease in children of 7–8 years of age living in the city of Smolensk. In almost half of the cases, AR is characterized by multimorbidity. This fact must be taken into account when developing individual tactics for managing children with AR.

Freedom of assembly has several historical roots. In early times, freedom of assembly was closely linked with the right to petition, that is, the self-interest of citizens and the public good were directed against the monarch. In consultative forms of direct democracy, the use of individual institutions of freedom of assembly in public and political processes is very important. Thus, for people to be able to exercise their public rights, they can effectively influence political power through the institution of freedom of assembly, in a consultative form. This is one of the main means of balancing the activities of political power. The freedom of assembly is guaranteed by legal guarantees and corresponding restrictions of the Constitution and international agreements. The main goal of the state is to take appropriate measures for peaceful and free assembly without weapons. The principle of equality cannot be violated in the exercise of this right to freedom. "Assembly" means a temporary gathering of several people in public places for political purposes, which may take the form of public events, rallies, pickets, tent cities, demonstrations, street processions, etc. A person or a group of persons organizing various forms of freedom of free assembly must receive official approval in advance from the executive authority or notify them about the relevant measure. The warning should be justified by the organizers and its purpose should be explained. In holding these mass events, the will of the people should be accepted as the main factor, and the requirements of the law should be strictly followed. The development dynamics of consultative forms of democracy directly depend on the level of democratic statehood of those democratic states. One of the main factors here is the presence of civil solidarity and the state's liberal legislative system. In the application of the freedom of free assembly, the expression of opinion and will of the people and a part of it, as one of the means of influencing the political power, these processes take place in the same direction as the process of democratic development of the state. These political institutions are one of the people's opportunities to control democratic processes and develop them continuously.

ObjectiveSpontaneous isolated abdominal aortic dissection (SIAAD) is a rare aortic emergency and not yet fully understood. This study aims to report the characteristics and treatments of 31 patients with SIAAD in the past 12 years.MethodsA total of 31 consecutive patients with SIAAD between 2010 and 2022 were included. The clinical manifestations, treatment strategies, and outcomes were reviewed. Following the SVS/STS reporting standard, we compared the clinical characteristics with different locations of primary entry, or different numbers of dissected zones. Furthermore, we compared the effects of surgical and conservative therapies on the outcome during the follow-up.ResultsAmong the 31 patients with SIAAD, 16 (51.6%) were in the acute phase on admission. The primary entry of SIAAD was mainly located in Zone 9 (67.7%). Most patient presented with dissection involving 1 or 2 aortic zones (61.3%). In addition, 35.5% and 64.5% of SIAADs involved the visceral and iliac arteries, respectively. Compared with asymptomatic SIAADs, the symptomatic ones had longer dissection lengths (P = 0.008) and tended to involve iliac artery more frequently (P = 0.098). There were differences in the number of dissected aortic zones (P = 0.005) among patients with primary entry located in Zone 5 (Supraceliac aorta), Zone 6–8 (Paravisceral aorta) and Zone 9 (Infrarenal aorta). The involvement of visceral artery (P = 0.039) and iliac artery (P = 0.006) was significantly different between the subgroups of SIAAD involving one, two, and three or more aortic zones. The cumulative incidence of adverse false lumen progression events was significantly lower (P = 0.000) and the rate of false lumen thrombogenesis or disappearance was higher in patients receiving surgery (P = 0.001). The cumulative all-cause mortality was 9.7% at 1-year, and 19.7% at 5-year, with no significant difference between surgical and conservative therapies.ConclusionsClinical features of SIAAD vary depending on the location of the primary entry and the number of dissected aortic zones. Although surgery was not associated with a lower all-cause mortality compared with conservative therapy, it was associated with a lower incidence of adverse false lumen progression and a higher rate of aortic remodeling.

Head and neck infection (HNI) can lead to life-threatening complications, including death. The purpose of this study is to look at the entire clinico-demographic profile of patients with HNI as well as the microbiologic profile of recurring bacterial infection cases with a variety of symptoms. A retrospective cross-sectional study was conducted on 1080 HNI patients in a tertiary care hospital in Bhubaneswar, Odisha, India, from January 2018 to December 2022. Of the 1080 cases, 771 (71.39%) were males, 309 (28.61%) were females, and 603 (55.83%) were from rural areas reporting to a tertiary care hospital. 62% of the cases were between the ages of 31 and 60. Neck abscesses account for 570 (52.78%) of all cases, with parotid abscesses accounting for 233 (21.57%), peritonsillar abscesses accounting for 170 (15.74%), otitis media 32 (2.96%), and oral cavity infection accounting for 26 (2.41%). In 854 (79.07%) cases, the etiology was odontogenic, followed by sinus in 188 (17.41%) and otogenic in 38 (3.52%). The most common presenting features were neck swelling in 537 (49.72%) cases and face swelling in 238 (22.04%) cases, followed by jaw pain in 26 (2.41%) cases and others. Patients were hospitalized for an average of 11.824.38 days. Treatment and recurrence had a strong significant relationship (p 0.001). Microbiologic investigation of recurrent patients revealed 12 microorganisms, including bacteria and fungus, mainly multidrug-resistant in given ascending order Staphylococcus aureus (26.74%), Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, Candida albicans (4.65%), Aspergillus fumigatus, A. flavus, A. niger, C. tropicalis, C. glabrata, C. krusei. Apart from colistin, almost all antibiotics were highly resistant to gram-negative bacteria, whereas against S. aureus, benzylpenicillin, and oxacillin showed 100% resistance, followed by erythromycin (91.3%), levofloxacin (86.96%), and ciprofloxacin (82.61%). This exploratory study would aid in determining the HNI burden and epidemiology, as well as their treatment status.

Tarih boyunca futbol oynandığı her dönemde toplumları etkileyen önemli bir rekabet ve görsel şölen olmuştur. Başlangıçta askeri talim ve üst düzey sınıfı eğlendirmek amacıyla ortaya çıkan futbol, zamanla kurumsallaşma açısından önemli bir ilerleme kaydederek çağımızın popüler spor oyunlarından birisi haline gelmiştir. 19. yüzyılından itibaren küreselleşme ve kitle iletişim araçlarındaki gelişmeyle beraber daha geniş bir halk kitlesine ulaşmaya başaran futbol artık günümüz dünyasında ülkelerin rekabet alanlarından birisi haline gelmiştir. Bu sportif faaliyetlerden birisi olan futbol, insani bir girişim olması hasebiyle içinde birçok kültürel öğeyi bünyesinde barındırmaktadır. Futbol bu özelliği sebebiyle basit bir oyundan öte pek çok sosyal, ekonomik ve kültürel olguyla ilişkilendirilen ve anlamlandırılan bir oyun hâline gelmiştir. Bugün ülkelerin futbol ile olan ilişkileri incelendiği zaman kendi milli takımlarının başarısında büyük pay sahibi olan futbolcuların, üstün futbol yeteneği sayesinde adeta mitleştirilerek içinde yaşadıkları toplumun gözünde sıradan insanlardan farklı konumda değerlendirildiği görülmektedir. Amacı kutsalın futboldaki tezahürlerinin tespit edilmesi olan bu çalışmada, dokümantasyon metodu kullanılmıştır. Bu çerçevede tespit edilen kavram ve semboller etnometodolojik analize tabi tutularak yorumlanmıştır. Bu çalışmada tespit edilen en önemli husus post-modern çağda bireylerin veya grupların kutsalla olan ilişkisini geleneksel dini kurumlar olmadan da bir şekilde devam ettirmeleridir.

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. In December 2019, cases of pneumonia with unknown cause were first reported in Wuhan, Hubei Province, China. Confirmed cases and death rates due to COVID-19 in the world are still increasing. One part of the body that is affected and causes clinical symptoms in COVID-19 is the skin. This review aims to describe and analyze cutaneous manifestation in COVID-19. This study method is a review of the literature sourced from Google Scholar and PubMed. The literature was selected using English language criteria, using the clinical study method in the form of case reports. Meanwhile, literature review, systematic literature, and meta-analysis were excluded. Journal searches were carried out using the keywords "skin" OR "cutaneous" AND "manifestation" AND "COVID-19" OR "coronavirus". The skin manifestations of COVID-19 have been observed. The most common clinical symptoms of COVID-19 were fever (47%), dry or productive cough (25%), sore throat (16%), generalized sore throat (6%), and pain (5%). However, currently there has been a shift in the approach to diagnosing COVID-19 because it can cause symptoms in other organ systems, one of which is skin manifestations. There are early reports of skin involvement (erythematous rash, extensive urticaria, and chickenpox-like vesicles) occurring in 20% of patients in the course of the COVID-19 disease. In addition, several case reports provide descriptions of petechiae and chilblains. Based on the cases that have been reported, patients with COVID-19 who have manifestations on the skin can give a picture of maculopapular eruptions, vesicular eruptions, petechiae, and also childblains.

Iqbal considers love as the basis of life. The wonderful manifestation of universe is driven by love. Iqbal's fundamental philosophy is selfhood. Life cannot sustain it- self without love. Love is the basic passion of a man's life. It is the enhanced form of affection. There is elegance and exhilaration in the realm of water and earth due to love. The power of conquest owes to love. Love, the force that is free from the limits of time and space. Cannot be guaged with the measuring stick of day and night. In a nutshell love is the key to the whole universe. Love is the ecstasy of life and under it is covered man's glory. The foundation stone of every magnum opus is laid on love. Love is the essence of life. Love brings vitality to life and makes one understand the way of life

The present article proposes a reading key to understand the structural role of knowing and truth, exposed by Hegel in the introduction of the Phenomenology of Spirit, starting from the Kantian principle of apperception and the notion of the manifold without any further. It will be seen that this leads to an original excision that Hegel first rejects in the writing on Difference, but which he must then assume in the introduction to the Phenomenology in order for this project to take on consistency.

Background: Several studies have reported prolonged symptoms especially neurological symptoms following acute infection in patients with COVID-19, known as long COVID-19. There are only few studies investigating this population and relatively less known, including nervous system involvement. A systematic review and meta-analysis of these studies are required to understanding the prevalence of persistent neurological manifestations after COVID-19. Objective: To conduct a systematic review and meta-analysis on the persistent neurological manifestations in COVID-19 survivors. Methods: Authors conducted a literature search through PubMed and MedRxiv from January 1st, 2020 to October 2021 according to PRISMA guideline. Furthermore, the authors added additional sources by reviewing related references. Studies presenting the neurologic features of long COVID-19 patients in their data were included. Case reports and case series also included in this review. The quality of the studies was assessed based on the Oxford Centre for Evidence-Based Medicine guidelines. Selected studies were included in the meta-analysis of proportion and heterogeneity test. Findings: From 128 identified studies, 36 were eligible, with 9944 participants included. Most of the included studies had mean duration of follow-up after COVID-19 onset of less than 6 months. Fatigue was the most common (52.8%, 95%CI 19.9 – 84.4) symptoms of long COVID, followed by cognitive disorder (35.4%, 95%CI 2.1 – 81.7); paresthesia (33.3%, 95%CI 2.7 – 76.6); sleep disorder (32.9%, 95%CI 6.5 – 67.4); musculoskeletal pain (27.8%, 95%CI 12.7 – 46); and dizziness (26.4%, 95%CI 4.6 – 57.9). Conclusion: Neurological manifestations are prevalent and persisting in patients with long COVID. The duration of the symptoms are vary among literatures. However, the frequency are mostly observed during the first six months after the illness onset.

Coronaviruses are a large family of enveloped RNA viruses found in numerous animal species. They are well known for their ability to cross species barriers and have been transmitted from bats or intermediate hosts to humans on several occasions. Four of the seven human coronaviruses (hCoVs) are responsible for approximately 20% of common colds (hCoV-229E, -NL63, -OC43, -HKU1). Two others (SARS-CoV-1 and MERS-CoV) cause severe and frequently lethal respiratory syndromes but have only spread to very limited extents in the human population. In contrast the most recent human hCoV, SARS-CoV-2, while exhibiting intermediate pathogenicity, has a profound impact on public health due to its enormous spread. In this review, we discuss which initial features of the SARS-CoV-2 Spike protein and subsequent adaptations to the new human host may have helped this pathogen to cause the COVID-19 pandemic. Our focus is on host forces driving changes in the Spike protein and their consequences for virus infectivity, pathogenicity, immune evasion and resistance to preventive or therapeutic agents. In addition, we briefly address the significance and perspectives of broad-spectrum therapeutics and vaccines.

Pheochromocytoma (PHEO) manifestation can be triggered by many different factors, including infectious diseases. In 2019, measles continued to spread in global outbreaks around the world. According to WHO data, more than 60 % of all measles cases in European Region were reported in Ukraine, a leader in measles occurrence. Measles is a dangerous viral disease, which remains an overwhelmingly important problem for healthcare system. Measles cause various life-threatening complications, which not only affect patients’ health and decrease quality of their lives, but can also lead to onset of many other medical conditions. Authors provide an example from their own clinical experience, which they have observed during the measles outbreak. Patient D., 22 y.o., female, was admitted to Lviv Infectious Diseases Communal Clinical Hospital because of measles. Condition was followed by severe intoxication, fever, hacking cough, skin rash all over the body. On 4th day after the appearance of rash patient developed atypical hypertensive crisis: in supine position started severe tachycardia, thumping headache, tremor of proximities and whole body, arterial blood pressure increased to 180/110 mm Hg; after changing the sitting position, symptoms started slowly decrease, in this regard patient had to spend a few days crouched in bed, she also complained about exaltation, insomnia, psychic tension, asthenia. Patient has undergone surgical treatment — laparoscopic left adrenalectomy. Perform differential diagnostics of hypertension accurately, paying special attention to determining its’ reason. Take into consideration, that PHEO manifestation and hypertonic PHEO crises can be provoked by multiple reasons. If PHEO is suspected, hormonal, visualization and morphological examination methods should be performed. Keep in mind, that PHEO can be a constituent part of number of hereditary diseases: MEN 2A, MEN 2B, Von Recklinghausen’s Disease (Neurofibromatosis 1), Von Hippel-Lindau syndrome and can be possibly malignant.

The difference between revelation and natural reason seems to be as obvious as it is indestructible. Despite this conventional view, Eric Voegelin claims that this difference must be “swept aside” and “cleared away” as it obscures the sphere of original meaning and manifestation and posits the divine as an object. According to Voegelin, through recourse to the ancient philosophers Plato and Aristotle, we can discover that there is no natural reason at all but instead: “reason is firmly rooted in revelation.” Obviously, this requires a reinterpretation of revelation. It can neither be equated with the content of the Holy Scripture nor should it be confined to the manifestation of God in Jesus Christ. Rather, claims Voegelin, we ought to think of it as a primordial attraction, a movement drawing into the search for truth and the ground of reality. Such an approach may raise objections and provoke accusations of either subordinating philosophy to theology or misusing the language. As I attempt to show in the article at hand, Voegelin insists on revelation because it designates the original manifestation of the ground, and both faith and philosophical elucidation are two modes of responding to this appearing.

Background: Individuals diagnosed with schizophrenia or bipolar affective disorder (BAD) are not always violent or make violent responses. However, psychiatric disorders such as schizophrenia and BAD are associated with violent acts of patients in various forms such as physical, verbal, and emotional violence. The victims to these violent acts by individuals suffering from schizophrenia or BAD are the caregivers most of the times. In addition, the treating team experiences violence by psychiatric patients during their stay in the hospital, especially in the initial days of hospitalization. Materials and Methods: This study was a cross-sectional, descriptive research. A total of 104 caregivers were selected for the study as per the inclusion and exclusion criteria. Sociodemographic and clinical details were collected through semi-structured interview schedule. Data were collected including sociodemographic details, Family Violence Scale, Family Burden Interview Schedule, and Depression Anxiety and Stress Scale. Results: The study states that caregivers of individuals diagnosed with schizophrenia or BAD experience overall burden. The experience is associated with being a victim of violence made by the relative suffering with psychiatric disorder. In addition, the events of violence create adverse impact on the psychological well-being of the caregivers, causing stress, anxiety, and depression. Conclusion: The study clearly indicates the need to attend the psychological needs of the caregivers of individuals suffering from schizophrenia or BAD.

ObjectivesTERT rs2736100 genetic polymorphism is commonly found in human malignancies, indicating its key role in cancer cell transformation. The aim of this study is to investigate the effects of the functional TERT rs2736100 genetic polymorphism on the outcomes of papillary thyroid carcinoma (PTC) patients.Materials and methodsWe performed a retrospective study on the relationship between rs2736100 and clinicopathological outcomes of PTC in 500 patients (378 females and 122 males) aged 43.8 ± 11.4 years (range 15–74 years) with a median follow-up of 60 months (range, 1–455 months).ResultsTERT rs2736100 genetic polymorphism (TG/GG vs. TT) was significantly associated with several high-risk clinicopathological features such as tumor spread, extrathyroidal extension, central/lateral lymph node metastases, and Stage T III or IV disease. However, in Kaplan–Meier survival analyses, the rs2736100 mutation was unrelated to overall disease-free survival with a log-rank value of p > 0.05. In Cox-regression analyses, the overall survival rate of recurrence/neo-metastasis was related to a larger tumor size, younger age, and tumor spread but unrelated to the rs2736100 mutation.Conclusions and significanceTERT rs2736100 genetic polymorphism mutation is more likely to manifest with aggressive clinicopathological characteristics but cannot worsen prognosis in PTC.

BACKGROUND & OBJECTIVE: Arsenic is present both naturally and from manmade sources like factory effluents. Contamination by arsenic of the groundwater is a major source of health detriment in south-east Asian countries. The aim of this study was to identify levels of arsenic in drinking water sources and factory effluents and to analyse arsenic levels in hair samples from factory workers and their families, along with morphological changes in hair in industrial workers in Peshawar. METHODOLOGY: Water and hair samples were collected by random sampling from a labor colony of 81 factory and non-factory household members living and working in the same industrial estate and analyzed for arsenic. Hair morphology was carried out in histomorphology laboratory at Khyber Medical University, Peshawar. The results obtained from both groups were compared with normal hair histomorphology. The data was analyzed by using SPSS version 20. RESULTS: The arsenic level in drinking water, colony tube wells and households was not within the permissible level of WHO (10µg/L). The arsenic level in factory effluent was 68µg/l (Pakistan Government's acceptable level is 50µg/L). The difference was statistically significant p≤0.001 between the two groups, the factory workers had a relatively higher level of arsenic, ~34ppb, in their scalp hair. Hair arsenic level also came out to be

Abstract Background Healthcare fraud entails great financial and human losses; however, there is no consensus regarding its definition, nor is there an inventory of its manifestations and factors. The objective is to identify the definition, manifestations and factors that influence health insurance fraud (HIF). Methods A scoping review on health insurance fraud published between 2006 and 2020 was conducted in ACM, EconPapers, PubMed, ScienceDirect, Scopus, Springer and WoS. Results Sixty-seven studies were included, from which we identified 6 definitions, 22 manifestations (13 by the medical provider, 7 by the beneficiary and, 2 by the insurance company) and 47 factors (6 macroenvironmental, 15 mesoenvironmental, 20 microenvironmental, and 6 combined) associated with health insurance fraud. We recognized the elements of fraud and its dependence on the legal framework and health coverage. From this analysis, we propose the following definition: “Health insurance fraud is an act of deception or intentional misrepresentation to obtain illegal benefits concerning the coverage provided by a health insurance company”. Among the most relevant manifestations perpetuated by the provider are phantom billing, falsification of documents, and overutilization of services; the subscribers are identity fraud, misrepresentation of coverage and alteration of documents; and those perpetrated by the insurance company are false declarations of benefits and falsification of reimbursements. Of the 47 factors, 25 showed an experimental influence, including three in the macroenvironment: culture, regulations, and geography; five in the mesoenvironment: characteristics of provider, management policy, reputation, professional role and auditing; 12 in the microenvironment: sex, race, condition of insurance, language, treatments, chronic disease, future risk of disease, medications, morale, inequity, coinsurance, and the decisions of the claims-adjusters; and five combined factors: the relationships between beneficiary-provider, provider-insurance company, beneficiary-insurance company, managers and guānxi. Conclusions The multifactorial nature of HIF and the characteristics of its manifestations depend on its definition; Identifying the influence of the factors will support subsequent attempts to combat HIF.

Śiva’s sense of self is ever-evolving, ever-changing. His selfawareness is in constant motion, expanding and contracting in its many manifestations. The movement is circular. It forms Śiva’s life cycle which is structured and bound to an internal dynamic based on a tensile balance between the reflexive and reflective modes of the god. The following article examines this dynamic, sketches the structure of the life cycle as it appears in the Kālavadha Kāvya of Kṛṣṇalīlāśuka, and aims to shed new light on the vibrant sense of Śiva’s self.

Manifestations caused by coronavirus family have presented it in many ways during the previous years. The aim of this systematic review was to gather all possible cardiovascular manifestations of the coronavirus family in the literature. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Scopus, Web of Science, Cochrane and ProQuest which were updated on May 1, 2020 for the last time. Regarding to the novelty and speed of publications on COVID-19, we searched Google Scholar and also references of included studies and review articles in the systematic search results were searched manually. The searched keywords were the combination of the following MeSH terms: "COVID-19", "SARS", "MERS" and "cardiovascular presentation". The systematic review was registered with ID CRD42020180736 in International Prospective Register of Systematic Reviews (PROSPERO). After screening, 28 original articles and ten case studies (five case reports and five case series) were included. Most of the studies were focused on COVID-19 (20 original articles and four case studies) while the only studies about Middle East Respiratory Syndrome (MERS) were a case report and a case series. Almost all the cardiovascular presentations and complications including acute cardiac injury, arrhythmias and the thrombotic complications were more prevalent in COVID-19 than severe acute respiratory syndrome (SARS) and MERS. The cardiac injury was the most common cardiovascular presentation and complication in COVID-19 whereas thrombotic complications were commonly reported in SARS. The cardiac injury was the predictor of disease severity and mortality in both COVID-19 and SARS.Coronavirus 2019 may present with cardiovascular manifestations and complications in signs and symptoms, laboratory data and other paraclinical findings. Also, cardiovascular complications in the course of COVID-19 may result in worse outcomes.

Coronavirus yang baru, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pertamakali timbul di Wuhan, Provinsi Hubei Cina, pada bulan Desember 2019, dan menyebar dengan cepat ke seluruh dunia ke lebih dari 190 negara. Pasien harus ditapis untuk covid-19 menggunakan kombinasi riwayat penyakit, computed tomography (CT) dada, dan pemeriksaan real time quantitative polymerase chain reaction (RT-qPCR) bergantung kebijakan institusinya. Keluhan neurologis seperti dizziness, headache, hypogeusia dan hyposmia, sering (36%) pada pasien covid-19. Encefalopati dan perubahan status mental juga terjadi pada pasien yang telah terinfeksi dengan virus SARS-CoV-2. Penyakit serebrovaskuler lebih sering pada covid-19 yang berat; acute ischemic stroke telah dilaporkan pada 5,7% dan gangguan kesadaran pada 15% pasien. Tindakan pembedahan rutin kranial dan spinal aman untuk dilakukan. Operasi endoscopic endonasal tidak aman dan harus dihindari. Ekstubasi setelah anestesi umum bila memungkinkan dilakukan di ruangan tekanan negatif, personil tetap memakai alat pelindung diri (APD) level 3. Harus dihindari pasien batuk saat ekstubasi. Setelah ekstubasi, pasang oksigen binasal, dan pasien harus memakai masker bedah dan aliran oksigen tinggi harus dihindari (berikan 6L/menit) untuk menghindari terjadinya aerosolisasi Perioperative Anesthesia Consideration for Neurosurgical patients with Covid-19 Abstract The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province China, in December 2019, and spread fast to all the world more than 190 countries. Patients should be screened for covid-19 using a combination of history, computed tomography (CT) chest, and real time quantitative polymerase chain reaction (RT-qPCR) testing depending on institutional policies. Neurological symptom as dizziness, headache, hypogeusia and hyposmia, common (36%) at covid-19 patient. Encephalopaty and changed mental status exist in patient infected by SARS-CoV-2 virus. Cerebrovascular diseases more in severe covid-19; acute ischemic stroke had reported in 5.7% and altered level of consciousnes in 15% patient. Surgical measuremet cranial and spinal rutine is safe, endoscopic endonasal surgery not safe and must be avoided. Extubation after general anesthesia if possible do air negative pressure room, and personil still use personal protection equipment (PPE) level 3. Must be avoid patient cough during extubation. After extubation, give oxygen nasal canule, surgical mask, and high flow oxygen (give 6 L/min) avoided given the risk of aerosolization

The International Carnival of Vrnjci is a manifestation that has been organized for 15 years in Vrnjačka Banja. As a manifestation that gathers a large number of tourists and visitors, besides its positive impacts, attention should be paid to the level of satisfaction of the local population in Vrnjačka Banja with this manifestation, which is the aim of this paper. In addition, the paper examines the existence of a statistically significant difference in the level of local population's satisfaction with this manifestation depending on their different socio-demographic characteristics. A survey method was applied to a sample of 300 respondents. Descriptive statistical analysis, independent sample t-test and one-factor analysis of variance (ANOVA) were used to process the collected responses. The results of the research showed that there is a statistically significant difference in the level of satisfaction with the Carnival of Vrnjci between respondents of different gender, as well as that the level of satisfaction of the respondents influenced by professional status, length of residence in Vrnjacka Banja and the connection between the respondent's job and tourism.

The crisis of identity and the lack of clear theoretical foundations in the construction of religious buildings that are rooted in the deep meanings of Islamic philosophy is one of the challenges of today’s Iranian architecture. A lack that has had adverse results not only in the process of creating architecture but also in recognizing and intervening past buildings. Therefore, more research is needed on concepts such as beauty and glory, which are recognizable both in the nature of architectural works and in their perception. Considering that the concepts of beauty and glory have always been studied under the subject of beauty, first a specific theoretical framework was developed that expresses two different views on beauty. The aesthetic categories, from which the concepts of beauty and splendor are defined, are elaborated in the next step. Then, the concept of beauty and glory, derived from the theoretical framework, is accomplished. This section initiated from qualitative concepts and purely theoretical topics and finally reached quantitative-qualitative results in architecture. In the end, certain parameters were stated that, on the other hand, determine what are the attributes of the two words beauty and glory of manifestation and what effect they have on the audience. Research in terms of purpose is an applied research and in terms of strategy falls into the category of descriptive-analytical research. In addition, analytical-historical research methods have been used, particularly in past artworks and monuments. The collection of information in the field of theory has been done with library studies and with the help notetaking methods. Research objectives: 1- Explaining the position of the concepts of beauty and glory in different approaches to Islamic aesthetics 2- Achieving how to realize the concepts of beauty and glory in Islamic architecture Research questions: 1- From what approaches can the position of beauty and glory under the subject of beauty in the Islamic world be explained? 2- How are the concepts of beauty and glory realized in Islamic architecture?

Ke Chen,1 Xinxing Wan,1 Liling Zhao,1 Shaoli Zhao,1 Lin Peng,2 Wenjun Yang,1 Jingjing Yuan,1 Liyong Zhu,3 Zhaohui Mo1 1Department of Endocrinology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, People’s Republic of China; 2Department of Nephrology, The First Hospital of Changsha, Changsha, Hunan 410005, People’s Republic of China; 3Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, People’s Republic of ChinaCorrespondence: Zhaohui Mo Tel/Fax +86 731 88618006Email easd04mzh@126.comBackground: Multiple symmetric lipomatosis (MSL) is a rare disease showing chronic progression of multiple, symmetrical, and non-encapsulated subcutaneous lipoma. The cause of the disease remains unknown.Patients and Methods: This study reported and summarized 13 sporadic cases of Type I MSL patients in terms of histopathology and cellular and molecular biology and assessed the CBLB c.197A>T mutation in the IRS1-PI3K-Akt pathway.Results: The clinical data showed that these 13 Type I patients were all male with a mean age of 57.0 ± 6.6 years old and consumed alcohol heavily. The laboratory tests revealed that most of the patients had hyperuricemia, diabetes, hyperinsulinemia, or insulin resistance; however, their blood lipid levels were close to a normal range. The imaging data exhibited lipomas that only occurred subcutaneously but not viscerally, ie, Types Ia (15.4%), Ib (30.8%), and Ic (53.8%). The molecular analyses of adipocytes of isoprenaline stimulated human adipose tissue-derived mesenchymal stromal cells (hADSCs) isolated from the adipose tissue lipoma-like masses (ATLLM) demonstrated that these adipocytes did not express UCP-1. The Cbl proto-oncogene B (CBLB), an E3 ubiquitin-protein ligase, was associated with insulin resistance and obesity and was mutated (ie, CBLB c.197A>T) in four MSL patients after the whole genome and Sanger sequencing of the blood samples. Furthermore, the CBLB c.197A>T mutation induced hADSC resistance to insulin by inactivation of the IRS-1-PI3K-AKT pathway.Conclusion: This study analyzed clinical, histopathological, and cellular and molecular biological characterizations of 13 Type I MSL patients and identified the CBLB c.197A>T heterozygous mutation that could be responsible for MSL metabolic dysfunction or even MSL development.Keywords: multiple symmetric lipomatosis, MSL, manifestation, characterization, CBLB

"The embodiment of deeds", or the ontological relationship of human actions and beliefs with pleasures and pains of afterlife, is one of the most important and complex issues raised in resurrection. Gnostics pointed to this issue before philosophers and explained their angles based on intuition and traditions. In this article, the ontological foundations of Ibn Arabi, those are involved (direct or even indirect) in the embodiment of deeds, have been examined and their relationship with the embodiment of acts has been clarified. The principles studied in this article are: unity of being, manifestation, the accordance of worlds and the renewal of likes. Among the above mentioned principles, the unity of existence and the manifestation have indirect influence on the idea of ​​embodiment, and on the other hand, the accordance of worlds and the renewal of likes have had a direct influence on the formation of this view. Based on these principles, nothing in the universe has been annihilated and death is due to the appearance of the manifestations, namely the transfer of the visible world to invisible world and the embodiment of acts is nothing but the appearance of the immanence. Therefore, human actions will not be lost and become visible in other worlds.

The crisis of identity and the lack of clear theoretical foundations in the construction of religious buildings that are rooted in the deep meanings of Islamic philosophy is one of the challenges of today’s Iranian architecture. A lack that has had adverse results not only in the process of creating architecture but also in recognizing and intervening past buildings. Therefore, more research is needed on concepts such as beauty and glory, which are recognizable both in the nature of architectural works and in their perception. Considering that the concepts of beauty and glory have always been studied under the subject of beauty, first a specific theoretical framework was developed that expresses two different views on beauty. The aesthetic categories, from which the concepts of beauty and splendor are defined, are elaborated in the next step. Then, the concept of beauty and glory, derived from the theoretical framework, is accomplished. This section initiated from qualitative concepts and purely theoretical topics and finally reached quantitative-qualitative results in architecture. In the end, certain parameters were stated that, on the other hand, determine what are the attributes of the two words beauty and glory of manifestation and what effect they have on the audience. Research in terms of purpose is an applied research and in terms of strategy falls into the category of descriptive-analytical research. In addition, analytical-historical research methods have been used, particularly in past artworks and monuments. The collection of information in the field of theory has been done with library studies and with the help notetaking methods. Research objectives: 1- Explaining the position of the concepts of beauty and glory in different approaches to Islamic aesthetics 2- Achieving how to realize the concepts of beauty and glory in Islamic architecture Research questions: 1- From what approaches can the position of beauty and glory under the subject of beauty in the Islamic world be explained? 2- How are the concepts of beauty and glory realized in Islamic architecture?

Abstract Background 47,XYY is a chromosomal abnormality syndrome that is typically observed in patients with a male phenotype. Few patients with XYY syndrome will have infertility. We here report a case of 46,XY/47,XYY syndrome diagnosed in a patient with a female phenotype. Case presentation A 15-year-old patient with a female phenotype visited our hospital owing to a chief complaint of short stature as of the age of 6 years. She was diagnosed with dwarf syndrome at the age of 10, but no change was noted after 2 months of growth hormone treatment. The patient’s height was 136 cm and the weight was 29 kg, both of which were below the third percentile for her age/gender. In addition to short stature, the 4th and 5th metacarpals were short and there was no significant sex development. Karyotype analysis showed 47,XYY, and chromosomal microarray examination showed a chimera of 46,XY/47,XYY. Conclusion This is an extremely rare case of 47,XYY abnormality in a patient with a female phenotype, with only one such known case reported previously. Since the cause is unknown, and symptoms of this syndrome are highly atypical and variable in childhood, clinicians should be aware of this possibility to avoid misdiagnosis and offer counseling and hormone therapy as needed to patients and their parents to improve their quality of life.

Coronavirus disease 2019 (COVID-19) is a new viral disease that has become a global public health concern in 2020. This disease is caused by a novel coronavirus firstly detected in the People’s Republic of China. This viral infection can cause febrile illness and respiratory problems. There are other uncommon clinical presentations of COVID-19 such as afebrile illness, diarrhea, non-coughing and confusion. These atypical presentations can result in difficulty in diagnosing the disease. In this short review, the authors specifically discuss the important uncommon atypical presentations of COVID-19.

Abstract The theories of aesthetic schools of philosophical schools each have defined the concept of aesthetics and explained its perceptional process. In the aesthetic theories of the Western philosophical schools, by the epistemological analysis of the concept of beauty, have considered aesthetics as tangible and subjective. But in Islamic theology we see a distinct approach to the question of beauty and its perception. In the theological attitude, the truth and the existence of man and the world around him is regarded as the manifestation of goodness and divine glory. The unified universe is beautiful and beauty is not an epistemological and subjective matter, but an ontological and objective one. Art and beauty for the mystic poet like Rumi is an experience in which beauty is not a specific concept but a unique living truth that brings man closer to the essence of truth and a means of understanding and perceiving Rumi's truth, ideas and theories about beauty is merely a religious and Islamic; moreover, art and beauty are dominated by a divine theology.In this research, which has been accomplished via library method, by citing and quoting Masnavi and Shams Tabrizi's sonnets the mentioned feature is regarded upon and summarized. The results of the study imply that Rumi's perception of beauty is not sensual pleasure but a way to guide and connect to the source of existence, goodness, and aesthetical beauty. For him, the discussion of art and beauty is outshone by a divine theology. Also, Rumi makes it challenging for anyone with no humanity to be aware of the place of goodness and beauty in the universe, but also considers it impossible to know the true and aesthetic existence on an equal footing, which is in fact the indicator and manifestation of God in this worldly universe. Research aims: 1- The examination of Rumi's views on beauty in Masnavi and Shams' sonnets. 2- To Study the concept of beauty and its perception in Islamic theology. Research questions: 1. What are Rumi's conceptions and interpretations of the aesthetical beauty in Masnavi and Shams' sonnets? 2. How is the issue of beauty and its perception expressed in Islamic theology?

Research on Way Ratai geothermal field has been done by measuring the thermal conductivity method. The thermal conductivity data is used to generate a map of the dispersion of heat conductively conductive rocks in the geothermal system. The result of measurement by thermal conductivity method in Way Ratai geothermal field is data of k (conductivity), Rt (thermal resistivity), and T (temperature). The value of the measured conductivity data in the geothermal field has range between 0.056-0.664 W/mK, the measured thermal resistivity value has range between 1.344-17.527mK/W, and the measured temperature value is between 22.68-52.59°C. The difference value of rock’s thermal conductivity is influenced by several factors, which is the existing geological structures in the field such as normal faults and lineaments, the presence of alteration, also the manifestation zone of hot water or hot vapor that caused from fumaroles.

Abstract Background Few studies have compared the etiology and clinical features between pure lateral medullary infarction (LMI) and pure medial medullary infarction (MMI). Methods All patients included were hospitalized at The First Affiliated Hospital and The Second Affiliated Hospital of Wenzhou Medical University from January 2015 to July 2020. Their risk factors, clinical manifestation, stroke mechanisms and short‐term prognosis were analyzed retrospectively. Results Among the 387 patients enrolled, 266 (68.7%) had LMI, 109 (28.2%) had MMI, and 12 (3.1%) (nine men and three women) had LMI plus MMI. We analyzed the 375 patients of LMI and MMI. The average ages of LMI and MMI were 59.4 years and 62.69 years, respectively. Univariate analysis and multivariable logistic regression was used to investigate the existing risk factors of MMI relative to LMI. Prior infarction, poor glycemic control, and atherosclerosis were more frequently associated with MMI than with LMI. The clinical manifestation was significantly different between LMI and MMI. We used modified Rankin Scale (mRS) score as the short‐term prognostic evaluation criteria, and MMI appeared worse than LMI. Conclusions This study reveals that: (1) patients with MMI are older than those with LMI; (2) prior infarction, poor glycemic control, and atherosclerosis are independent risk factors of MMI than that of LMI; (3) the clinical manifestations of LMI and MMI are heterogeneous; (4) short‐term prognosis of MMI is worse than LMI.

The SARS-CoV-2 pandemic has disrupted global health systems and brought the entire globe to its knees. Although born as a disease of the respiratory system, COVID-19 can affect different parts of the body, including the skin. Reports of ongoing skin manifestations of COVID-19 have gradually multiplied, pushing researchers to investigate the etiopathogenic mechanisms underlying these phenomena in more depth. In an attempt to investigate the possible association between SARS-CoV-2, ACE2, TMPRSS2 and skin manifestations, we performed immunohistochemical investigations of the ACE2 receptor and TMPRSS2 in nine skin samples from SARS-CoV-2-positive patients compared to a cohort of healthy controls. Furthermore, after consulting public databases regarding ACE2 mRNA expression in various cell populations resident in the skin, we conducted a literature review aimed at outlining the current state of this topic. We did not find statistically different immuno-expression of ACE2 and TMPRSS2 between the group of SARS-CoV-2-positive patients (nine skin biopsies) and the control group. Regarding ACE2, major immunolabeling was present in the epidermal keratinocytes and, rarely, in the fibroblasts and in the adenomeres of the eccrine sweat glands. Regarding the immune expression of TMPRSS2, we found no significant differences between the two groups, with a weak immune staining only in some skin cytotypes. From the review of the literature, we isolated 35 relevant articles according to the inclusion criteria adopted. ACE2 appears to be a target of SARS-CoV-2, although, other receptor molecules may potentially be implicated, such as TMPRSS2. Future studies with large cases and different molecular investigative methods are needed to further elucidate the mechanisms underlying the skin manifestations of SARS-CoV-2.

Background: Feline infectious peritonitis (FIP) is a fatal immune-mediated disease in cat, caused by mutated feline coronavirus (FCoV). Due to its difficulties in diagnosis, FIP is sometimes underdiagnosed. Therefore, several laboratory procedures were performed to gain high index suspicion of FIP. However, through several laboratory findings, not only FIP but also SEZ infection was confirmed in this case. Case description: A-year-old male, domestic cat was admitted to Veterinary Medicine Clinical Pathology Laboratory, Universitas Gadjah Mada, for further effusion examination due to its high suspicion of feline infectious peritonitis (FIP). Further examination using molecular and post-mortem analysis resulted on confirmed SEZ infection and FIP. This study informed the manifestation and pathological changes in patient with SEZ and FIP in the same time. Conclusions: This study showed that viral infection followed by bacterial infection could be fatal and untreatable. After these findings, clinicians may consider SEZ infection in cat with respiratory disorder followed by thoracic effusion besides FIP. Companion animal, especially outdoor-kept animal, possibly become infected from its contact to another human or animal in the environment.

Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose. More and more clinical cases show that clown nose-like lesion can also be the indication of some genetic syndromes, not just the manifestation of metastatic visceral tumor as it initially proposed. However, the clinical features of clown nose-like lesion indicated by metastatic malignancies, genetic cancer predisposition syndromes or primary diseases involving the nasal tip are lacking. In this study, patients with clown nose-like lesion in our clinical practices and from published literatures were collected and reviewed. We found that clown nose-like lesions caused by metastatic malignancies including lung cancer are often solitary and more common in male (24/31) older individuals (average age 62.3, ranging 40–78 years old). In addition, they usually appear for a short time, and are prone to be misdiagnosed as primary nasal diseases, leading to a poor prognosis (all patients with data available died within 4 months). Clown nose-like lesions associated with genetic cancer predisposition syndromes usually develop at a young age (mean age 15.3) with female preference (9/10). They are accompanied by multiple-systemic involvements, including low hair volume, developmental delay, cancer predisposition or neurological diseases. They show slow development and often positive family history (6/10). These two kinds of clown nose-like lesions are often asymptomatic, which delays the diagnosis and treatment of underlying malignancies or syndromes. In brief, the term of clown nose-like lesion is underrecognized, and should be updated. Clown nose-like lesions can serve as indicators to at least three categories of clinical issues: metastatic visceral tumors, genetic syndromes, and primary diseases involving the nasal tip. Increased awareness of clinical features of updated clown nose-like lesions can alert physicians to these underlying malignancies or syndromes, render earlier detection of associated medical issues, and allow for genetic counseling of family members.

In an epistemic disagreement, if the counterparts insist on their rightfulness and falsification of other’s opinions, the cognitive contradictions often end up with conflict. If one of them ignores his belief and accept other’s beliefs unconditionally, it leads to domination and sovereignty of others. Here, Ibn ‘Arabī proposes a third way. Despite sticking to his belief, he considers other’s beliefs as opportunity for further excellence and knowledge. In Ibn ‘Arabī’s system of thought, every creature is ontologically a manifestation of a name or some names of God. Also, epistemologically, their understanding of God depends on their ability to receive the divine manifestations. Ibn ‘Arabī accepted the idea of inaccessibility to the whole truth by connecting the discrepancy of ideas and beliefs to the discrepancy of talents and manifestations. This idea can be one of his most important bases in addressing epistemic disagreement.

Gulshan-i Raz is one of the most important texts in theoretical mysticism and the influence of Ibn Arabi’s thoughts on Shabestari is evident in Gulshan-i Raz. This study analyzes the content of Gulshan-i Raz to clarify how the verses could be classified thematically and what the pivotal thought dominating the work is. Since theoretical mysticism is based on theism, anthropology and cosmology, verses are categorized under these three poles. In order to analyze the text, 70% of verses were sampled and it was determined how each verse should be categorized under each pole considering the context of each unit of text. Finally, the frequency of each pole was measured. The results show that discussion about human and the relation between God-human is the most frequent issue in Gulshan-i Raz. This issue is rooted in these factors: firstly, the elevated status of human in the Sublime Qur’an and Hadith; secondly, dependence of theism on human recognition according to Prophetic Hadiths; thirdly, belief in comprehensiveness of human being and perfect man’s function as mediator of grace in theoretical mysticism; and fourthly, the importance of conduct (sulook) to the Sufis and their attempt to eventually become united with God in practical mysticism.

Transcendental Phenomenology of language wrestles with the relationship of language to mind’s manifestation of being. Of special interest is the sense in which language is, like one’s embodiment, a medium of manifestation. Not only does it permit sharing the world because words as worldly things embody meanings that can be the same for everyone; not only does speaking manifest to others the common world from the speaker’s perspective; but also speaking, as a meaning to say, may achieve the manifestation of the world also for the speaker herself. This requires finding the right words to form true propositions in a well-formed sentences. The manifest telos of proposition-rendering sentences is adumbrated and founded in the infant’s elemental formation of simple phonemic identity syntheses and syntax. This instinctual dynamism is founded in what Husserl names “the idea of truth” which supports the thesis of a universal language instinct.

Abstract Background Globally, the burden of diabetes mellitus has increased to epidemic proportions. Estimates from the International Diabetes Federation predict that the greatest future increase in the prevalence of diabetes mellitus will occur in Africa. Methods This article reviews literature on the manifestation of diabetes in adult patients in sub-Saharan Africa highlighting the distinct phenotypes, plausible explanations for this unique manifestation and the clinical significance of comprehensively defining and understanding the African diabetes phenotype. Results There are few studies on the manifestation or phenotype of diabetes in Africa. The limited data available suggests that, compared to the Western world, the majority of patients with diabetes in Africa are young and relatively lean in body size. In addition, hyperglycaemia in most cases is characterised by a significantly blunted acute first phase of insulin secretion in response to an oral or intravenous glucose load and pancreatic beta cell secretory dysfunction, rather than peripheral insulin resistance predominates. Genetic and environmental factors like chronic infections/inflammation, early life malnutrition and epigenetic modifications are thought to contribute to these distinct differences in manifestation. Conclusions While published data is limited, there appears to be distinct phenotypes of diabetes in sub-Saharan Africa. Large and more detailed studies are needed especially among newly diagnosed patients to fully characterize diabetes in this region. This will further improve the understanding of manifestation of diabetes and guide the formulation of optimal therapeutic approaches and preventive strategies of the condition on the continent.

The agricultural-industrial exhibition in Pancevo in 1905 was a great success. The rest was noted that there were guests from all sides, even from Washington. All exhibitors were pleased, and the City made good money. The number of guests who came from Belgrade was about 19.000, which was then the number of inhabitants in all of Pancevo. The exhibition went beyond the local significance and in terms of its characteristics, the number of visitors, exhibitors, trade, the person in charge in front of each pavilion that provided information on the products, was most similar to today's fair. Exceptional organization, renovation of the existing and construction of new infrastructure of the city, introduction of new steam and railway departures to Pancevo and from Pancevo to larger centres, represented a great overture for the success of this great and significant event. As part of the preparation for the exhibition, the beginnings of the development of marketing in the organization of events, such as printing photographs and postcards from the exhibition, tickets, invitations, advertisements and cancelling events in newspapers, are observed. Supplementary contents complemented by exhibitions such as performances, horse races, concerts, fireworks, would today have the character of accompanying contents of any kind of business event, not only here but in the world. Considering the organization of such an event that took place over 100 years ago, we should consider ways of organizing most business and event events in our country, which should form the backbone of tourism development and reflect the progress and civilization maturity of people, with the aim of overcoming their fair character and amateur organization. Serbia has comparative (comparative) competitive advantages (natural conditions, resources and resources, etc.) for the dynamic, long-term and priority development of agricultural production and events that are in accordance with it. Creativity is an engine of economic growth and a key strategic resource for increasing competitiveness in a knowledge-based economy, just like exhibitions in the past.

Abstract Cells respond to external signals and stresses by activating transcription factors (TF), which induce gene expression changes. Prior work suggests that signal‐specific gene expression changes are partly achieved because different gene promoters exhibit distinct induction dynamics in response to the same TF input signal. Here, using high‐throughput quantitative single‐cell measurements and a novel statistical method, we systematically analyzed transcriptional responses to a large number of dynamic TF inputs. In particular, we quantified the scaling behavior among different transcriptional features extracted from the measured trajectories such as the gene activation delay or duration of promoter activity. Surprisingly, we found that even the same gene promoter can exhibit qualitatively distinct induction and scaling behaviors when exposed to different dynamic TF contexts. While it was previously known that promoters fall into distinct classes, here we show that the same promoter can switch between different classes depending on context. Thus, promoters can adopt context‐dependent “manifestations”. Our analysis suggests that the full complexity of signal processing by genetic circuits may be significantly underestimated when studied in only specific contexts.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still underway. An understanding of the virus's mode of transmission and infection is required for its effective containment. Besides the respiratory and digestive tracts, the ocular surface presents an additional mucosal surface that is exposed to infectious droplets and direct/indirect contact. The relationship between SARS-CoV-2 infection and the eye remains controversial. This review examines up-to-date information on ocular manifestation, laboratory testing, transmission, and prevention of COVID-19. Based on clinical observations, the risk of conjunctivitis in COVID-19 is low. Despite the low incidence, positive SARS-CoV-2 results in eye specimens suggest that the ocular surface may harbor SARS-CoV-2, which may increase the infection and transmission risk. We conclude that the ocular surface remains a potential transmission route for the virus that should not be ignored. In addition, the intraocular findings have also been described in COVID-19. The measures for eye and face protection should be widely adopted to stem the tide of the pandemic.

Bedhaya Sri Nawa Kumala dance is a composition of Bedhaya Ketawang Dance idea manifested into a brand new form by Guruh Sukarno Putra, a choreographer and dancer who is experienced in interpreting and reinterpreting. Guruh Sukarno Putra considered that dance can be manifested by exploring the existing value in a community. The value of sacredness as in Bedhaya can be manifested in various forms and shapes. Bedhaya Sri Nawa Kumala dance performance emphasizes Surakarta Traditional Female Dance Style which dance music consisting of the teachings of Sunan Kalijaga contains Islamic values. The costumes cover the head and body of the dancers, which is a manifestation of worship to God Almighty. The method used in this research was dance ethnography with Ethnochoreology approach supported by Marco De Maramis theory explaining that art performance is multilayer. Field research was conducted to obtain data from observation, data analysis, style explanation, and write a synthesis that aims to determine the style of Bedhaya Sri Nawa Kumala dance performance by Guruh Sukarno Putra which contains Islamic Values.