This complete enumeration, comparative, before-and-after study (without controls) was conducted on 60 first-year MBBS students (30 females and 30 males) at a municipal medical college in Maharashtra, India. The outcome studied was the difference in cognitive domain scores after attending didactic lectures (by a pre-test) and integrated teaching with case scenarios (by a post-test). The participants included all first-year MBBS students, who gave written informed consent after the purpose and procedure of the study was explained to them. Didactic lectures on anaemia were followed by a pre-test and integrated teaching with case scenarios, conducted by the same set of teachers. Next, the post-test was administered using a questionnaire that was identical to that of the pre-test. The difference between the overall pre- and post-test scores was highly significant (Z=5.966; p<0.00001). The differences between the pre- and post-test scores for female (Z=3.463; p<0.00053) and male students (Z=3.636; p<0.00027) were also significant. In the pre-test, the mean score (out of 20) was 8.40  2.92 (95% CI: 7.36–9.44) and 8.07  2.55 (95% CI: 7.16–8.98) for females and males, respectively and the gender difference in scores was not significant (Z=0.466; p=0.641). In the post-test, the mean score (out of 20) increased to 11.40  3.74 (95% CI: 10.06–12.74) and 10.53  2.69 (95% CI: 9.57–11.49) for females and males, respectively and the gender difference in scores was not significant (Z=1.034; p=0.301). The study results reveal that blending integrated teaching with case scenarios significantly increases cognitive domain scores.

Responsive Governance requires the government to be responsive to changes in situations / conditions that can accommodate people's aspirations. The Makassar city government can better understand the wishes of the city community through the application of smart city applications so that decision making in service delivery is more responsive to the demands of the community. Through the glasses of Responsive Governance, a concept that emphasizes the point of view of decision making involving all components involved in governance by linking interesting issues about smart city (specifically the application of Tangkasaki and Dottoro'ta Trucks) which are focused on responsive aspects of governance this research can provide impact in the form of an understanding of responsive governance that still lacks research literature that discusses the concepts and theories of responsive governance and helps the Makassar city government in finding new approaches and perspectives in promoting the existence of Makassar's smart city concept

Objective: The purpose of this study was to see the behavior of accounting student to obtain chartered accountant certification, where the behavior is seen from attitudes, subjective norms and perceived behavioral control. This research was conducted on 250 respondents who legitimately filled out the questionnaire in August-September 2018 at the University in Palembang, Indonesia. The collected data was analyzed using Partial Least Square. The research findings revealed that attitudes toward behavior, subjective norms, and perceived behavioral control had a positive and significant influence on obtaining a chartered accountant certification. In addition, the interest of obtaining chartered accountant certification has a significant influence for the behavior of interest in obtaining chartered accountant certification.

Therapeutic modalities for metastatic breast cancer have not stopped progressing in recent years, in particular hormonotherapy targeting hormonal receptors (HR), and targeted therapies targeting Human Epidermal Growth Factor Receptor-2 (HER2), which allowed to improve the overall survival of patients over expressing these receptors, however, the high risk of metastatic relapse makes the prognosis remain impaired. Among the causes of these relapses, the phenotypic instability, which would be at the origin of expression change of the HR and HER 2 on the surface of tumor cells.This discordance of phenotypic expression between the primary tumor and the metastatic relapse leads to an assessment of therapeutic modalities initially undertaken? Through this work, we will compare our study about 17 female flight crew with metastatic breast cancer, conducted at the aerospace medical center of the military hospital Mohamed 5 of Rabat, with literature data

Loranthaceae are epiphytic hemiparasitic plants that cause considerable damage to cultivated and spontaneous woody plants around the world. These plants are also used locally to treat many health problems. The aim of this work is to identify the various potentials of Phragmanthera capitata exploited by tradi-practitioners of traditional medicine. An ethnobotanical survey based on direct and semi-structured interviews was conducted among 121 tradi-practitioners in the city of Douala. About 52.9% of the surveyed tradi-practitioners knew only P. capitata as a hemiparasitic plant while 47.1% knew about other Loranthaceae species. In the latter group, 56.2% differentiated them only through flowers. 26 plant species have been recognized as host plants to P. capitata, 73.1% of which are woody species. The most cited species were Persea americana, Dacryodes edulis and Psidium guajava. 64.5% of the tradi-practitioners surveyed used P. capitata only for medicinal purposes (UV = 0.64) and the rest added ritual practices (UV = 0.71). The inventory identified 38 health problems treated by this species among which, hypertension, diabetes, nerve pain, cancer, heart disorders and mystical diseases are the most concerned. The leaves (93.3%) and stems (56.7%) are mostly used. This study showed the importance of P. capitata in the traditional pharmacopoeia of Cameroon despite its pernicious nature. Phytochemical and pharmacological investigations are envisaged to highlight certain medicinal properties of P. capitata.

Introduction: Sjögren's Syndrome is a complex and chronic autoimmune disease that affects the salivary and lacrimal glands, however the immunoregulatory and immunosuppressive effect of vitamins has been related to the disease. The objective was to know the vitamins related to the Sjögrens Primary Syndrome compared with a control group. Materials and Methods: A review was made in the PubMed database with the key words (Vitamin and Primary Sjogrens Syndrome and Primary Sjögrens Syndrome) without restriction of date until November 2, 2018, only studies conducted in humans and published in English were selected. Results: We identified 50 studies with the search criteria, 5 studies were conducted on animals and were excluded, 7 studies were written in a language other than English and were excluded, only 38 studies were eligible and 7 of them were included. The vitamins A, D, E, and 25 hydroxyvitamin D3 were analyzed in the pSS compared to a control group. Conclusion: The vitamins D are important to balance calcium, phosphorus for the development of bone tissue and in patients with pSS the musculoskeletal system may be affected.

The purpose of this research was to identify the internal and external factors to formulate strategy and to prioritize alternative strategies for increased local tax revenue BPHTB. The research are using Internal Factor Evaluation and External Factor Evaluation, SWOT analysis and Analytical Hierarchy Process (AHP). The results indicated that the emergence of factors that affect the goals are (1) facilities and infrastructure (2) BPHTB regulation (3) updated NJOP (4) the growth of the industrial property (5) the integrity and capacity of human resources (6) awareness and knowledge of the taxpayer. Actors who influenced in this study is the tax payers, tax officers, internal Auditors and Notary Public/PPAT. The increase of capacity and integrity was selected as the priority strategy based on AHP research. Managerial implications of the human resources improvement program is oriented on increased local tax revenue BPHTB based on the principle of good governance. This research was the top recommendation of the deregulated of regulation BPHTB to anticipating the loss of potential revenue BPHTB and for the Central Government BPHTB along with the House of Representatives (DPR) for the amendment UU Nomor 28 Tahun 2009

The aim of this study is to find out the relationship between corporate governance (measured by: institutional ownership; board of commissioner; and independent commissioner), tax avoidance, leverage and company size to earnings management. Based on previous research, we identify some factors can make the company doing earnings management such as corporate governance, tax avoidance, leverage, company size. This research took population and sample from banking companies that listed in IDX 2015-2017. The results show that institutional ownership has significant effect to avoid earnings management. These results also showed that tax avoidance, leverage, Size Company has no significant effect to avoid earnings management.

Plants have formed the basis of sophisticated traditional medicinal systems that have been in existence for thousands of years and continue to provide mankind with new remedies. The study of total ethanol extract of Shorea robusta oleoresin and Wrightia tinctoria bark investigated the antiallergic activity study by sheep (Capra hircus) serum and compound 48/80 induced mast cell degranulation method using ketotifen fumarate and antipruritic activity study by compound 48/80 method using chlorpheniramine maleate as standard. The results showed both plants are excellent candidates.

This study critically examines the procurement Act 663, its impact on accountability and transparency of officers in the public sector. Specific research objectives were set to determine the laid down procedures for procurement Act; determine the competence of procurement staff in the procurement sector and to review the budgetary perspective of the procurement entity in Ghana. As methodology, the study adopted a quantitative research approach while employing a case study approach. Overall, 380 questionnaires were administered as well as face-to-face interviews conducted. The study findings revealed that the staff lacked professional knowledge on procurement service as the financial budget allocated for staff training was vastly inadequate. The study also revealed that a varied level of compliance existed among the procurement institute studied in respect of part II of the Act. It was also established that, whereas there was a high level of compliance in areas of well-established tender committees among significant others, prior mandatory days before scheduled date for meetings and professional expertise in procurement practice showed relatively low compliance. Furthermore, even though high education levels were indicated in the study; little was revealed about the acquisition of professional qualification in procurement among staff in the entity. The study recommends among others that an operational manual for procurement Act should be given to all procurement staff to guide and make them conversant with the procedures that guide procurement profession.

The aim of the study was to study effectiveness of inhalation sevoflurane with the laryngeal mask airway (LMA) in children undergoing surgeries below umbilicus. Thirty premedicated children 3-12 years old with the American Society of Anaesthesiologists physical status of I to II were enrolled and received induction with sevoflurane 7% by face mask and maintained with 50% oxygen and 50% nitrous oxide mixture followed by 1.7% sevoflurane with LMA. Demographic data, induction time, number of attempts, LMA insertion, removal and recovery times, haemodynamic parameters, complications, Aldrete score and child’s behaviour score were recorded. LMA insertion was successful at the first attempt in 93% with sevoflurane. LMA insertion, removal and recovery times were (1.26±0.36, 2.76±0.51, 5.16±1.6 minutes respectively). Perioperative minor complications were there. Recovery milestones including Aldrete score in the group was (9.03) t 5 minutes and comparable at 15 and 30 minutes. There was a greater incidence of excitatory phenomena with sevoflurane. Haemodynamics were studied. Sevoflurane provided short LMA insertion, removal and recovery times in children undergoing minor surgeries below umbilicus with little perioperative complications. Agitation was seen with sevoflurane.

Pregnancy related acute kidney injury (PRAKI) contributes to 3.7% of overall acute kidney injury cases in Indian subcontinent. It is a major cause of maternal and foetal morbidity and mortality in developing countries. To find out the maternal and foetal outcome in cases of pregnancy related acute kidney injury. A total of 50 patients with PRAKI were enrolled in this hospital based observational study. Cases were divided according to KDIGO criteria and maternal and foetal outcome were analysed in relation to age, parity, pregnancy status, mode of delivery, etiological factors and need for dialysis. Out of 50 cases mortality was 14% (7 cases). Aetiology was found to be multifactorial with sepsis in majority of cases (92%) and maximum cases were in the postpartum period. All the expired cases belonged to multipara group and all having anaemia and toxaemia of pregnancy. Out of 17 dialysed patients 29.4% (5 cases) expired

Aim of this work was to compare properties of two etching gels produce by Kerr Orange and Spofa Dental. Etching gel are water solution of phosphoric acid using in total etch techniques. They are applicable on enamel surface for 30 seconds to make partially dissolving of hydroxyapatite crystals and increase mechanical adhesion between bonding agents and tooth structure. Materials and methods two commercial phosphoric acid gels (Kerr and Spofa Dental) were tested in consistency, thixotropic properties, water disintegration, force necessary for extrusion material from syringe, fil thickness. Results: Kerr materials has higher consistency, is less thixotropic compare to Spofa product, has longer time to dissolve (18 min), lower force necessary to extrusion 5 N and film thickness 4 microns. Conclusion: On the market exist etching gel based on different gelling agent organic gums or fumed silicas. Some clinician prefer material with higher viscosity for some application, other groups of practicing doctors are using less viscous materials.

The purpose of this study was to find out the effect of trust, security, quality of service and perceived risks on online purchasing decisions. To investigate thehypotheses of the research, data were collected through distributing questionarre with a samplesize of 385 samples.The questionnaire consisted of a list of statements submitted to respondents to obtain data relating to research. The methodology was conducted usingStructural Equation Modeling (SEM) program, and LISRELsoftware to perform factor analysis. The study revealed that trust variable on online Purchasing Decisions (PD) had positive and not significant effect with t-value of 1.38 and the estimated value of 0,19. The effect of Security Variable on Purchasing Decisions (PD) had a positive and not significant effect with t-value of 0.87 and estimated value of 0.12. The effect of Quality of Serivice (QS) on Purchase Decisions (PD) had a positive and significant effect with t-value of 6.03 and estimated value of 0.37. The effect of the Perceived Risk Variable on Purchasing Decisions (PD) had a positive and significant effect with t-value of 5.82 and estimated value of 0.44. The Quality of Serivice (QS) variable had a dominant effect on online purchasing decisions through Social Networking Websites compared to the Perceived Risk variables, Trust Variables and Security Variables

Fatigue is often cited as a contributing factor in air incidents and accidents. Usually, the words "fatigue" and "sleepiness" are used by aircrew to describe the same feelings, a questionnaire has been developed for subjective level assessment of fatigue and sleepiness among Moroccan aircrew. A 4-month prospective study including all aircrew (civilian, military) and air traffic controllers was conducted at the Aero-medical center of Rabat during their review visit. The questionnaire included the Pichot scale for fatigue and Epworth scale for sleepiness. It was filled anonymously. Out of more than 400 cards distributed, only 200 were exploitable. 23% of the subjects in the study had moderate fatigue. 6.5% of the sample presented moderate sleepiness and 4.5% had excessive daytime sleepiness. These two states seem to be preponderant in young aircrew population especially cabin crews. The occurrence of fatigue and daytime sleepiness in aircrew especially at the beginning of their career can be explained by the difficulty of adapting to aeronautical constraints. It is important to remember the countermeasures of fatigue to preserve aviation safety