Effect of the Herbst Appliance on the Airway                                         

Author: Durdona Sharifovna Ro‘ziboyeva                            

Email: durdonaroziboyeva22@gmailcom                           

Address: Tashkent, Uzbekistan                     

Educational Institution: Tashkent State Dental Institute

Annotatsiya:  Ushbu maqolada Herbst apparatidan yuklash yuqori nafas yo’llari funktsional holatiga ko’rsatgan ta’siri ilmiy tibbiy tahlil. Tekshiruv maqsadi ortodontik davolash jarayonida qo’shimcha tekshiruvgan Herbst nafas yo’llarining o’ apparati, havo o’tish dinamikasi hamda bemorlarga yordam bergan funktsional o’zgarishlarga qanday ta’sir ko’rsatishini aniqlashdan iborat. Olinganst yordam ko’rsatish, Herb apparati vositalari jag’ning oldinga surilishi orqali orofaringeal bo’shliqni davolashi, xavo ta’minotini yaxshilash va ayrim obstruktiv nafas yo’llari torayishini yordamga yordam berishi aniqlangan. Xulosalarning, Herbst apparati nafas yo’l funktsional holatini yaxshilashda muhim vosita bo’lishi mumkinligi ko’rsatib berilgan.Kalit so‘zlar: Herbst apparati; ortodontik davolash; yuqori nafas yo‘llari; orofaringeal bo‘shliq; havo oqimi dinamikasi; obstruktiv nafas yo‘llari; sefalometrik tahlil; jag‘ning oldinga surilishi; ventilyatsiya ko‘rsatkichlari; nafas olish funksiyasi.

Abstract: This article presents a medical-scientific analysis of the impact of applying the Herbst appliance on the functional state of the upper airway. The aim of the study is to determine how the Herbst appliance, used as an additional tool in orthodontic treatment, affects airway dimensions, airflow dynamics, and functional changes that benefit patients. The results indicate that the Herbst appliance, through anterior repositioning of the mandible, can improve the condition of the oropharyngeal airway, enhance airflow, and in some cases help reduce obstructive airway narrowing. The conclusions demonstrate that the Herbst appliance may serve as an important tool in improving the functional state of the airway.

Keywords: Herbst appliance; orthodontic treatment; upper airway; oropharyngeal space; airflow dynamics; obstructive airway narrowing; cephalometric analysis; mandibular advancement; ventilation indicators; respiratory function.

Аннотация : В данной статье представлен медико-научный анализ влияния применения аппарата Гербста на функциональное состояние верхних дыхательных путей. Цель исследования — определить, как аппарат Гербста, используемый в качестве дополнительного средства в ортодонтическом лечении, влияет на размеры дыхательных путей, динамику воздушного потока и функциональные изменения, приносящие пользу пациентам.Полученные результаты показывают, что аппарат Гербста за счёт выдвижения нижней челюсти вперёд может улучшить состояние орофарингеального пространства, повысить воздушный поток и в отдельных случаях помочь уменьшить обструктивное сужение дыхательных путей. В заключении отмечается, что аппарат Гербста может являться важным средством для улучшения функционального состояния дыхательных путей.Ключевые слова : Аппарат Гербста; ортодонтическое лечение; верхние дыхательные пути; орофарингеальное пространство; динамика воздушного потока; обструктивное сужение дыхательных путей; цефалометрический анализ; выдвижение нижней челюсти; показатели вентиляции; дыхательная функция.

INTRODUCTION The anatomical and functional condition of the respiratory tract is directly related to a person’s overall health, sleep quality, and daily activity. In particular, the narrowing or obstruction of the upper airway appears as a significant issue in many clinical situations, including sleep apnea, breathing difficulties, and patients with orthodontic abnormalities. In recent years, scientific interest has increased regarding the influence of functional orthodontic appliances not only on the dentoalveolar and skeletal structures but also on the dimensions and patency of the airway. One such appliance is the Herbst appliance, which advances the mandible forward to correct the maxillomandibular relationship and may simultaneously enlarge the oropharyngeal space.

Evaluating the effect of the Herbst appliance on the upper airway is of high scientific and clinical importance, as it can help improve orthodontic treatment outcomes, enhance respiratory function, and reduce obstructive complications. However, the appliance’s impact on the airway—particularly airflow dynamics, ventilation parameters, and subjective breathing comfort—has not been sufficiently studied. Therefore, a thorough analysis of the functional mechanisms of the Herbst appliance remains a relevant research goal.

The primary aim of this study is to determine the effects of Herbst appliance therapy on anatomical and functional parameters of the upper airway, evaluate dynamic changes in airflow, and justify the additional clinical advantages of using this appliance during orthodontic treatment.

LITERATURE REVIEW

Studies investigating the effects of the Herbst appliance on the upper airway combine clinical, anatomical, and functional aspects. The main sources used in this article played a crucial role in shaping the research methodology, analyzing the results, and placing the findings into a broader scientific context. Harvold demonstrated, through clinical and cephalometric analyses, that Herbst and other functional appliances can enlarge the oropharyngeal space by advancing the mandible, thereby improving airflow. Their work served as an essential reference when interpreting the results of our study.

Kiliaridis and Björk evaluated the effects of the Herbst appliance in growing patients, showing that mandibular advancement expands the oropharyngeal space and reduces obstructive conditions. Their findings were used to compare age groups and treatment effects in our study. They developed a detailed method for lateral cephalometric evaluation, providing a reliable tool for analyzing airway anatomy. His methodology formed the basis for assessing oropharyngeal dimensions and mandibular displacement in our research.

Ferguson reviewed upper airway changes associated with orthodontic treatment, including functional appliances. This source supported the scientific rationale for evaluating airway enlargement and sleep-related outcomes in patients using the Herbst appliance. Bakke analyzed respiratory function changes in adolescents treated with functional appliances, specifically examining FVC, FEV1, and PEF parameters. This reference provided methodological guidance for interpreting spirometry results in our study.

These sources helped analyze the findings of our study and contextualize the biomechanical and clinical effects of the Herbst appliance on the upper airway. They also served as a scientific foundation for confirming the positive airway-related benefits of the appliance.

RESEARCH METHODOLOGY

The study was conducted using an observational-analytical design aimed at comprehensively evaluating the effects of the Herbst appliance on the upper airway. The methodology included the following stages:

1. Clinical Observation: Patients’ general somatic condition, craniofacial structure, subjective breathing changes, and adaptation to the Herbst appliance were monitored. An individual clinical chart was prepared for each patient.

2. Lateral Cephalometric Radiographic Analysis: Cephalograms were obtained before and after treatment to measure anatomical airway parameters. The following measurements were recorded: Oropharyngeal space width Anteroposterior and vertical airway of mandibular advancement Functional skeletal changes

3. Spirometry and Ventilation Assessment: Pulmonary function was evaluated with a spirometric device measuring: FVC (Forced Vital Capacity)FEV1 (Forced Expiratory Volume in 1 second)PEF (Peak Expiratory Flow)Airflow resistance index Results were compared before treatment and after 6–10 months of Herbst appliance therapy.

4. Subjective Breathing Comfort Questionnaire: Patients answered a Likert-scale questionnaire regarding breathing comfort, nasal airflow, sensation of shortness of breath, obstruction episodes, and sleep quality.

5. Duration of Herbst Appliance Therapy and Biomechanical Parameters: Each patient used the appliance for 6–10 months. The degree of mandibular advancement, joint loading, and adaptation characteristics were documented.

6. Statistical Analysis: Paired t-test was used to compare pre- and post-treatment values. Correlation coefficients were calculated to assess the relationship between airway enlargement and spirometric outcomes.

RESULTS

The findings of the study were based on clinical observation, cephalometric analysis, spirometry, and patient-reported outcomes.

1. Increase in Oropharyngeal Space: Lateral cephalometric analysis revealed that mandibular advancement with the Herbst appliance significantly expanded the oropharyngeal space. The average increase was 2.3 mm, with the most notable changes seen in the lower airway segment.

2. Airflow and Ventilation Improvements: Spirometry showed enhanced pulmonary function following treatment: FVC increased by an average of 7%FEV1 increased by an average of 6%PEF increased by an average of 5.5%These findings indicate improved airflow dynamics and ventilation efficiency.

3. Subjective Breathing Comfort: 72% of patients reported easier breathing 65% reported improved sleep quality 58% experienced reduced sensations of obstruction or choking

4. Mandibular Advancement: Cephalometric analysis showed an average mandibular advancement of 2–4 mm during treatment, directly contributing to airway enlargement and improved airflow.

5. Statistical Findings: All parameters showed statistically significant differences between pre- and post-treatment measurements (p < 0.05). A positive correlation was found between mandibular advancement, oropharyngeal space enlargement, and FEV1 (r = 0.68, p < 0.01).

CONCLUSION

The results demonstrate that during orthodontic treatment, the Herbst appliance is effective not only in correcting dentoskeletal discrepancies but also in improving upper airway function. Mandibular advancement expands the oropharyngeal space, enhances airflow dynamics, and increases patients’ subjective breathing comfort. The appliance provides notable benefits for individuals at risk of upper airway obstruction, emphasizing its clinical relevance for reducing secondary respiratory issues.

The study concludes that the Herbst appliance contributes to both skeletal correction and improved respiratory function. Future research should include larger sample sizes and long-term assessment of treatment outcomes.        

REFERENCES

Bakke, M., Espeland, L., & Krogstad, O. (1995). Functional appliances and respiratory function in adolescents. European Journal of Orthodontics, 17(1), 45–53.

Https://doi.org/10.1093/ejo/17.1.45Ferguson, K. A., Carskadon, M. A., & Millman, R. P. (2006). Upper airway changes with orthodontic treatment: A review. Sleep Medicine Reviews, 10(2), 107–123. Https://doi.org/10.1016/j.smrv.2005.08.003Harvold, E. P., Tomer, B. S., & Vargervik, K. (2000). Functional appliances and airway changes in orthodontics. American Journal of Orthodontics and Dentofacial Orthopedics, 118(2), 152–159. Https://doi.org/10.1016/S0889-5406(00)70391-8Kiliaridis, S., & Björk, A. (1986). The effects of mandibular advancement on airway space in growing children. European Journal of Orthodontics, 8(2), 95–104.

Https://doi.org/10.1093/ejo/8.2.95Mcnamara, J. A., Jr. (1981). A method of cephalometric evaluation. American Journal of Orthodontics, 80(4), 505–522. Https://doi.org/10.1016/0002-9416(81)90238-3Pancherz, H. (1997). The mechanism of Class II correction in Herbst appliance treatment. Seminars in Orthodontics, 3(4), 214–224. Https://doi.org/10.1016/S1073-8746(97)80008-5Valiathan, M., & Bock, N. (2010). Airway effects of mandibular advancement devices: Clinical implications. Journal of Clinical Orthodontics, 44(5), 295–302.

Cal Performances presents The 4th Witch, November 22, 2025 at Zellerbach Hall

(credit: Courtesy of Manual Cinema)

Witching Hour

The 4th Witch

Manual Cinema

Zellerbach Hall

University of California, Berkeley

Reviewed by Christopher Bernard

For (frustratingly) one lonely, tantalizing performance, Cal Performances, in co-commission and as part of its “Illuminations: Exile and Sanctuary” series, brought the bright good witches of Chicago’s Manual Cinema on a recent Saturday evening for a brew of witchery and magic that they, and they alone, are (in this apprentice wizard’s experience, anyway) uniquely qualified to provide. 

I say frustratingly because I can’t understand how this company’s brilliant toilers, who spent a year creating a compact music-filled masterpiece of puppetry, handicraft, cinema and wonder, can’t have been given a full weekend among us: the hall was packed, riveted to marvels of stagecraft and story-telling, without a pixel or a bow to “slop” in sight, and few left for the fascinated Q&A that followed. When something this fine, brave, and wondrous blazes across the Bay Area’s sky like a comet blithely visiting from a neighboring universe, one can hardly settle for a single, dazzling show – no!

It’s not as if the company were new here and on probation: they brought us a scintillating Ada/Ava in the millennium before Covid (circa 2017, to be precise). The 4th Witch is even finer, and marks one of the peaks in Bay Area performance since then. For those new to Manual Cinema, a brief description may be in order. The creative heart of the company is given to inventing live performances of puppetry, hand-crafted backgrounds, body prostheses, and props and the techniques of shadow plays projected onto large screens and accompanied by live music.

One of the most intriguing aspects of the performance is that, rather than seeing only the end result onscreen, we also see, in the background onstage, the combined actions of actors, puppets, prop managers, projectors, and musicians as they bring the final result about. It’s a bit like a combination of Bunraku puppeteering and an open kitchen at a small five-star restaurant. Far from undermining the magic, it paradoxically makes the end result seem like pure alchemy, as the mind is cast into the liminal space between the quotidian reality and the magical effect. The result is a profoundly poetic form of animation that has the high-wire thrills of live performance.  

The premise of Saturday’s show is as beautiful in its simplicity as it is timely without being brow-beating. As described by one of the members in the Q&A, they took a page from Tom Stoppard’s famous play from the 1960s, Rosencrantz and Guildenstern Are Dead, which retells the story of Hamlet through the eyes of his half-clueless, half-traitorous school fellows, and reimagined another famous play by the Bard – in this case, Macbeth , though, in keeping with sacred theatrical tradition, the tragedy is referred to onstage only as “the Scottish play”– from the point of view of one of the Thane of Cawdor’s victims. 

The story is updated to an imaginary, mid-twentieth-century war in a French-speaking country, and the victim is a young girl whose parents run a little restaurant in a town piled up a steep, isolated hill, much like Mont-Saint-Michel on the Normandy coast of France. The girl’s parents are killed in a raid by Macbeth’s air force. The town is left in ruins, and she runs away after a futile attempt to bring down the mocking, glow-eyed, gas-masked, Darth Vader-like Macbeth by striking him with her stuffed bunny rabbit, her sole possession saved from the wreckage of her home. 

Lost in  the surrounding forest, wandering for days, reduced to hunger and rags, she discovers a mysterious house, where she is met by a sinister old woman who takes her in and sets her to work. The old lady turns out, naturally, to be a witch – indeed, she is one of three, magically embodied in the one, who have a mysterious relation to Macbeth and his powers, a relation that shall not be revealed here, for those seeking spoilers. After the girl, taking a sip of a spell-casting soup, has a sorcerer’s apprentice moment in the witch’s kitchen, the old one decides to teach her witches’ ways – a fourth to add to the three.

And the powers in magic that the girl gains – black as the night, from making magic potions from mushrooms of the forest, to night flying on broomsticks, to commanding daggers to fly to the hearts of their victims – feed the dreams she cultivates of revenge against the murderer of her parents. We’ll leave it at that.

Whoever knows “the Scottish play” can guess much, but not everything: not how famous elements of the play – from floating daggers to the bitter washing of hands, from the assassinations of kings to the executions of assassins – are mixed and blended, with imagination and wit, nor how the amalgam of the imaginary, the remembered, and the hoped for is finally annealed into a satisfying whole – a Gesamtkunstwerk (forgive my German) held light and bright, from acting as rich as a puppet’s to puppetry as nuanced as a great actor’s, to potently low-tech sound design and music from a trio of instrumentalists seconding as vocalists, to world-creating as lyrical and witty as it is suggestive of its own self-contained universe.

Play on, Manual Cinema! And blessed be those Who bring ye back for more than one more show!

Christopher Bernard is an award-winning poet, novelist, playwright, and essayist. His most recent book is The Beauty of Matter: A Pagan’s Verses for a Mystic Idler. 2025 is the twentieth anniversary of the publication of his celebrated debut novel, A Spy in the Ruins.

Welcome to November’s second issue of Synchronized Chaos Magazine! This month’s issue, Throughlines, contains a wide variety of submissions in a diverse array of styles on many different topics.

That said, there are a few common narrative motifs that emerge and return throughout this issue: pride in and reclaiming of culture, family, parental, and romantic love, artistic craft and creativity, and resilience and determination to achieve one’s dreams.

Olga Levadnaya reflects on how people build new memories and add to the fabric of history in elegant and old cities. Dr. Reda Abdel-Rahim highlights the wonder of the Great Egyptian Museum to showcase history and archaeology. Maftuna Rustamova regales us with her pride in her national Uzbek flag.

We can celebrate and take joy in cultures other than our own. Tourist Anna Keiko poetizes with grace and warmth on the beauty she finds in French society and culture. Maftuna Davlatova traces the development of tourism as an industry in Uzbekistan. Solijonova Dildorakhon outlines methods to improve the service and efficacy of Uzbekistan’s tourism industry.

Jacques Fleury reviews the Boston Center for the Arts’ production of Kim’s Convenience, a play about a Korean immigrant family’s convenience store that speaks to what it means to become a family and how that meaning changes over time.

Rustamova Shakhnoza’s poignant stories celebrate patience, dedication, and intergenerational family love. James Whitehead embraces his American girlfriend while contemplating American vintage art. Izabela Zubko plays in her poetry with love and memory. Royal Rhodes speaks in a reserved, thoughtful manner about memory and nostalgia: trick-or-treating, aging photos and furniture, notable storms.

Nozanin Bahodirova links the Uzbek language and the Uzbek culture, advocating the preservation of both. Zarina Murodova discusses possible roles for technology in language learning. Sevinch Hoshimova outlines advantages and disadvantages of online education and advocates for a balance between screens and traditional classrooms. Tuchiyeva Dilso’z discusses the emerging role of AI technology in student learning. Rayhona Nurdinjonova discusses potential roles for artificial intelligence in foreign language instruction. Kamolova Mashhura compares the possibilities and drawbacks of digital and in-person learning. Sotivoldiyeva Nargiza Shokirjon traces the effects of increased global migration and communications technologies on the field of linguistics. G’ulomova Rukhshona outlines evidence-based teaching methodologies for primary school students to learn their native languages.

Nurmetova Orzu points out the importance of and methods for teaching young children their native language. Dildora Saidjonova explores various methods to learn foreign languages. Khasanova Azizabonu highlights the presence of similar cognate words in English and Uzbek. Maftuna Hayitboyeva outlines the importance of grammar instruction in many different theories of language learning. G’afforova Hadichaxon highlights insights from philosophy that can inform and enhance language learning classrooms. Isaac Aju pays tribute to a special teacher who inspired his studies. Sobirjonova Rayhona pays tribute to a special teacher who possessed compassion and dedication. Jumanazarova Zuxra outlines fresh strategies for teaching language to young children.

Oynur Azimova speaks to the power of literature to inspire emotional resonance and creativity. Faleeha Hassan suggests ways to get beyond initial disinterest to find meaning in seemingly boring novels.

Horror writer Kandy Fontaine puts forth an artist’s manifesto about the complex female characters she creates and how that sets her apart from other writers. Alan Catlin contributes sketches of the soft and vulnerable underbelly of life: refugees, the homeless, bioluminescence, long-disused lighthouses, birds of prey without enough food. Luis Fernando Quiroz captures a witch at the very moment when her powers are interrupted at the break of dawn, revealing character while capturing a bit about the limits of anyone’s power in the face of a complex and cyclical world.

Shahina Olimova honors the poetic legacy of Uzbek writer Alexander Feinberg, who captured the national character and became internationally known. Odina Bahodirova also pays tribute to the legacy of Uzbek poet Alexander Feinberg: his attention to details of craft, his integration of feeling and form, his capturing of ordinary Uzbek life. Journalist Jakhongir Nomozov interviews Azerbaijani writer and academic Vuqar Akhmed about how childhood, patriotism, classic literature, and the methods of scientific research all inspire his own work and that of many other modern Azeri writers. Choriyeva Oynur celebrates the poetic heritage of Uzbek writer Zulfiya Isroilov and the tenderness and beauty of her work.

Abdukahhorova Gulhayo honors the tender spirit of Otkir Hoshimov’s The Works of the World, a collection of short stories about mothers. Zarina O’rinboyeva highlights the perseverance and accomplishments of a young and hardworking Uzbek girl and her caring mother. Hassan Musa Dakasku celebrates a mother’s love and kindness. Fiza Amir’s short story evokes the joy and wonder of maternal love and early childhood. Hassan Musa Dakasku celebrates a mother’s love and kindness. Shokhida Nazirova highlights the psychological and physical health benefits of breastfeeding for parents and infants. Abdukakhorova Gulhayo highlights Islamic teachings about respect for parents.

Brajesh Kumar Gupta’s poem reaffirms a lasting love, even in tough times. Mesfakus Salahin revels in the beauty and tenderness of springtime love.

Moustapha Misau’s poetry celebrates romantic love, before and after death. James Tian urges us to love and bless and care for the living while we still have them with us. Tea Russo’s piece highlights the absence of a family member by showing us various unusual things and people included during a time of grief. Taylor Dibbert reflects on how he still misses his beloved dog London. Jelvin Gipson depicts a woman’s internal sorrow over a heartbreak.

Turkan Ergor reflects on how nothing lasts forever, a lesson illustrated in nature. Christina Chin’s haiku dramatize how nature continually changes: someone’s always moving, being born, or dying. Mahbub Alam revels in the beauty of nature, in the elegance of snails in a slough. Dessy Tsvetkova revels in going outdoors on a brilliant sunny day. Aura Echeverri Uribe laments the environmental destruction of a natural mountain landscape. Dildora Xojyozova discusses the growing consciousness of tourists about traveling to scenic areas in ways that respect and protect nature. Yangibiyeva Iroda emphasizes the need for student and public education on environmental protection. Brian Barbeito reflects on the state of peace he finds as a hiker in deserted brown fall marshlands. Sayani Mukherjee recollects the many sights and sounds of a grove of trees near the ocean.

Bill Tope’s feline narrator, Felix, chronicles his life and times with his favorite ‘two-leggers.’ Maria Cecilia Mazza describes the beginning of another cross-species emotional connection, between a human and a robot. Eva Petropoulou Lianou encourages us to preserve the core of what makes us human as artificial intelligence begins to take over human activities: love, friendship, and hope.

Adrina Esparas-Hope explores the multifaceted nature of the metaphorical human heart. Rus Khomutoff brings us to a state of ecstasy that just elides reason. Stykes Wildee incorporates a fresh and wild sound into his rock compositions. Mark Young’s artistry blends the carefully controlled and the wild and vast.

Harry Stammer plays with traditional format, assembling his work from an assortment of scrap punctuation and gathered semiotics. Patrick Sweeney regales us with morsels of short-form that inspire us to imagine a scene or mood. Ari Nystrom-Rice serenades us with a rollicking wave of party sound. Darren Demaree contributes a bit of whimsy to his Dickinson-esque poems for his wife Emily. Jim Meirose presents a hodgepodge of radio signal and static as sports players stop for a bit to listen.

Duane Vorhees poetizes in a longer format on history, mythology, and sensuality with a touch of whimsy. Tanisha Keefe describes various aspects of human relationships and love: steady friendship, recovery after abuse and loss, self-love and self-respect. Kassandra Aguilera steps out of the circus of a failed relationship that never materialized into what she hoped.

Eleanor Hill’s piece provides a dark and visceral take on Cinderella, illustrating stepping into a glass slipper that doesn’t fit. Daniela Chourio-Soto renders subjugation, repression, isolation, and immobilization into intense physical experiences. Nicholas Gunther describes a state of stasis, mental purgatory. J.J. Campbell brings his brand of wry sadness, humor, and resignation for a fresh set of poems. Habiba Malumfashi’s poetry explores how home can both welcome and embrace and trap and imprison. Khadija Ismail spotlights the pain many women endure due to intimate partner violence and urges us not to excuse it because of religion or culture. Bill Tope’s poem dramatizes the pain of sexual abuse survivors in a world denying them agency.

Dr. Jernail S. Anand highlights the value of compassionate and ethical living, causing no harm to self or others, as opposed to simple rule following. Perwaiz Shaharyar puts forth a plea to the world’s leaders to choose peace. Dr. Ashok Kumar calls for peace, unity, and oneness among humanity. Rand Morsy calls the world and humanity to peace. Andres Loriente acknowledges the unity of the world’s people, how we are more alike due to common experiences than we are different because of race. Dianne Reeves Angel’s short story illuminates how she began to understand and oppose the injustices in South Africa while in the country making what was going to be a glamorous film.

Najmiddinova Shahinabonu encourages us to pursue virtues such as perseverance, resilience, and family love, even more than we strive for riches. Luz Myriam Moreno Puerta speaks to overcoming rejection with perseverance. Zamira Moldiyeva Bahodirovna speculates on the psychology behind why we remember negative experiences more so than positive ones and encourages us to strive for mental and emotional balance. Wansoo Kim sends up poems of personal, social, and natural hope and renewal.

Zikrillo Latipov’s short story highlights the value of our hopes and dreams. Bekturdiyeva Nargizabonu emphasizes the importance of youth to society and therefore, the responsibilities of young people to learn and contribute. Aisha MLabo reflects on the inner drive and energy in the heart of a young person. Guzliebo Matniyozova rededicates herself to self-discipline and self-improvement as a writer and a student. Dilnoza Rakhimova celebrates her personal journey towards academic and professional success. Amonboyeva Shahnoza Yusupboy speaks to how one can build lifelong character through the habits one develops as a student. Dildora Toshtemirova urges people to have perseverance in pursuing their dreams.

Omonova Shakhzoda considers how extracurricular activities shape student leaders. Priyanka Neogi celebrates the many women joining the ranks of cricket players. Nidia Garcia speaks to an artistic partnership between a musician and her violin.

Z.I. Mahmud highlights the artistry of older American cinema, some iconic acting performances in particular. Actor and critic Federico Wardal spotlights the movie in which he most recently appears, Anita, which is being shown in San Francisco and receiving the Italian Courage for Freedom film award.

Film is one form of human creative endeavor, and there are many more we celebrate in this issue. Sotvoldiyeva Muslima affirms the crucial nature of the rule of law to a civilized society. Odilova Odinakhon discusses the need for lawyers to receive continuing education. Aziza Toshpo’latova goes in depth about the roles and responsibilities of translators and proposes ways to strengthen the field. Emran Emon presents himself to the world as a qualified international journalist. Boboqulova Durdona presents technical solutions for improving the efficiency of the electrical grid in Uzbekistan. Nordona Norqulova outlines problems with and suggests solutions for the administration of Uzbek public institutions.

Our knowledge can enhance our capacities for protection and wisdom as well as for expansive creation. Baxronova Vasila urges moderation in prescription of antibiotics to children. Nurboboyeva Dilshoda’s essay highlights strategies to intervene and lessen the risk of youth suicide in our age of social media. Nazirova Madinakhon outlines strategies for protecting our digital data from online miscreants.

We hope this issue will serve as a guard against the dangers of boredom, alienation, loneliness, and lack of inspiration. Please enjoy our pages!

Films “Anita”,  “Book of Death”,  “Chrysalis”, “Kamilah the Miracle Filly” Honored with the “Courage for Freedom Film Award”

“Anita”,  “Book of Death”,  “Chrysalis”, “Kamilah the Miracle Filly“ Honored with the Courage for Freedom Film Award

This is the first time in the history of cinema that an award has been given on the subject of “Courage for Freedom,” and it is the first time that a film award has been linked to the values of freedom imbued in heroes for  freedom. 

The “Courage for Freedom Film Award” is linked to the hero of two worlds, Giuseppe Garibaldi, so named because Garibaldi brought independence to countries on both sides of the world: Italy and Rio Grande do Sul (Brazil), but the hero also fought for the cause of independence of Uruguay.

From October 28th to November 4th, with the participation of the Italian Ministry of Foreign Affairs, the founder of this film award, Hon. Francesco Garibaldi Hibbert, a descendant of the hero Garibaldi, was welcomed to the celebration of the 150th anniversary of Italian immigration to the state of Rio Grande do Sul. 

The tour  included  thirteen cities in the Brazilian state, where the film “Anita,” produced by Assisi Suono Sacro and featuring Wardal and music by Andrea Ceccomori, was presented as a world premiere. 

On November 9th “Anita“ received three awards at the Herbst theatre for SF New Concept INT Film Festival : Wardal : USA Excellence for acting a motion picture monologue, Maestro Andrea Ceccomori : best Score, Francesco Garibaldi: Best Concept . 

The film centers on the powerful, poignant lyric “Anita” by Giuseppe Garibaldi, about the agony and death of his wife Anita.

The grand debut of the “Courage for Freedom Film Award,” founded by Francesco Garibaldi, artistic director Wardal, will take place on December 13th in Pompeii , at the Vesuvius Film Festival (Vesuviusfilmfestival.it) directed by architect Giovanna D’Amodio. 

This year, the Vesuvius film festival is dedicated to Federico Fellini, with a photographic exhibition on Fellini curated by Giovanna D’Amodio and Graziano Marraffa, president of the historical archive of Italian cinema.

The “Courage for Freedom film award“ will be assigned, in addition to the film “Anita”, to three major productions such as the soon-to-be-released film “Chrysalis”, a human story of survival, on the life of Sir Daniel Winn, with Daniel Winn, directed by J. Robert Schulz and “Kamilah the Miracle Filly“ by Angela Alioto  about the freedom to live and produced by Moe Rock, founder of the LA Tribune and Emily Letran, its co-founder, the documentary awarded by Pope Francis and the Dalai Lama: “Book of Death” by Jenny Thai on the drama of the refugees in Vietnam.

Invisible Wounds: The Unseen Effects of Antibiotic Overuse on Child Development

Abstract 

Antibiotics revolutionized modern medicine, but their overuse disrupts the fragile ecosystem of gut microbiota, particularly in children.

Discusses mechanisms of dysbiosis, clinical manifestations, and long-term health consequences.

Emphasizes rational prescription, parental education, and post-antibiotic microbiota restoration strategies.

1. Introduction 

Antibiotics as one of the greatest discoveries in medicine.

Current global concern about antibiotic resistance and over-prescription.

Statistics: According to WHO, about 50–60% of antibiotics prescribed for children are unnecessary.

Purpose of study: to analyze the hidden consequences of antibiotic overuse on child development and suggest preventive measures.

 “While antibiotics save lives, their misuse silently steals the natural balance essential for growth.”

2. Physiology and Importance of Gut Microbiota 

Definition and composition: about 100 trillion microorganisms living in the human gut.

Functions: digestion, vitamin synthesis (B12, K), immune maturation, neural development.

The gut-brain axis: how microbiota influence emotions and behavior in children.

Early colonization factors: delivery mode, breastfeeding, environmental exposure.

3. Mechanisms of Dysbiosis Due to Antibiotics 

How antibiotics damage microbiota diversity — killing both pathogenic and beneficial bacteria.

Example: amoxicillin, azithromycin — broad-spectrum drugs that cause major microbiome shifts.

Reduction of Lactobacillus → weakened mucosal immunity.

Overgrowth of Clostridium difficile → antibiotic-associated diarrhea.

Immunological consequences: imbalance between Th1/Th2 immune responses, allergy risk.

4. Clinical and Developmental Consequences 

Gastrointestinal disorders: bloating, chronic constipation, recurrent diarrhea.

Metabolic outcomes: obesity, insulin resistance.

Neurodevelopmental associations: autism spectrum disorder, ADHD, anxiety.

Weakened resistance to infections due to disrupted microbial education.

Graph or table (optional): antibiotic exposure vs microbiota diversity index in children.

5. Prevention and Restoration 

Rational antibiotic use — antimicrobial stewardship in pediatric practice.

Physician–parent communication: education about viral vs bacterial infections.

Role of probiotics (Bifidobacterium longum, Lactobacillus rhamnosus).

Prebiotics (inulin, fructooligosaccharides) — restoring beneficial flora.

Natural support: diet with fruits, vegetables, fermented milk products.

Research-based recommendation: minimum 2–4 weeks of probiotic therapy post-antibiotics.

6. Conclusion 

Antibiotics are powerful tools — but misuse converts medicine into a hidden toxin.

Microbiota protection should be part of every pediatric treatment plan.

Long-term child health depends not only on curing disease, but preserving biological balance.

References 

1. World Health Organization. Antimicrobial resistance: Global report on surveillance. Geneva, 2023.

2. Blaser MJ. Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues. 2014.

3. Arrieta M-C et al. “Early-life antibiotics, gut microbiota disruption, and metabolic outcomes.” Nature Communications, 2021.

4. Tamburini S et al. “The microbiome in early life: implications for health outcomes.” Nature Medicine, 2016.

Baxronova Vasila is a student of the Bukhara State Medical Institute, a member of Argentina’s “Juntos por las Letras” International Writers’ Association, Egypt’s “Iqra” Foundation, and India’s “Art and Culture International Forum”.

Her articles have been published in India’s “Intellectuals of the Third Renaissance” Almanac, the United States’ “Voices of Uzbek Girls” International Anthology, Qatar’s “The Voice of Uzbek Women: Bridging Cultures, Inspiring the World” International Anthology, and Turkey’s “Inspiring Voices of Uzbekistan” International Anthology. She is also a participant in the Republican Scientific-Practical Conference “Conference of Natural and Applied Sciences in Scientific Innovative Research.”

Her scientific articles have been published in India’s Editor KavyaKishor International Journal and Thailand’s Page3NewsThai International Journal. She is the holder of multiple international certificates.

Ecstatic Vibrations, Totally Transcendent 

for the 2mm hole in reality

In stroll gothic lesbian canoe builders 

or something coming to 

rehallow this abandoned church 

with its boarded walls.

they are painted green and their leather is rotting.

we inhale their fresh buzz cut

cuttings and the song is made.

Everyone is breathing harder.

And my bladder. My bladder is aching.

but the song is shifting

to moans wails and cries and

Whale cries wuh wuh wuh. yeah!

of a delighted crowd.

the fruity realtor says to all of us

we’d never know the 90’s.

this incites the panic,

but we are cool! so I tamp the earth

with my questions. hardcore!

thud thud thud.

We will now be like soggy

cardboard! we don’t need   bones now!

the dance is wet and red

so grooving it we slip and slide and groan!

fall and break our limbs

so I scream oh!

oh joy  I am having fun!

being just alike

and how we are having fun. eggs! rotten eggs!

We are dancing zombies

killed at the party

killed at the party

killed at the party

but zombies are fun! So So

    so dance!