bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemo-resistant Gestational Trophoblastic Neoplasia and the Use of Immunotherapy: A Case Report and Review of Literature
Authors: Jacinto, MD Elizabeth K.
Published: June 2024

This is the first reported case of the use of immunotherapy in chemo-resistant Gestational Trophoblastic Neoplasia (GTN) in the country. A 41-year-old, Gravida 4 Para 3 (3013) with a diagnosis of GTN, Stage III: WHO risk score of 13 (Choriocarcinoma) was initially managed with 10 cycles of multiple agent Etoposide, Methotrexate, Actinomycin D- Cyclophosphomide and Vincristine (EMACO) and 19 cycles of Etoposide, Cisplatin- Etoposide Methotrexate and Actinomycin D (EP-EMA). With continuous rise in beta human chorionic gonadotropin (ßhCG) levels, the patient was referred to a Trophoblastic Disease Center where there was note of tumor progression to the brain. She was started on third-line salvage chemotherapy of Paclitaxel and Carboplatin (PC) with concomitant whole brain irradiation completing three cycles after which chemoresistance was again diagnosed with increasing hCG titers and increase in the number and size of the pulmonary masses which were deemed unresectable. Immunotherapy was started with Pembrolizumab showing a good response with marked fall in ßhCG levels. The onset of immune-related adverse events (irAEs) caused a marked delay in subsequent cycles of immunotherapy. With management of the irAEs, two more cycles of Pembrolizumab with fifty percent dose reduction were given with corresponding drop in ßhCG levels. However, the patient subsequently developed gram-negative septicemia with possible hematologic malignancy and finally succumbed to massive pulmonary embolism. The case highlights the importance of prompt diagnosis and referral to a Trophoblastic Disease Center and the use of immunotherapy in chemo-resistant GTN.
Clinical Characteristics and Outcomes of Elective Gynecologic Cases Using Modified Medically Necessary, Time Sensitive (MeNTS) Scoring System in the Prioritization of Surgery at the Philippine General Hospital during the COVID-19 Pandemic
Authors: Macanip, MD Divine S. , Amosco, MD, PhD Melissa D. , Uichanco, MD, MHA Ernesto S.
Published: June 2024

Objectives. The use of a scoring system that integrates various factors helps in decision-making and triage for Medically Necessary, Time Sensitive (MeNTS) surgical procedures during the COVID-19 pandemic. This study aimed to determine the clinical characteristics and outcomes of cases who were screened and underwent elective gynecologic surgery at a tertiary hospital using the MeNTS tool for prioritization.   
Methods: A cross sectional study was carried out using data collected through medical chart review of all gynecologic cases screened in a 6-month period, from June 18, 2020 to December 18, 2020.
Results. A total of 155 gynecologic cases were screened, with 134 (86.4%) MeNTS cases and 21 (13.5%) non-MeNTS cases. The median length of stay (5 days), the median operating room time (3 hours and 30 minutes), and median estimated blood loss (400ml) were within the acceptable expected outcome as with the scoring system, albeit with some cases (53%) requiring blood transfusion attributed to low baseline hemoglobin levels. There were no cases with post-operative COVID-19 transmission, needing ICU care and intubation, nor mortalities reported.  
Conclusions: The MeNTS scoring system allowed efficient handling of the backlog of elective gynecologic cases with minimal morbidity and absence of mortality.  The study supports the utility of this scoring system in addressing the need of the healthcare system not just to optimally utilize and fairly allocate hospital resources but also to ensure the safety of the patient with the best health service delivery during the pandemic.
İTALYA, ALMANYA, RUSYA VE TÜRKİYE’DE OPERA ŞAN EKOLLERİNİN TARİHİ VE GELİŞİMİ
Authors: Baltayeva Gülaram
Published: June 2024

Birbirine benzemeyen ve değişik zamanlarda ortaya çıkan İtalyan, Alman ve Rus şan ekolleri, farklı şekillerde gelişerek dünya opera sanatına belli bir oranda katkıda bulunmuşlardır. Makalede adı geçen ekollerin, tarihin farklı dönemlerinde dünya çapında yayılma eğilimi ve etkisi incelenmektedir. Bununla birlikte bu yayılma eğilimini sağlayan koşullar ve etkisine sebep olan faktörler de araştırılmaktadır. Çalışmada anılan ekollerden seçilen sanatçıların ve eğitmenlerin isimleri, onların çalışmalarının kısa tanıtımı da yapılmıştır. Makalenin sonuç kısmında İtalyan, Alman, Rus şan ekollerinin farkları ve etkileşimleri ve onların Türkiye opera sanatına olan tesirinin analizi yapılmaktadır.
ARSLANBEYLİ MAHALLESİ’NDE ÖNEMİ BÜYÜK OLAN ŞEYH ŞÜCÂ’EDDÎN’İN HAYATI VE VELÂYET-NÂMESİ’NİN DÖNEMİN KÜLTÜREL YAPISI BAKIMINDAN İNCELENMESİ
Authors: Uysal Çağlar , Tanyeri Bekir
Published: June 2024

Arslanbeyli, Eskişehir ilinin Seyitgazi ilçesine bağlı bir mahalle ve nüfusunun büyük çoğunluğu Alevi-Bektaşi inançlı insanlardan oluşmaktadır. Bu mahalle, Şücâ’eddin Velî Ocağı adındaki önemli Alevi-Bektaşi inanç-dede ocağının merkezidir. Bu çalışma, Eskişehir iline bağlı Arslanbeyli Mahallesi'nin kültürü ve Arslanbeyli Mahallesi halkı olarak bilinen yerel halk üzerinde etkisi büyük olan Seyyit Sultan Şücâ’eddin Velî ile ilgili bir derlemedir. Eskişehir'in Arslanbeyli Mahallesi’nin kültürüne ilişkin ve Seyyit Sultan Şücâ’eddin Velî ile ilgili çok az araştırma yapıldığı görülmektedir. Bölgenin kültürünü kapsamlı bir şekilde ele alan bu araştırmanın yerel kültürü anlamak açısından değerli olduğunu düşünülmektedir. Bu çalışmanın sonraki araştırmalar için bir temel oluşturacağı ve değerli bir kaynak haline geleceği umulmaktadır.
OKTOBAS: BİR ENSTRÜMANIN İNCELENMESİ
Authors: Tokgöz Hande
Published: June 2024

Bu makalenin amacı, ender bulunan oktobas enstrümanının ülkemizdeki müzik literatürüne katılması ve ileride orkestralarda kullanımının sağlanabilmesidir. Bu makalede sadece oktobas enstrümanı derinlemesine incelendiği için amaçlı örnekleme tekniği kullanılmış olup, veriler literatür tarama yöntemiyle elde edilmiştir. Müzik tarihinde sıra dışı enstrümanlar her daim merak uyandırmış ve sesin sınırlarını genişletmiştir. Bu bağlamda oktobas müziğin geleneksel sınırlarını zorlayan, derin tonlu ve görsel olarak dikkat çekici bir enstrüman olarak öne çıkmaktadır. Bu makalede oktobas enstrümanının fiziksel özellikleri, ses aralığı, akort sistemi, mekanizması, çalımındaki sınırlılıklar, tarihsel gelişim süreci ve bunların müzik dinamiklerine etkisi incelenmiştir.
Silêncios impostos, estupros em família: sobre mães solteiras e “crias” espúrias
Authors: Beltrão Jane Felipe
Published: June 2024

Demostrar a longa duração de estupro de mulheres "acobertados" pelas/os familiares com arranjos, por vezes mais violentos que o próprio estupro (se é que se admitem gradações), pois atinge os frutos da relação imposta produzindo, no início do século XX: mães solteiras, filhas deserdadas, filhas/os confinadas/os em orfanatos entre tantos outros atos violentos que atingem mulheres e suas descendências. Atos que hoje se apresentam marcados pela intolerância religiosa. O relato que se apresenta é singular, mas não é único. É forte o suficiente para expressar o acobertamento de crimes entre familiares que, segundo a narrativa colhida só pode ser revelado após a morte da interlocutora, pois o caso soa como anátema. A moralidade de ontem permanece, a mudança não se fez sentir para mulheres estupradas e crianças descendentes da relação não consentida que deita fortes raízes e, a depender do tempo, se revela mais fortes ou mais esmaecida pelo silêncio imposto às vítimas.
Cruzada sexogenérica e a arte como regime de moralidade: reflexões a partir do Queermuseu
Authors: Leite Junior Jorge , Grunvald Vi
Published: June 2024

Nos últimos anos, uma série de polêmicas e suas consequentes disputas sociopolíticas tomaram a arte como centro de gravidade para construção de argumentos relativos a padrões sociais que devem ser seguidos e observados, a questões morais que devem ser encampadas e problematizadas e a grupos políticos que, através dessas disputas, devem ser fortalecidos ou rechaçados.O caso que talvez melhor exemplifique as contendas do que, inicialmente, poderíamos precisar como pânico sexogenérico é o da exposição Queermuseu: cartografias da diferença na arte brasileira, realizada em 2017.
Extração, quantificação e detecção da cafeína em alimentos como estratégias de ensino de ciências
Authors: Matos Danielle Durães Ferreira , Veloso Pedro Henrique Fonseca , Royo Vanessa de Andrade
Published: June 2024

Este estudo tem como objetivo aplicar a técnica de extração líquido-líquido (ELL) em aulas práticas de ciências, explorando a presença de cafeína em alimentos comuns. A cafeína, um alcaloide presente em grãos de café, foi escolhida devido à sua relevância na cultura global de consumo. A metodologia envolve a extração de cafeína de café verde, café torrado, cacau em pó e bebida energética. Os resultados indicam que a extração foi eficaz, com concentrações variadas de cafeína nas amostras analisadas. O café torrado apresentou a maior concentração (101mg), seguido pelo café verde (56mg), cacau (15mg) e bebida energética (64mg). A cromatografia em camada delgada confirmou qualitativamente a presença de cafeína nas amostras. A metodologia utilizada neste estudo proporciona uma abordagem interdisciplinar, integrando conceitos de biologia e química. Além disso, destaca a importância da experimentação no ensino de ciências, promovendo o estímulo à investigação prática. O experimento é de execução simples, permitindo que os alunos assumam um papel ativo nas etapas necessárias para sua realização. O estudo também aponta para possíveis ampliações, como investigar a influência do processo de torrefação do café na concentração de cafeína e explorar variações regionais nas concentrações de cafeína em grãos de café verde. Conclui-se que esta abordagem prática contribui significativamente para o conhecimento científico dos alunos, promovendo a compreensão da separação de substâncias e a presença de cafeína em alimentos e bebidas.
Saturated and monounsaturated fatty acids in human milk after gastric bypass: a case study.
Authors: Siqueira Trindade Oliveira Débora , Belfort Gabriella Pinto , Gonçalves Rosângela Simões , Chaves Célia Regina Moutinho de Miranda , Palha Adriane , Costa Roseli de Souza Santos da
Published: June 2024

The Roux-en-Y gastric bypass is one of the most commonly used techniques in bariatric surgery for the treatment and control of obesity, involving restriction and malabsorption. Some studies have evaluated the micronutrient content and polyunsaturated fatty acids of human milk in women who have undergone bariatric surgery, but data about the saturated and monounsaturated fatty acids in nursing mother who underwent bariatric surgery human milk have been lacking.
 In this case, we quantify the content of saturated and monounsaturated fatty acids in the stages of lactation: colostrum, transitional milk, and mature milk of a nursing mother undergoing gastric bypass surgery in Y-de-Roux two months before pregnancy.
The participant had 29-year-old. In December 2017, she underwent Roux-en-Y gastric bypass surgery, and, 2 months after the procedure, she became pregnant. Fatty acids were quantified on the Perkin Elmer Autosystem XL Chromatograph. High concentrations of myristic fatty acid and lower levels of trans fatty acids were observed in the human milk of women in our study compared to the milk of mothers who did not undergo bariatric surgery.
A limitation of the present study was that it represents a case study. Thus, we cannot state that the composition of fatty acids found in this case report reflects the composition of fatty acids in the human milk of all women who underwent BS. More studies are needed to better assess the implication of BS in the composition of fatty acids in human milk.
European Union coordination of social security systems with respect to the social insurance of farmers. Selected aspects
Authors: Nawrocka-Sobczak Małgorzata
Published: June 2024

The coordination of social security systems is one of the key issues related to implementing freedom of movement and freedom to engage in work in the European Union, and one of the most complex and technical sections of international law applied in the Agricultural Social Insurance Fund (KRUS or Fund).
The purpose of this study is to present how provisions related to the coordination of social security systems are implemented in practice with respect to persons who can demonstrate periods of agricultural insurance, and also to popularise the knowledge on shaping social security rights and obligations when two or more European Union states are concerned. The Agricultural Social Insurance Fund acts as a liaison body regarding benefits from the social insurance of farmers, cooperating with the relevant Polish authorities, Polish and foreign liaison bodies, and relevant authorities of the European Union, as well as the European Free Trade Association (EFTA).
eywords: coordination, regulations, social security system.
Reasons for the operation of the social insurance system, including social insurance in agriculture
Authors: Pawłowska-Tyszko Joanna
Published: June 2024

The problem of risk in agriculture affects, as in any other activity, many of its areas not only of an economic nature, but also of a social one. At a time of growing social crisis, the search for models for the functioning of the welfare state seems justified. One instrument that mitigates social risks so that they can be incorporated into the normal functioning of societies is social insurance. The purpose of this study was to identify the rationale for constructing universal insurance systems, with a particular focus on social insurance in agriculture. Underlying the design of insurance systems designed for agriculture are socioeconomic reasons (the strategic importance of the agricultural sector to the economy and the preservation of socioenvironmental balance, the high uncertainty and unpredictability of the conduct of agricultural activities, and the large fluctuations in income), as well as political reasons, as explained by public choice theory.

Keywords: ENASP, KRUS, agriculture, insurance schemes, social insurance, social insurance in agriculture.
Click Service
Authors: Dr. T Subburaj  , Mr. Deeraj C  , Mr. Akash Adiga
Published: June 2024

Keeping up with domestic chores can frequently seem overwhelming in a world that is moving faster and faster. "Click service" is an all-inclusive platform created to make it easier to obtain necessary home services. Through the Click service, consumrs caneasily conect and qualified professionals for anything from haircuts to plumbing, electrical, and house moving aid, as well cleaning services. People can easily explore, book, and manage appointments for a variety of services with ease thanks to an intuitive interface, providing convenience and peace of mind. Click service strives to transform the way individuals handle their domestic service needs by focusing on quality, cost, and dependability. This will make everyday leving easier and more manageable. It might be hard to manage home responsibilities in a world that is becoming faster and faster. "Click service" is an all- inclusive platform made to make it easier to obtain necessary home services. With the click of a button, customers may instantly connect with qualified professionals. In order to guarantee openness and satisfaction, the platform also provides features like safe payment methods, real-time service tracking, and customer feedback. People can easily explore, book, and manage appointments for a variety of services with ease thanks to an intuitive interface, providing convenience and peace of mind. With an emphasis on dependability, cost, and quality, Click service seeks to transform household service demands into something easier to handle and less stressful
Innovative AI Solution for Diabetic Retinopathy Health
Authors: Dr. Mage Usha U  , Dr. T. Subburaj  , Hemanth K J
Published: June 2024

Current retinal disease detection methods primarily rely on lesion detection techniques or multiple instance learning frameworks, yet they often struggle to effectively represent various lesions from fundus images. This paper introduces an innovative approach leveraging pre-trained convolutional neural networks (CNNs) through transfer learning. The method harnesses the learning capabilities of recent deep CNN models, augmented by a classifier at the network's end. Additionally, a pre- processing technique tailored is applied to enhance classification outcomes. Experimental validation on Messidor and IDRiD databases showcases significant improvements, achieving accuracies of 96.28% and 94.81% respectively. The proposed method presents a promising avenue for computer-aided diagnosis in retinal screening systems, effectively supporting disease screening through deep learning methodologies
Machine Learning-Based Fake Online Review Comment Detection
Authors: Dr. Mage Usha U  , Jayakumar N
Published: June 2024

The proliferation of online reviews has made them a vital source of information for consumers in making purchasing decisions. However, the prevalence of fabricated feedback has become a significant concern, undermining the trustworthiness of these platforms. This project aims to develop a machine learning-based system for detecting fake reviews[3] and assisting users in making informed choices. The Research study leverages a dataset consisting of labeled reviews, where each review is classified as fake or genuine[1]. This is used to train and judge the performance of a variety of machine learning models. The initial phase of the project involves preprocessing the textual data by applying techniques such as :
• tokenization,
• stop-word removal, and
• stemming to extract relevant features.
Furthermore, the system incorporates natural language processing (NLP) methods:
• to capture semantic and syntactic information, [2]
• enabling a depth knowing of the review content. [4]
To increase the detection accuracy, the project explores the integration of additional contextual features, such as
• User profiles,
• Review timestamps, and
• Review ratings.
These above provided info for establishing patterns and identifying anomalies associated with fake reviews[3].
IOT based QuantumClean SparkSwift
Authors: Sadiq  , Dr. T Subburaj  , Deeraj C
Published: June 2024

QuantumClean SparkSwift is an innovative IoT-based project focuses in the development automatic vaccum cleaner. Leveraging the IoT technology, the system allows users to remotely control and monitor the vaccum cleaner through a mobile application. The device employs sensors for obstacle detection and obstacle avoidance and mapping, ensuring efficient cleaning. The integration of smart features such as obstacle detection, obstacle avoidance, mapping, Bluetooth control, voice command controlling enhances user convenience, making it a practical and innovative solution for automated home cleaning
Train Collision Avoidance System with Wireless Communication
Authors: Aniket R. Shamraj  , A. D. Harale
Published: June 2024

In India, human error and negligence are now the main causes of train accidents. The aim of the paper is to eliminate train crashes through the use of surveillance. An automatic surveillance system is fitted in every locomotive. The locomotive's internal surveillance system reads the distinct track numbers that are assigned to each segment of the railway network's train lines. This track number will be shared with neighbouring trains by the surveillance system via radio frequency communication. Subsequently, the system's track number is cross-referenced with the track numbers of adjacent trains. In order to halt the train and avoid accidents, the surveillance system acts to notify the concerned motorman of the same track numbers. A specific technique for numbering train tracks segment by segment is recommended by the study. In order to guarantee data flow between the systems' radio frequency transceivers operating in half duplex mode, a communication protocol is also suggested. Because they can move a lot of people and cargo at once, railways constitute an efficient mode of transportation. At either end of the branch track, Wireless Monitoring Units (WMUs), also known as nodes, are placed to allow for the detection of train arrival and departure times for that particular branch
ENFOQUE DEL TRATAMIENTO INTEGRAL DE LA TENDINITIS DEL HOMBRO
Authors: Darroman Hall Constantino , Mora Mora Ana Lucia , Bustamante Cruz Rosa Erlinda
Published: June 2024

El dolor de hombro es una de las consultas que se atienden con mayor frecuencia en la práctica médica; es la tercera causa de dolor músculo esquelético, que afecta las actividades de la vida diaria, incluyendo el sueño. Se estima que el 40% de las personas lo presentan en algún momento de su vida.  La prevalencia aumenta con la edad y con algunas profesiones o actividades deportivas. Los tendones del manguito rotador son la clave para un buen funcionamiento saludable del hombro y están sujetos a tendinitis, desgarros, rupturas o degeneración en la medida que usemos los hombros, hagamos esfuerzos exagerados o sufran traumas, lo que hace necesario acudir a terapias que contribuyan en el tratamiento y la pronta recuperación.
Análisis de la producción científica de Matemática, publicada en el portal de revistas de la Universidad de Panamá
Authors: Caballero Vigil Lorenzo , Castillo M. Johanna E. , Caballero Vigil Alexander A.
Published: June 2024

Este artículo es el resultado de un estudio observacional descriptivo realizado en el portal de revistas de la Universidad de Panamá, en el cual se buscaba determinar el nivel de productividad científica en matemática.  Después de revisar cada una de las revistas con que cuenta este portal, se determinó que solo en trece de ellas son aceptados artículos relacionados con matemática, ya que las demás son de áreas específicas del conocimiento.  En esas trece revistas durante los últimos cinco años (2018-2022), únicamente se han publicado veintiséis artículos de matemática, lo que representa solo un 2,89% de la producción total; este porcentaje incluye artículos que son resultado de alguna investigación y escritos referentes a una revisión bibliográfica.
Dwelling architecture in the context of socio-economic and technological conditions of modern Kazakhstan (on the example of Almaty city)
Authors: Tabynbayeva Karlygash , Abdrassilova Gulnar
Published: June 2024

The relevance of this research is highlighted by Almaty’s continuing status as a historical and cultural centre and a financially independent city, despite no longer serving as the capital of the Republic of Kazakhstan. Currently, an important issue is the formation of the “Smart City” plan in the context of modern concepts of resource conservation and environmental policy. The research aims to substantiate changes in the formation of housing architecture under the influence of socio-economic, political, and technological processes in the context of gradual historical changes in the example of Almaty, as well as to determine the priority directions of development of urban planning processes, in particular on the territory of the residential zone. The following methods of scientific research were used: abstract-logical method; comparative method; historical method; method of system analysis and synthesis. To achieve the research aims, the elements of the socio-economic development of Almaty in the context of historical, cultural, and educational centres were defined. The peculiarities of dwelling architecture from the 1920s to the present day are analysed. This research proposes priority directions for urban planning in Almaty’s residential area by analysing historical architecture influenced by socio-economic and technological factors.
Short communication: rabbit meat consumption trends in selected Maltese rural areas
Authors: Alexander Francesco Luca , Buttigieg Noel , Attard George
Published: June 2024

This study aimed to analyse trends in rabbit meat consumption amongst consumers in selected Maltese rural communities. To the best of the authors’ knowledge, this is the first study that attempts to assess and report on Maltese consumer perceptions and behaviours related to rabbit meat. Data was collected using a survey conducted through random telephone calls. Results indicate that only 19 of the 250 interviewees did not consume rabbit meat. This meat source is perceived as being lean and low in cholesterol, healthier and tastier than other meats, and price does not seem to be an issue. However, this meat is consumed in moderation. Nonetheless, it is an esteemed food item that is generally the main dish on special occasions (fenkata), including the Sunday meal. Thighs are the most preferred part of the carcass and frying/braising is the most frequent method of cooking. An element of mistrust in the supply chain exists, so much so that consumers prefer to source from family and friends that rear rabbits mainly for their own consumption. While rabbit meat consumption is still popular among Maltese consumers, the retail sector marketing rabbit meat needs to be aware of the fact that there is a strong consumer tendency towards lack of trust in the supply chain.
Characteristics of mental toughness in young basketball players of different age groups
Authors: Pocius Eimantas , Malinauskas Romualdas
Published: June 2024

Purpose

Assessing the development of skills that ensure personal mental toughness in adolescence is important because adolescents’ increasing autonomy and socialisation during adolescence inevitably create the conditions for an increasing number of external stressors to emerge. Paradoxically, adolescents’ confidence in their ability to cope with external stressors decreases during adolescence, which may lead to poorer sports performance in adolescent athletes. This study aimed to determine and analyse mental toughness skills in the cadet and junior age groups of young basketball players. Another aim was to reveal how general (total) mental toughness and age predict each athletic mental toughness skill.

Methods

This study surveyed 378 young basketball players using a two-stage cluster sampling approach. The Mental Toughness Questionnaire 48 (MTQ48) was chosen to assess general mental toughness skills. The Performance Inventory-Alternative (PPI-A) was chosen to assess athletic mental toughness skills.

Results

The study’s results revealed that players in the junior age group scored significantly higher on challenge (p < 0.001; d = –0.41), commitment (p < 0.001; d = –0.65), emotional control (p < 0.001; d = –0.76), life control (p = 0.02; d = –0.26), overall control
(p < 0.001; d = –0.64), self-confidence in one’s abilities (p < 0.001; d = –0.73), self-confidence in interpersonal interactions (p < 0.001; d = –0.50), overall self-confidence
(p < 0.001; d = –0.73), total mental toughness (MTQ-48) (p < 0.001; d = –0.78), determination (p < 0.001; d = –0.47) and visualisation (p < 0.001; d = –0.81). Significant correlations (r ranges from 0.12 to 0.37) were found between mental toughness skills and age groups for all scales mentioned above, except positive cognition and self-belief. Total mental toughness strongly predicted athletic mental toughness skills, but age did not predict determination and self-belief skills.

Conclusions

The findings of the present study suggest that promoting mental toughness can lead to improved athletic mental toughness indicators, emphasising its relevance for coaches, trainers, and sports psychologists in enhancing athletes’ development and performance.
A study of the fastest courses for professional triathletes competing in IRONMAN® triathlons
Authors: Thuany Mabliny , Valero David , Villiger Elias , Fernandes Matheus Santos Sousa , Forte Pedro , Weiss Katja , Nikolaidis Pantelis T. , Cuk Ivan , Knechtle Beat
Published: June 2024

Purpose

The IRONMAN® triathlon is an endurance multisport discipline of high popularity. Professional IRONMAN® triathletes need to qualify for the IRONMAN® World Championships and, therefore, would benefit from identifying the fastest race courses. Our purpose was to identify the fastest races held for professional IRONMAN® triathletes competing from 2002 to 2022.

Methods

This was an observational study, sampling 7,078 race records (380 different events in 55 different event locations) of professional IRONMAN® triathletes of both sexes (4,235 males and 2,843 females). We downloaded information about sex, nationality, both split (swimming, cycling, and running) and overall race times, the event location, and the year. Information about race course characteristics, water temperatures, and air temperatures was obtained. Descriptive statistics were calculated for each event location, and factorial ANOVA tests were used to explore the statistical significance of the results. A confidence interval of 95% was adopted.

Results

The fastest overall IRONMAN® average race times were achieved during the IRONMAN® Tallinn, IRONMAN® Switzerland held in Thun, and IRONMAN® Des Moines. A lake for the swim split characterized the first five courses, while the bike split featured rolling or hilly terrain. For the run split, most of the courses were characterized as flat. For environmental characteristics, lower water and air temperatures also added time to the average finish time.

Conclusions

Understanding the fastest race courses and their characteristics would assist professional IRONMAN® triathletes in selecting races that offer the optimal conditions for their competition. Fast IRONMAN® race courses typically feature a lakeside swim course, a rolling or hilly bike course, and a flat run course.
An Assessment of Armed Banditry Activities on Rural Markets in Zamfara North
Authors: Shehu Sirajo , Ismail Bukoye Ademola , Hassan Abdul Sabur
Published: June 2024

Armed banditry has been a pandemic on human phenomenon especially in Zamfara state. This paper assesses the effect of armed banditry activities on rural markets in Zamfara north. The research work is anchored on Strain and Frustration–Aggression theory. Purposive sampling technique was utilized in the selection of 150 market participants from Shinkafi market, kasuwan-Daji market, and Dauran markets. A qualitative research design is employed to generate primary data through administering of 5 Likert scale structured questionnaires. Data were analyzed using structural equation model. The findings of the study indicate that incessant killing, Kidnapping, and Terrorism has significant statistical impacts on Rural markets operation. The researchers recommended that policies makers should implement targeted intervention programs aimed at addressing the root causes of incessant killing, Kidnapping and Terrorism in rural communities, such as poverty, unemployment, substance abuse, and interpersonal conflicts.
IT PROCESS OPTIMIZATION THROUGH THE IMPLEMENTATION OF BIMODAL IT WITH DEVOPS
Authors: Charles do Nascimento Marreiros Emerson , José Galvão do Nascimento Esrom
Published: June 2024

In recent years, changes have been made in the development of information systems software for a more agile way of working. Agile teams are responsible for obtaining requirements in a multidisciplinary set, where the business part and the development part are represented in a single project. DevOps is a new movement that tries to improve agility in service delivery. It encourages greater collaboration and communication between development teams and operations and prevents problems and operational needs from being exposed in the project, affecting software quality. For large and cross-platform businesses, it is essential to consider the mainframe in these tool chains because data and mainframe applications are among their strategic digital assets. The ideal architecture for mainframe inclusion harmoniously combines the specificity of the well-integrated mainframe / task platform (DevOps) into the broader environment of the development and operations chain. Inclusive tooling chains generate a significant competitive advantage by enabling you to have quality information from the mainframe code, making the platform much more accessible to DevOps equipment. Thus, the main problem of the work is: what are the main benefits that would lead a company’s IT area to invest in the implementation of bimodal IT with DevOps, aiming to optimize processes?
Comparison of Maternal Bleeding During Preterm and Term Cesarean Delivery
Authors: Irfan Saima , Mushtaq Rubina , Khan Sumaira , Khawar Maliha , Hiba Nafeesa
Published: June 2024

Objective: To compare maternal bleeding in pregnant women undergoing term and pre-term Cesarean delivery.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Gynecology and Obstetrics Department, Pak Emirates Military Hospital, Rawalpindi, Pakistan Jan to Jun 2021.
Methodology: A total of 211 pregnant women undergoing Caesarian section at our tertiary care center were included in the study. They were divided into two groups based on gestational age as term or pre-term, with delivery at 37 completed weeks being labelled full term. Lower segment cesarean section was carried out by consultant gynecologist on all the patients as per standard protocol and blood loss was compared in term and pre-term Caesarian deliveries.
Results: Out of 211 study participants, 108(51.1%) had a Caesarian section at term while 103(48.9%) had pre-term Caesarian section. The mean age of participants was 29.35±4.10 years. Mean blood loss during the Caesarian section in term pregnancies was 437.03±129.76 ml while in pre-term pregnancies was 641.26±157.40 ml. Independent t-test showed that bleeding was statistically significantly more in pre-term pregnancies (p-value<0.001). Post-operative hemoglobin was also significantly different in term and preterm pregnancies (p-vale<0.001).
Conclusion: Women undergoing Caesarian section pre-term were at risk of having more blood loss and fall in hemoglobin levels as compared to those undergoing Caesarian section at term.
Vitamin D and Calcium Pharmaceutical Supplements: All we Need to Know to Choose the Right One
Authors: Majid Hafsa , Zehra Nawazish , Khan Ablooj , Jafri Lena , Khan Aysha Habib
Published: June 2024

Calcium and Vitamin D deficiency is highly prevalent in Pakistan. Both micronutrients have a significant role in human growth and development. Supplementation becomes essential when the available natural sources like food and sunlight, cannot replenish the deficiencies. Nevertheless, it is critical that while prescribing Calcium or Vitamin D supplements, physicians should know the composition and specific application of each supplement. This review explores the different types of Calcium and Vitamin D pharmaceutical supplements available in the market their composition, indication and contraindications. Data of Calcium and Vitamin D supplements has been collected by Pakistani drug sites databases, including ‘Drug Infosys (www.druginfosys.com)’, ‘Dawaee.pk’, ‘Sehat.com.pk’ and ‘Medicine Net’ by pharmacists and orthopaedists. The commonly prescribed supplements are Cholecalciferol (Vitamin D) and Calcium Carbonate (Calcium). Over time, an increase in market share of Vitamin D and Calcium supplementations is due to their over-the-counter availability, increased physicians' prescriptions, and self-prescribed use by the population. There is a need to develop national guidelines and policies to safeguard the population's health at large.
Association of Age and Parity with Pregnancy-Induced Hypertension
Authors: Ashraf Abida , Hameed Samina , . Yasmin , Ahmad Mansoor , Saleem Muhammad Zeeshan , Ahmed Ijaz
Published: June 2024

Objective: To determine the association of age and parity with gestational hypertension.
Study Design: Case-control study.
Place and Duration of Study: Department of Gynaecology and Obstetrics, Combined Military Hospital, Sibi Pakistan, from Oct 2020 to Sep 2021.
Methodology: A total of two hundred and sixty-eight (n=268) patients (134 controls and 134 cases) were included in this study. Data about age, parity, economic status and education status was recorded. Two consecutive readings of blood pressure were recorded in sitting position, 4 hours apart, and the second reading was entered on the proforma.
Results: Mean age of the patients was 28.10±5.61 years and 28.99±6.29 years in cases and controls, respectively. Mean gestational age was 38.46±1.02 weeks in cases and 38.04±1.00 weeks in controls. In cases, primigravida were 88(65.7%) and multigravida were 46(34.3%) and in controls 58(43.3%) were primigravida and 46(56.7%) were multigravida. Odds ratio was 2.50(95% CI: 1.53-4.10), p value was <0.001. In cases, 111 women (82.8%) were from young age group and 23 women (17.2%) belonged to advanced age group. In controls 94 women (70.2%) were of young age group while 40 women (29.8%) belonged to advanced age group (p value was 0.013).
Conclusion: Primigravidae and women of younger age seem to have association with pregnancy induced hypertension
Pattern of Healthcare-Associated Infections in a Tertiary Care Setting
Authors: Tariq Anam , Mirza Irfan Ali , Fahim Qanita , Hameed Fatima , Khalid Ayesha , Ashfaq Ambar
Published: June 2024

Objective: To establish the frequency of emerging pathogens and their susceptibility profiles amongst various healthcare-associated infections.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Jan to Dec 2020.
Methodology: One hundred and ninety-six samples with a history of hospital-acquired infections were received and processed following standard microbiological techniques. Antibiotic susceptibility testing was done by the Kirby-Bauer Disk Diffusion technique for the commonly used antibiotics. For colistin susceptibility, the Clinical and Laboratory Standards Institute recommends broth microdilution, colistin broth disk elution, or colistin agar testing MIC methods, however, colistin susceptibility was performed by the E-strip method.
Results: One hundred and ninety-six clinical samples with bacterial isolates causing healthcare-associated infections were processed. Specimens were from patients with surgical site infections (59,30.1%), Catheter-associated bloodstream infection (52, 26.5%); Ventilator-associated pneumonia (48, 24.5%) and Urinary tract infection (37,18.9%). Klebsiella pneumoniae (64, 32.7%), E.coli (51, 26%) and Acinetobacter baumanii (45,23%) were the leading bacterial pathogens. A total of 72(36.7%) isolates showed multidrug resistance whereas extensively drug-resistant isolates were calculated to be 124(63.3%).
Conclusion: High level of bacterial resistance amongst common health-care-associated infections is an eye-opener and impacts applying strict infection control measures along with antimicrobial stewardship. It will also help clinicians modify empiric treatment regimes in affected patients.
Gastric Variceal Bleeding In Patients of Liver Cirrhosis With Portal Hypertension
Authors: Zakir Muhammad Fahad , Afzal Adeel , Kalwar Hamid Ali , Mujtaba Ghulam , Karim Shahid , Hussain Manzoor
Published: June 2024

Objective: to establish how common Gastric Variceal bleeding is in Chronic liver Disease patients to allow them to be screened regularly and avoid morbidity and mortality.
Study Design:  Cross sectional study.
Place and Duration of Study: Gastroenterology Department, Liaquat National Hospital and Medical College, Karachi Pakistan, from Jan to Dec 2020.
Methodology:  A total of 135 patients with history of melena, hematemesis and known diagnosis of Chronic liver Disease for more than six months who fulfilled the inclusion criteria were enrolled in this study. Gastroscopy was carried out and dilated veins in the gastric fundus, either with active spurter or an overlying punctum, were labelled as Gastric Variceal bleeding.
Results: This study included known Chronic Liver Disease patients for duration of 6 months or more with recent stigmata of upper Gastrointestinal Bleed. Out of 135 cases, 76(56.3%) were male and 59(43.7%) were female. Enrolled patients’ mean age was 51.0±5.2 years, and the mean duration of Chronic liver Disease was 4.9±2.6 years. Gastric Variceal bleeding in Chronic liver Disease patients who underwent endoscopy had a frequency of 18(13.3%) times.
Conclusion: Gastric Variceal bleeding bleeding is rare but lethal complication of Chronic liver Disease, seen in patients in the age group of <50 years, female gender, hypertensive patients, and those with a duration of chronic liver disease <5 years.
Evaluation of Risk Factors in Individuals with Vascular Thrombosis at High Altitude
Authors: Latif Atif , Ain Qurrat-ul- , Zaman Muhammad , Qadir Manzoor , Shah Sajid Ali
Published: June 2024

Objective: To evaluate the risk factors for developing vascular thrombosis at high altitude.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Combined Military Hospital, Skardu Pakistan, from Mar 2018 to Feb 2020.
Methodology: All individuals evacuated from high altitude with suspicion of vascular thrombosis were consecutively inducted and evaluated radiologically. Subjects diagnosed as VT were further categorized on basis of height of evacuation into high altitude, very high altitude and extremely high altitude categories.
Results: Out of 295 individuals evacuated from HA, 54(18.3%) were diagnosed as VT. All patients were males. Mean age was 31+5.3 years. Cerebral venous thrombosis was diagnosed in 19(35%) and was the most frequent followed by pulmonary embolism in 18(33%) and deep venous thrombosis in 14(26%) patients. Risk of VT increased with increase in altitude as 05(10%) cases were from high altitude, 18(33%) were from very high altitude and 31(57%) from extremely high altitude. VT was more frequent in smokers [36 cases (67%), p<0.05] and in cold weather (37 cases (69%), p<0.05). Duration of stay has significant inverse correlation with height of deployment (r= -0.592, p< 0.001). Significant difference was found in duration of stay (p<0.001), haemoglobin (p=0.016) and haematocrit (p=0.012) among different categories of high altitude.
Conclusion: Cases of vascular thrombosis increase with increasing altitude even in shorter period of stay. Increasing haemoglobin and haematocrit with increase in altitude, cold environmental temperature and smoking are important risk factors for development of VT.
The Effect of Fibrosis on DNA Yield from Formalin Fixed Paraffin Embedded Tissues
Authors: Naveed Muhammad , Tariq Hassan , Gul Asma , Arzo Natasha , Hussain Muhammad , Buksh Sumaira
Published: June 2024

Objective: To report the effect of fibrosis on yield of Deoxyribonucleic Acid extraction from Formalin-Fixed Paraffin-Embedded tissue.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Molecular Pathology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, Jul to Dec 2021.
Methodology: Fifty-four Formalin-Fixed Paraffin-Embedded tissues having size <2cm containing fibrosis (Mild, Moderate, Severe) were included in the study. Formalin-Fixed Paraffin-Embedded tissues having tissue size > 2cm were excluded. Deoxyribonucleic Acid was extracted and quantified from Formalin-Fixed Paraffin-Embedded blocks.
Results:  Nine (17%) Formalin-Fixed Paraffin-Embedded tissues had no fibrosis, 28(51%) had Mild fibrosis, 9(17%) and 8(15%) had Moderate and Severe fibrosis. Measurement scale in 5 different stages for evaluation of our quantified results were used. For specimens with no fibrosis the DNA quantity fell on scale 1, 0(0%); on scale 2, 1(11%); on scale 3, 0(0%); on scale 4, 1(11%); and on scale 5, 7(78%). Deoxyribonucleic Acid yield in moderate fibrosis specimens fell on scale 1, 0(0%)’ on scale 2, 7(78%); on scale 3, 0(0%); on scale 4, 1(11%); and on scale 5, 1(11%). Among severe fibrosis the Deoxyribonucleic Acid quantity fall on scale 1, 5(62%); on scale 2, 3(38%); on scale 3, 0(0%); on scale 4, 0(0%); and on scale 5, 0(0%).
Conclusion: Formalin-Fixed Paraffin-Embedded tissues having severe fibrosis resulted in significantly lower Deoxyribonucleic Acid yield as compared to Formalin-Fixed Paraffin-Embedded tissues having no fibrosis
Frequency of Methicillin Resistant Staphylococcus Aureus carriers in Intensive Care Unit Staff of Tertiary Care Hospitals
Authors: Hammad Muhammad , Mahmood Asad , Aziz Amna , Yasir Muhammad , Saeed Hafiz Asad
Published: June 2024

Objective: To investigate and compare the frequency of MRSA carriers among medical and surgical Intensive Care Unit staff in Tertiary Care Hospitals.
Study Design: Cross-sectional comparative study.
Place and Duration of Study: Department of Medicine, Two Tertiary Care Hospitals, Rawalpindi Pakistan, from Mar to May 2022.
Methodology: A total of 134 ICU staff in different working shifts, including consultants, residents, nurses, paramedics, ward attendants, and sanitary workers, were subjected to nasal swabs, which were sent for culture and sensitivity. The nasal swab culture was found to be positive and negative for MRSA.
Results: Out of 70 individuals from the surgical ICU, 12(17.14%) tested positive for MRSA, while 8(11.4%) out of 64 individuals from the medical ICU tested positive for MRSA (p=0.568). The overall MRSA carriage among ICU staff was found to be 14.9%. Out of these 20(14.9%) individuals, 3 were doctors, 4 nurses, 10 paramedical staff, 1 ward attendant, and 2 sanitary workers. Only 7(35%) had confirmed contact with MRSA patients within the last 2 months, and 15(11.2%) had received prior decolonization. A total of 44(32.8%) out of 134 individuals had contact with a MRSA-carrier patient in the last 2 months. 27(20.1%) individuals had received prior decolonization for MRSA carriage, with a mean duration of 5.37±4.404 months.
Conclusion MRSA is an important superbug in our ICUs. With the use of prophylactic and gunshot therapies in intensive care units, these bacteria tend to acquire resistance to the anti-microbial agents, rendering our most expensive and last line of defence ineffective.
Comparison of Outcome of Metformin And Inositol on Hormonal Aspects in Women with Polycystic Ovaries: A Quasi-Experimental Study
Authors: Mazhar Namra , Mahmud Ghazala , Ashfaq Mazhar , Tabassum Shakira , Akbar Amina , Idrees Fatima
Published: June 2024

Objective: To individually assess the role of Metformin and Inositol in dealing with hormonal problems in terms of serum Luteinizing Hormone/ Follicular stimulating hormone ratio, serum prolactin and serum progesterone in females with polycystic ovarian disease over a period of one year.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Gynaecology and Obstetrics, PAF Hospital Islamabad Pakistan, from Jul 2020 to Jul 2021.
Methodology: Patients (n=80) presenting with OPD were divided into two equal groups and followed over a period of six months. Group-A was given Tab Inositol 4g once daily, and Group-B was given Tab Metformin 500 mg three times daily. Over a period of three to six months, Metformin and Inositol were used to compare biochemical parameters such as serum Luteinizing Hormone/ Follicular stimulating hormone ratio, serum prolactin, and serum progesterone.
Results The results showed that Inositol has better results in terms of hormonal aspects, with a mean Luteinizing Hormone/ Follicular stimulating hormone ratio of 2.55±0.02 at 6 months. At three and six months, the mean serum prolactin and mean serum progesterone were comparable in both groups.
Conclusion: Inositol has a better impact on hormonal aspects in women with polycystic ovarian disease by improving patients’ biochemical profiles.